Public Health Policy in the United Kingdom: After the War on Tobacco, Is a War on Alcohol Brewing?

Abstract

The United Kingdom now has one of the most comprehensive tobacco control policies in the world, a far cry from its status two decades ago. Some influential public health voices have called for a similar campaign against alcohol consumption. But is the comparison appropriate? We identify the factors which were important in the relatively successful campaign for tobacco control, then analyse the obstacles and opportunities facing the movement for more stringent alcohol control. Alcohol policy today often bears a striking resemblance to tobacco policy pre-1990s, when the UK started on its path to becoming a leading regulatory on this policy.

Democracy and power in alcohol premises licensing: A qualitative interview study of the Scottish public health objective

“…In entering the licensing process, public health is seeking to establish its voice in a quasi-judicial regulatory environment dominated by legal specialism, political authority, and the experiential, local knowledge of licensing officials. Finding a place in established networks of power that are resistant to change requires flexible thinking on all sides, and will take time (45). Where public health actors feel frustration at institutional blocks to their engagement, licensing officials express scepticism as to why population-oriented perspectives should be prioritised within a regulatory environment that, by tradition, deals with local, specific and proximate issues (22).…”

Implementing a Public Health Objective for Alcohol Premises Licensing in Scotland: A Qualitative Study of Strategies, Values, and Perceptions of Evidence

“…When there are multiple ways to understand a problem, and “evidence” is contested, persuasion and argument—how problems and solutions are framed by stakeholders and understood by policymakers—become central to the acceptance of the public health (or any) interpretation of the best way forward [49,50,51]. This takes time, perhaps decades, to achieve [60]. Greater awareness amongst public health practitioners of the fact that health is often one of several competing goals of policy may help them to understand that evidence presented within political discussions does not necessarily tell policymakers what to do.…”

The Alcohol Health Alliance: The emergence of an advocacy coalition to stimulate policy change

“…On the other hand, there is the view that problems are linked to the total consumption of alcohol in the population and that measures are needed that target population wide drinking (see: House of Lords, 2015 for witness statements and a discussion of these differing perspectives). This approach has been suggested as an option for well over half a century but has only recently gained a degree of policy attention as public health concerns have become more central in the alcohol arena and as evidence for a population wide approach has increased (Babor, 2010;Cairney, 2014). It is important, therefore, to examine the belief systems which underpin coalition action and which are part of the 'glue' necessary to build consensus among members -the normative commitments and causal perceptions which serve to unite individuals and organisations and to direct action towards attaining policy goals or policy change (Sobek, 2003).…”