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Farkouh EK, Vallance K, Wettlaufer A, Giesbrecht N, Asbridge M, Farrell-Low AM, Gagnon M, Price TR, Priore I, Shelley J, Sherk A, Shield KD, Solomon R, Stockwell TR, Thompson K, Vishnevsky N, Naimi TS. An assessment of federal alcohol policies in Canada and priority recommendations: Results from the 3rd Canadian Alcohol Policy Evaluation Project. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2024; 115:640-653. [PMID: 38739320 PMCID: PMC11303602 DOI: 10.17269/s41997-024-00889-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 04/02/2024] [Indexed: 05/14/2024]
Abstract
OBJECTIVE To systematically assess the Canadian federal government's current alcohol policies in relation to public health best practices. METHODS The 2022 Canadian Alcohol Policy Evaluation (CAPE) Project assessed federal alcohol policies across 10 domains. Policy domains were weighted according to evidence for their relative impact, including effectiveness and scope. A detailed scoring rubric of best practices was developed and externally reviewed by international experts. Policy data were collected between June and December 2022, using official legislation, government websites, and data sources identified from previous iterations of CAPE as sources. Contacts within relevant government departments provided any additional data sources, reviewed the accuracy and completeness of the data, and provided amendments as needed. Data were scored independently by members of the research team. Final policy scores were tabulated and presented as a weighted overall average score and as unweighted domain-specific scores. RESULTS Compared to public health best practices, the federal government of Canada scored 37% overall. The three most impactful domains-(1) pricing and taxation, (2) marketing and advertising controls, and (3) impaired driving countermeasures-received some of the lowest scores (39%, 10%, and 40%, respectively). Domain-specific scores varied considerably from 0% for minimum legal age policies to 100% for controls on physical availability of alcohol. CONCLUSION Many evidence-informed alcohol policies have not been adopted, or been adopted only partially, by the Canadian federal government. Urgent adoption of the recommended policies is needed to prevent and reduce the enormous health, social, and economic costs of alcohol use in Canada.
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Affiliation(s)
- Elizabeth K Farkouh
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada.
- Mayo Clinic Alix School of Medicine, Rochester, MN, USA.
| | - Kate Vallance
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Ashley Wettlaufer
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, ON, Canada
| | - Norman Giesbrecht
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Mark Asbridge
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada
| | - Amanda M Farrell-Low
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Marilou Gagnon
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Tina R Price
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Isabella Priore
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Jacob Shelley
- Faculty of Law, University of Western Ontario, London, ON, Canada
| | - Adam Sherk
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Kevin D Shield
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Robert Solomon
- Faculty of Law, University of Western Ontario, London, ON, Canada
| | - Tim R Stockwell
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Kara Thompson
- St. Francis Xavier University, Antigonish, NS, Canada
| | - Nicole Vishnevsky
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Timothy S Naimi
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
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Stockwell T, Zhao J, Alam F, Churchill S, Shi Y, Naimi T. Alcohol sales in Canadian liquor outlets as a predictor of subsequent COVID-19 infection rates: a time-series analysis. Addiction 2022; 117:3069-3078. [PMID: 35913022 PMCID: PMC9538471 DOI: 10.1111/add.16011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 07/14/2022] [Indexed: 12/01/2022]
Abstract
AIMS Government alcohol sales data were used to examine whether age 15+ per-capita alcohol consumption (PCAC) (i) changed during COVID-19 and (ii) predicted COVID-19 infections 2-5 weeks later. DESIGN Interrupted time-series analyses were applied to panels of data before and after COVID-19 restrictions were introduced in Canada. SETTING AND PARTICIPANTS The populations, aged 15+, of the provinces of Ontario (ON), British Columbia (BC) and Nova Scotia (NS), Canada. INTERVENTION Expansion of home delivery options and hours of trading for liquor stores while restrictions on travel, social and economic activities were imposed by governments during COVID-19 from 17 March 2020 until 29 March 2021. MEASUREMENTS Weekly estimates of (i) age 15+ PCAC using sales data supplied by provincial government alcohol distributors for liquor stores, bars and restaurants, (ii) stringency of public health measures assessed by the Public Health Agency of Canada (PHAC) and (iii) new COVID-19 infections reported by PHAC. FINDINGS PCAC increased by 7.10% (P = 0.013) during the pandemic versus previous years, with increased private liquor store sales partly offset by reduced bar/restaurant sales. Consumption was positively associated with stringency of public health measures. Weekly PCAC was positively associated with new COVID-19 infections 2 weeks later (+6.34% for a one drink/week increase, P < 0.001). Lagged associations with COVID-19 infections 2 or 3 weeks later were observed for PCAC from all sales channels, with larger effect sizes per standard drink/person/week increase for on-premise outlets (+77.27% week 2, P = 0.009) than government liquor stores (+6.49%, week 2, P < 0.001) or private liquor stores (+7.13%, week 4, P < 0.001). CONCLUSIONS Alcohol consumption increased in three Canadian provinces during COVID-19 to degrees corresponding to the extent of the strictness of measures imposed to prevent viral spread. Increased consumption of alcohol was associated with increased COVID-19 infection rates 2 weeks later.
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Affiliation(s)
- Tim Stockwell
- Canadian Institute for Substance Use ResearchUniversity of VictoriaVictoriaBCCanada
| | - Jinhui Zhao
- Canadian Institute for Substance Use ResearchUniversity of VictoriaVictoriaBCCanada
| | - Fariha Alam
- Canadian Institute for Substance Use ResearchUniversity of VictoriaVictoriaBCCanada,Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
| | - Sam Churchill
- Canadian Institute for Substance Use ResearchUniversity of VictoriaVictoriaBCCanada
| | - Yipu Shi
- Public Health Agency of CanadaOttawaOntarioCanada
| | - Timothy Naimi
- Canadian Institute for Substance Use ResearchUniversity of VictoriaVictoriaBCCanada
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Stockwell T, Giesbrecht N, Vallance K, Wettlaufer A. Government Options to Reduce the Impact of Alcohol on Human Health: Obstacles to Effective Policy Implementation. Nutrients 2021; 13:2846. [PMID: 34445006 PMCID: PMC8399748 DOI: 10.3390/nu13082846] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/10/2021] [Accepted: 08/11/2021] [Indexed: 12/25/2022] Open
Abstract
Evidence for effective government policies to reduce exposure to alcohol's carcinogenic and hepatoxic effects has strengthened in recent decades. Policies with the strongest evidence involve reducing the affordability, availability and cultural acceptability of alcohol. However, policies that reduce population consumption compete with powerful commercial vested interests. This paper draws on the Canadian Alcohol Policy Evaluation (CAPE), a formal assessment of effective government action on alcohol across Canadian jurisdictions. It also draws on alcohol policy case studies elsewhere involving attempts to introduce minimum unit pricing and cancer warning labels on alcohol containers. Canadian governments collectively received a failing grade (F) for alcohol policy implementation during the most recent CAPE assessment in 2017. However, had the best practices observed in any one jurisdiction been implemented consistently, Canada would have received an A grade. Resistance to effective alcohol policies is due to (1) lack of public awareness of both need and effectiveness, (2) a lack of government regulatory mechanisms to implement effective policies, (3) alcohol industry lobbying, and (4) a failure from the public health community to promote specific and feasible actions as opposed to general principles, e.g., 'increased prices' or 'reduced affordability'. There is enormous untapped potential in most countries for the implementation of proven strategies to reduce alcohol-related harm. While alcohol policies have weakened in many countries during the COVID-19 pandemic, societies may now also be more accepting of public health-inspired policies with proven effectiveness and potential economic benefits.
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Affiliation(s)
- Tim Stockwell
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC V8P 5C2, Canada;
| | - Norman Giesbrecht
- Centre for Addiction and Mental Health, Toronto, ON M5V 2B4, Canada; (N.G.); (A.W.)
| | - Kate Vallance
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC V8P 5C2, Canada;
| | - Ashley Wettlaufer
- Centre for Addiction and Mental Health, Toronto, ON M5V 2B4, Canada; (N.G.); (A.W.)
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Vallance K, Stockwell T, Wettlaufer A, Chow C, Giesbrecht N, April N, Asbridge M, Callaghan R, Cukier S, Hynes G, Mann R, Solomon R, Thomas G, Thompson K. The Canadian Alcohol Policy Evaluation project: Findings from a review of provincial and territorial alcohol policies. Drug Alcohol Rev 2021; 40:937-945. [DOI: 10.1111/dar.13251] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 12/11/2020] [Accepted: 12/16/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Kate Vallance
- Canadian Institute for Substance Use Research, University of Victoria Victoria Canada
| | - Tim Stockwell
- Canadian Institute for Substance Use Research, University of Victoria Victoria Canada
| | - Ashley Wettlaufer
- Centre for Addiction and Mental Health Institute for Mental Health Policy Research Toronto Canada
| | - Clifton Chow
- Canadian Institute for Substance Use Research, University of Victoria Victoria Canada
| | - Norman Giesbrecht
- Centre for Addiction and Mental Health Institute for Mental Health Policy Research Toronto Canada
| | - Nicole April
- Direction du développement des individus et des communautés Institut national de santé publique du Québec Québec City Canada
| | - Mark Asbridge
- Departments of Community Health and Epidemiology and Emergency Medicine Dalhousie University Halifax Canada
| | - Russell Callaghan
- Northern Medical Program University of Northern British Columbia Prince George Canada
| | - Samantha Cukier
- Centre for Journalogy Ottawa Hospital Research Institute Ottawa Canada
| | - Geoff Hynes
- Population Health, Canadian Institute for Health Information Ottawa Canada
| | - Robert Mann
- Centre for Addiction and Mental Health Institute for Mental Health Policy Research Toronto Canada
| | | | - Gerald Thomas
- Canadian Institute for Substance Use Research, University of Victoria Victoria Canada
| | - Kara Thompson
- Department of Psychology St. Francis Xavier University Antigonish Canada
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