A long-brewing crisis: The historical antecedents of major alcohol policy change in Ireland

Matthew Lesch*, Jim McCambridge

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Introduction: The Public Health (Alcohol) Act 2018 in Ireland has been hailed as a world-leading package of alcohol policy reforms. Existing studies have identified the events that led to alcohol emerging onto the high-level policy agenda in Ireland, particularly after 2009. Using policy feedback theory, this study specifically investigates the political consequences of accumulating alcohol-related health and social harms for processes of policy change prior to 2009. Methods: The study traces the development of alcohol policy in Ireland over the past three decades. It draws on primary documents, secondary literature and interviews with public health advocates, medical doctors, public health experts and key decision-makers. Results: The study documents a decades-long struggle to have alcohol recognised as a public health issue in Ireland. We identify 2008/2009 as the key turning point, where policy conditions decisively shifted in a public health direction. We show how insufficient institutional authority and the accumulation of the effects of earlier policy failures helped foster this dynamic. These two factors elevated the visibility of alcohol-related harm for key stakeholders, helping spur greater demand for major policy change. Discussion and Conclusions: Not acting on the population health harms caused by alcohol can produce significant societal costs, particularly when consumption is rising, and entail subsequent political consequences. Understanding of innovations in alcohol policy decision making requires an appreciation of the historical context, including earlier policy failures.

Original languageEnglish
Pages (from-to)135-143
JournalDrug and Alcohol Review
Issue number1
Early online date3 Jun 2021
Publication statusPublished - 9 Jan 2022

Bibliographical note

Funding Information:
This work was supported by the Wellcome Trust Investigator Award in Humanities and Social Science (200321/Z/15/Z) to JM.

Publisher Copyright:
© 2021 The Authors.


  • alcohol
  • Ireland
  • policy failure
  • policy feedback theory
  • public health

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