Thomas F. Babor’s research while affiliated with University of Connecticut and other places

Alcohol is a favorite psychoactive substance of Canadians. It is also a leading risk factor for death and disability, playing a causal role in a broad spectrum of health and social issues. Alcohol: No Ordinary Commodity is a collaborative, integrative review of the scientific literature. This paper describes the epidemiology of alcohol use and current state of alcohol policy in Canada, best practices in policy identified by the third edition of Alcohol: No Ordinary Commodity, and the implications for the development of effective alcohol policy in Canada. Best practices - strongly supported by the evidence, highly effective in reducing harm, and relatively low-cost to implement - have been identified. Measures that control affordability, limit availability, and restrict marketing would reduce population levels of alcohol consumption and the burden of disease attributable to it.

This article describes the relevance of the book, Alcohol: No Ordinary Commodity to policy development in Low- and Middle-income Countries (LMICs). Per capita alcohol consumption is growing in the emerging economies of Asia and Africa, and it is already high in Latin America and the Caribbean. In the context of limited policy controls, this expansion has created a “perfect storm” driving increased alcohol consumption and harms. Along with the alcohol industry’s attempts to subvert evidence-based policy, these trends signal the need for the kinds of policy solutions proposed in the book. Implications for global health are also discussed.

From a public health perspective, alcohol is no ordinary consumer product. On a global level, it is a major contributor to disease, disability, and premature mortality. It also has an adverse impact on many aspects of social life. Alcohol: No Ordinary Commodity – Research and Public Policy describes recent advances in alcohol research that have direct relevance for the development of effective alcohol policies at the local, national and international levels. It covers the search for policies that protect health, prevent disability, and address the social problems associated with the misuse of beverage alcohol. This book is, at its core, a scientific treatise on what alcohol policy is, why it is needed, which interventions are effective, how policy is made, and how scientific evidence can inform the policy-making process. The book opens with an introduction to the policy agenda. The second section then presents a snapshot of drinking patterns and alcohol-related problems throughout the world, providing a global panorama of the challenges faced. The third section critically reviews the evidence for six strategies that have often been used as a basis for alcohol policy: taxation and pricing, regulating the physical availability of alcohol, modifying the drinking context, drinking-driving countermeasures, regulating alcohol promotion, education and persuasion programmes, and treatment and early intervention services. Section four provides an international analysis of the policy making process. The book concludes with a consumer’s guide to effective alcohol policy, synthesising what is known about how communities and nation states can effectively manage this extraordinary commodity.

Zusammenfassung: Hintergrund und Ziele: Dieser Artikel fasst die Ergebnisse und Schlussfolgerungen der dritten Ausgabe des Buches „Alkohol: Kein gewöhnliches Konsumgut“ zusammen. Mit der jüngsten Überarbeitung dieses Buches werden die wissenschaftlichen Erkenntnisse über gesundheitspolitische Maßnahmen bei Alkoholkonsum aus der Sicht der Bevölkerungsgesundheit (Public Health) kritisch bewertet. Aufbau: Zusammenfassung des Buchinhalts nach fünf Hauptthemen. Ergebnisse: Eine Vielzahl epidemiologischer Studien zeigt, dass Alkoholkonsum in Ländern mit hohem, mittlerem und niedrigem Einkommen einen erheblichen Beitrag zur weltweiten Belastung durch Krankheit, Behinderung und Tod leistet. Aktuelle Trends von Alkoholprodukten und -vermarktung lassen erkennen, dass sich ein großer Teil der globalen Industrie zu einer kleinen Anzahl von transnationalen Konzernen fusioniert hat und diese Konzerne ihre Aktivitäten vor allem nach Asien, Afrika und Lateinamerika ausweiten. Der Hauptteil dieses Buches ist einem Überblick über strukturelle Maßnahmen und zumeist überindividuelle Strategien gewidmet, die alkoholbedingte Schäden verhindern oder minimieren sollen. Die wirksamsten Strategien zum Schutz der Bevölkerungsgesundheit sind – kurz gefasst – eine Besteuerung, die die Finanzierbarkeit des Konsums verringert, und Beschränkungen der physischen Verfügbarkeit von Alkohol. Ein vollständiges Verbot der Vermarktung von Alkohol ist ebenfalls eine wirksame Strategie zur Verringerung des Konsums. Darüber hinaus sind Maßnahmen zur Bekämpfung des Alkoholkonsums im Straßenverkehr, Kurzinterventionen bei Risikokonsument_innen und die Behandlung von Personen mit Alkoholabhängigkeit wirksam, um Schäden in Hochrisikosituationen und in Gruppen mit einem riskanten Trinkverhalten zu verhindern bzw. zu minimieren. Schlussfolgerungen: Alkoholpolitische Maßnahmen sind das Ergebnis konkurrierender Interessen, Werte und Ideologien unterschiedlicher Akteure. Die Zusammenarbeit mit der Alkoholindustrie zeitigt aufgrund des Interessenskonflikts zwischen Profit und Gesundheit meistens ineffektive politische Maßnahmen. Mit dem zunehmenden Wissen darüber, welche Strategien dem Gemeinwohl am besten dienen, sind die vielfältigen Umsetzungsmöglichkeiten einer evidenzbasierten Alkoholpolitik klarer als je zuvor.

This book is about alcohol policy: why it is needed, how it is made, and the impact it has on health and well-being. It is written for both policymakers and alcohol scientists, as well as the many other people interested in bridging the gap between research and policy. It begins with a global review of epidemiological evidence showing why alcohol is not an ordinary commodity, and it ends with the conclusion that alcohol policies implemented within a public health agenda are needed to reduce the enormous burden of harm it causes. The core of the book is a critical review of the cumulative scientific evidence in seven general areas of alcohol policy: pricing and taxation; regulating the physical availability of alcohol; modifying the environment in which drinking occurs; drink-driving countermeasures; marketing restrictions; primary prevention programmes in schools and other settings; and treatment and early intervention services. The final chapters discuss the current state of alcohol policy in different parts of the world, the detrimental role of the alcohol industry, and the need for both national and global alcohol policies that are evidence-based, effective, and coordinated. This book shows that opportunities for evidence-based alcohol policies that better serve the public good are clearer than ever before, as a result of accumulating knowledge on which strategies work best.