More nuance in liquor licence assessment beneficial for public health

Social Policy Research Centre

Localised data on alcohol-related harm and licensed outlets will help decisions on new liquor licences maintain a health focus, says UNSW alcohol policy researcher.

A new toolkit that provides data on alcohol-related harm and licenced premises helps new liquor licence applications be considered within their local health context, says Dr Claire Wilkinson from UNSW’s Social Policy Research Centre.

The toolkit, developed by NSW Health, connects local health district practitioners to information on alcohol-related violence and hospitalisations, and existing licenced venues and their trading hours. It also gives examples of conditions that can be placed on licensees to help reduce alcohol-related harm.

Dr Wilkinson, who was commissioned by NSW Health to evaluate the pilot program, found that facilitating easy access to these statistics, and promoting the use of conditions, helped practitioners make evidence-based decisions with a focus on health.

“The [evaluation] findings supported nuance [in assessing new applications]. There was this sense that for it be an effective public health intervention you needed to decline applications. However, placing a range of conditions on liquor licences also supports public health outcomes,” Dr Wilkinson says.

“[Alcohol] is a harmful commodity but it's one that’s very much embedded in our lives. So, thinking about how we can make it available in ways that don't promote excessive consumption [is important].”

Dr Wilkinson is an NHMRC Senior Research Fellow at the Drug Policy Modelling Program at UNSW. Her research focuses on public health and alcohol policy, drawing on current policy as well as historical perspectives.

The Drug Policy Modelling Program contributes valuable drug policy insights and interventions to better inform government responses to drug-related problems, such as alcohol-related harm.

While local health district practitioners are limited in what they can do to prevent alcohol-related harm – they cannot change the labels on beverages, increase the price or regulate bulk-buying, for example – the way alcohol is made available plays an important role, she says.

“There is a correlation between late opening hours and [the consumption of] products with a higher alcohol content, such as spirits, and alcohol-related harm,” she says.

Placing limits on trading hours and the types of alcohol sold can have a positive impact on public health while still supporting local business, she says.

Through interviews with local health district practitioners, her research identified barriers, challenges and future potential for using the licensing tool.

“The research played an important role in ensuring the toolkit was evidence-based and useful to local health district liquor licence responses,” says John Haydock from NSW Health. “It makes an important contribution to the prevention and minimisation of alcohol-related harms in local communities.”

The toolkit, piloted in four local health districts, has now been rolled out to all local health districts.

Navigating our changing relationship with alcohol with COVID

The toolkit’s introduction supports a positive change in practice around bricks and mortar sales, however the during the pandemic has introduced new challenges, Dr Wilkinson says.

Additionally, lockdowns reduced our access to other avenues of stress relief, such as socialisation and structured exercise in sport, group fitness and gyms.

Dr Wilkinson and Ms Stephanie Colbert, a PhD candidate from UNSW Medicine & Health, are conducting into the effect of the growing alcohol home delivery market.

“Regulation of online alcohol sales needs to be lifted to meet the same standards as bricks and mortar shops. It doesn’t make sense to have a two-tiered regulatory system, with some alcohol sales regulated less strictly than others,” Ms Colbert says.

Online sales, for example, do not currently have to comply with regulations around the responsible service of alcohol, age verification and restrictions on late-night takeaway alcohol.

This kind of “light” regulation increases the risk of alcohol-related harm, particularly for , with some Australian retailers found to be , Dr Wilkinson says.

“This is concerning given the well-established harms associated with alcohol consumption by underage youth, including an increased risk of damage to the developing brain and developing an alcohol use disorder in adulthood,” says Dr Wilkinson.

Perhaps surprisingly, for most people lockdown did not increase their alcohol consumption throughout 2020, she says. A third of people reported a decrease in their alcohol consumption during the pandemic and another third felt their consumption remained unchanged in a .

“It is a missed opportunity if we don’t look at what was going on for those people who decreased their consumption to help guide alcohol policy and practice,” she says.

Unique opportunity to improve government policy

Dr Wilkinson is also mapping international alcohol policy responses to the pandemic in consultation with researchers from the UK, Canada, Chile, Italy: “This is a unique – a real opportunity to share information about what’s going on in different areas of the world,” she says.

“We’re asking, are there sweet spots, or win-wins, where some of the restrictions implemented during COVID could be retained [for ongoing public health benefits] … [We’re asking how we can support] a night-time economy but perhaps having one that’s less associated with alcohol-related harm,” she says.

In Australia, for example, local restaurants and cafes were permitted to sell take-away alcohol – a change that proved very popular: “People enjoyed being able to show their support for local businesses,” she says.

Going forward governments may consider retaining this with some additional restrictions, such as requiring this to include the purchase of food to promote harm reduction, she says.

Contributing expert opinions through communities of practice gives state and territory governments greater context and invaluable insight as they consider tightening regulations around online alcohol availability, she says.

“There is very little research around such a new issue, so it’s important to provide evidence of the possible options for tightening restrictions and [identifying] what do we know about the effectiveness of those options,” she says.

“Pursuing better government policy, and asking how we can tinker with alcohol’s availability, can help us balance its benefits with its harms.”