Advancing alcohol research in low-income and middle-income countries: a global alcohol environment framework
Advancing alcohol research in low-income and middle-income countries: a global alcohol environment framework
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DOI：
10.1136/bmjgh-2019-001958
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发表时间：
2020-04-01
影响因子：
8.1
通讯作者：
London, Leslie
中科院分区：
文献类型：
--
作者：
Walls, Helen;Cook, Sarah;London, Leslie
近年来，与酒精相关的危害在高收入国家（HIC）越来越受到关注，加上政府监管，减少了酒精消费。酒类行业已将注意力转向低收入和中等收入国家（LMIC）市场，将其作为新的增长和利润来源，促进了LMIC消费的增加。低收入和中等收入国家的酒精使用量也在增加。特别是在中低收入国家，有必要了解行业战略在塑造当地饮酒环境方面的影响。我们借鉴概念化的食品系统的研究，并研究健康的商业决定因素，制定一个新的方法来制定酒精研究和讨论酒精研究的影响，特别是在中低收入国家，专注于南非作为一个说明性的例子。我们提出了一个概念化的“酒精环境”的酒精供应，收购和消费系统，包括，批判性地，行业广告和营销，随着政治，经济和监管背景下的酒精行业，调解人们的饮酒模式和行为。虽然每个国家和地区的酒精使用情况各不相同，但我们对比了中低收入国家和高收入国家酒精环境的几个明显不同的特征。提高对饮酒行为的全方位影响的认识，特别是在中低收入国家，对于制定干预措施和政策以促进更健康的环境和减少与酒精消费相关的危害至关重要。我们的框架进行酒精研究可用于结构混合方法实证研究，特别是在中低收入国家的酒精环境的作用。
Alcohol-related harm has gained increased attention in high-income countries (HICs) in recent years which, alongside government regulation, has effected a reduction in alcohol consumption. The alcohol industry has turned its attention to low-income and middle-income country (LMIC) markets as a new source of growth and profit, prompting increased consumption in LMICS. Alcohol use in LMICs is also increasing. There is a need to understand particularly in LMICs the impact of industry strategy in shaping local contexts of alcohol use. We draw on conceptualisations from food systems research, and research on the commercial determinants of health, to develop a new approach for framing alcohol research and discuss implications for alcohol research, particularly in LMICs, focusing on South Africa as an illustrative example. We propose a conceptualisation of the 'alcohol environment' as the system of alcohol provision, acquisition and consumption-including, critically, industry advertising and marketing-along with the political, economic and regulatory context of the alcohol industry that mediates people's alcohol drinking patterns and behaviours. While each country and region is different in terms of its context of alcohol use, we contrast several broadly distinct features of alcohol environments in LMICs and HICs. Improving understanding of the full spectrum of influences on drinking behaviour, particularly in LMICs, is vital to inform the design of interventions and policies to facilitate healthier environments and reduce the harms associated with alcohol consumption. Our framework for undertaking alcohol research may be used to structure mixed methods empirical research examining the role of the alcohol environment particularly in LMICs.