Editors' Introduction International Perspectives on Alcohol Policy Effect Studies, Policy Opinion, and Policy Formation

In recent decades there have been dramatic international changes in alcohol policy initiatives, access to alcohol, level of consumption, drinking patterns, and damage associated with alcohol consumption. A number of studies have shown strong associations among drinking levels, drinking patterns and the physical harms and social problems derived from the effects of alcohol (e.g., Babor, Caetano, Casswell, Edwards, Giesbrecht, Graham, et al. 2003; Edwards, Anderson, Babor, Casswell, Ferrence, Giesbrecht et al. 1994; Rehm, Chisholm, Room & Lopez 2006). Concurrently, evaluations and reviews of alcohol policies and other interventions demonstrate that some prevention strategies are more effective than others in reducing alcohol-related harms (Babor et al. 2003). However, recent changes in many jurisdictions have effectively increased access to alcohol, suggesting that drinking rates and levels of damage may increase in the future (e.g., WHO 2007). While research has documented the substantial damage from alcohol (Rehm et al. 2006; WHO 2002) and pointed to effective interventions, some of the most effective policy levers have been eroded in recent years (Room, Babor & Rehm 2005). Thus it is expected that alcohol-related social and health harms will increase, particularly in jurisdictions where controls on alcohol are eroded or underdeveloped, where a large portion of drinking occasions involve high-volume consumption and/or where overall alcohol consumption rates are on the rise.The articles in this issue and its companion issue (Volume 34, No. 3) are based on some of the research papers presented at a thematic symposium of the Kettil Bruun Society for Social and Epidemiological Research on Alcohol (KBS), which was held in Toronto, Canada, in October 2006. The title of the symposium was "Population Level Studies of Alcohol Consumption and Harm. " It offered an opportunity to provide an update on recent and ongoing international studies of alcohol consumption and damage and to examine their implications and impact, if any, on the policy process or outcomes. Of particular interest were international and national studies that examined population-level studies of changes in alcohol management and access to alcohol, alcohol control systems, drinking patterns and levels, and damage associated with alcohol use.As illustrated in this issue and its companion issue, articles were presented from several Latin American countries, two European jurisdictions, Canada, and the United States. The ten articles in this edition are organized into two groups: the first four are policy-effect studies and the next six focus on themes of policy opinion and policy formation and implementation. In the companion issue the focus is on population surveys and epidemiological studies.Salme Ahlstrom and Petri Huhtanen (2007) use a combination of archival data (minimum legal purchasing age or MLDA) and cross-sectional self-reported data from 30 countries that participated in the 2003 European School Survey Project on Alcohol and Other Drugs (ESPAD). The authors examine the perceived availability of alcoholic beverages, reported purchasing habits, and prevalence of drinking and intoxication. Perceived good availability of wine and spirits was associated with the probability of purchasing and drinking wine and spirits; however, perceived availability was not associated with prevalence of self-reported intoxication.Martin Stafstrom (2007) uses two cross-sectional student surveys conducted in southern Sweden in 2003 and 2005 to examine the drinking patterns of adolescents. Between the two surveys he found an increase of 31% in the proportion reporting that they often or always consumed imported alcohol, but a significant decrease in binge drinking. In recent years an increase in access to alcohol, particularly in southern Sweden-brought about by a dramatic elevation in import upper limits from the late 1990s and increased transportation access to cheaper alcohol in Denmark and Germany-appears to have contributed to changes in beverage choices among adolescents in southern Sweden, but not necessarily to an increase in binge drinking. …