Abstract
INTRODUCTION: Commercial Determinants of Health (CDoH) are the private sector activities that have direct, indirect, positive or negative impact on human health. CDoH affects risk factors like air pollution, smoking, alcohol consumption, obesity and physical inactivity, and various health outcomes. Its influence on alcohol consumption is a serious public health issue. The first paper of the Lancet series on CDoH gave a model with seven commercial sector practices. This study aimed to understand how commercial sector practices of alcohol industries affect public health in Nepal. METHODS: A qualitative study was carried out in Nepal, comprising interviews of 28 participants from government bodies, civil society and private sector. Participants were carefully selected from a diverse range of fields and expertise, spanning policy and implementation levels to academia, ensuring a well-rounded and insightful exchange of ideas. Interview guides prepared after extensive literature review and content expert's feedback were used. Framework analysis of the transcribed interviews was done, categorising the findings into seven commercial sector practices given by the model of CDoH. RESULT: Participants from government bodies and civil society shared about the influence of large alcohol industries in policy making. Activists revealed that they were being threatened by alcohol industries for speaking against them. Most shared about the cunning advertisement strategies of alcohol industries such as sponsoring different programmes to promote their products. Participants shared about strict financial monitoring done by the government and poor compliance of alcohol industries to them. They also talked about the involvement in social activities and other tactics of industries to maintain good reputation. CONCLUSIONS: The study explored commercial sector practices of alcohol industries in Nepal through multiple stakeholders' experiences and understanding, and how these practices affect public health. These findings underscore the need for strict implementation of policies and can help in evidence-based policymaking, prioritising public health.