Effective alcohol policies and lifetime abstinence: An analysis of the International Alcohol Control policy index

June Leung, Sally Casswell, Karl Parker, Taisia Huckle, Jose Romeo, Thomas Graydon-Guy, Karimu Byron, Sarah Callinan, Surasak Chaiyasong, Ross Gordon, Nadine Harker, Anne Marie MacKintosh, Petra Meier, Guillermo Paraje, Charles D. Parry, Cuong Pham, Petal Petersen Williams, Stephen Randerson, Karen Schelleman-Offermans, Gantuya SengeePerihan Torun, Wim van Dalen

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Introduction: Alcohol abstinence remains common among adults globally, although low and middle-income countries are experiencing declines in abstention. The effect of alcohol policies on lifetime abstinence is poorly understood. The International Alcohol Control (IAC) policy index was developed to benchmark and monitor the uptake of effective alcohol policies and has shown strong associations with alcohol per capita consumption and drinking patterns. Uniquely, the index incorporates both policy ‘stringency’ and ‘impact’, reflecting policy implementation and enforcement, across effective policies. Here we assessed the association of the IAC policy index with lifetime abstinence in a diverse sample of jurisdictions. Methods: We conducted a cross-sectional analysis of the relationship between the IAC policy index score, and its components, and lifetime abstinence among adults (15+ years) in 13 high and middle-income jurisdictions. We examined the correlations for each component of the index and stringency and impact separately. Results: Overall, the total IAC policy index scores were positively correlated with lifetime abstinence (r = 0.76), as were both the stringency (r = 0.62) and impact (r = 0.82) scores. Marketing restrictions showed higher correlations with lifetime abstinence than other policy domains (r = 0.80), including restrictions on physical availability, pricing policies and drink-driving prevention. Discussion and Conclusion: Our findings suggest that restricting alcohol marketing could be an important policy for the protection of alcohol abstention. The IAC policy index may be a useful tool to benchmark the performance of alcohol policy in supporting alcohol abstention in high and middle-income countries.

Original languageEnglish
Pages (from-to)704-713
Number of pages10
JournalDrug and Alcohol Review
Issue number3
StatePublished - Mar 2023
Externally publishedYes


  • abstention
  • abstinence
  • alcohol
  • alcohol policy
  • policy index


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