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Introduction: While effective policies exist to reduce alcohol‐related harm, political will to enact them is low in many jurisdictions. We aimed to identify key barriers and strategies for strengthening political priority for alcohol policy reform. Methods: A framework synthesis was conducted, incorporating relevant theory, key informant interviews (n = 37) and a scoping review. Thematic analysis informed the development of a framework for understanding and influencing political priority for alcohol policy. Results: Twelve barriers and 14 strategies were identified at multiple levels (global, national and local). Major barriers included neoliberal or free trade ideology, the globalised alcohol industry, limited advocate capacity and the normalisation of alcohol harms. Strategies fell into two categories: sector‐specific and system change initiatives. Sector‐specific strategies primarily focus on influencing policymakers and mobilising civil society. Examples include developing a clear, unified solution, coalition building and effective framing. System change initiatives target structural change to reduce the power imbalance between industry and civil society, such as restricting industry involvement in policymaking and securing sustainable funding for advocacy. A key example is establishing an international treaty, similar to the Framework Convention on Tobacco Control, to support domestic policymaking. Discussion and Conclusions: Our findings provide a framework for understanding and advancing political priority for alcohol policy. The framework highlights that progress can be achieved at various levels and through diverse groups of actors. The importance of upstream drivers of policymaking was a key finding, presenting challenges for time‐poor advocates, but offering potential facilitation through effective global leadership. [ABSTRACT FROM AUTHOR]

Using a national survey of 8,500 New Zealand high school students, we investigated adolescents' concerns about their drinking, associated factors including help-seeking preferences and access to health care services, and how these varied by ethnicity and level of socioeconomic deprivation. Approximately 23.9% of the 3,704 current drinkers reported concerns (i.e., being worried about their drinking and/or having tried to cut down). Regression analyses revealed that Māori and Pacific youth were more likely than their New Zealand European peers to be concerned about their drinking. Concerned drinkers were more likely than nonconcerned drinkers to report hazardous drinking behaviors and alcohol-related problems, but these associations varied by age, ethnicity, and socioeconomic deprivation. Help-seeking preferences differed strongly by ethnicity. Concerned drinkers, and Māori and Pacific drinkers, were more likely to report difficulties accessing health care and alcohol and drug services. The factors associated with adolescents' drinking concerns and paradoxical difficulties accessing health care highlight the importance of engaging adolescents in developing responsive and equitable services. [ABSTRACT FROM AUTHOR]

Competing Interests: Hoek has received travel funding to attend advisory group meetings at the Health Promotion Agency. Hoek is a member of Project Sunset Oceania, which is a network of public health researchers and advocates that support calls for phasing out the commercial sale of combustible tobacco products. Members of the network participate on a volunteer basis. Member of global Project Sunset group. Hoek received a $50 gift for giving a plenary address at the Dental Hygienists conference (April 2021). Jackson and Chambers have no competing interests.