Research Update

Alcohol Use and Pregnancy: An Important Canadian Public Health and Social Issue

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6.2 Alcohol Control Measures

It may be surmised that measures effective in limiting alcohol consumption, particularly heavy consumption, in a general population would have the effect of reducing prenatal alcohol exposure and FASD. Various regulatory approaches – for example, increased taxation, advertising regulations, responsible service, and limiting hours of service or numbers of outlets – have been recommended. In some jurisdictions, these approaches have been implemented to reduce alcohol consumption. The regulatory measure to reduce consumption that is most supported by evidence is increased pricing through taxation. One study showed women reducing their consumption due to price increases more than men, which suggests that this measure may be effective for reducing drinking by pregnant women.¹²⁷ A limitation of these alcohol-specific measures is that they do not account for individuals switching to another substance when alcohol becomes less available – for whatever reason. Although the empirical evidence on this phenomenon is limited,¹²⁸ it is possible that some pregnant women who cannot access beverage alcohol may seek out other substances, some of which could be just as, or more, harmful (e.g. home brew, inhalants).

Community alcohol policies that guide whether and how alcohol is made available (e.g. through special events licences) may be perceived as having an impact on this issue; however, no relevant research was found. Lauzon et al. reported on an Ontario on-reserve alcohol policy initiative that led to greater regulation of the sale and service of alcohol at community events.¹²⁹ Findings indicated a reduction of some problems; however, drinking during pregnancy was not measured. Preliminary evidence from an Alaskan study suggests that a community alcohol ban resulted in a significant reduction in heavy alcohol use among pregnant women in the short term.¹³⁰ The long-term implications have yet to be determined. Having worked with many Ontario communities to develop municipal alcohol policies (MAPs) that reduce alcohol-related harms, the Centre for Addiction and Mental Health is currently adapting the approach to be culturally appropriate for First Nations, but no public documentation of the process or outcome of this work has been made available to date.¹³¹

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