Too high a cost: A public health approach to alcohol policy in Canada

PURPOSE: To outline the goals, process, outcomes and next steps of a position statement on alcohol policy approved by the Canadian Public Health Association (CPHA). METHOD/PROCESS: Following an initial proposal to the CPHA Board in June 2010, a seven-person work group met a dozen times by teleconference and in person to draft, revise and finalize a 20 page statement. Feedback on a draft was provided by a dozen national and international experts on alcohol issues, and CPHA's policy group. The report is based on epidemiological and survey research, archival data, government statistics and includes 180 citations, including 12 reviews. RESULTS: The document provides an eight-fold rationale for a position statement, then indicates current drinking patterns including high-risk drinking among adolescents. It outlines two contrasting trends: 1. increasing access to alcohol and higher exposure to advertising; 2. a number of international, national and regional initiatives to control alcohol-related harm and promote health. The main focus is on a multi-dimensional and comprehensive policy response organized into three groups of recommendations: 1. population-based policies and interventions – alcohol pricing policies, controlling physical and legal availability, curtailing alcohol marketing, regulating and monitoring alcohol control systems; 2. targeted policies and interventions – countering drinking and driving, changing the drinking context, educating and promoting behaviour change, increasing access to screening and brief intervention; 3. cross-cutting activities – surveillance and research, knowledge exchange and skill-building. NEXT STEPS: Disseminate the position statement among governments, regional public health authorities, NGOs and internationally in order to stimulate and monitor actions.