Guest blog by Dr Frank Houghton, Director of Social Sciences ConneXions, Technological University of the Shannon
Alcohol represents a clear threat to health and well-being both in Ireland and globally. Alcohol is the cause of 8% of all deaths in Ireland and, according to the World Health Organisation (WHO), responsible for the deaths of over 2.5 million people annually throughout the world. Although alcohol consumption in Ireland is not yet back at the levels seen at the height of the Celtic Tiger, in 2023 problem alcohol use here reached its highest levels in over a decade. Alcohol-related deaths are only the tip of the iceberg. The wider negative impacts of alcohol include high levels of morbidity, hospitalisations, road traffic incidents, assaults, domestic violence, suicide, and homicide.
In response to this threat, the Irish Government introduced the Public Health (Alcohol) Act (2018) to help reduce the adverse impacts of alcohol. The Act includes many elements. However, the three most important sections include the introduction of Minimum Unit Pricing (MUP) for alcohol, alcohol advertising controls, and the forthcoming (2026) introduction of alcohol warning labels on bottles and cans.
The WHO has identified what they term ‘Best Buys’ to tackle non-communicable diseases. These are cost-effective and proven measures. The WHO’s Best Buys for alcohol control include: increasing excise taxes on alcohol; enacting and enforcing bans or comprehensive restrictions on alcohol advertising; and enacting and enforcing restrictions on the physical availability of retailed alcohol. Not surprisingly, Ireland’s Public Health (Alcohol) Act has been heralded as a crucial step in alcohol control. However, as noted by the WHO, the application of such legislation must necessarily involve recourse to the full means of enforcement and deterrence provided by the Act.
To date, there have been no evaluations of the enforcement of the Public Health (Alcohol) Act. Therefore John Lombard from the University of Limerick and I decided to explore this issue. Getting access to this information was tricky. Details of Environmental Health Officer (EHO) enforcement of the Tobacco Acts is routinely released online by the Health Services Executive (HSE). However, this is not currently the case for alcohol control enforcement. Therefore we used a series of Freedom of Information (FOI) Act requests to examine data on Environmental Health Service (EHS) inspections and enforcement actions between 2019 and 2023, as they related to the 2018 Act.
Our FOI Act requests revealed over 2,600 instances of non-compliance with the Act had been noted by EHOs. However, in four full years of operation, no convictions for summary or indictable offences related to the Act were recorded despite the high level of non-compliance. Perhaps even more problematically, no attempts at prosecution by the HSE had even been attempted.
Compliance rates with the Public Health (Alcohol) Act have improved over time. These have more than doubled from 39.9% in 2020 to 85.5% in 2023. However, they remain below 90% and appear to be plateauing. More elements of the Act concerning media advertising have recently been introduced (10th January 2025). It remains to be seen if these will be equally unenforced.
Enforcement is a crucial element of alcohol control. However, minimal enforcement is the norm in Ireland. This may seriously inhibit the performance of the Public Health (Alcohol) Act. More robust enforcement actions are appropriate to promote adherence to the Act. Authorised officers should ensure that all enforcement fully complies with the Act by publishing and maintaining a transparent register of actions taken.
The widespread non-enforcement of the Public Health (Alcohol) Act is particularly problematic in the context of the Sale of Alcohol Bill (SoAB) and the Intoxicating Liquor Bill (ILB). These aim to significantly increase the availability of alcohol by lengthening the opening hours of pubs and nightclubs and expanding the number of venues that can sell alcohol. Given the lack of enforcement identified in relation to the Public Health (Alcohol) Act, this proposed legislation may simply lead to an effectively unregulated free-for-all in alcohol sales. It is essential that the SoAB and the ILB are preceded by a comprehensive and objective Health Impact Assessment (HIA) to explore their impacts on public health.
