From Policy to Politics: Is there a Nordic Model for the regulation of alcohol and gambling?

Abstract

Aim: Control policies in the fields of alcohol and gambling show similarities across Nordic countries. The so-called Nordic model has consisted of strong state intervention and, in many cases, monopolistic provision. However, internal and external pressures pose challenges to the model. This article provides a comparative review of current policies on alcohol and gambling in the Nordic region. Methods: We analyse framings, implementation and outcomes of current alcohol and gambling policies in Denmark, Finland, Iceland, Norway and Sweden. We produce a review of legal documents and grey literature. We also analyse on-going and recent policy changes (2021-2024). Our focus is on policies related to World Health Organisation's evidence-based "best buys": physical availability, taxation and marketing. While these best buys are designed for alcohol, we also apply these to gambling. Results: Control policies in the region take place on a spectrum from more restrictive to more market-oriented. Overall, alcohol policy is more restrictive than gambling policy. In comparison with gambling policy, alcohol policy was characterised by a stricter public health framing and consistent implementation based on the best buys. In terms of policy outcomes, more stringent alcohol regulations translated, to some extent, to lower consumption and prevalence, but not systematically. Recent policy developments suggest that alcohol policy may be heading towards increased de-regulation, whereas gambling policies are becoming stricter. Conclusions: The Nordic model continues to be visible particularly in alcohol control. However, the model is challenged by politics. To persist, the Nordic model needs political will and increased cross-country and cross-sectoral collaboration.