1. Healthy lifestyle - the corner stone of public health St. Petersburg, Russia, 24.11.2011 Mariliis Tael, specialist National Institute for Health Development, Estonia Alcohol policies in ND area countries

2. NDPHS ASA EG To promote sustainable development of comprehensive policies and actions in the entire region to prevent and minimize harm from tobacco smoking, alcohol and drug-use to individuals, families and society (especially children and young people). 2

3. Alcohol consumption in ND area 3 Recorded adult (15+) per capita consumption in ND area, WHO’s HFA database

4. Estonia, Finland, Latvia, Lithuania, Norway, Poland, Russia, Sweden Control on production and sale, regulation on control, taxation system, advertising regulations, drunk driving, illicit alcohol production and smuggling, alcohol consumption and outcomes, interventions, research and monitoring, treatment 4

5. Overview of strategies Estonia – development of the Green book of alcohol policy began in October 2011 Finland – Alcohol Programme 2008 –2011 Latvia – „Public Health Strategy for 2011–2017“, preparation of new action plan “Reduction of alcohol consumption and restriction of alcohol addiction for 2012–2014” Lithuania – Alcohol and Tobacco Control 2012–2014 Norway – National Action Plan on Alcohol and Drugs Poland – National Programme for the Prevention and Solving of Alcohol-Related Problems 5

6. Overview of strategies Russia – development of state policy to reduce alcohol abuse and alcohol prevention among population of Russian Federation for the period up to 2020 was adopted by the Russian Government on 30.12.2009 Sweden – alcohol policy is a part of a national strategy for alcohol, illicit drugs, doping and tobacco 2011–2015 6

7. Governmental control on production and sale in Sweden Alcohol retail monopoly – Systembolaget AB – takes inctructions from Government Sale of alcoholic beverages takes place in controlled forms, without a profit motive, competition and boost sales Municipalities are responsible for administering permissions to sell and serve alcoholic beverages 7

8. Measures to reduce alcohol availability CountryMinimum ageOpening hours of off-premise alcohol sale Estonia1810:00–22:00 Finland18 (<4.7%) 20 (>4.7%) 09:00–20:00 (Mon–Fri) (>4.7%) 09:00–18:00 (Sat) (>4.7%) 09:00–21:00 (Mon–Sun) (<4.7%) Latvia1808:00–22:00 Lithuania1808:00–22:00 Norway18 (<22%) 20 (>22%) 08:30–18:00 (Mon–Fri) (>4.7%) 08:30–15:00 (Sat) (>4.7%) 08:00–18:00 (Mon–Fri) (<4.7%) 08:00–15:00 (Sat) (<4.7%) Poland18 0:00-24:00 Russia18 08:00–00:00 (>15%) Sweden18 (<3.5%) 20 (>3.5%) 10:00–21:00 (Mon–Fri) (>3.5%) 10:00–15:00 (Sat) (>3.5%) 8

9. Alcohol taxation system in Norway Example: Litre of red wine (14%) has an excise duty of 60.30 NOK (7.75 EUR) In Poland -> 0.413 EUR 9 ProductUnit Excise duty rates in euros Alcohol based beverages 2.7% 3.7% 4.7% 22% Spirits Litre Volume % and litre 0.38 1.43 2.48 0.55 0.85

10. Regulation of alcohol control in Estonia Violations of Alcohol Act – fines, losing the notation in the commercial registry, confiscating illegal alcohol, imprisonment It is prohibited to drink alcohol on streets, in stadiums, parks, public transport or in other public places In 2007–2009 there were 61974 cases of consumption of alcoholic beverages in public places or appearance in public places while intoxicated -> 57 cases per day 10

11. Advertising regulations in Lithuania Starting on 1st January 2012, alcohol advertising in mass media and all types of outdoor advertising is prohibited. Ban on advertising of all types of alcohol if: – it aims at children and adolescents up to 18 years of age; – presents false and/or misleading information about alcohol beverages. Alcohol advertising is prohibited: – in the newspapers, journals, books, television and radio programmes aimed at children and adolescents; – at education, science and training institutions; – inside and outside of means of public transport. 11

12. Drunk driving in Russia At the end of March 2010, State Duma introduced an amendment abolishing the minimum blood alcohol content – 0% (according to the old Law – 0.03%) In the case of causing serious harm to human health: – imprisonment for up to 3 years; – disqualification to drive a car for up to 3 years. In case of a person's death – imprisonment up to 7 years ; – deprivation of the right to operate the machine up to 3 years. In case of death of two or more people – imprisonment up to 9 years; – disqualification to operate a vehicle up to 3 years. 12

13. Limits of blood alcohol content for driving 13 CountryBAC Estonia 0.02 Finland 0.05 Latvia 0.05 0.02 (driving experience < 2 years) Lithuania 0.04 0.02 (driving experience < 2 years; professional/ commercial drivers) Norway 0.02 Poland 0.02 Russia 0.03/ 0.00 Sweden 0.02

14. Illicit alcohol production and smuggling in Latvia Alcoholic beverages, which do not comply with mandatory harmlessness and quality requirements or have been produced illegally or imported illegally, are considered as dangerous to human health and life. In case of illegal production, storage or transport of illegal alcoholic beverages: – legal persons – fine from LVL 1000 (1410 EUR) up to LVL 10 000 (14 100 EUR), with confiscation of the alcoholic beverages and the vehicles used to transport them or without confiscation of the vehicles. Action plan against smuggling was developed in 2010. Based on the plan different legislative bodies performed various activities to restrict smuggling of illegal alcohol. 14

15. Drunkenness distribution among 15-year old boys and girls in Lithuania Source: Health behaviour of school-aged children 2009/2010 15 * Figure presented on 24.11.2011 was accidentally taken from Estonian profile

16. Distribution of consuming six or more portions of alcohol at once among 15–64-year old respondents in Finland Source: Health behaviour and health among the Finnish adult population 2009 16 * Figure presented on 24.11.2011 was accidentally taken from Estonian profile

17. Local interventions Awareness raising campaigns Campaigns for pregnant women (e.g. “Alkoholfritt svangerskap” in Norway) Drunk-driving campaigns Mystery shopping 17

18. Research and monitoring Institutions for alcohol research: – Norwegian Institute for Alcohol and Drug Research (SIRUS) – Department of mental health and alcohol research in Finnish National Institute for Health and Welfare – National Research Center on Addictions in Russia Surveys to get an overview of consumption patterns: – HBSC – ESPAD – Finbalt in Finland, Estonia, Latvia and Lithuania – Health Interview Survey in Norway 18

19. Alcohol dependence treatment in Poland The Act on Upbringing in Sobriety and Counteracting Alcoholism and the Regulation of the Ministry of Health of 31.12.1999 are the legal base of dependence treatment in Poland Dependence treatment service is funded from the public resources as a result of contracts concluded between healthcare centers and the National Health Fund Dependence treatment of alcohol-dependent people may be undertaken exclusively by public or non-public healthcare centers and is free of charge, also for people without health insurance 19

20. Conclusions Clear definition of alcohol-related terms, identical methods to measure consumption Alcohol policies must operate within a clear regulatory framework Successful programmes Solid knowledge base -> research and evidence are one of the most valuable and important tools for that Good market knowledge and insight into the composition and production of illicit alcohol Results on alcohol consumption provided annually to WHO’s HFA database 20

21. THANK YOU! 21