This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on http://www.researchprotocols.org, as well as this copyright and license information must be included.
Excessive alcohol consumption has significant adverse economic, social, and health outcomes. Recent estimates suggest that the annual economic costs of alcohol in Australia are up to AUD $36 billion. Policies influencing price have been demonstrated to be very effective in reducing alcohol consumption and alcohol-related harms. Interest in minimum pricing has gained traction in recent years. However, there has been little research investigating the level of support for the public interest case of minimum pricing in Australia.
This article describes protocol for a study exploring Western Australian (WA) public knowledge, understanding, and reaction to a proposed minimum price policy per standard drink.
The study will employ a qualitative methodological design. Participants will be recruited from a wide variety of backgrounds, including ethnic minorities, blue and white collar workers, unemployed, students, and elderly/retired populations to participate in focus groups. Focus group participants will be asked about their knowledge of, and initial reactions to, the proposed policy and encouraged to discuss how such a proposal may affect their own alcohol use and alcohol consumption at the population level. Participants will also be asked to discuss potential avenues for increasing acceptability of the policy. The focus groups will adopt a semi-structured, open-ended approach guided by a question schedule. The schedule will be based on feedback from pilot samples, previous research, and a steering group comprising experts in alcohol policy and pricing.
The study is expected to take approximately 14 months to complete.
The findings will be of considerable interest and relevance to government officials, policy makers, researchers, advocacy groups, alcohol retail and licensed establishments and organizations, city and town planners, police, and other stakeholder organizations.
Excessive alcohol consumption has a direct negative impact on economic, social, and health outcomes. Regular moderate-to-heavy alcohol exposure is associated with numerous chronic health conditions, including liver cirrhosis, a range of cancers, and mental health problems [
In Australia, studies by Collins and Lapsley [
Against this background, investigating attitudes to minimum pricing in Australia is an important research priority for public health advocates interested in policy avenues to reduce excessive consumption. An understanding of the Australian public’s attitudes and beliefs toward minimum pricing will provide critical insights into the likelihood of acceptability or opposition and inform public information campaigns that may pave the way for its introduction. The aim of this qualitative study is to investigate public beliefs and attitudes toward the introduction of a minimum price per standard drink policy. The study will be the first to investigate perceptions regarding alcohol minimum pricing in Australia and it will not only seek to provide evidence as to whether the public will support the introduction of minimum pricing, but also perceptions as to what circumstances or conditions may maximize its acceptability.
A panoply of alcohol control policies have been proposed and implemented worldwide to reduce excessive alcohol consumption (see Babor et al for review [
While several leading public health organizations (eg, the National Alliance for Action on Alcohol, which represents 75 organizations) and organizations concerned with alcohol consumption in specific areas have voiced support for minimum pricing, public opinion on the policy is unclear. In fact, there is a dearth of studies worldwide investigating public opinion to minimum pricing [
Few studies have investigated public opinion toward minimum pricing [
This protocol outlines the design of a study examining the knowledge, attitudes, and beliefs of members of the Western Australian (WA) public regarding a minimum price per standard alcoholic drink policy. The study will adopt a qualitative design to generate participant-led data on minimum pricing, including basic awareness, knowledge, and understanding of the policy and attitudes and beliefs toward its effect and possible introduction.
The study will employ a qualitative design, involving focus groups to gain in-depth and detailed insight into the awareness and knowledge of minimum pricing in members of the WA general public, their attitudes and beliefs toward the policy, and suggestions for increasing acceptability if the policy was introduced in WA. The study will be conducted over a 14-month period and recruit 10-15 focus groups comprising 8-10 adults in each group. Focus groups will last approximately 1 hour, led by a trained facilitator, and follow a semistructured standardized question schedule (
The focus group schedule will be separated into 3 main parts. First, participants will be asked to indicate their understanding of the phrase “minimum pricing policy” with respect to alcohol. After assessing the participants’ knowledge, the facilitator will then provide a clear-language explanation of the policy for all participants. Information given by the facilitator will include a clear outline of the proposal, as well as previous evidence and findings related to the proposal. Second, the facilitator will subsequently enquire about participants’ attitudes and beliefs toward minimum pricing. Third, focus group participants will be asked to consider ways in which the policy could be made more acceptable and effective.
In-depth discussion will be stimulated by the facilitator throughout each part of the discussion. Data will be recorded on 2 voice-recording machines placed strategically to capture all voices in the room. The facilitator will encourage participation in an autonomy-supportive manner and prompt participants to be candid in their views and freely elaborate on their responses. Visual aids will also be introduced and explained to participants to assist with their understanding of how the minimum price policy will affect the price of alcoholic beverages.
Eligible participants will include WA adults from a diverse cross section of backgrounds, including students, blue/white collar workers, minority groups, unemployed, and retired workers. Individuals younger than 18 years of age will be ineligible to participate as they are not old enough to purchase alcohol in WA. Further, participants who are considered harmful drinkers, according to a screening tool administered prior to the beginning of the focus group (eg, Fast Alcohol Screening Test), will be excluded. Any harmful drinkers identified during the course of the recruitment phase will be referred to alcohol awareness and counseling services.
Participants will be recruited through targeted advertisements and the research team’s existing collaborative links with the community, including schools, local employers, local clubs and organizations, and job seeker’s pages in local newspapers and in Perth job centers. Advertising materials (eg, posters and emails) will be developed to inform potential participants of the study aims and encourage them to contact the primary researcher to join a focus group. Posters advertising the study will be disseminated across the Perth metropolitan area, as well as emails sent to a wider catchment area in the neighboring suburbs of Perth. Email addresses will be sourced through word-of-mouth and Internet sites of groups and clubs.
One focus group will be exclusively female as research suggests women are likely to hold particular views and beliefs regarding alcohol drinking [
Interview questions for minimum price policy focus groups.
Focus group topic | Key questions | Follow-up questions |
Reaction to minimum pricing | What are you your immediate thoughts about the minimum price policy? | What do think about the idea of minimum pricing? |
|
|
Do you think it is a good idea? Do you think it will work? |
|
|
Are you in favor of it? |
|
What concerns, if any, would you have about minimum pricing policy of alcohol? |
|
|
What information/conditions would you like about the minimum pricing policy of alcohol before it was introduced? |
|
|
What do you think are the possible outcomes of a minimum pricing policy? |
|
|
Do you think that introducing minimum pricing policy will actually reduce how much people drink? |
|
|
Who do you think will be most influenced by price increases? |
|
|
How do you think price increases might influence your drinking? | Would minimum pricing policy change how much or what you drink? |
|
Do you think a minimum pricing policy will reduce alcohol-related harm, crime, social disorder? |
|
|
Is alcohol different to other commodities? Would you continue to drink excessively regardless of any price increases? |
|
|
Do you think minimum pricing policy will affect poor and rich people differently? |
|
|
What impact do you think minimum pricing policy of alcohol will have on underage drinking? Heavy drinkers? |
|
Would you support the introduction of a minimum pricing policy of alcohol? | What are your reasons for supporting the policy? Or not? |
|
|
What are the possible advantages of introducing the policy? |
|
|
What possible negative effects do you think the policy may have? |
|
|
Do you think the policy is aimed at particular subgroups of the Australian population? What are your reasons for this? |
|
|
Do you think the policy fairly or unfairly focuses on certain subgroups in society? |
|
|
Do you think the policy will work? |
|
What factors do you think would make a minimum pricing policy more tolerable or accepted by Australians? | What do you think would make the policy more effective? |
|
|
Are there any additional steps (eg, information, public education) you think the government could take to help make this policy more acceptable? |
|
Given the paucity of research regarding public perceptions about minimum pricing, the adoption of a qualitative approach using focus groups is appropriate and fits well with the general aim to provide a comprehensive overview of people’s knowledge, attitudes, and beliefs of minimum pricing and to construct a model of the factors affecting the acceptability of the policy. Our qualitative approach will be data-driven following recommendations in the literature by qualitative research methodologists [
Although the approach is not guided by theory, it is not atheoretical. Instead, we will use a theory-building, inductive approach rather than a traditional theory-testing, deductive approach. Specifically, data in the form of transcripts of focus group discussions on minimum pricing will be subjected to inductive thematic content analysis [
Based on Lonsdale et al [
A research question protocol will be developed (
The study is expected to take approximately 14 months to complete. This includes 2-3 months for the development of materials (eg, question protocol, study posters). Approximately 1-2 months will be required for advertising and recruitment, followed by 4-5 months of data collection. It is then expected to take between 3 and 4 months to transcribe the data, analyze and agree on emergent themes, and write the results into a coherent framework.
This study protocol outlines study methodology to investigate attitudes and beliefs toward minimum pricing and identify avenues for increasing acceptability in members of the WA general public. This study will be the first of its kind in Australia and add to a nascent literature exploring public opinion about minimum pricing [
Although the planned analysis will be inductive and focus on emergent themes generated from the data, such a process does not occur in a “vacuum” independent of other literature and previous research. Based on previous research we can therefore form a candidate list of themes that may emerge from the data [
The unique perspective and in-depth exploratory qualitative approach are major strengths of the current proposed study. It is the first study to examine the public interest case for minimum pricing in Australia and will provide valuable information on the perceptions of the general public that may assist in the development of legislation and messages toward the introduction of the policy. Furthermore, the methodological approach facilitates in-depth exploration of participants’ views and beliefs, and the use of a predetermined question protocol enables group comparisons.
There are some limitations with the current research. First, the researcher will not blind the study or background research. It may be the case that participants in each focus group ask the researcher for his or her views of minimum pricing. In this situation, the researcher will be briefed to remain neutral, will remind the group that the goal of the research is to canvas opinion and redirect the discussion to eliciting participants’ views and beliefs. Having an informed researcher is also an advantage in the context of the current study as confusion has been found to surround minimum pricing [
Western Australia
This research was supported by a Health Promotion Research Project Grant #22961 from the Western Australian Health Promotion Foundation (Healthway).
MSH conceived the study and wrote the original protocol. DAK and MSH drafted the manuscript and contributed to the protocol design. NC, TC, and MD assisted in developing the protocol and read and approved the final manuscript. SH helped to draft the manuscript and provide expertise in relation to the proposed data collection and qualitative analysis.
None declared.