Prioritising action on alcohol for health and developmentBMJ 2019; 367 doi: https://doi.org/10.1136/bmj.l6162 (Published 06 December 2019) Cite this as: BMJ 2019;367:l6162
All rapid responses
Rekve et al. identified the barriers of implementing alcohol-related policies and called for the wide implementation of effective policies and initiatives at global and national levels. Therefore, we suggest we could consider using 3I framework (institutions, interests, and ideas) to help and support the development and implementation of the policy or legislation.
First, in the aspect of institutions, we need to analyze the government structures, policy networks, and policy legacies. We think the policy legacies will play an important role. The past policies or legislations related to alcohol control, in one or more jurisdictions, will have the resource (or incentive) and interpretive effects on related actors (i.e. government elites, interests, and mass publics). Therefore, it is necessary to collect and analyze the past and current relevant policies or legislation and their effects on different actors at the local, national or global levels.
Second, in the aspect of interests, we need to focus on the involved interest groups and how they will act based on their interests. For this case, there are many interest groups, such as civil servants and officials of health and economics, family and community, the producers and retailers of alcohol, etc. We need to analyze the potential gains and losses of these relevant interest groups, which will influence how they will support or oppose the new policy.
Third, in the aspect of ideas, we need to focus on the research evidence and values. As Rekve et al. analyzed, there were supporting evidence about the benefits of alcohol control. However, we need more evidence about other outcomes, such as acceptability, equity, etc. More importantly, we should explore public’s or other stakeholders’ values, especially for the case, to identify why people using the alcohol inappropriately even with knowledge of harmful drinking, or why some authorities not adopting the effective policy that already being recommended in other jurisdictions.
Considering and combining the above aspects of the 3I framework, the new policy or legislation will be developed and implemented in a better way. In all, we think policymakers, researchers, public or other stakeholders should work together to develop the robust and feasible policies and initiatives to reduce the use of alcohol, and to further ensure their successful implementation.
Competing interests: No competing interests