Fitzgerald Niamh, Nicholls James, Winterbottom Jo, Katikireddi Srinivasa Vittal
Institute for Social Marketing, UK Centre for Tobacco and Alcohol Studies, Faculty of Health Sciences and Sport, University of Stirling, Stirling FK9 4LA, UK.
Alcohol Research UK, London SW1H 0HW, UK.
Int J Environ Res Public Health. 2017 Feb 23;14(3):221. doi: 10.3390/ijerph14030221.
The public health objective for alcohol premises licensing, established in Scotland in 2005, is unique globally. We explored how public health practitioners engaged with the licensing system following this change, and what helped or hindered their efforts. Semi-structured interviews were conducted with 13 public health actors, audio-recorded, and analysed using an inductive framework approach. Many interviewees viewed the new objective as synonymous with reducing population-level alcohol consumption; however, this view was not always shared by licensing actors, some of whom did not accept public health as a legitimate goal of licensing, or prioritised economic development instead. Some interviewees were surprised that the public health evidence they presented to licensing boards did not result in their hoped-for outcomes; they reported that licensing officials did not always understand or value health data or statistical evidence. While some tried to give "impartial" advice to licensing boards, this was not always easy; others were clear that their role was one of "winning hearts and minds" through relationship-building with licensing actors over time. Notwithstanding the introduction of the public health objective, there remain significant, and political, challenges in orienting local premises licensing boards towards decisions to reduce the availability of alcohol in Scotland.
2005年在苏格兰确立的酒精场所许可的公共卫生目标在全球范围内独一无二。我们探究了公共卫生从业者在这一变化之后如何与许可制度打交道，以及哪些因素促进或阻碍了他们的工作。我们对13名公共卫生相关人员进行了半结构化访谈，进行了录音，并采用归纳框架法进行分析。许多受访者认为新目标等同于降低人群层面的酒精消费量；然而，许可相关人员并不总是认同这一观点，其中一些人不认为公共卫生是许可的合理目标，或者将经济发展置于优先地位。一些受访者惊讶地发现，他们向许可委员会提供的公共卫生证据并未带来他们期望的结果；他们报告称，许可官员并不总是理解或重视健康数据或统计证据。虽然一些人试图向许可委员会提供“公正”的建议，但这并非总是易事；另一些人明确表示，他们的角色是通过与许可相关人员建立长期关系来“赢得人心”。尽管引入了公共卫生目标，但要让苏格兰当地的场所许可委员会做出减少酒精供应的决定，仍然存在重大的政治挑战。
