Background: Alcohol related harm is a major problem in Australia, and in particular rural Australia. There are a number of interventions which have been shown to be effective in reducing alcohol related harm; however other ineffective interventions are often implemented in practice. Where public opinion on the optimal strategies to reduce alcohol related harm significantly differs from those viewed as cost-effective by professionals, sub-optimal intervention may be implemented because they are more politically attractive.
Methods: A postal questionnaire was sent to 7,985 individuals who were randomly selected from the electoral role of 20 communities in rural New South Wales, Australia. The individuals were asked to allocate a percentage of the total funds to 8 intervention areas in order to reduce alcohol related harm in their rural community.
Results: The top 3 intervention areas which were on average given the most funding by the public were school based interventions, educational messages in the media and greater police enforcement. Differences in the preferences for each interventions exists across a number of dimensions such as community of residence, gender, age and drinking status, however the ranking in terms of most preferred to least preferred in general was relatively stable across dimensions.
Conclusions: There are large discrepancies between public opinion and D&A professionals about the optimal set of interventions to reduce alcohol related harm in rural communities. Governments are likely being persuaded by the opinions of the median voter in terms of which alcohol intervention strategies to implement rather than scientific evidence regarding cost effectiveness of interventions. Either professionals' have not correctly taken into consideration the social worth of some interventions or the public needs to be better informed about the most cost-effective interventions in order for such policies to become politically viable.