Summary
The International Alcohol Control Policy Index measures the strength of a country’s alcohol control policies across ten areas, helping to compare national approaches and support more effective public health strategies. New research has used the Index to assess how well six countries, including Aotearoa New Zealand, and four Canadian provinces ranked in terms of the status of alcohol control policies known to be effective in reducing alcohol harm.
Overall, Aotearoa New Zealand’s score was the lowest of all the eleven jurisdictions analysed. This reflected our lack of regulation of alcohol marketing and longer than average hours of alcohol sales per week. Our drink driving legislation scored well, as did that of the others in the study. Our best score was on affordability, the pricing of cheap alcohol relative to income and this reflected the regular inflation adjustment to alcohol excise tax. Australia did somewhat better than us overall and the top scorers were Lithuania, Norway, Finland and Ireland.
The findings highlight areas to improve policy to reduce the harm from alcohol in Aotearoa New Zealand.
This Briefing outlines a new approach for the collection of indicators relevant to effective alcohol policy and compares scores in Aotearoa New Zealand (NZ) relative to other similar jurisdictions in 2022/3. Benchmarking policy scores across countries is used in the public policy space1, for example, in regard to tobacco2, but is less common in relation to alcohol.
The International Alcohol Control study’s Alcohol Policy Index
The International Alcohol Control (IAC) collaboration developed an online data collection tool to assess the status of four policy domains with the strongest evidence of effectiveness: availability; pricing; marketing and drink driving countermeasures.3 Data are provided by collaborators in each country and checked and validated as far as possible by the coordinating team at Massey University. Forty countries have now participated in the collaboration since 2013 and in 2023, with funding from Health New Zealand - Te Whatu Ora, a comparison was made between Aotearoa and 10 other similar jurisdictions, six countries and four Canadian provinces 4—now published in the journal Drug and Alcohol Review
In the calculation of the IAC Policy Index, indicators were chosen to represent interventions key to the policy domains, covering both stringency of legislation and impact of policy on the ground; for example, the legal maximum hours of sale and the typical hours of sale at outlets. These were then weighted according to likely effectiveness in reducing consumption and harm and summed to produce an overall Index score and separate scores for each policy domain.
How Aotearoa scored
Four countries scored above average and higher than NZ both in the overall score and in three of the four policy domains. The countries with the highest scores were Lithuania, Norway, Finland and Ireland. New Zealand scored the lowest on the overall Policy Index, below the Netherlands, Australia and the four Canadian provinces, Ontario, Quebec, British Colombia and Alberta (Figure 1).
Our scores were comparable or worse in most domains. Legal trading hours were longer in NZ than all other countries including Australia, while most countries, including NZ, did not have any national laws restricting outlet density. NZ scored poorly on restricting alcohol marketing with only Alberta having a worse score. On drink driving policy NZ was similar to most jurisdictions, however, four scored higher due to having zero tolerance alcohol policy for professional drivers or an adult limit below .05%. NZ scored below average in terms of alcohol tax (measured by the percentage of low-cost alcohol products’ price that comes from tax). However in 2022, in the context of high inflation and regular adjustment of excise tax4, our affordability (calculated as the percentage of gross national income needed to buy 100 low-priced drinks) was the least affordable and was comparable with Lithuania and Finland.
The IAC Policy Index scores in this study reflected what is known from previous research about alcohol policy internationally. Norway and Finland’s relatively good alcohol policy status scores are in line with Scandinavian countries that traditionally have strong policies.5 However, Finland’s lower score than Norway is largely a result of liberalisation of alcohol laws in 2018.6 Both Lithuania and Ireland reformed their legislation in recent years with the explicit aim of reducing alcohol harm, including a range of evidence-based policy measures recommended by the WHO7 8; Lithuania’s more comprehensive reforms have improved health outcomes and reduced inequities.9
Economic circumstances are known to impact alcohol consumption.3 NZ’s relatively good score on the important indicator of alcohol affordability10 reflects the circumstance of high inflation in 2022 coupled with our longstanding legislation that automatically adjusts alcohol excise tax in line with inflation, a law that has been maintained despite lobbying by the commercial interests11. Recent polling of the NZ population shows public concern over the availability of cheap alcohol, supporting a strengthening of tax law and high levels of support for stronger policy in the other key areas of availability and marketing.12
Comparison with previous IAC Policy Index scores
Previous research in NZ using the IAC Policy Index allowed a comparison of 2022 data with our status in 2013 prior to implementation of the reformed Sale and Supply of Alcohol Act (2012). The analysis showed that restrictions in trading hours due to the 2012 Act led to a modest improvement in stringency and impact scores, whereas the reduction of legal BAC level from 0.08 to 0.05 in 2014 was not accompanied by an improvement in impact score due to a reduction of breath alcohol tests.13
The very limited legal restrictions on alcohol marketing in NZ were strengthened in the 2012 Act, however, the low level of prosecutions and the increased impact of digital marketing resulted in a worse score in 2022.13 Digital marketing is an increasingly problematic issue with even a country like Norway, which has had an effective ban on alcohol marketing since 197514, reporting widespread alcohol marketing in digital media in 2022.4
More recent policy developments in Local Alcohol Policies and community engagement in licensing15 have not yet been monitored using the IAC Policy Index.
What this Briefing adds
- The IAC Policy Index provides a useful framework to compare and communicate alcohol status in different jurisdictions and within jurisdictions over time
- The design of the IAC Policy Index incorporates some measures on impact as well as stringency of the policy and allows for comparison of overall scores and separate policy domains
- The IAC Policy Index highlighted the relative weakness in overall alcohol control policy status in NZ compared to other comparable jurisdictions and identified domains of particular concern.
Implications for policy and practice
- Alcohol marketing remains largely unaddressed and its ubiquity and likely additional impact via digital marketing remains an urgent need for policy reform in Aotearoa as elsewhere.
- Indexing of alcohol excise tax to inflation is a valuable tool but income levels also play a role. To reduce harm, excise tax rates need to reduce alcohol product affordability, which should be monitored over time.
Authors details
Prof Sally Casswell Co-Director of the SHORE and Whariki Research Centre, College of Health at Massey University |Te Kunenga ki Pūrehuroa
Steve Randerson Research officer at the SHORE and Whariki Research Centre, College of Health at Massey University |Te Kunenga ki Pūrehuroa
Karl Parker Statistician at the SHORE and Whariki Research Centre, College of Health at Massey University |Te Kunenga ki Pūrehuroa
Assoc Prof Taisia Huckle Leader of the quantitative research team at SHORE & Whariki Research Centre, College of Health at Massey University |Te Kunenga ki Pūrehuroa
Acknowledgements
We wish to acknowledge our collaborators who have made the project possible: Sarah Callinan, Orfhlaith Campbell, Thomas Karlsson, Ingeborg Rossow, Gillian Shorter, Mindaugas Štelemėkas, Kate Vallance, Wim van Dalen, Ashley Wettlaufer and Thomas Graydon–Guy for assistance with data collection.
