{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T03:10:25Z","timestamp":1790392225204,"version":"4.1.0"},"reference-count":52,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2024,12,2]],"date-time":"2024-12-02T00:00:00Z","timestamp":1733097600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009187","name":"Medical Research Foundation","doi-asserted-by":"publisher","award":["MR\/V032380\/1"],"award-info":[{"award-number":["MR\/V032380\/1"]}],"id":[{"id":"10.13039\/501100009187","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>Harmful use of alcohol causes more deaths in Sub-Saharan Africa than in any other region. In Tanzania, where alcohol use disorders rates are twice the overall African average, harmful alcohol consumption is a public health concern. Given the lack of a contemporary overview of the alcohol policy landscape, we conducted a mixed-methods review of key alcohol-related policies, implementers, and initiatives in Tanzania. We conducted a desk-based review of policy-related documents, and in-depth interviews with eight key informants guided by the 10-composite-indicator framework of a tool for measuring alcohol policy implementation developed by World Health Organization. Representatives were from health-service delivery, community-based organizations, governmental organizations, research, and policymakers whose work is related to alcohol in Tanzania. Data was collected in June and October 2022, and finalized in March 2023. Findings were analyzed using Microsoft Word v2021. Themes were identified, collected, combined, and tabulated. Differences were then resolved by first and second authors. Our findings revealed no single comprehensive national alcohol policy. Pending finalization of a draft policy, various documents and actors govern alcohol production, distribution, licensing, and consumption. Little intersectoral linkage between entities contributes to poor enforcement of these regulations. Regulation is stronger in urban areas, and restrictions more effective on industrial alcohol. However, the majority of consumed alcohol in Tanzania is informally-produced, especially in rural settings. Socio-cultural context plays a key role in alcohol production and consumption, contributing to early-age exposure to alcohol. Alcohol is a growing source of revenue for the Tanzanian government and, therefore, imposing further restrictions is a low priority. There are important policy gaps in various sectors pertaining to alcohol regulation. Our results strongly suggest the need for a comprehensive approach to developing an overarching alcohol policy, with involvement of key stakeholders, stronger enforcement, and increased awareness, resources, and collaborations.<\/jats:p>","DOI":"10.1371\/journal.pgph.0003203","type":"journal-article","created":{"date-parts":[[2024,12,2]],"date-time":"2024-12-02T13:51:34Z","timestamp":1733147494000},"page":"e0003203","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["The landscape and level of alcohol policy enforcement in Tanzania"],"prefix":"10.1371","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0927-1678","authenticated-orcid":true,"given":"Kim","family":"Madundo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7123-2422","authenticated-orcid":true,"given":"Aliza","family":"Hudda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7000-3624","authenticated-orcid":true,"given":"Maaike L.","family":"Seekles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5550-1916","authenticated-orcid":true,"given":"Blandina","family":"Mmbaga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6801-8889","authenticated-orcid":true,"given":"Angela","family":"Obasi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,12,2]]},"reference":[{"key":"pgph.0003203.ref001","author":"World Health Organization (WHO)","year":"2022","journal-title":"Alcohol"},{"key":"pgph.0003203.ref002","first-page":"74","article-title":"World Health Organization","volume":"65","author":"J Hammer","year":"2018","journal-title":"Global status report on alcohol and health 2018"},{"key":"pgph.0003203.ref003","doi-asserted-by":"crossref","first-page":"S18","DOI":"10.1016\/S2214-109X(20)30159-5","article-title":"Association between alcohol use and violence-related injury in emergency department patients in Moshi, Tanzania: analysis of a prospective trauma registry.","volume":"8","author":"K Friedman","year":"2020","journal-title":"Lancet Glob Health."},{"issue":"6","key":"pgph.0003203.ref004","doi-asserted-by":"crossref","first-page":"1543","DOI":"10.1111\/add.15735","article-title":"Associations of common mental disorder with alcohol use in the adult general population: a systematic review and meta-analysis.","volume":"117","author":"J Puddephatt","year":"2022","journal-title":"Addict Abingdon Engl"},{"key":"pgph.0003203.ref005","article-title":"The Influence of Alcohol Outlet Density and Advertising on Youth Drinking in Urban Tanzania.","volume":"58","author":"M Sommer","year":"2019","journal-title":"Health Place"},{"key":"pgph.0003203.ref006","author":"MOVENDI International","year":"2020","journal-title":"Tanzania: Communities Call for Alcohol Policy to Be Part of Election Campaign Discourse"},{"key":"pgph.0003203.ref007","author":"World Health Organization (WHO).","year":"2022","journal-title":"Towards an action plan (2022\u20132030) to effectively implement the Global strategy to reduce the harmful use of alcohol"},{"key":"pgph.0003203.ref008","article-title":"EAST AFRICAN COMMUNITY REGIONAL POLICY ON PREVENTION, MANAGEMENT, AND CONTROL OF ALCOHOL","author":"East African Regional Community","year":"2019","journal-title":"DRUGS AND OTHER SUBSTANCE USE"},{"key":"pgph.0003203.ref009","first-page":"1","author":"World Health Organization (WHO).","year":"2017","journal-title":"Policy in action. A tool for measuring alcohol policy implementation"},{"key":"pgph.0003203.ref010","first-page":"1","volume":"15","author":"World Health Organization (WHO).","year":"2016","journal-title":"Global strategy to reduce the harmful use of alcohol"},{"key":"pgph.0003203.ref011","article-title":"National Institute of Medical Research (NIMR), Mwanza Intervention Trials Unit (MITU)","author":"STRIVE","year":"2012","journal-title":"SITUATION ANALYSIS REPORT. HIV PROGRAMMING FOR YOUNG PEOPLE IN TANZANIA: EXISTING STRUCTURES AND ALCOHOL RELATED POLICIES"},{"key":"pgph.0003203.ref012","first-page":"1","author":"United Republic of Tanzania","year":"1966","journal-title":"The Moshi (Manufacture and Distillation) Act."},{"key":"pgph.0003203.ref013","first-page":"1","author":"United Republic of Tanzania","year":"2007","journal-title":"The Business Activities Registration Act."},{"key":"pgph.0003203.ref014","first-page":"1","author":"United Republic of Tanzania.","year":"1968","journal-title":"The Intoxicating Liquors Act."},{"key":"pgph.0003203.ref015","first-page":"1","author":"United Republic of Tanzania. CAP","year":"2019","journal-title":"168 The Road Traffic Act, Amendment of 2019."},{"key":"pgph.0003203.ref016","first-page":"1","author":"United Republic of Tanzania","year":"2009","journal-title":"The Standards Act\u20142009."},{"issue":"3","key":"pgph.0003203.ref017","first-page":"799","article-title":"Standard Treatment Guidelines and National Essential Medicines List Tanzania Mainland, Sixth Edition, 2021","volume":"93","author":"Ministry of Health, Community Development, Gender, Eldery and Children (MoHCDGEC)","year":"2021","journal-title":"Gov Tanzan."},{"key":"pgph.0003203.ref018","first-page":"7","author":"National AIDS Control Programme; MoHCDGEC; Tanzania TUR of. National Guidelines for the Management of HIV and AIDS.","year":"2019","journal-title":"Development"},{"key":"pgph.0003203.ref019","author":"Tanzania Revenue Authority","year":"2023","journal-title":"Applying driving license for the first time"},{"key":"pgph.0003203.ref020","first-page":"1","author":"United Republic of Tanzania.","year":"2008","journal-title":"The Excise (Management and Tariff) Act."},{"key":"pgph.0003203.ref021","first-page":"1","author":"United Republic of Tanzania","year":"2009","journal-title":"The Law Of The Child Act, 2009."},{"key":"pgph.0003203.ref022","first-page":"1","author":"United Republic of Tanzania","year":"2009","journal-title":"The Public Health Act, 2009."},{"key":"pgph.0003203.ref023","first-page":"1","volume-title":"The Fair Competition Act","author":"United Republic of Tanzania","year":"2003"},{"key":"pgph.0003203.ref024","first-page":"5","author":"United Republic of Tanzania","year":"2006","journal-title":"The Tanzania Revenue Authority Act, 2006."},{"key":"pgph.0003203.ref025","first-page":"2016","volume-title":"ALCOHOL CONSUMPTION: LEVELS AND PATTERNS: Tanzania.","author":"World Health Organization (WHO) (WHO).","year":"2016"},{"key":"pgph.0003203.ref026","first-page":"1","volume-title":"World Health Organization (WHO).","author":"Tanzania Ministry of Health and Social Welfare (MoHSW); National Institute of Medical Research (NIMR)","year":"2013"},{"key":"pgph.0003203.ref027","first-page":"1","volume-title":"Gender, Elderly, and Children (MoHCDGEC).","author":"Ministry of Health, Community Development","year":"2017"},{"key":"pgph.0003203.ref028","first-page":"1","author":"United Republic of Tanzania","year":"2019","journal-title":"DRAFT UPDATED MENU OF POLICY OPTIONS AND COST-EFFECTIVE INTERVENTIONS FOR THE PREVENTION AND CONTROL OF NON- COMMUNICABLE DISEASE."},{"issue":"1","key":"pgph.0003203.ref029","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13011-022-00479-x","article-title":"Missed opportunity for alcohol use disorder screening and management in primary health care facilities in northern rural Tanzania: a cross-sectional survey","volume":"17","author":"D Mushi","year":"2022","journal-title":"Subst Abuse Treat Prev Policy"},{"issue":"1","key":"pgph.0003203.ref030","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1186\/s12888-022-04496-9","article-title":"Prevalence, severity, and associated factors of depression in newly diagnosed people living with HIV in Kilimanjaro, Tanzania: a cross-sectional study.","volume":"23","author":"K Madundo","year":"2023","journal-title":"BMC Psychiatry."},{"key":"pgph.0003203.ref031","first-page":"1","volume-title":"Historical Perspectives on the State of Health and Health Systems in Africa","author":"M. Azevedo","year":"2017"},{"key":"pgph.0003203.ref032","first-page":"1","author":"Drug Control and Enforcement Authority (DCEA).","year":"2018","journal-title":"Guidelines for the Establishment and Management of Sober Houses in Tanzania Mainland"},{"key":"pgph.0003203.ref033","article-title":"Ten Years After\u2014Drug Use and Recovery Among Male Heroin Users in Zanzibar","author":"J Pedersen","year":"2021"},{"key":"pgph.0003203.ref034","first-page":"1","article-title":"Welcome to Alcoholics Anonymous in Tanzania","author":"Alcoholics Anonymous","year":"2021","journal-title":"AA Tanzania"},{"key":"pgph.0003203.ref035","volume-title":"Traders: Alcohol sachets ban big blow.","author":"The Citizen.","year":"2017"},{"key":"pgph.0003203.ref036","author":"Tanzania Revenue Authority","year":"2023","journal-title":"Tanzania Revenue Aithority: About"},{"key":"pgph.0003203.ref037","first-page":"1","volume-title":"Tanzania: TRA Records 34% Increased Revenues On Liquor","author":"AllAfrica","year":"2019"},{"issue":"10","key":"pgph.0003203.ref038","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1371\/journal.pone.0140041","article-title":"The epidemiology of alcohol use and alcohol use disorders among young people in Northern Tanzania.","volume":"10","author":"J Francis","year":"2015","journal-title":"PLoS ONE"},{"key":"pgph.0003203.ref039","first-page":"0","volume":"10","author":"Tanzania Bureau of Standards (TBS).","year":"2017","journal-title":"Tanzania Bureau of Standards\u2014LIQUEURS\u2014SPECIFICATIONS."},{"key":"pgph.0003203.ref040","first-page":"2","author":"World Health Organization (WHO).","year":"2012","journal-title":"TANZANIA STEPS Survey\u20142012. STEPS Survey"},{"key":"pgph.0003203.ref041","first-page":"1","volume-title":"Alcohol taxation, pricing and packaging: experiences from Tanzania and opportunities for structural interventions targeting young people.","author":"M. Gerry","year":"2014"},{"key":"pgph.0003203.ref042","article-title":"Alcohol Use and Drinking Norms among Young People in Northern Tanzania: Preliminary findings from a qualitative study.","author":"D Mbata","year":"2013","journal-title":"STRIVE"},{"issue":"November","key":"pgph.0003203.ref043","first-page":"S18","article-title":"The Alcohol Environment Protocol: A new tool for alcohol policy","volume":"37","author":"S Casswell","year":"2018","journal-title":"Drug Alcohol Rev"},{"issue":"4","key":"pgph.0003203.ref044","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1093\/alcalc\/agv036","article-title":"Alcohol control policies in 46 African countries: Opportunities for improvement.","volume":"50","author":"C Ferreira-Borges","year":"2015","journal-title":"Alcohol Alcohol."},{"key":"pgph.0003203.ref045","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1111\/add.13591","article-title":"Alcohol marketing and youth alcohol consumption: a systematic review of longitudinal studies published since 2008.","volume":"112","author":"D Jernigan","year":"2017","journal-title":"Addiction"},{"key":"pgph.0003203.ref046","volume-title":"Tanzania bans alcohol sachets.","author":"The Guardian","year":"2017"},{"issue":"8","key":"pgph.0003203.ref047","doi-asserted-by":"crossref","first-page":"e052879","DOI":"10.1136\/bmjopen-2021-052879","article-title":"Effects of minimum unit pricing for alcohol in South Africa across different drinker groups and wealth quintiles: a modelling study.","volume":"11","author":"N Gibbs","year":"2021","journal-title":"BMJ Open"},{"issue":"11","key":"pgph.0003203.ref048","doi-asserted-by":"crossref","first-page":"2270","DOI":"10.2105\/AJPH.2009.186007","article-title":"Effects of alcohol tax and price policies on morbidity and mortality: a systematic review.","volume":"100","author":"A Wagenaar","year":"2010","journal-title":"Am J Public Health"},{"key":"pgph.0003203.ref049","first-page":"5","article-title":"Alcohol pricing and criminal harm: a rapid evidence assessment of the published research literature.","author":"A Booth","year":"2018","journal-title":"The University of Sheffield"},{"issue":"2","key":"pgph.0003203.ref050","first-page":"328","article-title":"Can Beer Taxes Affect Teen Pregnancy? Evidence Based on Teen Abortion Rates and Birth Rates.","volume":"70","author":"B. Sen","year":"2003","journal-title":"South Econ J"},{"key":"pgph.0003203.ref051","article-title":"Harmful Use of Alcohol: A Shadow over Sub-Saharan Africa in Need of Workable Solutions.","author":"C Ferreira-Borges","year":"2017","journal-title":"Int J Environ Res Public Health"},{"issue":"2","key":"pgph.0003203.ref052","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.alkona.2015.06.003","article-title":"On monitoring unrecorded alcohol consumption","volume":"28","author":"J Rehm","year":"2015","journal-title":"Alcohol Drug Addict"}],"container-title":["PLOS Global Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0003203","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,2]],"date-time":"2024-12-02T13:51:47Z","timestamp":1733147507000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0003203"}},"subtitle":[],"editor":[{"given":"Medhin Selamu","family":"Tegegn","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,12,2]]},"references-count":52,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12,2]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pgph.0003203","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2024.04.17.24305975","asserted-by":"object"}]},"ISSN":["2767-3375"],"issn-type":[{"value":"2767-3375","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,2]]}}}