Forschungsergebnisse / Research results

24.04.2007  (forsc179.htm)  


Medical News Today, Public Library of Science


Donald A. Brand1,2,3¤, Michaela Saisana4, Lisa A. Rynn5, Fulvia Pennoni6, Albert B. Lowenfels7,8*

1 Department of Medicine, New York Medical College, Valhalla, New York, United States of America, 2 Department of Pediatrics, New York Medical College, Valhalla, New York, United States of America, 3 School of Public Health, New York Medical College, Valhalla, New York, United States of America, 4 Joint Research Centre, European Commission, Ispra, Italy, 5 New York Medical College, Valhalla, New York, United States of America, 6 Department of Statistics, University of Milano-Bicocca, Italy, 7 Department of Surgery, New York Medical College, Valhalla, New York, United States of America, 8 Department of Community and Preventive Medicine, New York Medical College, Valhalla, New York, United States of America


Comparative Analysis of Alcohol Control Policies in 30 Countries /
Vergleichende Analyse der Alkohol Kontroll-Politik in 30 Ländern

to    Medical News Today, 23.4.07


Link to    Public Library of Science, April 2007 with Article of Editor


Link to    Public Library of Science, April 2007 with Article of Editor (large pdf)


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Comparative Analysis of Alcohol Control Policies in 30 Countries

Alcohol consumption causes an estimated 4% of the global disease burden, prompting goverments to impose regulations to mitigate the adverse effects of alcohol. To assist public health leaders and policymakers, the authors developed a composite indicator—the Alcohol Policy Index—to gauge the strength of a country's alcohol control policies.

Methods and Findings

The Index generates a score based on policies from five regulatory domains—physical availability of alcohol, drinking context, alcohol prices, alcohol advertising, and operation of motor vehicles. The Index was applied to the 30 countries that compose the Organization for Economic Cooperation and Development and regression analysis was used to examine the relationship between policy score and per capita alcohol consumption. Countries attained a median score of 42.4 of a possible 100 points, ranging from 14.5 (Luxembourg) to 67.3 (Norway). The analysis revealed a strong negative correlation between score and consumption (r = −0.57; p = 0.001): a 10-point increase in the score was associated with a one-liter decrease in absolute alcohol consumption per person per year (95% confidence interval, 0.4–1.5 l). A sensitivity analysis demonstrated the robustness of the Index by showing that countries' scores and ranks remained relatively stable in response to variations in methodological assumptions.


The strength of alcohol control policies, as estimated by the Alcohol Policy Index, varied widely among 30 countries located in Europe, Asia, North America, and Australia. The study revealed a clear inverse relationship between policy strength and alcohol consumption. The Index provides a straightforward tool for facilitating international comparisons. In addition, it can help policymakers review and strengthen existing regulations aimed at minimizing alcohol-related harm and estimate the likely impact of policy changes.

Funding: This study was sponsored, in part, by a grant from the Christopher D. Smithers Foundation, and by award 2D54HP00022 from the Health Resources and Services Administration, United States Public Health Service. The Smithers Foundation, a private philanthropic organization emphasizing public education about the disease of alcoholism, has supported ABL's alcohol-related research since the 1970s. Since 2000, the Health Resources and Services Administration has provided general support for a health outcomes research initiative at New York Medical College that facilitated the present study. Neither sponsor played any role in the design or conduct of the study; collection, management, analysis, or interpretation of the data; or preparation, review, or approval of the manuscript.

Competing Interests: The authors have declared that no competing interests exist.

Academic Editor: Phillipa Hay, James Cook University, Australia

Citation: Brand DA, Saisana M, Rynn LA, Pennoni F, Lowenfels AB (2007) Comparative Analysis of Alcohol Control Policies in 30 Countries. PLoS Med 4(4): e151 doi:10.1371/journal.pmed.0040151

Received: October 5, 2006; Accepted: February 22, 2007; Published: April 24, 2007

Copyright: © 2007 Brand et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abbreviations: CI, confidence interval

¤ Current address: Office of Health Outcomes Research, Winthrop University Hospital, Mineola, New York, United States of America

* To whom correspondence should be addressed. E-mail:

Editors' Summary


Alcohol drinking is now recognized as one of the most important risks to human health. Previous research studies (see the research article by Rodgers et al., linked below) have predicted that around 4% of the burden of disease worldwide comes about as a result of drinking alcohol, which can be a factor in a wide range of health problems. These include chronic diseases such as cirrhosis of the liver and certain cancers, as well as poor health resulting from trauma, violence, and accidental injuries. For these reasons, most governments try to control the consumption of alcohol through laws, although very few countries ban alcohol entirely.

Why Was This Study Done?

Although bodies such as the World Health Assembly have recommended that its member countries develop national control policies to prevent excessive alcohol use, there is a huge variation between national policies. It is also very unclear whether there is any link between the strictness of legislation regarding alcohol control in any given country and how much people in that country actually drink.

What Did the Researchers Do and Find?

The researchers carrying out this study had two broad goals. First, they wanted to develop an index (or scoring system) that would allow them and others to rate the strength of any given country's alcohol control policy. Second, they wanted to see whether there is any link between the strength of control policies on this index and the amount of alcohol that is drunk by people on average in each country. In order to develop the alcohol control index, the researchers chose five main areas relating to alcohol control. These five areas related to the availability of alcohol, the “drinking context,” pricing, advertising, and vehicles. Within each policy area, specific policy topics relating to prevention of alcohol consumption and harm were identified. Then, each of 30 countries within the OECD (Organization for Economic Cooperation and Development) were rated on this index using recent data from public reports and databases. The researchers also collected data on alcohol consumption within each country from the World Health Organization and used this to estimate the average amount drunk per person in a year. When the researchers plotted scores on their index against the average amount drunk per person per year, they saw a negative correlation. That is, the stronger the alcohol control policy in any given country, the less people seemed to drink. This worked out at around roughly a 10-point increase on the index equating to a one-liter drop in alcohol consumption per person per year. However, some countries did not seem to fit these predictions very well.

What Do These Findings Mean?

The finding that there is a link between the strength of alcohol control policies and amount of alcohol drinking does not necessarily mean that greater government control causes lower drinking rates. The relationship might just mean that some other variable (e.g., some cultural factor) plays a role in determining the amount that people drink as well as affecting national policies for alcohol control. However, the index developed here is a useful method for researchers and policy makers to measure changes in alcohol controls and therefore understand more clearly the factors that affect drinking rates. This study looked only at the connection between control measures and extent of alcohol consumption, and did not examine alcohol-related harm. Future research might focus on the links between controls and the harms caused by alcohol.

Additional Information.

Please access these Web sites via the online version of this summary at

Teilweise Übersetzung H.T. Meyer:


Die Wirkung der Alkohol-Kontrol-Politik, wie sie mit dem Alkohol-Politik-Index geschätzt wird, varierte stark unter den 30 Ländern aus Europa, Asien, Nordamerika und Australien. Die Studie zeigte eine klare entgegengesetzte Beziehung zwischen Strenge der Politik und dem Alkoholkonsum. Der Index stellt ein direktes Werkzeug dar, um internationale Vergleiche zu erleichtern. Zusätzlich kann er den Politikern helfen, die bestehenden Regeln zu überblicken und zu verstärken, die dazu dienen, alkoholbedingte Schäden zu minimalisieren und die wahrscheinlichen Auswirkungen von Änderungen der Politik abzuschätzen.

Kommentar: Die Schweiz rangiert auf dem zweitletzten Platz. Dabei ist die Herabsetzung der Promillegrenze im Strassenverkehr wahrscheinlich nicht berücksichtigt, eventuell auch nicht die Sondersteuer auf Alcopops.



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