Toward the Prevention of Alcohol Problems Government, Business, and Community Action (1984) / Chapter Skim
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INTRODUCTION
INTRODUCTION
Pages 1-10
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We began with the idea that public policy in a democracy is a very subtle concept. People often imagine that it is located in the official documents of legislatures and the speeches of chief elected officials, or that it lies in the mechanics of programs.
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We thought it important, then, to examine public policy instruments that might successfully handle this piece of the problem. These instruments had to have some rather special characteristics: they had to operate across a very large segment of the population, and they had to rest lightly.
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We scanned the possibilities for controlling these problems without overly constraining people's freedom of choice or preventing them from taking advantage of the benefits offered by alcohol.Our conclusion was that more attention needed to be given to the underemphasized area of prevention -- not individualized approaches such as early detection and intervention, designed to reach hidden alcoholics or prealcoholics, but nonpersonalized approaches that would operate broadly on drinking practices throughout the population or break typical links between drinking practices and adverse consequences. THREE ASPECTS OF PREVENTION We divided the general concept of prevention into three somewhat narrower ideas.
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FOCUSING ON PREVENTION EFFORTS Two major developments occurred between the last meeting of the panel that authored Alcohol and Public Policy, in May 1980, and the follow-up conference from which the present report derives, in May 1983. The first development began with the national election of 1980: in its aftermath a series of policy changes substantially affected relations between the federal and the state governments, markedly altering the role of the National Institute on Alcohol Abuse and Alcoholism (NIAAA)
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, compares alcohol abuse to the great public health challenges of the past, calling on Americans to mobilize and act in concert to further our traditional public health ideals. Illinois mental health commissioner Margaret Hastings reminds us that calls for community action are inherently competitive with other agendas; she notes the political obstacles that prevention interests must overcome, as well as the political assets they can wield.
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Chapter 5 comes to grips with the mass media, particularly the role of television programming and advertising in creating images and conveying information about alcohol use and its consequences. After reviewing the major scientific studies that bear on the relation of mass media to alcohol abuse, health educator Lawrence Wallack, in his lead paper, concludes that ethical values and logical principles must remain the major guides to coordinating action in this realm.
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Their periodic return during the discussions to the most general issues shows that it is difficult enough just to grasp fully the broad prevention strategy recommended in Alcohol and Public Policy. Although presented as a fairly simple idea, this strategy runs askew from nearly everything we have been thinking about alcohol problems for many years; we are all to some degree prisoners of persistent habits of thought, the power of which we only dimly perceive.
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POLITICS, POLICIES, AND PROGRAMS By politics, we mean the Aristotelian idea of trying to change people's minds about what a problem is and what can reasonably be done about it. To a certain extent, Alcohol and Public Policy is a part of politics: it has become a common discussion item, a touchstone that people can use to certify the legitimacy and complementarity of a broad band of possible preventive measures.
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PREVENTION POLICIES AND THE ALCOHOL BEVERAGE INDUSTRY One prominent issue in this field is the relationship between proposals for prevention policies and the position of the alcohol beverage industry. There is a strong temptation to see these interests as inevitably and diametrically opposed, to think that when prevention policies gain force, the alcohol beverage industry has to take losses.
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It is highly appropriate for the National Institute on Alcohol Abuse and Alcoholism to support and serve as a conduit of high-quality information about the success -- and failure, when that occurs -- of these experiments in prevention policy.
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