Would the Brazilian population support the alcohol policies recommended by the World Health Organization?

Authors

DOI:

https://doi.org/10.11606/s1518-8787.2022056004093

Keywords:

Alcohol Drinking, prevention & control, Products Publicity Control, Public Policy, Public Opinion, Brazil

Abstract

OBJECTIVE To evaluate the support of the Brazilian population to the alcohol-policies proposed by the World Health Organization to decrease alcohol harm (specifically: to decrease alcohol availability and advertising, and to increase pricing). In addition, we evaluated the factors associated with being against those policies. METHODS Data from 16,273 Brazilians, aged 12–65 years, interviewed in the 3rd Brazilian Household Survey on Substance Use (BHSU-3) were analyzed. The BHSU-3 is a nationwide, probability survey conducted in 2015. Individuals were asked if they would be against, neutral, or in favor of seven alcohol policies grouped as: 1) Strengthen restrictions on alcohol availability; 2) Enforce bans or restrictions on alcohol advertising, sponsorship, and promotion; and 3) Raise prices on alcohol through excise taxes and pricing. Generalized linear models were fitted to evaluate factors associated with being against each one of those policies and against all of policies. RESULTS Overall, 28% of the Brazilians supported all the above mentioned policies, whereas 16% were against them. The highest rate of approval refers to restricting advertising (53%), the lowest refers to increasing prices (40%). Factors associated with being against all policies were: being male (AOR = 1.1; 95%CI: 1.0–1.3), not having a religion (AOR = 1.4; 95%CI: 1.1–1.8), being catholic (AOR = 1.3; 95%CI: 1.1–1.5), and alcohol dependence (AOR = 1.6; 95%CI: 1.1–2.4). CONCLUSIONS The Brazilian government could count on the support of most of the population to restrict alcohol advertising. This information is essential to tackle the lobby of the alcohol industry and its clever marketing strategy.

References

World Health Organization. Global status report on alcohol and health 2018. Geneva (CH); WHO; 2018 [cited 2021 Jul 23]. Available from: https://www.who.int/publications/i/item/9789241565639

World Health Organization. World Health Statistics 2017: monitoring health for the SDGs, sustainable development goals. Geneva (CH): WHO; 2017 [cited 2021 Jul 23]. Available from: https://apps.who.int/iris/handle/10665/255336

GBD 2016 Alcohol Collaborators. Alcohol use and burden for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2018;392(10152):1015-35. https://doi.org/10.1016/S0140-6736(18)31310-2

De Boni RB, Vasconcellos MTL, Silva PN, Coutinho C, Mota J, Peixoto JNB, et al. Reproducibility on science: challenges and advances in Brazilian alcohol surveys. Int J Drug Policy. 2019;74:285-91. https://doi.org/10.1016/j.drugpo.2019.07.029

Institute for Health Metrics and Evaluation. Burden of Disease: country profiles-Brazil. Seattle, WA: IHME; 2017.

Room R, Babor T, Rehm J. Alcohol and public health. Lancet. 2005;365(9458):519-30. https://doi.org/10.1016/S0140-6736(05)17870-2

World Health Organization. Global strategy to reduce the harmful use of alcohol. Geneva (CH): WHO; 2010 [cited 2022 Jan 14]. Available from: https://www.who.int/publications/i/item/97892415999318. Monteiro MG. The World Health Organization’s SAFER initiative and the challenges in Brazil to reducing harmful consumption of alcoholic beverages. Epidemiol Serv Saude. 2020;29(1):e202000. https://doi.org/10.5123/S1679-49742020000100011

Organização Pan-Americana da Saúde, Unidade de Saúde Mental e Abuso de Substâncias, Departamento de Doenças Crônicas Não Transmissíveis e Saúde Mental. Pacote Técnico SAFER: Um Mundo Livre dos Danos Relacionados ao Álcool: cinco áreas de intervenção em âmbito nacional e estadual. Washington, DC: PAHO: 2020 [cited 2022 Jan 14 ]. Available from: https://iris.paho.org/handle/10665.2/51903

World Health Organization, Department for Management of NCDs, Disability, Violence and Injury Prevention. ‘Best buys’ and other recommended interventions for the prevention and control of noncommunicable diseases. Geneva (CH): WHO; 2017. (Tackling NCDs best buys). [cited 2022 Jan 14 ]. Available from: https://apps.who.int/iris/bitstream/handle/10665/259232/WHO-NMH-NVI-17.9-eng.pdf

Tsebelis G. Veto players: how political institutions work. Princeton, NJ: Princeton University Press; 2002.

Oliveira CWL, Mendes CV, Kiepper A, Monteiro MG, Wagner GA, Sanchez ZM. Analysis of gaps in alcohol policies in Brazil using the Pan American Health Organization’s Alcohol Policy Scoring. Int J Drug Policy. 2021;97:103322. https://doi.org/10.1016/j.drugpo.2021.103322

Pan American Health Organization. Alcohol Policy Scoring: assessing the level of implementation of the WHO Global strategy to reduce the harmful use of alcohol in the Region of the Americas. Washington, WA: PAHO; 2018 [cited 2022 Jan 14]. Available from https://iris.paho.org/bitstream/handle/10665.2/49679/9789275120453_eng.pdf?sequence=2&isAllowed=y

De Boni RB, Pechansky F, Vasconcellos MT, Bastos FI. Have drivers at alcohol outlets changed their behavior after the new traffic law? Rev Bras Psiquiatr. 2014;36(1):11-5. https://doi.org/10.1590/1516-4446-2013-1131

De Boni R, Pechansky F, Silva PLN, Vasconcellos MTL, Bastos FI. Is the prevalence of driving after drinking higher in entertainment areas? Alcohol Alcohol. 2013;48(3):356-62 https://doi.org/10.1093/alcalc/ags126

De Boni R, Silva PLN, Bastos FI, Pechansky F, Vasconcellos MTL. Reaching the hard-to-reach: a probability sampling method for assessing prevalence of driving under the influence after drinking in alcohol outlets. PloS One. 2012;7(4):e34104. https://doi.org/10.1371/journal.pone.0034104

Dekker MR, Jones A, Maulik PK, Pettigrew S. Public support for alcohol control initiatives across seven countries. Int J Drug Policy. 2020;82:102807. https://doi.org/10.1016/j.drugpo.2020.102807

Seo S, Chun S, Newell M, Yun M. Korean public opinion on alcohol control policy: a cross-sectional International Alcohol Control study. Health Policy. 2015;119(1):33-43. https://doi.org/10.1016/j.healthpol.2014.10.016

Burton R, Henn C, Lavoie D, O’Connor R, Perkins C, Sweeney K, et al. A rapid evidence review of the effectiveness and cost-effectiveness of alcohol control policies: an English perspective. Lancet. 2017;389(10078):1558-80. https://doi.org/10.1016/S0140-6736(16)32420-5

De Boni RB, Vasconcellos MTL, Silva KML, Bertoni N, Coutinho CFS, Mota JC, et al. Substance use, self-rated health and HIV status in Brazil. AIDS Care. 2021;33(10):1358-62. https://doi.org/10.1080/09540121.2020.1799923

Krawczyk N, Silva PLN, De Boni RB, Mota J, Vasconcellos M, Bertoni N, et al. Non-medical use of opioid analgesics in contemporary Brazil: findings from the 2015 Brazilian National Household Survey on Substance Use. Glob Public Health. 2020;15(2):299-306. https://doi.org/10.1080/17441692.2019.1629610

Bertoni N, Szklo A, De Boni R, Coutinho C, Vasconcellos M, Silva PN, et al. Electronic cigarettes and narghile users in Brazil: Do they differ from cigarettes smokers? Addict Behav. 2019;98:106007. https://doi.org/10.1016/j.addbeh.2019.05.031

Krawczyk N, Mota JC, Coutinho C, Bertoni N, Vasconcellos MTL, Silva PLN, De Boni RB, et al. Polysubstance use in a Brazilian national sample: correlates of co-use of alcohol and prescription drugs. Subst Abus. 2022;43(1):520-6. https://doi.org/10.1080/08897077.2021.1949666

Rakovski C, Cardoso TA, Mota JC, Bastos FI, Kapczinski F, De Boni RB. Underage drinking in Brazil: findings from a community household survey. Braz J Psychiatry. 2021 Dec 15:S1516-44462021005031201. https://doi.org/10.1590/1516-4446-2021-2103. Epub ahead of print.

Instituto Brasileiro de Geografia e Estatística, Sistema IBGE de Recuperação Automática – SIDRA. Censo Demográfico 2010. Rio de Janeiro: IBGE; ano? [cited year Month day]. Available from: http://www.sidra.ibge.gov.br/bda/orcfam/default.asp

Idler EL, Benyamini Y. Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav. 1997;38(1):21-37.

Associação Americana de Psiquiatria. Manual diagnóstico e estatístico de transtornos mentais DSM. 4. ed. rev. Porto Alegre, RS: Artes Médicas; 2002.

Silva PLN, Vasconcellos MTL, Bastos FI, De Boni RB, Bertoni N, Coutinho C, Mota J. First reproducible nationwide survey on substance use in Brazil: survey design and weighting. In: Proceedings of the Joint Statistical Meetings 2018 Survey Research Methods Section; Jul 28-Aug 2; Vancouver, Canada [cited year Month day]. Available from: http://www.asasrms.org/Proceedings/y2018/files/867101.pdf

Lumley T. Complex surveys: a guide to analysis using R. Hoboken, NJ: John Wiley & Sons; 2010.

Creswell JW, Creswell JD. Research design: qualitative, quantitative, and mixed methods approaches. 5. ed. Los Angeles, CA: SAGE Publications; 2018.

Chrystoja BR, Monteiro MG, Owe G, Gawryszewski VP, Rehm J, Shield K. Mortality in the Americas from 2013 to 2015 resulting from diseases, conditions and injuries which are 100% alcohol‐attributable. Addiction. 2021;116(10):2685-96. https://doi.org/10.1111/add.15475

Raynes-Greenow C, Gaudino JA, Wilson RT, Advani S, Weiss SH, Al Delaimy W. Beyond simple disclosure: addressing concerns about industry influence on public health. BMJ Glob Health. 2021;6(2):e004824. https://doi.org/10.1136/bmjgh-2020-004824

Bartlett A, McCambridge J. Doing violence to evidence on violence? How the alcohol industry created doubt in order to influence policy. Drug Alcohol Rev. 2022;41(1):144-52. https://doi.org/10.1111/dar.13354

Hawkins B, Durrance-Bagale A, Walls H. Co-regulation and alcohol industry political strategy: a case study of the Public Health England-Drinkaware Drink Free Days Campaign. Soc Sci Med. 2021;285:114175. https://doi.org/10.1016/j.socscimed.2021.114175

Knai C, Petticrew M, Capewell S, Cassidy R, Collin J, Cummins S, et al. The case for developing a cohesive systems approach to research across unhealthy commodity industries. BMJ Glob Health. 2021;6(2):e003543. https://doi.org/10.1136/bmjgh-2020-003543

Lacy-Nichols J, Marten R. Power and the commercial determinants of health: ideas for a research agenda. BMJ Glob Health. 2021;6(2):e003850. https://doi.org/10.1136/bmjgh-2020-003850

McCambridge J, Mialon M, Hawkins B. Alcohol industry involvement in policymaking: a systematic review. Addiction. 2018;113(9):1571-84. https://doi.org/10.1111/add.14216

Trangenstein PJ, Greenfield TK, Karriker-Jaffe KJ. Interested constituents: identifying groups to mobilize in community organizing efforts to strengthen alcohol control policies. Am J Drug Alcohol Abus. 2021;47(3):393-401. https://doi.org/10.1080/00952990.2020.1870690

Giesbrecht N, Ialomiteanu A, Anglin L, Adlaf E. Alcohol marketing and retailing: public opinion and recent policy developments in Canada. J Subst Use. 2007;12(6):389-404. https://doi.org/10.1080/14659890701262189

Pantani D, Sanchez ZM, Pinsky I. The urgent need to advance alcohol marketing regulation to protect children. alcoholism: clinical and experimental research. 2020;44(10):2141-2. https://doi.org/10.1111/acer.14442

Boniface S, Critchlow N, Severi K, MacKintosh AM, Hooper L, Thomas C, et al. Underage Adolescents’ Reactions to Adverts for Beer and Spirit Brands and Associations with Higher Risk Drinking and Susceptibility to Drink: a cross-sectional study in the UK. Alcohol Alcohol. 2021:agab018. https://doi.org/10.1093/alcalc/agab018

Rossow I. The alcohol advertising ban in Norway: effects on recorded alcohol sales. Drug Alcohol Rev. 2021;40(7):1392-5. https://doi.org/10.1111/dar.13289

Štelemėkas M, Manthey J, Badaras R, Casswell S, Ferreira-Borges C, Kalėdienėet R, et al. Alcohol control policy measures and all‐cause mortality in Lithuania: an interrupted time–series analysis. Addiction. 2021;116(10):2673-84. https://doi.org/10.1111/add.15470

Zatoński WA, Zatonski M, Janik-Koncewicz K, Wojtyla A. Alcohol-related deaths in Poland during a period of weakening alcohol control measures. JAMA. 2021;325(11):1108-9. https://doi.org/10.1001/jama.2020.25879

Wright A, Smith KE, Hellowell M. Policy lessons from health taxes: a systematic review of empirical studies. BMC Public Health. 2017;17:583. https://doi.org/10.1186/s12889-017-4497-z

Miracolo A, Sophiea M, Mills M, Kanavos P. Sin taxes and their effect on consumption, revenue generation and health improvement: a systematic literature review in Latin America. Health Policy Plan. 2021;36(5):790-810. https://doi.org/10.1093/heapol/czaa168

Marten R, Amul GGH, Casswell S. Alcohol: global health’s blind spot. Lancet Glob Health. 2020;8(3):e329-30. https://doi.org/10.1016/S2214-109X(20)30008-5

Madden M, McCambridge J. Alcohol marketing versus public health: David and Goliath? Global Health. 2021;17(1):45. https://doi.org/10.1186/s12992-021-00696-2

Babor T, Caetano R, Casswell S, Edwards G, Giesbrecht N, Graham K, et al. Alcohol: no ordinary commodity: research and public policy. Oxford (UK): Oxford University Press; 2010.

Babor T, Holder H, Caetano R, Homel R, Casswell S, Livingston M, et al. Global structure and strategies of alcohol industry. In: Babor TF, Caetano R, Casswell S, Edwards G, Giesbrecht N, Graham K, et a.l Alcohol no ordinary commodity. Oxford (UK): Oxford University Press; 2010.

Sama TB, Konttinen I, Hiilamo H. Alcohol industry arguments for liberalizing alcohol policy in Finland: analysis of Twitter data. J Stud Alcohol Drugs. 2021;82(2):279-87.

Petticrew M, Maani N, Pettigrew L, Rutter H, Van Schalkwyk MC. Dark nudges and sludge in big alcohol: behavioral economics, cognitive biases, and alcohol industry corporate social responsibility. Milbank Q. 2020;98(4):1290-328. https://doi.org/10.1111/1468-0009.12475

Downloads

Published

2022-07-04

Issue

Section

Original Articles

How to Cite

De Boni, R. B., Mota, J. C., Coutinho, C. ., & Bastos, F. I. (2022). Would the Brazilian population support the alcohol policies recommended by the World Health Organization?. Revista De Saúde Pública, 56, 66. https://doi.org/10.11606/s1518-8787.2022056004093