Support for alcohol policy

Read about public perceptions about alcohol and cancer, about economic evidence that supports alcohol policy, and about indicators that measure success in reducing alcohol consumption

How does the public perceive this issue?

In 2017, 56 per cent of Canadians involved in a public survey indicated alcohol use is completely socially acceptable (in comparison to other substances such as tobacco and cannabis).1

In 2016, the Canadian Cancer Society conducted a public opinion survey related to alcohol and cancer risk in Ontario and Québec:2

  • In Ontario and Québec, only 28 and 30 per cent of the public, respectively, know that consuming alcohol can increase the risk of developing cancer.
  • Two-thirds of Ontarians and Quebecers said they would reduce their consumption of alcohol if they learned that drinking alcohol increases their risk of cancer.

What economic evidence exists in support of alcohol policy approaches?

Listed below are various cost-effective and cost-saving policy measures to reduce alcohol consumption:

  • Taxation of alcohol is found to be a cost-effective and cost-saving approach to reducing alcohol consumption and harm1
  • Minimum pricing of alcohol is found to be a cost-effective and cost-saving approach to reducing alcohol consumption and harm2
  • Complete bans on alcohol advertising are cost-effective and cost-saving. However, effectiveness and cost-effectiveness decrease dramatically with partial advertising bans3
  • Reducing hours and days of sale is found to be cost-effective and may reduce harms from alcohol4

How will we know we are making progress on alcohol policy?

Cancer Care Ontario’s Prevention System Quality Index1 includes examples of alcohol-policy indicators at the municipal or regional level, which include:

  • Minimum retail price of alcohol sold in off-premise alcohol outlets
  • Percent of privately-owned off-premise alcohol outlets
  • Alcohol outlet density, both on- and off-premise and the number of outlets per 10 000 population

Strategies to reduce alcohol-related harms and costs in Canada Policy Indicators2
Several academic institutions collaborated on the development of 10 alcohol policy dimensions and indicators for Canada. Policy indicators reflect a policy that has been mandated at the provincial (or territorial) level and is included in legislation or provincial (or territorial) regulations (e.g., a policy that restricts the location or number of retail outlets).

Policy indicators for alcohol pricing

  • Coverage of off-premise minimum prices
  • Level of off-premise minimum prices
  • Presence of off-premise minimum pricing loopholes
  • Price of common low cost, high alcohol products
  • Coverage of on-premise minimum prices
  • Level of on-premise minimum prices
  • Presence of off-premise minimum pricing loopholes
  • Price of common low cost, high alcohol products
  • Average price levels
  • Indexation (differences from alcohol price indexes and consumer price index)
  • Automatic indexation
  • Price bands
  • Pricing on alcohol content

Policy indicators for the alcohol control system

  • Proportion of off-premise outlets that are publicly owned
  • Alcohol sales beyond on-premise and off-premise outlets (e.g., online, delivery, ferment on premise/at home)
  • Ratio of spending on product promotion versus social responsibility messaging
  • Policy on dedicated prevention/social responsibility funds
  • # of mediums employed for social responsibility messaging
  • Ministries overseeing alcohol retail and control

Policy indicators for physical availability of alcohol

  • Regulations limiting on- and off-premise outlet density
  • Regulation of hours of operation
  • Limiting hours of operation to no more than 9 business hours per day and limited availability in early morning and late at night
  • Presence of exceptions and extensions for hours and days of sale

Policy indicators for drinking and driving

  • Comprehensive 3-year graduated licensing program for new drivers
  • Zero tolerance blood alcohol content level for drivers under 21 or with less than 5 years experience
  • 7-day Administrative License Suspension (ALS) and vehicle impoundment program
  • Parallel ALS and vehicle impoundment program for those who fail or refuse sobriety tests
  • Mandatory interlock program for all federal impaired driving offenders
  • Mandatory administrative forfeiture for drivers with >2 federal impaired driving violations within 10 years
  • Mandatory remedial program for federal impaired driving offenders, and for drivers with a repeat short term 90-day impairment related ALS within 5 years

Policy indicators for marketing and advertising of alcohol

  • Content restrictions beyond CRTC regulations
  • Placement restrictions
  • Quantity restrictions
  • Regulations restricting advertisement of price promotions
  • Specific authority responsible for enforcement of regulations
  • Presence of a formal complaint system
  • Strong or escalating consequences for violation
  • Presence of sponsorship policies

Policy indicators for legal drinking age

  • Legal drinking age
  • Legislation prohibiting sale or purchase of alcohol by minors
  • Policies pertaining to serving minors in a private residence of licensed area
  • Enforcement of legal drinking age in off-premise outlets
  • Enforcement of legal drinking age in on-premise outlets

Policy indicators for Screening, Brief Intervention and Referrals (SBIR)

  • Inclusion of SBIR in a provincial/territorial strategy or action plan
  • SBIR practice guidelines issued by professional association
  • Fee for service codes

Policy indicators for server training and Challenge & Refusal programs

  • Mandatory server and management training program for all licensed events and venues (on-premise)
  • Policy prohibiting sale of alcohol to someone who is intoxicated (on and off premise)
  • Comprehensiveness of challenge criteria (on and off premise)
  • Server training program based on face-to-face protocol (on and off premise)
  • Server training program requires periodic re-training (on premise)
  • Server training program based on evidence (on and off premise)
  • Server training program enforced (on and off premise)

Policy indicators for provincial alcohol strategy

  • Presence and focus of strategy (e.g., alcohol main focus versus under umbrella of a broader strategy on addictions and mental health)
  • Range of policy interventions within strategy

Policy indicators for alcohol warning labels and signs

  • Mandatory warning labels on alcohol products
  • Quality of warning label message(s)
  • Rotating warning label messages
  • Warning labels include graphics
  • Size and prominence of warning labels
  • Mandatory off-premise warning signs
  • Mandatory on-premise warning signs
  • Variation in warning sign messages (on and off premise)
  • Quality of warning sign messages (on and off premise)