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Local Government Alcohol Policy: Community Sentiment and the Policy Development Process

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Local Government Alcohol Policy: Community Sentiment and the Policy Development Process Local Government Alcohol Policy: Community Sentiment and the Policy Development Process Brett A. Maclennan A thesis submitted for the degree of Doctor of Philosophy at the University of Otago, Dunedin, New Zealand May 2010 Abstract Hazardous drinking is a major public health concern in New Zealand. In general, policy interventions that restrict the availability and promotion of alcohol are the most effective strategies for reducing alcohol consumption and related harm. Against this backdrop of empirical evidence, in recent decades central government has liberalised alcohol availability and promotion in New Zealand. Communities therefore have to rely on local government to manage alcohol-related problems. The Local Government Act (2002) stated the purpose of local government as facilitating public decision-making and promoting the well-being of communities. Communities are faced with a conundrum: public opinion should theoretically play an important role in the policy development process but local government’s scope for action is restricted by legislation and limited resources. The aims of this research were to measure public sentiment toward local government alcohol policies, identify factors associated with support for alcohol controls, examine the consistency between public sentiment and local government alcohol policies, and to investigate the alcohol policy development process. Six local government areas were selected as study sites: North Shore City, Hamilton City, Palmerston North City, Wellington City, the Selwyn District and Dunedin City. A seventh area (Alexandra) was selected as a pilot community in which methods and instruments were tested. Community sentiment toward local government alcohol policies was assessed using a postal questionnaire sent to residents randomly selected from the electoral roll in each study area (Overall N = 1372, response: 59%). Overall, support for local government restrictions on alcohol availability and promotion was fairly high (e.g., 80% supported restrictions on opening hours of on-license premises). Support varied significantly by study area (greater in Dunedin, Palmerston North and Hamilton; weaker in Alexandra, Selwyn District and North Shore) and by a number of demographic and personal factors. For example, residents experiencing a greater range of adverse effects (e.g., being woken at night, seeing vomit on footpaths) tended to be more supportive of alcohol controls. Those who believed greater alcohol availability leads to more problems, and that alcohol controls are effective in reducing problems, also tended to be more supportive of controls. The level of consistency between public opinion and local government policy varied across the seven local government areas, as did the total number of policies and strategies ii employed to manage alcohol-related problems. Detailed case studies in three local government areas suggested possible reasons for this variation, including the process by which issues are put on the policy agenda, the views and political mix of local politicians, and the ability of politicians and local government departments to reach a compromise on a plan of action. Given the Law Commission “once in a generation” review of the regulation of alcohol in New Zealand and the current government’s proposed legislated agenda, these findings are particularly timely. The communities in this study were not supportive of the prevailing liberal alcohol environment and local governments in these areas have public support for restricting the availability and promotion of alcohol. Their ability to do this would be facilitated by more supportive and enabling central government legislation. iii Acknowledgements I am extremely grateful to my supervisors, Dr. Kyp Kypri, Prof. John Langley and Prof. Robin Room for their guidance, encouragement and support throughout this project. I am very grateful also to Andrew Gray, who supplied study samples from the electoral roll, taught me how to use Stata, and provided valuable statistical advice. I would like to thank the staff of the Injury Prevention Research Unit for their support over the years, in particular Dianne Casey, Sue Walker and Linda Holman for their administrative support. A special thank you to past and present students of the Department of Preventive and Social Medicine for their friendship and encouragement during this time (Simon Horsburgh, Rebbecca Lilley, Selwyn McCracken, Melissa Purnell, Louise Marsh, Helen Harcombe and Kim Cousins to name but a few). Thanks also to my other friends for their support and generosity. I am grateful for the opportunity to undertake doctoral research full-time, afforded me by an Accident Compensation Corporation PhD Career Development Award, administered by the Health Research Council. I am grateful also to the Alcohol Advisory Council, the Canadian Social Sciences and Humanities Research Council and the Injury Prevention Research Unit for providing me with funds to present my work at national and international conferences. Feedback received from these presentations was extremely useful and helped shape my thesis research. I thank them for their generosity. To the 1300 residents and 18 key informants and who gave their time to participate in this research, I give special thanks. Finally, but certainly not least, thanks to Kerri and to my family for the immeasurable support, tolerance and generosity that has enabled me to complete this thesis. Graduation dinner is my shout. iv Table of Contents Abstract...................................................................................................................................ii Acknowledgements ...............................................................................................................iv Table of Contents....................................................................................................................v List of Tables.........................................................................................................................xi List of Figures......................................................................................................................xiv List of Abbreviations...........................................................................................................xvi PART I...................................................................................................................................1 CHAPTER 1 : Alcohol in New Zealand: Patterns of Consumption and Adverse Consequences ............................................................................................. 2 1.1. The Public Health Significance of Hazardous Drinking ......................................3 1.1.1. Patterns of alcohol consumption............................................................................ 3 1.1.2. Chronic health effects of alcohol consumption...................................................... 4 1.1.3. Adverse outcomes of alcohol consumption........................................................... 4 1.1.4. Social effects of alcohol consumption................................................................... 5 1.1.5. Economic effects of alcohol consumption............................................................. 5 1.1.6. Benefits of alcohol consumption ........................................................................... 6 1.2. Alcohol Consumption in New Zealand ................................................................ 7 1.2.1 Patterns of drinking................................................................................................ 9 1.2.2 Demographic differences in alcohol consumption and drinking patterns............ 11 1.2.3 Location of consumption..................................................................................... 14 1.2.4 New Zealand in an international context............................................................. 15 1.3. Alcohol-Related Harm in New Zealand.............................................................16 1.4. Summary............................................................................................................. 21 CHAPTER 2 : Reducing Alcohol-Related Harm in New Zealand: Strategies and the Role of Local Government......................................................................22 2.1 Strategies to Reduce Alcohol Consumption and Related Harm.........................22 2.1.1 Education and persuasion strategies.................................................................... 25 2.1.2 Brief interventions............................................................................................... 28 2.1.3 Treatment strategies............................................................................................. 29 2.1.4 Reducing the economic availability of alcohol.................................................... 29 2.1.5 Reducing the physical availability of alcohol...................................................... 32 2.1.6 Regulating the drinking environment .................................................................. 36 2.1.7 Controls on advertising and promotion................................................................ 38 2.1.8 Drink-driving countermeasures ........................................................................... 40 v 2.1.9 Summary of strategy effectiveness...................................................................... 40 2.1.10 Best practice strategies........................................................................................
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