Public Attitudes Towards Alcohol and Alcohol Taxation Policies: Insights from a Cross-National Survey

Aims Alcohol consumption is a major global health risk, yet effective policies like alcohol taxation remain politically contentious and underutilized. Since public support is critical for advancing these measures, this study explores public attitudes towards alcohol harms and taxation in Brazil, Colombia, Mexico, Kenya, and the Philippines, revealing opportunities and barriers for immediate policy action. Design, Setting, and Participants Nationally representative cross-sectional surveys among adults aged 18+ years, conducted between March 8 and April 15, 2024, using telephone surveys in Brazil, Colombia, and Mexico and in-person household surveys in Kenya and the Philippines (Ns=1000-1096 per country). Measurements Key outcome measures were attitudes towards alcohol tax policies. Predictors included country of residence, demographic characteristics, alcohol use status, exposure to media coverage of alcohol harms, concern about and knowledge of alcohol-related harms, attitudes toward government responsibility in addressing alcohol harms, perceptions of alcohol industry interference in policymaking, and industry culpability for alcohol-related damage. Findings Substantial majorities (88% overall; range: 66% Philippines-94% Colombia and Mexico) identified alcohol consumption as a problem, with violence as the most prominent concern (55% overall; range: 38% Mexico-62% Colombia). Majorities agreed that it is the government's responsibility to address alcohol's harms (79% overall; range: 66% Philippines-89% Kenya); that the alcohol industry is culpable for these harms (62% overall; range: 59% Brazil and Philippines-71% Kenya); and that alcohol taxes are an effective policy measure (65% overall; range: 55% Mexico-67% Philippines). In regression analyses, predictors of agreement in alcohol tax effectiveness included: media exposure to alcohol harms (AOR=1.18, 95% CI:1.03-1.36); alcohol use status (AOR=0.74, 95% CI:0.62-0.89); recognition of the population-wide benefits of alcohol policies (AOR=1.56, 95% CI:1.36-1.79); beliefs in government responsibility (AOR=1.70, 95% CI:1.47-1.97), alcohol industry interference in policymaking (AOR=1.43, 95% CI:1.25-1.64), and alcohol industry culpability for alcohol-related damages (AOR=1.46, 95% CI:1.28-1.66). Conclusions Public concern about alcohol harms, especially violence, is widespread, underscoring the urgent need for policy action. While alcohol taxation is recognized as an effective policy solution by majorities in all countries, policymakers must clearly communicate their broader societal benefits, reinforce the government's responsibility in protecting public health, and explicitly expose alcohol industry culpability and interference in policymaking to strengthen and sustain public support.