ALCOHOL CONTROL POLICY IN LITHUANIA Dr. AUDRONE ASTRAUSKIENE MINISTRY OF HEALTH OF THE REPUBLIC OF LITHUANIA WARSAW,

MAIN NATIONAL STRATEGIC DOCUMENTS 1. Lithuanian Health Program , approved by the Parliament ( 2. National Public Health Care Strategy , approved by the Government 3. Inter-institutional action plan for horizontal priority of the National Progress Program "Health for All“, approved by the Government 4. Two action plans in health sector in line with the Lithuanian Health Program for the period , including mapping of the necessary infrastructure (European structural funds): 1) Action plan for reduction disparities in health care (EU funding is directed for prevention of drugs abuse) 2) Action plan for healthy aging

THE MAIN LEGISLATION Law On Alcohol Control of the Republic of Lithuania Drug, Tobacco and Alcohol prevention inter- institutional work plan, approved by the Resolution No. 217, of February 25, 2015, of the Government of the Republic of Lithuania, which main goal is –„reduce drugs, tobacco and alcohol supply and demand, strength management and coordination“.

PREVENTION MEASURES RELATED WITH ALCOHOL USE REDUCTION IMPLEMENTED IN LITHUANIA Lithuania applies a licensing system for alcoholic beverages (licenses for import, admission and export of alcoholic beverages, also licenses for production, retail trade and wholesale of alcoholic beverages are issued). Prohibition of home-made alcoholic beverages (except for cases of personal use when alcoholic beverages of natural fermentation are produced not exceeding 18 percent of alcohol concentration, and for beer - 9,5 percent; Definition of sites for alcohol sale establishing places where trade in alcoholic beverages is allowed and prohibited; Setting of the minimum age to buy alcoholic beverages granting the sellers the right to request a document certifying the person's age, and prohibiting persons younger than 18 years of age to use or possess alcoholic beverages, Prohibition to sell alcoholic beverages to intoxicated persons establishing that sellers must ensure unavailability for intoxicated persons to acquire alcoholic beverages; Alcohol beverages sale prohibition at night time (10 p.m – 8 a.m) Reduction of alcohol use through taxation: Increase of Excise duty on alcohol Prohibition to sell alcohol on September 1. Prohibition to use, have and transport alcoholic beverages in open packaging in the passenger compartment of automobiles; Organisation of narcological supervision including treatment interventions for alcohol dependent persons and providing restrictions of action in the cases of dependence; Advertising of alcoholic beverages is limited in the radio and TV programmes during the daytime. Advertising of alcohol allowed only at night time on TV. Prohibition to keep open bottles, cans with alcohol inside the vehicles.

ALCOHOL CONSUMPTION IN LITRES PER PERSON AGED 15+ YEARS AND OLDER, 2010 LIETUVA

ALCOHOL USE AND ALHOCOL RELATED DISORDERS, m. Šaltinis: Narkotikų, tabako ir alkoholio kontrolės departamentas

PREVENTION MEASURES AIM TO REDUCE ALCOHOL ABUSE AND ITS CONSEQUENCES The Lithuanian Drug Strategy prioritises the prevention of drug use in the family, among children and youths. Quite many programmes and methodological materials to develop life and social skills of children were prepared for Lithuanian educational establishments The Ministry of Education implements the universal prevention programme “Prevention of Use of Alcohol, Tobacco and Psychoactive Substances” In 2013, the programme for development of life skills for1-8 grade schoolchildren “Development of a Healthy Lifestyle“ was implemented in 490 schools, the programme for primary schoolchildren “Development of Life Skills” was implemented in 521 schools,

PERMITTED BLOOD ALCOHOL CONTENT (BAC) LIMIT On 26th June 2014 Seimas of the Republic of Lithuania adopted new amendments on Republic of Lithuania Law on Road Traffic Safety that has tightened drunk driving regulations. New amendment introduced 0 g/l maximum permitted blood alcohol content (BAC) limit for novice drivers (drivers who have held a license for less than 2 years) and all drivers who drive light four-wheel, four-wheel, powerful four-wheel vehicles with a maximum mass exceeding 3.5 tones or with more than 9 seats or transporting dangerous goods. The 0 g/l limit will be adopted for mopeds, motorcycles, tricycles and taxi drivers. By now novice drivers, motorcyclists and taxi drivers were allowed to have BAC limit of 0.2 g/l. The legal standard BAC for professional drivers who have held their license Road deaths per million inhabitants: comparison between 2001 and 2010

Community level: NETWORK OF PUBLIC HEALTH BUREAUS IN MUNICIPALITIES Since 2010, 48 municipal Public health bureaus were set up. The core main functions of the bureaus are public health promotion, including alcoohos preventions programmes

INTEGRATED ACTIVITIES OF FAMILY DOCTORS AND PUBLIC HEALTH SPECIALISTS NEW INITIATIVE: INTEGRATION OF PUBLIC HEALTH CARE AND PRIMARY HEALTH CARE ACTIVITIES „HEALTH PROMOTION PROGRAMME FOR CHD RISK GROUP OUTPATIENTS“ launched since 1st of January 2015 in Lithuania: – Procedure: Outpatient clinic (family) doctors addressing CHD risk group patients to attend intense Health Promotion Programme (managed by public health bureaus). The patients are consulted, educated and trained there (including alcohol prevention issues). – Our plans. Programme is going to be extended by by including diabetes risk group patients. 10

National Public Health Promotion Fund established in 2016 by Parliament This Fund is administered by the Lithuanian Ministry of Health. The Fund is intended to support the health promotion and healthy well-being activities, prevention projects, social advertising and scientific research. The Government of the Republic of Lithuania annually allocates a fixed percentage of the actual revenue from the excise duty from the sale of alcoholic beverages ( % or ~1.3MEUR). PRIORITIES IN 2016: ALCOHOL USE PREVENTION MENTAL HEALTH AND SUICIDE PREVENTION HEALTHY LIFE STYLE NATIONAL PUBLIC HEALTH PROMOTION FUND, since

New initiatives Draft on the Amendment of the Law on Alcohol Control is discussed in the Government A ban on alcohol advertising Retail sale of alcohol only in specialised stores Minimum legal age of 20 years to purchase and consume alcohol Restrictions for sales of alcoholic beverages near churches, school buildings, or other sites (Minimum distance 100 m). Instalation of Alcolocks (alcohol interlock systems) which are designed to prevent driving with excess alcohol by requiring the driver to blow into an in-car breathalyser before starting the ignition.