Gaining health : analysis of policy development in European ...

passing in 1991 of strict alcohol legislation, the so-called Loi
Évin. The Law aimed to ban the sale of alcohol to minors
below 16 years of age and in sports facilities and to restrict
the advertising on alcohol beverages, off-licence sales and
drink–driving. However, the stringency of the Law evoked
the opposition of wine makers and the alcohol industry in
general and its implementation was not entirely successful.
In the past 15 years, the Loi Évin has been amended many
times, for example to provide a more precise definition of
places where alcohol consumption is legal.
Ten years later, in 2001, the Government’s alcohol strategy
(23) set precise, quantifiable objectives over five-year terms,
supported by baseline measures, for:
• the consumption of wine, beer and distilled spirits;
• attitudes toward the consumption of alcohol on a daily
basis;
• drinking during pregnancy;
• the prevalence of “binge drinking”; and
• drink–driving.
The strategy paid special attention to reducing inequalities
regarding alcohol-related harm and to improving the capacity
for treatment.
These objectives were underpinned by the Public Health
Act of 2004, which ordered a report on alcohol policy for
the year 2005. Of the Act’s 100 objectives, two focus on
alcohol policy. These objectives foresee a 20% fall in alcohol
consumption and a reduction of alcohol-related harm
(binge drinking and drinking during pregnancy) by 2009. The
special focus on pregnant women is a strong characteristic
of the French alcohol policy and is also included in a number
of health campaigns. This special focus stems from 2004,
when three mothers publicly accused the Government of
not informing them about the hazards of drinking during
pregnancy.
A consultation of stakeholders on alcohol policy was
subsequently held in 2005, and the stakeholders suggested
creating a new alcohol policy-making mechanism. At national
level, the new mechanism should be based on three
strands: a National Orientation Committee (an intersectoral
body for guiding the implementation of the alcohol
policy), an expert group for advising on work based on
scientific evidence, and a working group between the Ministry
of Health and INPES. At regional level, DRASS creates
a forum for open debate among the stakeholders. A budget
has been allocated for DRASS to enhance its activity in the
alcohol policy field. According to the decision of the stakeholders
in 2005, alcohol was not part of the PRSP owing to
the predominantly social character of the problem. For this
reason, DRASS is necessary to represent alcohol policy at
regional level.
Evaluation of the consultation was carried out by an
interministerial committee in 2007 (24). The report does
not make a systematic evaluation of the objectives of the
Alcohol Strategy and the Public Health Act, but it makes
clear points about French alcohol policy. The report claims
that the main challenges remain insufficient knowledge
among the population about the hazards of alcohol consumption,
the positive popular image of alcohol and the
limited resources for alcohol research. The report recommends
strengthening the role of DRASS in alcohol policymaking
and disseminating information on alcohol-related
harm. In respect of the latter, INPES should be supported in
its campaigns, such as those promoting moderate drinking
and warning of the dangers of alcohol consumption during
pregnancy.
NGOs make a significant contribution to promoting responsible
and moderate drinking. The National Association
for Prevention of Alcoholism and Addiction is the oldest
and most important civil society organization in this field,
established in the late nineteenth century. It raises public
awareness on all problems related to acute and chronic
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Case studies: policy development in countries for tackling noncommunicable diseases