Building effective policies to reducing non-communicable disease: The relevance of the alcohol experience for curtailing unhealthy diets, physical inactivity and tobacco use

Background: Non-communicable diseases (NCD) comprise half of the overall global disease burden. Four proximal risk factors – alcohol use, tobacco use, physical inactivity, and unhealthy diet intake – account for a significant fraction of this disease burden. There are many parallels in policymaking on these risk factors, but the literatures on them have been largely separate. This presentation contributes thinking on the cross-over potential with regard to these risk factors, by examining how the alcohol experience – promotion or erosion of controls – can inform initiatives to control the other three risk factors. Methods: The authors reviewed over 50 papers published since 2000, including those that compared policy and prevention experiences involving at least two of the four risk factors. Results: Price, controls on physical availability, type of retailing system and controls on marketing and promotion are relevant to all four risk factors, although they have not been widely implemented to curtail physical inactivity or promote healthy diets. Other interventions such as prohibitions on selling to minors, server training and offering brief interventions for those at higher risk are more relevant to alcohol and tobacco. For tobacco, policies on outlet availability are under-developed, and government retailing of tobacco seldom used. Conclusions: NCD prevention will benefit from cross-referencing and comparison between risk factors of findings on the most effective policies and interventions – considering scope of impact and cost to implement. The alcohol experience provides insights, as well as cautions.