Finland: increases in alcohol availability and consumption.

This article briefly describes the changes that Finland has undergone during the 1960-2012 period with regards to societal changes, alcohol control policies, alcohol-related harms, and alcohol consumption, after which the findings of the analyses made by Allamani and his colleagues in the AMPHORA project are discussed. It seems that despite the changes in the alcohol field, the strong and comprehensive control policy measures still have a solid footing in the Finnish society. It is also evident that the policy changes implemented over the course of the last decades have affected the development of the total alcohol consumption to a large degree in both positive and negative directions, depending on the kind of measure implemented.

Contextual determinants of alcohol consumption changes and preventive alcohol policies: a 12-country European study in progress.

Beginning with France in the 1950s, alcohol consumption has decreased in Southern European countries with few or no preventive alcohol policy measures being implemented, while alcohol consumption has been increasing in Northern European countries where historically more restrictive alcohol control policies were in place, even though more recently they were loosened. At the same time, Central and Eastern Europe have shown an intermediate behavior. We propose that country-specific changes in alcohol consumption between 1960 and 2008 are explained by a combination of a number of factors: (1) preventive alcohol policies and (2) social, cultural, economic, and demographic determinants. This article describes the methodology of a research study designed to understand the complex interactions that have occurred throughout Europe over the past five decades. These include changes in alcohol consumption, drinking patterns and alcohol-related harm, and the actual determinants of such changes.

Estimates of harm associated with changes in Swedish alcohol policy: results from past and present estimates.

AIMS: (i) To compare actual developments of alcohol-related harm in Sweden with estimates derived prior to major policy changes in 1995 and (ii) to estimate the effects on consumption and alcohol-related harm of reducing alcohol prices in Sweden. DESIGN: Alcohol effect parameters expressing the strength of the relationship between overall alcohol consumption and different alcohol-related harms were obtained from ARIMA (Auto Regressive Integrated Moving Average) time-series analyses. MEASUREMENTS: Measures of Swedish alcohol-related mortality (liver cirrhosis, alcoholic psychosis, alcoholism and alcohol poisoning), accident mortality, suicide, homicide, assaults and sickness absence from 1950 to 1995. FINDINGS: Previous estimates of alcohol-related harm based on changes in alcohol consumption for the period 1994-2002 for Sweden were, in some cases (e.g. violent assaults and accidents), relatively close to the actual harm levels, whereas in other cases (e.g. homicides, alcohol-related mortality and suicide) they diverged from observed harm levels. A tax cut by 40% on spirits and by 15% on wine is estimated to increase total per capita alcohol consumption by 0.35 litre. This increase is estimated to cause 289 additional deaths, 1627 additional assaults and 1.6 million additional sickness absence days. CONCLUSIONS: The estimates of future changes in harm based upon even relatively modest increases in alcohol consumption produce considerable negative effects, with large economic consequences for the Swedish economy. The additional alcohol-related deaths, for instance, amount to more than half the number of yearly traffic fatalities in Sweden.

Changes in alcohol policies and public opinions in Finland 2003-2013.

INTRODUCTION: There is a constant and ongoing interplay between public opinions and public policies, alcohol policies being no exception. This article describes the development of public opinions regarding alcohol policy in Finland during a 10-year period between 2003 and 2013. Fluctuations in the alcohol policy opinion climate are put in context by looking at concurrent changes in alcohol policies and in total alcohol consumption. DATA AND METHODS: The study is based on data from opinion surveys on alcohol policies commissioned by the National Institute for Health and Welfare and the Finnish Social and Health Association. The opinion polls include questions about the general acceptance of prevailing alcohol policies, appropriate sales channels of different alcoholic beverage categories and opinions about the legal age limits and prices of alcoholic beverages. In the study, changes in alcohol policy during 2003-2013 are surveyed, and their relationship with changes in alcohol policy opinion is examined. RESULTS: There seem to be a strong positive correlation during the study period between the level of alcohol consumption and the share of those wanting a more restrictive alcohol policy in Finland. DISCUSSION: It seems that an increased level of awareness of alcohol-related issues among the general public created a more restrictive opinion climate on alcohol policy issues after the big alcohol excise duty decrease in 2004. The reverse seems to happen but in a lesser degree when alcohol excise duties has been increased after the year 2007.

Alcohol tax changes and the use of alcohol in Europe.

INTRODUCTION AND AIMS: Different motives in determining the level and structure of alcohol taxes lead to greatly varying alcohol excise duty levels. The aim of this paper is to look at alcohol excise duty rates in European Union (EU) and the mechanisms affecting them. Also the trends in alcohol prices and alcohol consumption will be discussed. MATERIAL: Material concerning alcohol taxes and consumption comes from available statistics and published literature. RESULTS: This paper shows that despite many attempts the EU has not been able to harmonise alcohol excise duty rates in its member states. The importance of alcohol taxes as an alcohol control measure has decreased as the real value of alcohol excise duty rates has decreased in most EU countries during the last decades. DISCUSSION: In most European countries the share of alcohol taxes of the price of alcoholic beverages is quite low. Therefore, increasing alcohol excise duty rates would in most countries lead to increased alcohol tax revenues to the public sector. Consequently, increasing alcohol excise duty rates would serve both the fiscal and the health and social policy interests of the state.

Potential consequences of replacing a retail alcohol monopoly with a private licence system: results from Sweden.

AIM: To examine the potential effects of replacing the Swedish alcohol retail system with a private licensing system on alcohol consumption and alcohol-related harm. DESIGN: Two possible scenarios were analysed: (1) replacing the current alcohol retail monopoly with private licensed stores that specialize in alcohol sales or (2) making all alcohol available in grocery stores. We utilized a multiplicative model that projected effects of changes in a set of key factors including hours of sale, retail prices, promotion and advertising and outlet density. Next, we estimated the effect of the projected consumption increase on a set of harm indicators. Values for the model parameters were obtained from the research literature. MEASUREMENTS: Measures of alcohol-related harm included explicitly alcohol-related mortality, accident mortality, suicide, homicide, assaults, drinking driving and sickness absence. FINDINGS: According to the projections, scenario 1 yields a consumption increase of 17% (1.4 litres/capita), which in turn would cause an additional 770 deaths, 8500 assaults, 2700 drinking driving offences and 4.5 million sick days per year. The corresponding figures for scenario 2 are a consumption increase of 37.4% (3.1 litres/capita) leading to an additional annual toll of 2000 deaths, 20 000 assaults, 6600 drinking driving offences and 11.1 million days of sick leave. CONCLUSIONS: Projections based on the research literature suggest that privatization of the Swedish alcohol retail market would significantly increase alcohol consumption and alcohol-related harm.

Weakening of one more alcohol control pillar: a review of the effects of the alcohol tax cuts in Finland in 2004.

AIMS: To review the consequences of the changes in Finnish alcohol policy in 2004, when quotas for travellers' tax-free imports of alcoholic beverages from other European Union (EU) countries were abolished, Estonia joined the EU and excise duties on alcoholic beverages were reduced in Finland by one-third, on average. DESIGN: A review of published research and routinely available data. SETTING: Finland. MEASUREMENTS: Prices of alcoholic beverages, recorded and unrecorded alcohol consumption, data on criminality and other police statistics, alcohol-related deaths and hospitalizations, service use. FINDINGS: Alcohol consumption increased 10% in 2004, clearly more than in the early 2000s. With few exceptions, alcohol-related harms increased. Alcohol-induced liver disease deaths increased the most, by 46% in 2004-06 compared to 2001-03, which indicates a strong effect on pre-2004 heavy drinkers. Consumption and harms increased most among middle-aged and older segments of the population, and harms in the worst-off parts of the population in particular. CONCLUSIONS: Alcohol taxation and alcohol prices affect consumption and related harms, and heavy drinkers are responsive to price. In Finland in 2004, the worst-off parts of the population paid the highest price in terms of health for cuts in alcohol prices. The removal of travellers' import quotas, which was an inherent part of creating the single European market, had serious public health consequences in Finland.

Какие механизмы борьбы с алкоголем являются наиболее эффективными и экономически целесообразными?

Сводный доклад Сети фактических данных по вопросам здоровья (СФДЗ), посвященный вопросу о наиболее действенных и экономически эффективных мерах контроля потребления алкоголя. Данные научных исследований показывают, что наиболее эффективный подход заключается в осуществлении комбинации следующих мер: повышение цен на алкогольную продукцию; снижение доступа к приобретению алкоголя; меры, направленные против управления транспортными средствами в состоянии опьянения и против употребления спиртных напитков несовершеннолетними. Доклад содержит обзор фактических данных о действенных и экономически эффективных мерах контроля потребления алкоголя и приводит рекомендации по формированию политики. Данный доклад – это ответ СФДЗ на вопрос, поступивший от разработчика политики. Он отражает в суммированном виде наиболее важные из имеющихся фактических данных, включая краткую сводку результатов научных исследований и возможные варианты построения политики по данному вопросу. СФДЗ – это инициированная и координируемая Европейским региональным бюро ВОЗ информационная служба для лиц, ответственных за принятие решений в системах общественного здравоохранения стран Европейского региона ВОЗ. Информация, предоставляемая СФДЗ, может быть полезна и для других заинтересованных сторон.

What are the most effective and cost-effective interventions in alcohol control?

This is a Health Evidence Network (HEN) synthesis report on the most effective and cost-effective interventions in alcohol control. Evidence shows the most effective approach is to implement a combination of: increases in alcohol prices, reduction in the availability of alcohol, and measures against drink–driving and underage drinking. A report from HEN reviews the evidence on effective and cost-effective interventions in alcohol control and outlines considerations for policy-making. This report is HEN’s response to a question from a decision-maker. It provides a synthesis of the best available evidence, including a summary of the main findings and policy options related to the issue. HEN, initiated and coordinated by the WHO Regional Office for Europe, is an information service for public health and health care decision-makers in the WHO European Region. Other interested parties might also benefit from HEN.