When dealing with complex public health issues such as alcohol, a multi-sectoral approach is needed. "Health in All Policies" is a strategy that calls on all government sectors and their partners to work together in establishing healthy public policies to foster healthy communities. A healthy community is one in which health equals a rewarding job with a living wage, food on the table and a place to call home, a good start in life, safe and environmentally friendly neighbourhoods, available options and opportunities for personal health, leisure time, learning, and community belonging.9
When weighing the costs and benefits of alcohol policies, decision makers and community members require factual and balanced information. The research is clear in this area, and outlines a number of policies that are effective in reducing consumption and alcohol related harm in the population.29 Giesbrecht and colleagues (2011) recommend a two-tiered response - first focusing on population level approaches and then targeting priority populations. The authors stress that "without effective action on the first tier, attempts to control the damage and costs from alcohol through second-tier interventions will, at best, be modestly effective."83
Table: Two-tiered response for reducing consumption and alcohol related harm
First Tier-- Population Level
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Second Tier-- Targeted Interventions
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Effective alcohol pricing
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Drinking and driving legislation
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Controlling physical availability
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Changing the context of drinking
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Curtailing alcohol marketing |
education and persuasion strategies |
Maintaining alcohol control systems |
Increased access to brief interventions |
To move forward in reducing the burden of alcohol all levels of government are required. Specifically the following actions are needed:
Federal government:
- Recognize that alcohol is the drug of choice for the majority of Canadians.
- Provide funding and support for the National Alcohol Strategy.84
Provincial government:
- Conduct a formal review and impact analysis of the health and economic effects of alcohol in Ontario.
- Support the development of a Provincial Alcohol Strategy for Ontario.
Municipal government:
The following summary provides an overview of local alcohol policy interventions and includes suggestions for moving forward at the local level.
Regulating physical availability
Policy strategies:
- Limit alcohol density.
- Confine hours of service.
- Limit alcohol allowed public events.
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- Strengthen local zoning regulations to avoid density and congestion.
- Evaluate license applications based on potential community impact (e.g. size of venue, number of patrons).
- Evaluate license application process considering health and safety decisions.
- Provide resolutions to the provincial government on alcohol availability concerns.
- Offer alcohol-free entertainment, recreation, and social events.
- Conduct impact study for all pending decisions and new applications.
- Maintain 2 a.m venue closures and consider earlier weekday closures.
- Review, strengthen, promote, and enforce the municipal alcohol policy.
- Advocate for stricter controls on the sale of large volume containers e.g. beer kegs.
- Advocate for the authority to restrict or ban alcohol delivery services within the municipality.
- Studies show a positive association between alcohol outlet density and alcohol-related problems.58,85 The over concentration of bars, restaurants, and off-premise establishments in certain areas of the city leads to neighbourhoods where alcohol-related problems such as public intoxication and assault can flourish and where quality of life becomes a concern. Limiting alcohol outlet density through the use of regulatory authority (e.g. licensing and zoning) is an evidence-informed policy consideration at the local level. 29
- In 2006, Kingston City Council advocated for changes to the Liquor License Act to curb the sale of large quantities of alcoholic beverages such as beer kegs, and encouraged other municipalities to also act.86 To date no changes have been made and individuals are still able to obtain multiple kegs at one time. One keg of beer is the equivalent of 7 cases of beer or 168 standard drinks.
Controlling affordability
Policy strategies:
- Appeal to provincial government.
- Appeal to federal government.
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- Maintain present government control on the sale of alcoholic beverages.
- Work with communities and government to implement minimum pricing laws, volumetric mark-ups, and impose penalties for drink discounting violations.
- Appeal for government to index alcohol prices to cost of living.
- Keep at or above the consumer price index.
- Work with government to introduce price incentives for lower-strength alcohol and disincentives for higher- strength alcohol.
- Direct revenues from alcohol to fund alcohol research and evidence-based programming
- While Ontario mandates minimum retail prices for different categories of alcohol, Saskatchewan is the only has implemented minimum pricing linked to the amount of pure alcohol in each product.
- By increasing the price of high alcohol content products, Saskatchewan saw a 12.6% decline in the sale of these products and a corresponding decrease in police calls for public intoxication.87
- In addition to a decline in alcohol consumption of 135,000 litres of absolute alcohol, Saskatchewan saw a revenue increase of $9.4 million in the year following the pricing changes88, 89

Restrictions on marketing
- Pursue local regulations.
- Support counter-advertising.
- Appeal for healthier alcohol advertising policies and practices.
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- Strengthen local restrictions on alcohol advertising such as imposing constraints on number, location, size, and content of ads.
- Apply sponsorship restrictions to civic events.
- Discourage venues from advertising and conducting "happy hour" sales.
- File advertising concerns and complaints to Advertising Standards Canada and advocate for new standards.
- Mobilize communities to build support for healthier alcohol advertising practices.
- Alcohol promotion is a global industry that utilizes many forms of media including television, radio, print, point- of-sale promotions, and the Internet to market their brands.
- Repeated exposure to high-level alcohol promotion leads to pro-drinking attitudes and increases the likelihood of heavier drinking.90
- Both youth and younger children are predisposed to drinking well before they are of legal age.
- Despite industry guidelines, alcohol advertising has been found to promote and reinforce perceptions of drinking as positive, glamorous, and relatively risk-free.91
- In Canada alcohol promotion and advertising is regulated by the Canadian Radio and Television Communications (CRTC). Up until 1997 the CRTC approved all alcohol ads through a system of "pre-screening". This was replaced by an industry "code of conduct", and pre- screening was turned over to Advertising Standards Canada (ASC), an industry trade group. In Ontario, the pre-approval of advertising by the Alcohol & Gaming Commission of Ontario (AGCO) continued until August 2002. Although removal of advertising pre-approval may have had financial and business merit, the rampant promotion of alcohol and messaging often targeted at youth demonstrates that self-regulation does not work.91
Modify the drinking context
Policy strategies:
- Regulate special occasion events.
- Improve conditions of on-premise alcohol outlets.
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- Regulate, manage, and evaluate public special-occasion events.
- Monitor changes to the Liquor Licence Act and consider potential health and safety impact on municipal events.
- Review, strengthen, promote, and enforce the municipal alcohol policy.
- Enact responsible beverage service training and in-house bar policies.
- Mandate Safer Bars training as part of licensing to reduce alcohol-related problems and violence in licensed establishments and bars.
- Provide inspectors and police with data on problem areas and assist with targeted policing initiatives.
- Bars, licensed restaurants, and special occasion events are places where people gather to socialize in our communities. Unfortunately, they are also places where excessive drinking and drunkenness can occur, increasing the risk for fights, sexual harassment and assault, vandalism, and impaired driving.63, 92
- Training programs on alcohol law and liability, and violence prevention, are available to help bar staff address these issues, and many local licensed establishments have voluntarily participated in this training.
- The Alcohol & Gaming Commission of Ontario (AGCO) instituted "Risk Based Licensing" which categorizes licensed premises according to their location, history, past infractions, etc. In some cases, conditions may be imposed on the license.93
- Municipalities can play a key role in ensuring safe licensed premises by mandating Safer Bars training as a condition of license, especially for those licensees who pose a greater risk to public safety or are not compliant with the law.94
Drinking-driving Prevention and Countermeasures
Policy strategies:
- Enhance enforcement.
- Shape public attitudes.
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- Increase enforcement activities (e.g. patrols, sobriety checkpoints). Educate public on legislation, penalties, fines, etc.
- Encourage the reporting of suspected impaired drivers to the police through Operation Lookout and
- Call 911 messaging.
- Advocate for lower Blood Alcohol Concentration (BAC) levels.
- Plan and promote safe transport to and from venues.
- Encourage screening, brief interventions, and remedial skill support for people with existing impaired driving charges.
- Promote media campaigns challenging the norms of impaired driving.
- Mobilize venues to teach staff the danger and unacceptability of drunk driving.
Education and Awareness on Reducing Alcohol-Related Harm
Policy strategies:
- Drive media-based initiatives.
- Target colleges and universities.
- Build support for comprehensive, coordinated and health oriented strategies.
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- Educate the public on alcohol use dangers, consequences, norms, myths, offered services, and misunderstandings.
- Challenge the norms of alcohol use and misuse with media campaigns.
- Utilize current health behaviour models and communication theories to shape campaigns . Utilize multiple mediums in education strategies.
- Include range of stakeholder representation in campaign planning and participation. Enhance role of public health specialists in alcohol policy deliberations.
- Educate political systems about evidence of damage and costs from alcohol.
- Facilitate the development of a comprehensive alcohol strategy for the City of Kingston. Advocate for the development of a provincial alcohol strategy.
- Advocate for the development of a provincial alcohol strategy.
Treatment and Brief Intervention
Policy strategies
- Improve services.
- Appeal to provincial government.
- Appeal to federal government.
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- Support local addiction services in efforts to improve treatment referral system within municipalities.
- Increase capacity for screening and brief interventions.
- Increase promotion of on-line brief intervention services.
- Implement a workplace alcohol policy for civic officials and staff.
- Encourage local businesses and industries to adopt comparable policies.
- Encourage local colleges and universities to adopt comparable policies.
Adapted and reprinted with permission from: Centre for Addiction and Mental Health and Public Health Ontario. July 2012. Draft: Tools for supporting local action to reduce alcohol-related harms. Policy options and a resource inventory to support alcohol policy in Ontario. Toronto; ON95