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Closing the Gap Between Evidence and Action: Lessons From a Dramatic Increase in Access to Alcohol
Norman Giesbrecht1,2, Elizabeth K Farkouh3,4
1Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Ontario, Canada.
Drug and Alcohol Review
|May 14, 2026
Summary
Ontario
Area of Science:
- Public Health Policy
- Alcohol Harm Reduction
- Evidence-Based Practice
Background:
- Alcohol consumption is a major cause of death, disability, and social problems in Canada.
- Significant gap exists between evidence-based alcohol policies and their implementation.
- Ontario's 2023 decision to expand off-premise alcohol sales by 290% is examined.
Purpose of the Study:
- Critically examine Ontario's decision to expand off-premise alcohol sales.
- Analyze the neglect of public health evidence in this policy decision.
- Provide insights for evidence-based policymaking in other jurisdictions.
Main Methods:
- Policy analysis of the Ontario government's 2023 alcohol sales expansion.
- Review of international and Canadian research on alcohol availability and harms.
- Examination of public health stakeholder concerns and government responses.
Main Results:
- The Ontario government's decision to expand alcohol sales disregarded evidence linking increased access to greater harms.
- Public health concerns were not incorporated, and no a priori health impact assessments were conducted.
- The policy proceeded with minimal mitigation and no evaluation protocol.
Conclusions:
- Ontario's alcohol policy expansion exemplifies evidence-neglect in public health.
- Governments must use evidence, consult stakeholders, mitigate risks, and evaluate policy impacts.
- This case offers a model for improving future alcohol policy development.
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