Abstract
Background and Objective: Effective policies to reduce harm from alcohol include restricting its marketing and availability and increasing its price. However, political will to enact these policies is low in many jurisdictions. Advocacy and research at global, national and local levels are crucial to progress alcohol policy change. Yet, the challenges and levers for influencing political will remain poorly understood. We aimed to identify the key barriers and strategies to enhance political priority for domestic alcohol policy reform using a mixed method approach.
Methods: Data came from a scoping review and 37 key informant interviews. Thematic analysis was used to identify the key barriers and strategies to generate political priority for alcohol policy.
Results: 52 articles met the inclusion criteria. Study authors and interviewees described the drivers of political will as complex, interrelated and context-dependent. Nonetheless, several strategies were viewed as important for influencing alcohol policy. Key challenges included the lack of an internationally binding treaty to support domestic policymaking, industry actions (e.g. lobbying), limited capacity of alcohol policy advocates and limited civil society involvement. Key strategies included working towards an internationally binding treaty, similar to the Framework Convention on Tobacco Control, framing around the public health harms of alcohol consumption, network building and exposing industry tactics. Several promising strategies were unspecific to alcohol, e.g. combined action to tackle the involvement of unhealthy commodity industries in policymaking
Discussion: The findings reveal a set of strategies that could assist advocates and researchers in influencing political will for alcohol policy reform. Two different types of strategies were identified: i) those targeting upstream policy changes to level the playing field between industry and alcohol policy advocates, and b) those seeking to enhance the effectiveness of advocates themselves.