Work carried out: University of Stirling, Stirling, FK9 4LA
Funding: Funding was provided by Lanarkshire Alcohol and Drug Partnership and NHS Health Scotland.
The authors declare no conflicts of interest.
Clinical trial reg:
Abstract: Aims: This study aimed to explore how public health actors have attempted to influence local alcohol licensing policies and decisions in Scotland to ensure that the licensing objective of ‘protecting and improving public health’ is met and to identify the factors which have been important in their experiences for helping or hindering their efforts.
Design, Setting, Participants, Measurements: Semi-structured telephone interviews (averaging 69 minutes) were conducted with 13 individuals, covering 20 of the 40 Scottish licensing boards, who had recent and in-depth experience of trying to influence local licensing policy and decisions. Interviews were audio-recorded and analysed using an inductive framework approach.
Results: The process of influencing licensing policy and decisions was one which required intensive effort and a wide range of strategies including developing expertise, working in alliances across the public sector and with licensing actors, raising awareness of others, building relationships over time and using a variety of sources of evidence including public opinion. Important factors which helped and/or hindered their efforts included aspects and perceived deficits of the licensing system in terms of both law and tradition; the influence exerted by individuals with particular views; perceptions of bias or conflicted interests on all sides; differing levels of expertise and understanding among all involved; attitudes to alcohol, licensing and evidence; capacity and resources, and the complexities of gathering data.
Conclusions: This qualitative study has uncovered the mechanisms and challenges of influencing alcohol licensing towards public health, including issues of relationships, beliefs, power and bias. It suggests that the introduction of a public health objective to the licensing process does not guarantee that the objective will be understood, operationalised or achieved by the relevant authorities and that guidance and support is needed at both national and local level, including through further legislation.