Addressing the harmful use of alcohol - WHO Western Pacific Region

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4. Regulating availability Rationale The evidence is strong that regulating the physical availability of alcohol for sale – that is, preventing easy access to alcohol at any time – can reduce alcohol-related harm. Availability theory postulates that alcohol consumption and related problems increase when alcohol becomes more accessible and convenient to use. Evidence from a wide range of policy evaluation studies supports this theory. By restricting hours, days, and locations of sale, as well as the density or concentration of alcohol outlets and drinking establishments, policymakers can reduce overall exposure to alcohol’s intoxicating and toxic effects, and thereby reduce alcohol-related problems (Babor et al. 2010). This principle underpins many commonly used laws and policies on alcohol. State controls over the availability of alcohol for sale is a long standing practice in the mature alcohol markets of the world. The purpose was initially tax revenue, then public order, then public health, as welfare states took up fiscal responsibility for health care in the 20th century (Room 1997). Some countries license, regulate or directly control the production and distribution of alcohol, but regulation of the sale of alcohol to the public is the main means by which governments seek to achieve public health objectives. The most effective of the laws on the sale of alcohol are those that restrict availability. High numbers of alcohol outlets affect availability and convenience of alcohol use, contributing to increased consumption and levels of alcohol-related harm. Research shows that the density of alcohol outlets has an impact on public health outcomes. The higher the density of alcohol outlets in a country, a region or a locality, then the greater the level of alcohol-related problems, including public order and violent crime. This effect is demonstrated most clearly in studies at the local level. In high density entertainment districts, a complex interaction of factors contributes to this effect. These findings from a breadth of research studies have implications for the management of the vibrant night-time economies that many cities seek to develop (Babor et al. 2010; Livingston 2008; Livingston et al. 2007). Return to TOC 29
Addressing the harmful use of alcohol : A guide to developing effective alcohol legislation The policies described below are not quantitative restrictions on alcohol products in the market (as, for example, in some import licensing). Rather they aim to reduce ease of access and convenience and ensure the responsible sale and supply of alcohol. The policy strategies and legislative examples addressed in this section are: • Reducing alcohol outlets; • Licensing the sale of alcohol; • Restricting hours and days of trading; and • Monitoring, enforcement and sanctions. Reducing alcohol outlets Reducing the number or density of alcohol outlets is not a quantitative restriction on alcohol products, but can be an effective way of regulating availability and accessibility and of reducing alcohol-related harm. Reducing the number of retail alcohol outlets and drinking venues is achieved in different countries by two main means: • government monopoly ownership of alcohol outlets; and • restrictions on the number, type, and location of alcohol outlets. Under previous Australia and New Zealand legislation, the number of licensed alcohol outlets was restricted through licensing criteria that require applicants to demonstrate community need for any new licensed premises. In countries with high levels of informal (untaxed) production and sale of alcohol some governments, for example, impose tax on sales above a certain monetary level. This might work to reduce informal sales outlets over time as might setting and enforcing licensing fees at levels which cover the costs involved with monitoring and enforcement (see section 7). Government monopoly of retail outlets In many jurisdictions around the world – parts of the United States of America, most Canadian provinces, most Nordic countries, and several Indian states – a large share of alcohol continues to be controlled through state monopoly ownership of retail outlets selling takeaway alcohol (Kortteinen 1989; WHO 2004). State agencies, sometimes one or several, license private businesses, such as restaurants, bars and accommodation hotels, to sell alcohol for consumption on the premises. 30 Return to TOC
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Page 8 and 9: 1. Introduction Purpose and audienc
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8. Regulating alcohol marketing whi
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9. Deterring drink-driving Blood al
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10. Implementation The importance o
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10. Implementation Public interest
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References Academy of Medical Scien
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References Euromonitor Internationa
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References Huckle, T., P. Sweetsur,
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References Rise, J. Natvig, H., Sto
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Addressing the harmful use of alcohol - WHO Western Pacific Region

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