Drug policy, whether for legal or illegal substances, is a controversial field that encompasses many complex issues. Policies can have effects on a myriad of outcomes and stakeholders differ in the outcomes they consider and value, while relevant knowledge on policy effects is dispersed across multiple research disciplines making integrated judgements difficult. Experts on drug harms, addiction, criminology and drug policy were invited to a decision conference to develop a multi-criterion decision analysis (MCDA) model for appraising alternative regulatory regimes. Participants collectively defined regulatory regimes and identified outcome criteria reflecting ethical and normative concerns. For cannabis and alcohol separately, participants evaluated each regulatory regime on each criterion and weighted the criteria to provide summary scores for comparing different regimes. Four generic regulatory regimes were defined: absolute prohibition, decriminalisation, state control and free market. Participants also identified 27 relevant criteria which were organised into seven thematically related clusters. State control was the preferred regime for both alcohol and cannabis. The ranking of the regimes was robust to variations in the criterion-specific weights. The MCDA process allowed the participants to deconstruct complex drug policy issues into a set of simpler judgements that led to consensus about the results.

Background and aims: Norwegian alcohol policy measures include national restrictions on sales hours and a state monopoly on retail sales. A 1‐hour extension of sales hours on Saturdays in the monopoly outlets took effect from September 2020. We aim to evaluate whether increase in sales hours results in (1) an increase in alcohol sales in the monopoly outlets and (2) an increase in total alcohol sales, including substitution effects from beer sales in grocery stores. Design: The extension of Saturday sales hours is implemented within a stepped wedge cluster‐randomized trial design. Block randomization of 62 of the 66 Norwegian trade districts allocated monopoly outlets to one of three sequences regarding date of implementation. Setting and participants: A total of 228 of 335 in total Norwegian state monopoly outlets are eligible and included. Intervention: The extension of sales hours is from 3 p.m. to 4 p.m. starting on the first Saturday in (i) September 2020, (ii) December 2020 or (iii) March 2021. Measurements: Growth rates in monthly alcohol sales, measured in litres of pure alcohol, in eligible monopoly outlets (primary outcome) are obtained together with beverage‐specific sales and alcohol sales in grocery stores (secondary outcomes). The observation period is set to 72 months prior to and 24 months after implementation. Findings: Power analyses indicate that this stepped wedge cluster‐randomized controlled trial has a power above 90%, even at a high significance level (α = 0.01) and with other conservative model specifications. The planned trial offers a rare opportunity to study possible causal effects of a relatively small change in a widely used alcohol policy measure.

The provision of accurate information on health damaging behaviours and products is a widely accepted and widespread governmental task. It is easily mismanaged. This study demonstrates a simple method which can help to evaluate whether such information corrects recipient risk beliefs. Participants assess risks numerically, before and after being exposed to a relevant risk communication. Accuracy is incentivised by awarding financial prizes to answers closest to a pursued risk belief. To illustrate this method, 228 students from the University of Oslo, Norway, were asked to estimate the mortality risk of Swedish snus and cigarettes twice, before and after being exposed to one of three risk communications with information on the health dangers of snus. The data allow us to measure how participants updated their risk beliefs after being exposed to different risk communications. Risk information from the government strongly distorted risk perceptions for snus. A newspaper article discussing the relative risks of cigarettes and snus reduced belief errors regarding snus risks, but increased belief errors regarding smoking. The perceived quality of the risk communication was not associated with decreased belief errors. Public health information can potentially make the public less informed on risks about harmful products or behaviours. This risk can be reduced by targeting identified, measurable belief errors and empirically assessing how alternative communications affect these. The proposed method of incentivised risk estimation might be helpful in future assessments of risk communications.

Background and aims: Evidence of the effect of limiting off‐premises alcohol trading hours is still scarce. This study tested the effect of a small extension in trading hours on alcohol sales in alcohol monopoly outlets in Norway. Design: The extension of trading hours was implemented within a stepped‐wedge cluster‐randomized trial design. Eligible state monopoly outlets ( n = 229) were clustered into trade districts ( n = 62), which were block‐randomized to one of three sequences regarding date of implementation: 1 September 2020 ( n = 21 districts, 82 outlets), 1 December 2020 ( n = 21 districts, 73 outlets) and 1 March 2021 ( n = 20 districts, 74 outlets). Outcomes were followed‐up for a 1‐year period. Setting and participants: Study participants were state monopoly outlets in urban and rural trade districts in all parts of Norway. Measurements: Monthly alcohol sales in litres of pure alcohol per trade district and per outlet were measured from March 2020 to March 2022 (primary outcome). We applied a linear mixed‐effect model with two‐way fixed effects within a difference‐in‐difference framework. As a robustness check we considered the effects of cross‐border trade and effects in subgroups of outlets. Trading hours in monopoly outlets were extended by 1 hour on Saturdays. The extension was permanent. Pre‐intervention periods and not‐yet‐treated units served as control conditions. Findings: We did not find a statistically significant effect of the small extension in trading hours on monthly alcohol sales (i) per trade district [average treatment effect: −185.5 litres, 95% confidence interval (CI) = −1159.9, 788.9] and (ii) per outlet (−35.3 litres, 95% CI = −142.1, 72.0). These findings were consistent across estimation methods and model specifications. Conclusion: There is no clear evidence that a small extension in off‐premises trading hours affected alcohol sales in monopoly outlets in Norway.