Community-Based Prevention of Alcohol Problems: Addressing the Challenges of Increasing Deregulation of Alcohol

Abstract

This article focuses on the erosion of alcohol management policies and the implications for local prevention efforts. It draws lessons from three large-scale multi-year multi-site programs in Canada, e.g., local addiction prevention projects, heart health programs, and tobacco control experiences. It explores five themes: getting alcohol on the agenda and implementing effective local responses to alcohol problems; assessing conceptual frameworks in order to identify the essential components of an effective prevention strategy; developing a system of local prevention initiatives that give priority to long-lasting structural changes; generating accurate information on alcohol-related damage in order to set priorities; and developing a prevention action plan in order to support local initiatives.

Keywords:

• alcohol deregulation
• community-based prevention
• agenda setting
• framework
• monitoring
• resources
• action plan

Notes

Notes

1. The following are major alcohol-related conditions contributing to morbidity and mortality (Babor et al., 2003, p. 66; see also Gutjahr et al., 2001): cancers—head and neck cancers as well as cancers of the gastrointestinal tract, liver cancer, and female breast cancer; neuropsychiatric conditions—alcohol-dependence syndrome, alcohol abuse, depression, anxiety disorder, organic brain disease; cardiovascular conditions—ischaemic heart disease, cerbrovacular disease; gastrointestinal conditions—alcoholic liver cirrhosis, cholelithiasis, pancreatitis; maternal and perinatel conditions—low birth weight, intrauterine grown retardation; acute toxic effects—alcohol poisoning; accidents—road and other transport injuries, fall, drowning and burning injuries, occupational and machine injuries; self-inflicted injuries—suicide; violent deaths—assault injuries.

2. Scored 8+ on the Alcohol Use Disorders Identification Test (AUDIT).

3. RIDE refers to reduce impaired driving everywhere and is a program of education, detection and enforcement involving the provincial police and city police forces in Ontario.

4. Source: Heart Health Resource Centre, 2004.

5. They are funded by the Public Health Branch, Health Promotion and Wellness of the Ontario Ministry of Health and Long-Term Care (MOHLTC) and are a project of the Ontario Public Health Association (OPHA).

6. For example, in some of the phases of the heart health initiative, alcohol was not listed as a risk factor for cardiovascular disease.

7. See also, An Alcohol Strategy, below.

8. The concept of “secular morality” is relevant here, see Brandt and Rozin (1997).