Review of Health Impact Assessments Informing Alcohol, Tobacco, and Marijuana Prevention and Control Policies

Background: Health impact assessments (HIAs) are used to systematically analyze the potential health impacts of proposed policies and provide recommendations that promote positive impacts and mitigate adverse impacts. This study reviewed HIAs conducted in the United States, England, and New Zealand on policies related to alcohol, tobacco, and marijuana Methods: Information was abstracted from relevant HIAs identified from multiple web sources using a set of predetermined criteria and key data elements. Four case studies were selected to highlight methods and impacts for conducting HIAs Results: Twenty-two HIAs from U.S., England, and New Zealand conducted from 2005-2019 were retained for the final analysis. Policies assessed included zoning laws and density for alcohol and tobacco outlets, raising legal tobacco purchasing age to 21, prevention of underage drinking, and marijuana regulations. These HIAs used methods such as literature review, local data, and stakeholder interviews to characterize the direction, magnitude, intensity, likelihood, and distribution of potential health effects. Stakeholder input was obtained on how to mitigate negative and promote positive health effects that could result from the proposed policy. The HIA results were provided to decision-makers to encourage them to consider health impacts in the decision process. Conclusion: HIAs are a promising tool for policymakers and stakeholders to assess the potential health impacts of proposed alcohol, tobacco, and marijuana policies. Our review is consistent with prior reports from other sectors suggesting that HIAs may increase awareness of health impacts among decision-makers, improve collaboration among stakeholders, and have direct impacts on policy decisions.