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Public health arguments for tighter restrictions on alcohol have a hard time gathering steam at state legislatures and with the general public, speakers lamented during last wk's annual Alcohol Law & Policy Conference presented by the Center for Alcohol Policy. Perhaps this lack of energy should come as no surprise in the wake of the Covid-19 pandemic, which simultaneously split public views of health agencies, experts, efforts and messaging and swept in some of the biggest shifts in state alcohol policy in some time. Yet comments weighing the relative weakness of public health in alcohol policy debates recurred throughout this yr's CAP event and other recent forums. Recall, CAP is non-profit org founded by NBWA. Its annual meeting is unique among industry and industry-adjacent events for its consistent inclusion of public health voices, which tend to be highly critical of industry activities. But there's long been a natural alignment between those advocating for stricter alcohol policies on the basis of public health and beer wholesalers advocating for strict adherence to 3-tier laws. At ALPC in Nashville last wk, folks in both camps expressed a notable frustration with a perceived lack of interest in and efficacy of public health arguments.Tracks Broader Political Energy Shift Compared to public health concerns, the relative strength of economic development claims predates Covid-19 and tracks a bigger political shift, one ALPC attendee observed from the audience. Public health advocates once found consistent allies among the religious right when working to tighten alc bev restrictions or to block attempts at loosening them. But these days, free market pleas seem much more appealing to legislators, pushing them the opposite direction. In a way, it represents one more existing trend accelerated (or division exacerbated) by the pandemic."Magic Words"; Even Effective Policies Can Fall To get a law passed in Indiana, it seems "all you have to do is say these two magic words, 'economic development,'" quipped Lisa Hutcheson, prevention & policy veep for Mental Health America of IN and director of the IN Coalition to Reduce Underage Drinking. "Convenience" casts a spell, too, she commented. The state's retail license quota system "gets busted every year at the legislative session" thanks to appeals for exceptions and exemptions, all in the name of economic growth. Exec director of Beer Wholesalers Assn of NJ, Michael Halfacre, told a similar story. In NJ, also a quota state, "liquor license reform" is just a "euphemism" used by real estate developers who "want to build a housing project or shopping center," but say they can't do it without a liquor license.Lisa also recounted the surprise passage and quick reversal of a "universal carding" policy in IN. In a "brief moment of nirvana," both public health advocates like her and industry advocates "all agreed" to a policy requiring retailers to ID everyone purchasing alcohol, regardless of how old they may look. And it was effective, she said, leading to a sharp decline in underage purchases (or attempted purchases). But then lawmakers "got tired of getting calls from grandma and grandpa," and changed the law back to requiring retail employees to only card adults who look younger than 40, not as effective, she claimed.The Feds & Health Messaging But state entities aren't the only ones seemingly downplaying public health interests these days. The report on competition in the US alc bev biz, published by the Treasury Dept early this yr, included plenty of discussion of policies like post-and-hold pricing, direct-to-consumer shipments and franchise protections. But "a lot of this is state level," NBWA gen counsel and sr veep Paul Pisano observed, calling the report a bit of a "head scratcher." It also barely touched commentary sent in by public health advocates, one of the report's many "missed opportunities," in Paul's view, as that's an area where the federal govt could take greater leadership.Then again, the day prior, TTB deputy administrator Dave Wulf faced a question about his focus on "economic development" instead of public health after making his usual comments about "facilitating and supporting" the industry's success. That's "something we're attuned to," Dave responded, but the TTB, at least, is "not really chartered as a public health entity." It is a Treasury Dept agency, after all.Mixed Research Messages & Raimee's Reminders The inclusion of public health voices by CAP also underscored some of the reasons why those voices are so often at odds with industry. A brief presentation from Cedars Sinai-based researcher Dr Yee Hui Yeo focused on recent peer-reviewed papers, including his own research into worrying increases in alcohol-related liver disease and mortality linked to alcohol use disorder during the pandemic (see May 10 issue). However, he also emphasized the same retail trends and 2020-2021 survey results that led media outlets to exaggerate total consumption increases. Alcohol consumption did increase, but not by anywhere close to 41% (the increase in heavy drinking days per month by women from 0.44 to 0.62, see AII from Oct 2, 2020), let alone 477% (the NielsenIQ-tracked increase in online alc bev sales from next-to-nothing before the pandemic to a small minority of off-premise retail sales, mostly driven by the pandemic shift to pick-up or delivery grocery purchases, compounded by closed on-premise outlets).By succinctly explaining the core public health perspective on policy-making, fellow panelist Raimee Eck of Sonrisa Solutions quickly revealed the fundamental divide with industry policy aims. While physicians focus on individuals, public health researchers take a "community perspective," thinking up policies to affect many people "all at once," she explained. They work to impact "not just the things you're doing personally, but the things you're exposed to&hellip;. We work at a systems level to make things at a very large population level better." That's what leads to policies targeting price, place and promotion, the sort that industry advocates may never support.

Public Health Woes and Weaknesses Weight at CAP; Magic Words, Mixed Messages

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