The Health, Social and Economic Impact of Alcohol Riga, 19 October 2005

Structure of presentation Is the European Commission serious about alcohol policy? Is alcohol good for the economy? Is drinking different across Europe?

Structure of presentation Is the European Commission serious about alcohol policy? Is alcohol good for the economy? Is drinking different across Europe?

The Alcohol Economy Alcohol’s economic role Goods account balance €9bn Tax revenue (€24bn in EU15) Employment: Industry say up to 3½ m jobs in EU15

The Alcohol Economy But… tax not dependent on consumption

The Alcohol Economy …and jobs not dependent on consumption Employment in the Hotels, Restaurants and Catering sector in Austria

The Alcohol Economy Total tangible costs – €135bn

Structure of presentation Is the European Commission serious about alcohol policy? Is alcohol good for the economy? Is drinking different across Europe?

Use of alcohol Relative dispersion of EU consumption

Binge drinking, men at least six portions per one occasion %

Binge drinking, women at least six portions per one occasion %

Consumption (L per adult) Use of alcohol Consumption-per-drinker: Much less variation EU range still 10-22 L Very high levels overall: 5 countries > 20 L Average 15 L Consumption (L per adult) Less than 14 14 to 15 15 to 18½ More than 18½

Use of alcohol Trends in binge- drinking in 15-16 year old male students, 1995- 2003 5+ drinks on a single occasion 3+ times in last 4 weeks

Structure of presentation Is alcohol important for social well-being and health Is alcohol an important European public health issue? Is it better to drink like southern Europeans?

Alcohol and individuals Choosing different policy options Cost of implementing same policy options per 100 people per year (€) in sub-region A of EU25; Adapted from Chisholm et al 2004

Structure of presentation Is alcohol important for social well-being and health Is alcohol an important European public health issue? Is it better to drink like southern Europeans?

Alcohol and Europe

Alcohol and Europe Each year, alcohol causes: 17,000 road traffic accidents 27,000 accidental deaths 2,000 murders 10,000 suicides 50,000 cancer deaths, of which 11,000 female breast cancer deaths 17,000 psychiatric deaths 45,000 deaths from liver cirrhosis

The geographical relationship between alcohol consumption and cirrhosis mortality

Structure of presentation Is alcohol important for social well-being and health Is alcohol an important European public health issue? Is it better to drink like southern Europeans?

Alcohol consumption and cirrhosis rates in southern Alcohol and southern Europe Alcohol consumption and cirrhosis rates in southern

Alcohol and southern Europe Alcohol and violence in EU15 countries Alcohol consumption 5.6 9.3 10.4 (litres per capita)

Structure of presentation Is alcohol policy effective? Is there a role for the alcohol industry? Is alcohol policy very different across Europe?

Alcohol policy Education and Persuasion Pricing and Taxation Regulating Physical Availability Regulating Alcohol Promotion Drinking-Driving Countermeasures Treatment and Early Intervention

Alcohol policy Choosing different policy options Impact of different policy options in preventing DALYs per million people per year

Alcohol policy Choosing different policy options Cost of implementing same policy options per 100 people per year (€)

Alcohol policy 10% in price: consumption 2% to 8% 9,000 deaths €3 billion in revenue

Alcohol policy Alcopops in Switzerland

Breadth of Research Support Effectiveness Breadth of Research Support Cost Efficiency Lowered BAC levels +++ Random breath testing (RBT) ++ + License suspension Graduated licensing Low BAC for youth Server training Designated drivers and ride services O

Alcohol policy Education programmes in young people Follow-up: Partially effective Ineffective “Negative” effect Short-term (1 year or less) 14 23 3 Medium-term (1-3 years) 13 19 2 Long-term (over 3 years) 6

Structure of presentation Is alcohol policy effective? Is there a role for the alcohol industry? Is alcohol policy very different across Europe?

Alcohol industry

Structure of presentation Is alcohol policy effective? Is there a role for the alcohol industry? Is alcohol policy very different across Europe?

Alcohol policy in Europe Tax levels Average effective tax adjusting for purchasing power PP € <400 PP € 400 – 1000 PP € > 1000

Alcohol policy in Europe Legal purchase age of 18 17, or 16 (B) and 18 (S) 16 Legal purchase age of 18 20 16 None On-premise Norway has a LPA of 20 for spirits (Iceland has 20 for all drinks) Off-premise Denmark and Finland are 20 for spirits; several countries move to 18 (inc. Belgium, from none) Buying any drink from bars Buying beer from shops

Alcohol policy in Europe Complete ad ban Legal restriction (not just content) Voluntary agreements Nothing TV advertising Stronger for spirits, esp. in EU10 Stronger than for other media, such as billboards, print, sponsorship etc. Beer advertising on television

Alcohol policy in Europe Variation in alcohol policy… Policy score Score (0-20) showing strength of alcohol policy < 9 9 – 12 > 12

Alcohol policy Education programmes in young people

Alcohol industry