SAFER

The level of regulation of the availability of alcohol will depend on local circumstances – including social, cultural and economic contexts – as well as on binding international obligations and the delegation of authority at national level. In some low- and middle-income countries, informal markets are the main source of alcohol; consequently, in such situations, the regulation of industrial alcohol should be complemented by actions either to abolish illicit or informally produced alcohol or to bring it under government control.

Where a government monopoly for the retail sale of alcohol exists, there is a strong argument for preserving it because such a monopoly can effectively limit the availability of alcohol and reduce alcohol-related harm. Where a monopoly of this kind does not exist, and where it is not feasible to introduce one, a licensing system for alcohol sales should be introduced or maintained. A licence should be issued to a specific business or individual owner for a defined time period and with annual renewal dependent on compliance with obligations related to public health and safety, sanitary conditions and business practices.

Effective enforcement of licensing regulations is a critical factor in compliance; the ability to revoke a licence for noncompliance is a strong deterrent. Enforcement may be undertaken by the police alone or by civilian inspectors or community coalitions that work in collaboration with the police. Licence renewals should be issued only to establishments that adhere to laws restricting sales to under-age alcohol users and intoxicated persons, that discourage patrons from being a public nuisance or engaging in violence, that sell only licit beverages and that adhere to the country’s sanitary standards.

Steps should be taken to ensure that local communities and municipalities do not use licensing systems merely as sources of revenue because this practice can lead to excessive distribution of licences. Licensing authorities should be charged with maintaining and improving public health rather than simply responding to market forces. Similarly, national licensing regulation should permit local bodies to act to reduce and prevent alcohol-related incidence of violence, crime, public disturbance and harm to health.

Governments should regulate the density of alcohol outlets and limit it where there is undue harm. It is advisable to avoid extending the days and hours of alcohol sales, and to curtail them further when certain neighbourhoods or communities experience increased alcohol-related harm.

A minimum age established by law for the purchase of alcohol enjoys broad public support. Where the minimum age is set at less than 18 years, it is recommended to increase it to at least 18 for all beverage products in both off-trade and on-trade establishments. “Mystery shoppers” – in this case, under-age purchasers – can be used to ensure that establishments enforce the minimum age for purchase. In accordance with national legislation, mechanisms should be considered for placing liability on sellers and servers to prevent sales to intoxicated persons and those below the legal drinking age.

Secondary supply of alcohol – e.g. by parents or friends – should be taken into consideration in measures to limit the availability of alcohol – perhaps in the form of fines and/or criminal charges, depending on the circumstances. Alcohol consumption by minors in the presence of parents, family or friends in on-trade establishments undermines the purpose of the law on a minimum age for purchasing and is therefore not recommended.

An emerging challenge regarding alcohol availability is remote selling (e.g. selling online or by telephone) and associated delivery systems for alcohol. It is important to ensure that regulations regarding minimum age, selling to intoxicated persons and days and hours of sales are safeguarded in this regard. 

The health ministry’s main partner in this area of policy (if it is not within the Ministry of Health) is the ministry that is responsible for licensing regulation. The two ministries can undertake joint actions to review or introduce licensing regulation and to analyse how changes might affect levels of alcohol-related harm and public nuisance.

Other important partners are the government ministries and departments responsible for laws and regulations on alcohol sales, as well as the police departments or other enforcement agencies responsible for actual enforcement. Together they can discuss how to better monitor and implement enforcement.

In many countries some restrictions regarding availability of alcohol are delegated to local governments. Any changes at national level must secure good buy-in at the local level, especially if national standards are under consideration to replace local competencies. National governments can also support local governments in their attempts to restrict the physical availability of alcohol.

It is common to consult alcohol producers and retailers when changes in availability or enforcement are contemplated, although the record shows that in general the industry does not support measures to reduce the availability of retail alcohol. Consequently, it will be important to protect the policy formulation process from undue influence. Governments must also be cognizant that regulation of informal production and sale will increase revenues to major commercial producers and will move revenues outside of the local communities; such producers should not be involved in planning these regulations. Efforts to stimulate alternative sources of income should be considered – especially for persons involved in informal production and sale of alcohol.