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Alcohol Harms & Effective Alcohol Policy Interventions
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Alcohol Harms & Effective Alcohol Policy Interventions
Lauri Beekmann, NordAN
Introduction
Introduction
Theory + some experiences and cases from practice
Public health
No variation in the health of the states of Europe is the result of chance; it is the direct result of physical and political conditions in which nations live.
—William Farr (1807–1883),
a British epidemiologist
Alcohol timeline
How alcohol is approached over the years
Hans Olav Fekjær, psychiatrist
1
1. paradigm
Focus: harm to others (families)
Drunkenness
1880-1950
"Less use will give less problems."
Strong regulation and as a result - reduced consumption and harm.
2
2. paradigm
Focus on problems among heavy drinkers
The theory of alcoholism
From ca 1950
Policy was liberalized and consumption grew
3
3. paradigm
Focus: the drinkers´ health problems
Public health perspective
From 1975
Recommended stronger restrictive policies but continued to be liberalized
4. paradigm
A brain disease
Focus on daily drinkers (addiction)
Ca 1990-s....
4
Aiming to find medicine or vaccine
"We are close to a breakthrough"
5. paradigm
Harm to others
Most problems seem to be due to individual incidents, not addiction
Recent years
5
50:50
New Understanding
Revolutionary developments
What we didn´t know before
Alcohol is a teratogen
Fetal Alcohol Spectrum Disorders
1-5%
teratogen
1-5%
"Experts estimate that the full range of FASDs in the United States and some Western European countries might number as high as 1 to 5 per 100 school children (or 1% to 5% of the population)."
1-5%
Estimated prevalence of fetal alcohol spectrum disorders among first-graders in 4 US communities ranged from 1.1% to 5.0% using a conservative approach.
France
Alcohol is carcinogen
carcinogen
No safe level
no safe level
Roots
Professor Robin Room
Roots of Alcohol policies
"The idea of ‘alcohol policy’ itself seems to be a Nordic coinage" (Room 1999)
The idea
Robin Room in the latest Nordic Studies on Alcohol and Drugs journal: "The countries north of the Baltic, in particular, have long stood out in social alcohol research; as young alcohol sociologists in California in the 1970s, we thought of Helsinki as devout Catholics might think of Rome."
Helsinki
Monopoly
Alcohol policy best-buys
Effective and cost-effective measures
MEASURES
Marketing
taxation
Availability
drink-drive
Education
Brief interventions
Best-buys
WHO study
Sin taxes
Traffic laws
Russia
marketing
PROBLEM
No measure works miracles
What are the obstacles for its effectiveness?
Cross-border trade
Estonia
Tax income
How many litres for average salary
365 L
770 L
Price policy is effective
But it has its limits.
There is no study saying that raising beer taxes 70% in Estonia in 2017, having Latvia as a neighbour, we could reduce consumption.
We have to understand the overall situation and sometimes it might be more effective to do less.
Another problem: we are not actually considering the most effective measures
Alcohol advertising: Partial versus total ban
Loi Evin as a best practice
Sweden had a total ban before 1995
Advertising in TV and Radio is still banned. But the problem comes from ...
The Commission decided to not allow Sweden to sanction the broadcasters. The case concerns article 4 of the AVMSD.
The AVMSD is based on the principle of the country of origin, according to which broadcasters are subject solely to the rules of the Member State where they are established, including when they broadcast to other EU countries.