Science and alcohol policy: a case study of the EU Strategy on Alcohol (2011)

AIMS: To describe the extent to which the content of the European Commission's Communication on alcohol reflects public health-based scientific evidence. DESIGN: Document retrieval and content analysis. SETTING: European Union. PARTICIPANTS: Background documents leading up to the European Commission's Communication on alcohol, the Communication itself and implementation actions following the Communication. MEASUREMENTS: Documents were read and analyzed for evidence-based alcohol policy content. FINDINGS: Although the Communication acknowledges and supports existing interventions which have high evidence for effectiveness, such as enforcing blood alcohol concentration (BAC) limits for drivers, it extensively promotes other interventions which have been shown to be ineffective; for example, recommending education and persuasion strategies as a measure across all its five priority areas. Measures to influence price are mentioned only once in relation to sales in drinking venues limiting two-for-one drinks offers. Measures to control physical availability are mentioned infrequently. CONCLUSIONS: The Communication reflects the science, in that it acknowledges the significance of alcohol as a social and health determinant in Europe. However, it places more emphasis on policy actions with less evidence for effectiveness than on those with strong evidence. It also focuses its efforts more on mapping member state actions and coordinating knowledge exchange than on providing concrete recommendations for action or developing Europe-wide policy measures. This may be a compromise between the rights of Member States to develop national policy and legislation and the obligation of the European Union as a collaborative body to protect health. Furthermore, it has been suggested that the European Union's roots as a trading block emphasizes collaboration with industry stakeholders and this influences the ability to prioritize health over trade considerations.