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www.ccsa.ca • www.cclt.ca

Canadian Alcohol Control Policy

International Seminar on Promoting Healthy Living:

Multi-sectoral Efforts in the AmericasGerald ThomasNovember, 2013

www.ccsa.ca • www.cclt.ca 2

Agenda

• About the Canadian Centre on Substance Abuse

• Levels and patterns of alcohol use in Canada

• Structure of alcohol control policy

• Examples of multi-sectoral collaboration:

– National Alcohol Strategy Working Group

– National Alcohol Strategy (2007)

– National Alcohol Strategy Advisory Committee (NASAC)

– A national research collaboration

• Opportunities and challenges of multi-sectoral collaboration


About CCSA

• Vision: All Canadians should live in a healthy society, free of alcohol and drugs-related harm

• Mandate and mission: Legislated mandate from the Government of Canada to provide national leadership and evidence-informed analysis and advice to mobilize collaborative efforts to reduce alcohol- and other drug-related harm

• Pan-Canadian and international role


Strategic focus

• Shared responsibility and accountability• 500 partners, 2100+ stakeholders• Community outreach

Partnerships

• Foster a knowledge translation environment• Knowledge exchange framework

Knowledge Exchange

• Monitoring and surveillance• Research in the substance abuse field• Policy development • International alcohol and drug policy activities

Research and Policy

• Performance measurement and evaluation• Communications best practices

Organizational Excellence and

Innovation


Context of CCSA’s work

• Working with all levels of government, and the non-profit and private sectors, CCSA and Health Canada led development of the first pan-Canadian framework on substance abuse in 2005.

• Includes 13 priority areas including reducing alcohol-related harm and costs.


National substance abuse resources

• The National Framework has generated several national strategies and guidelines all developed through multi-sectoral, collaborative processes:

– a national alcohol strategy– a national treatment strategy– a national youth drug prevention

strategy– national workforce competencies– a national prescription drug misuse

strategy


About Canada

• Population: 35M (3M less than California!)

• Land Area: 9.98M km2 (second largest in world overall with the world’s longest coastline)

• Life expectancy: 81 years

• Languages: English - 56.9% French - 21.3% Other - 21.8%

• GDP/capita: $52,219 (US)


Levels & patterns of alcohol use

Canada

S.A. (

avg.)

Arg

entina

Boliv

ia

Bra

zil

Chile

Colo

mbia

Ecu

ador

Guaya

na

Para

guay P

eru

Surinam

e

Uru

guay

Venezu

ela02468

101214

Consumption in litres of ethyl alcohol per capita age 15+

recorded unrecorded

Source: World Health Organization Global Status Report on Alcohol, 2011.

Note: 9.77 litres of ethyl alcohol equals 573 Canadian standard drinks per person age 15+ per year.


Levels & patterns (cont.)

Canada

C.A. (

avg.)

Beliz

e

Cost

a Rica

El S

alvador

Guate

mala

Hondura

s

Nica

ragua

Panam

a02468

101214


recorded unrecorded




Canada

Europe (a

vg.)

Belg

ium

Denm

ark

Fin

land

Fra

nce

Germ

any

Gre

ece

Irela

nd It

aly

Luxe

mbourg

Neth

erlands

Norw

ay

Portu

gal

Spain

Sweden

Switz

erland

0

4

8

12


recorded unrecorded




Canada

Aust

ralia

Japan

Mexic

o

New Z

ealand

Russ

ia

South

Afri

ca

South

Kore

a

Unite

d Kin

gdom

Unite

d Sta

tes

0

5

10

15


recorded unrecorded



Recent trends in alcohol use

• Sales increased 13% since 1997.

• Beer is the dominant beverage although wine is increasing in popularity over time.

19971999

20012003

20052007

20092011

0.01.02.03.04.05.06.07.08.09.0

Total

SpiritsWine

Beer

Recorded sales, Litres of ethyl alcohol per capita age 15+, Canada

Source: Statistics Canada, Table 183-0019, Volume of sales of alcoholic beverages in litres of absolute alcohol and per capita 15 years and over, fiscal years ended March 31.


Trends (cont.)

Males (5+) Females (5+) Females (corrected for 4+)

0

5

10

15

20

25

3024.5

8.8

13.2

26.8

11.4

17.1

Proportion of past-year drinkers age 12+ reporting monthly or more often risky drinking, Canada

2003 2005 2007 2008 2009 2010 2011

Source: Statistics Canada, Canadian Community Health Survey (CCHS).


Structure of alcohol control policy

• Authority for alcohol control policies is mainly located at the provincial and territorial level (exceptions: federal excise taxes and criminal drinking and driving laws).

• All provinces and territories maintain government control of wholesale alcohol sales, and in all but Alberta government liquor authorities are the dominant retailers through government owned and operated liquor stores.


Policy structure (cont.)

• Provincial liquor authorities report mainly to ministries of finance:

BC AB SK MB ON

Ministry of Justice

Ministry of Finance

Independent crown corporation

Ministry of Finance

Ministry of Finance

QC NB NS PEI NL

Ministry of Finance

Ministry of Finance

Ministry of Finance

Ministry of Innovation & Advanced Learning

Ministry of Finance



• Most P/T jurisdictions use a “mixed model” for retail distribution of alcohol

BC AB SK MB ON

Mixed public private system

Wholly privatized




QC NB NS PEI NL


Exclusive government monopoly


Exclusive government monopoly




• In most jurisdictions, direct alcohol-related costs exceeded direct revenue from alcohol in 2002.

Per capita alcohol-related deficit (red) /surplus (blue)

BC AB SK MB ON

$17.83 $48.97 $20.40 $12.86 $37.82

QC NB NS PEI NL

$53.15 $55.57 $18.53 $26.99 $17.63


Examples of multi-sectoral collaboration

• National Alcohol Strategy Working Group (NASWG, 2005-2007) and the National Alcohol Strategy (NAS, 2007)

• National Alcohol Strategy Advisory Committee (NASAC, 2007 – present)

• Pan-Canadian research collaboration (2013): – Strategies to Reduce Alcohol-Related Harms and

Costs in Canada: A Comparison of Provincial Policies


NASWG & the NAS

• Chaired by CCSA (NGO), Alberta Alcohol and Drug Abuse Commission (AADAC), and Health Canada (federal gov’t).

• Included representatives from liquor authorities, public health, academics, hospitality industry, NGO’s, alcohol industry (beer, wine and spirits), federal government, provincial governments.

• Commissioned five original research papers on several topics including alcohol & chronic disease, and brief interventions.

• Major output: Reducing Alcohol-related Harm in Canada: Creating a Culture of Moderation; Recommendations for a National Alcohol Strategy (2007)


Canada’s National Alcohol Strategy (NAS)

• 41 recommendations

• Canada’s Low-Risk Alcohol Drinking Guidelines (national consensus)

• Alcohol price policy reports on CCSA website:

• http://www.ccsa.ca/Eng/Priorities/Alcohol/Alcohol-pricing-in-Canada/Pages/default.aspx

• Screening, Brief Intervention and Referral protocol (online tool)

http://www.ccsa.ca/Eng/Priorities/Alcohol/Alcohol-pricing-in-Canada/Pages/default.aspx




National Alcohol Strategy Advisory Committee (NASAC)

• Created in 2007 to oversee the implementation of the National Alcohol Strategy.

• Chaired by CCSA, the Nova Scotia Department of Health and Wellness and MADD Canada.

• Members include representatives from federal government (PHAC, HC), provincial governments, provincial liquor authorities, alcohol industry, academic researchers, NGO’s, university administrators, etc.

• Meet annually for progress reports, priority setting, and project planning.


NASAC (cont.)

• On the horizon for the NASAC:

– Standard drink labelling

– Campus alcohol policies

– Municipal alcohol policies

– Server training and enforcement


Collaborative alcohol policy research

• Project funded by the Canadian Institutes for Health Research (CIHR)

• Project team included researchers from CAMH (Toronto), several Canadian universities, one US university, and “knowledge users” from MADD Canada and two provincial governments

• Involved close and on-going collaboration with provincial governments including retail liquor authorities and liquor regulators


Results of CIHR project

• Ten provinces rated on 10 evidence-based policy domains:


Challenges & opportunities of multi-sectoral collaboration on alcohol

• Differing perspective and viewpoints can at times make consensus challenging to achieve

• Some topics (e.g., alcohol pricing) are more controversial than others

• Cross-sectoral consensus decision making leads naturally to “win-win” policies (e.g., minimum social reference pricing)

• Once recommendations are agreed to, then all are theoretically “on board” and can be held to the decisions


Opportunities & challenges (cont.)

• Consensus recommendations are now informing provincial level policymaking with items that have been through the multi-sectoral “sausage grinder”

• Identifying and securing resources for implementation of recommendations and projects is an ongoing challenge


Contact information

Gerald Thomas

Canadian Centre on Substance Abuse

75 Albert Street, Suite 500

Ottawa, ON K1P 5E7,

Canada

Tel.: 613-235-4048

Cell: 250-317-2615

[email protected]

[email protected]

@CCSAcanada • @CCLTcanada

mailto:[email protected]

mailto:[email protected]

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