The harmful use of alcohol is one of the leading risk factors for disease, injury, disability and death worldwide; alcohol consumption contributes to three million deaths each year globally, as well as to the disabilities and poor health of millions of people suffering from chronic diseases and nonfatal injuries, according to World Health Organization (WHO).

Overall, harmful use of alcohol accounts for 5.1 per cent of the global burden of disease, across low, middle and high-income countries.

The Rwanda Biomedical Centre recently published its second Non-Communicable Disease Risk Factors study results. One of the key findings of this work showed a marked increase in alcohol consumption when compared to similar study findings of 2013.

It also showed the proportion of males (61.9 per cent) is significantly higher than females (34.3 per cent). There was also a significant increase in heavy drinking when compared to study results from 2013. Although the STEPS study is restricted to just indicating an increase in alcohol use, many other studies in other settings have been published clearly showing the intersection between consumption of alcohol and population harm from alcohol. We can learn a lot from this mountain of evidence.

As people become more aware of the impacts of alcohol intake, particularly in younger people, government regulations to restrict alcohol consumption due to cancer, liver, and other general health effects, have gotten stronger recently.

The best-supported policies aim to make alcohol less accessible, affordable, and socially acceptable. Procedures to limit population consumption, though, face opposition from vital commercial entrenched interests, advertisement, and product marketing as well as numerous other challenges.

Alcohol consumption among youth in Rwanda is a growing concern that the government is actively addressing to curb the number of people who potentially will fall ill, get injured, become less productive or die prematurely.

While the intent behind regulating alcohol consumption is commendable, the successful implementation of such policies faces several obstacles. In this article, we will explore some of these challenges and consider ways to overcome them.

Policymakers and public health advocates often need to carefully navigate these challenges while striving to implement evidence-based strategies to ensure the intended outcomes are achieved.

The World Health Organization recently launched the WHO-SAFER international initiative to reduce alcohol-related harm to help member countries implement alcohol reduction policies. Five areas of intervention are considered; strengthening restrictions on alcohol availability, advancing and enforcing drink-driving countermeasures, facilitating access to screening and treatment, reduction of alcohol advertisement and increasing prices on alcohol through taxes and pricing policies.

There are numerous repeating issues that may characterise resistance to the implementation of good alcohol regulations. However, this article will focus on what may possibly be the main areas.

The success of alcohol reduction plans depends on having an adequate public health strategy for awareness since it acts as the fundamental motivator for behavioural change. Effective awareness programmes not only inform the public about the health hazards linked to binge drinking, but also work to de-stigmatise the problem and encourage people, families, and communities to discuss it freely.

This allows people to choose their alcohol use wisely by increasing awareness and promoting a deeper understanding of the effects of alcohol abuse. Adequate public health strategies also support those who require help and encourage a societal shift towards responsible drinking habits.

Additionally, public health policies that place a high priority on awareness can foster a climate in which measures to reduce alcohol consumption, such as taxes, limits, and support services, are more universally accepted and embraced, ultimately leading to a more effective and sustainable reduction in alcohol-related harm

Public awareness, effective communication and engagement with the public are key to addressing scepticism and building support for alcohol reduction policies.

Government agencies and public health organisations should invest in clear, transparent, and evidence-based communication to explain the rationale behind policies and their expected benefits. Effective communication ensures that the public is informed about the justification for policies, their potential benefits, and the scientific evidence that supports them.

Engaging with stakeholders, such as communities, healthcare workers, and advocacy groups, promotes collaboration and buy-in, increasing the likelihood that policies will be approved and adhered to. Alcohol reduction programmes prioritise public education, participation, and communication, to not only address the health and socioeconomic problems caused by alcohol abuse but also empower individuals and communities to actively participate in promoting responsible drinking or alcohol use.

In particular, among young people, resistance to change can be a significant impediment to efforts to limit alcohol intake. When they believe that drinking is a deeply rooted societal standard or rite of passage, firmly engrained in their culture or peer groups, many people, whether young or old, may resist changing their behaviours.

Such opposition is frequently motivated by the worry of social exclusion or rejection if one deviates from conventional wisdom. In these situations, public health initiatives to alter these behaviours must not only inform the public about the risks but also work to change the social norms and perceptions surrounding alcohol consumption by putting an emphasis on alternative social activities and encouraging environments to promote a healthier and safer lifestyle choice.

A final thought. When I spoke to young people about these closures, many frequently recalled the time of the Covid-19 pandemic, when there appeared to be a spike in alcohol usage (or abuse) despite the closing of pubs and other popular venues.

Some thought we may be headed in that direction again, to which I disagree. I usually tell them those were different times, a time of so much anxiety, social isolation and uncertainty about the future. The community now has a big opportunity to reach our goals in terms of public health and economic results, thanks to the new limitations on alcohol. Additionally, to the young people out there, that enjoyable intoxicant isn’t cool— Gusinda si wane!

Dr Vincent Mutabazi is an applied epidemiologist.

Twitter: @VkneeM