Botswana alcohol policy and the presidential levy controversy

Aim To assess the state of alcohol policy in Botswana in the context of a substantial levy imposed on alcohol sales by the President. Design, measurements Analysis of policy documents and media reports to describe the drivers of policy formation. Setting, participants Botswana. Findings Legislation aimed at addressing the problem of excessive consumption of alcohol in the country has been proposed and enacted since independence in 1966 and a draft national alcohol policy is currently being debated. The policy recognizes the need to protect the rights of adult citizens of Botswana to purchase and consume alcohol in a safe and well‐regulated manner and the role of government in ensuring that vulnerable members of the community are protected against the impact of harmful use of alcohol. In 2008, controversy erupted over the proposal by the President of the country to impose a 70% levy on alcohol products, later reduced to 30%. The industry responded by threatening to go to court and has since focused their response on what they claim to be serious economic losses due to reduced consumption of their products. Conclusions The ongoing controversy in Botswana calls attention to the role of the industry in influencing the debate on alcohol and the need to keep in mind overall public health interest in efforts to develop and implement a national alcohol policy.     

The alcohol industry and public interest science

Aims This report argues that the growing involvement of the alcohol industry in scientific research needs to be acknowledged and addressed. It suggests a set of principles to guide ethical decision‐making in the future. Methods We review relevant issues with regard to relationships between the alcohol industry and the international academic community, especially alcohol research scientists. The guiding principles proposed are modelled after expert committee statements, and describe the responsibilities of governmental agencies, the alcohol industry, journal editors and the academic community. These are followed by recommendations designed to inform individuals and institutions about current ‘best practices’ that are consistent with the principles. Findings and conclusions Growing evidence from the tobacco, pharmaceutical and medical fields suggests that financial interests of researchers may compromise their professional judgement and lead to research results that are biased in favour of commercial interests. It is recommended that the integrity of alcohol science is best served if all financial relationships with the alcoholic beverage industry are avoided. In cases where research funding, consulting, writing assignments and other activities are initiated, institutions, individuals and the alcoholic beverage industry itself are urged to follow appropriate guidelines that will increase the transparency and ethicality of such relationships.     

Making visible the politics and ethics of alcohol policy research

Although research on alcohol policy has produced a huge international literature, alcohol research and policy itself—its cultural assumptions, methods, politics and ethics—has rarely been subject to critical analysis. In this article, I provide an appreciative review of an exception to this trend: Joseph Gusfield's 1981 classic, The Culture of Public Problems: Drinking‐Driving and the Symbolic Order. I first outline Gusfield's argument that the ‘problem of drinking‐driving’ is constructed as a ‘drama of individualism’ centring on the ‘killer drunk’. The ‘culture’ of drinking‐driving research and policy emphasizes alcohol as the problem and locates the source of car accidents in the moral failings of the individual motorist, rather than in social institutions or physical environments. For Gusfield, this construction of the problem is the outcome of political and ethical choices rather than of ‘objective’ conditions. In the second part of the article, I highlight the book's remarkable foresight in anticipating later trends in critical policy analysis, and argue that it should be regarded as a sociological classic and as required reading for those working in alcohol and indeed other drug policy research. I conclude by arguing that The Culture of Public Problems remains relevant to those working in alcohol and other drug policy research, although the reasons for its relevance differ depending on readers' theoretical commitments.     

Alcohol industry involvement in policymaking: a systematic review

Aims

To summarize the substantive findings of studies of alcohol industry involvement in national or supranational policymaking, and to produce a new synthesis of current evidence.

Methods

This study examined peer‐reviewed journal reports published in the English language between 1980 and 2016 of studies of alcohol industry involvement in policymaking. Included studies were required to provide information on data collection and analysis and to have sought explicitly to investigate interventions by alcohol industry actors within the process of public policymaking. Eight electronic databases were searched on 27 February 2017. The methodological strengths and limitations of individual studies and the literature as a whole were examined. A thematic synthesis using an inductive approach to the generation of themes was guided by the research aims and objectives.

Results

Twenty reports drawn from 15 documentary and interview studies identify the pervasive influence of alcohol industry actors in policymaking. This evidence synthesis indicates that industry actors seek to influence policy in two principal ways by: (1) framing policy debates in a cogent and internally consistent manner, which excludes from policy agendas issues that are contrary to commercial interests; and (2) adopting short‐ and long‐term approaches to managing threats to commercial interests within the policy arena by building relationships with key actors using a variety of different organizational forms. This review pools findings from existing studies on the range of observed impacts on national alcohol policy decision‐making throughout the world.

Conclusions

Alcohol industry actors are highly strategic, rhetorically sophisticated and well organized in influencing national policymaking.     

Estimates of harm associated with changes in Swedish alcohol policy: results from past and present estimates

AIMS: (i) To compare actual developments of alcohol-related harm in Sweden with estimates derived prior to major policy changes in 1995 and (ii) to estimate the effects on consumption and alcohol-related harm of reducing alcohol prices in Sweden. DESIGN: Alcohol effect parameters expressing the strength of the relationship between overall alcohol consumption and different alcohol-related harms were obtained from ARIMA (Auto Regressive Integrated Moving Average) time-series analyses. MEASUREMENTS: Measures of Swedish alcohol-related mortality (liver cirrhosis, alcoholic psychosis, alcoholism and alcohol poisoning), accident mortality, suicide, homicide, assaults and sickness absence from 1950 to 1995. FINDINGS: Previous estimates of alcohol-related harm based on changes in alcohol consumption for the period 1994-2002 for Sweden were, in some cases (e.g. violent assaults and accidents), relatively close to the actual harm levels, whereas in other cases (e.g. homicides, alcohol-related mortality and suicide) they diverged from observed harm levels. A tax cut by 40% on spirits and by 15% on wine is estimated to increase total per capita alcohol consumption by 0.35 litre. This increase is estimated to cause 289 additional deaths, 1627 additional assaults and 1.6 million additional sickness absence days. CONCLUSIONS: The estimates of future changes in harm based upon even relatively modest increases in alcohol consumption produce considerable negative effects, with large economic consequences for the Swedish economy. The additional alcohol-related deaths, for instance, amount to more than half the number of yearly traffic fatalities in Sweden.