Regulating Alcohol: Strategies Used by Actors to Influence COVID-19 Related Alcohol Bans in South Africa

South Africa has used intermittent alcohol prohibitions and restrictions as a strategy to relieve hospitals of alcohol-related trauma cases and spare services for COVID-19 caseloads. Alcohol regulation is highly contested and involves a diverse range of actors who influence policies to align with their interests. This study sought to examine the strategies used by these actors to shape the COVID-19 related alcohol regulation in South Africa as presented by online news media. We found that the voice of pro-regulation actors is smaller and fragmented compared to opponents of the regulation as each actor seeks to advance their own interests. Despite the regulations initially being framed as a COVID-19 public health measure, pro-regulation government ministries, such as police and transport, perceive the regulations as a way of reducing existing (pre-pandemic) alcohol-related harm, such as crime, road-traffic injuries, and gender-based violence. The pre-existing failures in the alcohol regulatory environment and the current policy momentum created by COVID-19 could present an opportunity to retain components of the new laws and improve alcohol regulation in South Africa. However, there is a dominant and cohesive alcohol industry voice that strongly opposes the regulations, citing economic impacts, illicit trade and lack of evidence on the positive effects of the alcohol bans. Strategies employed by industry include lobbying, framing, and litigation. The regulations implemented under the guise of COVID-19 prevention have presented valuable lessons for alcohol regulation more generally. However, whether these regulations translate to sustainable policy changes will depend upon how and if the strong industry voice is countered.

The effect of alcohol sales restrictions on alcohol poisoning mortality: Evidence from Russia

This paper examines the tough anti-alcohol legislation recently introduced in Russia, which due to regional variation allows it to be used as a natural experiment. The effect of the restricted trading hours on alcoholic poisoning mortality is estimated. To establish a causal link, difference-in-differences and synthetic controls are used. The main conclusion is that the sales restrictions lead to higher alcohol poisoning mortality, which implies that more toxic alcohol surrogates serve as substitutes for commercially available alcohol.

Russia's National Concept to Reduce Alcohol Abuse and Alcohol-Dependence in the Population 2010-2020: Which Policy Targets Have Been Achieved?

In the 2000s, Russia was globally one of the top 5 countries with the highest levels of alcohol per capita consumption and prevailing risky patterns of drinking, i.e., high intake per occasion, high proportion of people drinking to intoxication, and high frequency of situations where alcohol is consumed and tolerated. In 2009, in response to these challenges, the Russian government formed the Federal Service for Alcohol Market Regulation and published a national strategy concept to reduce alcohol abuse and alcohol-dependence at the population level for the period 2010-2020. The objectives of the present contribution are to analyze the evidence base of the core components of the concept and to provide a comprehensive evaluation framework of measures implemented (process evaluation) and the achievement of the formulated targets (effect evaluation). Most of the concept's measures were found to be evidence-based and aligned with eight out of 10 areas of the World Health Organization (WHO) policy portfolio. Out of the 14 tasks, 7 were rated as achieved, and 7 as partly achieved. Ten years after the concept's adoption, alcohol consumption seems to have declined by about a third and alcohol is conceptualized as a broad risk factor for the population's health in Russia.

Exploring the relationship between drinking preferences and recorded and unrecorded alcohol consumption in Russian regions in 2010-2016

BACKGROUND

In recent years, Russia has seen a decline in alcohol consumption per capita (APC) accompanied by a significant reduction in the share of spirits in total APC. Our aim was to investigate regional variation in alcohol consumption and the association between the share of spirits in APC, and recorded and unrecorded APC.

METHODS

Data on recorded APC were taken from Rosstat. Our estimates on unrecorded APC were based on the guidelines of the Ministry of Health of the Russian Federation and data on alcoholic psychoses and mortality from external causes (546 observations for 78 regions from 2010 to 2016). We estimated fixed effects models with the dependent variables of recorded and unrecorded APC of the population 15+. Independent variables included share of spirits in recorded APC, vodka prices, average income, duration of alcohol sales hours, and others.

RESULTS

During the 2010-2016 period, recorded APC varied by regions from 1.1 to 17.8 litres; unrecorded - from almost zero to 21 litres; the share of spirits in recorded APC - from 20.6% to 89.3%. A 1% increase in the share of spirits was attributed to a 0.2% increase in recorded APC and to a 2.1% increase in unrecorded APC. Various factors were related to regional APC: vodka prices (with elasticity coefficient -0.46 for recorded and 1.67 for unrecorded APC); income (0.23 for recorded and -2.23 for unrecorded APC); duration of sales hours (-0.9 for unrecorded APC); and shares of working age and of urban population.

CONCLUSION

Taking into account a strong correlation between the share of spirits in the recorded APC and consumption of recorded and unrecorded APC, the price of spirits should be increased. In the regions with pronounced preference for spirits, stricter availability restrictions on the alcohol sales are needed, along with strict control of shadow markets.