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

TY - JOUR

T1 - A long-brewing crisis

T2 - The historical antecedents of major alcohol policy change in Ireland

AU - Lesch, Matthew

AU - McCambridge, Jim

N1 - 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.

PY - 2022/1/9

Y1 - 2022/1/9

N2 - 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.

AB - 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.

KW - alcohol

KW - Ireland

KW - policy failure

KW - policy feedback theory

KW - public health

UR - http://www.scopus.com/inward/record.url?scp=85107066320&partnerID=8YFLogxK

U2 - 10.1111/dar.13331

DO - 10.1111/dar.13331

M3 - Article

AN - SCOPUS:85107066320

SN - 0959-5236

VL - 41

SP - 135

EP - 143

JO - Drug and Alcohol Review

JF - Drug and Alcohol Review

IS - 1

ER -