1. Reducing alcohol problems in the Baltic Sea Region: Effective Approaches to Tackle Alcohol Related Problems in Local Communities Riga, March 12 – 13, 2007 Some tentative conclusions and suggestions for the future

2. Situational analysis: Dag Rekve  Increasing consumption and problems in North and Eastern Europe, many third world countries  Problems expected to increase globally, unless action is taken  Promising initiatives in all WHO-regions

3. Adult per capita consumption in liter pure alcohol 2002

4. Patterns of drinking 2002

5. Round table: Andréasson  combine national control policies with local community prevention Khaltourina/  increase vodka taxation Korotayev  state monopoly on alcohol sales  seek public support Renström  up till now commission has regarded alcohol as an ordinary commodity  use the health impact assessment tool  Alcohol and Health Forum Nikogosian  international trade agreements  health sector

6. Plenary II Smate:  focus Latvian alcohol policy both on availability and demand reduction  reduce drunk driving and drinking on the job Mikhaylova  alcohol related mortality  age of first drinking going down Petrič  reducing availability; 18 year age limit  limiting commercial communication youth, sports  EU presidency: injury prevention; cancer  Latvia, Russia and Slovenia: key roles as EB members in WHO

7. Consumption Medical, social, econ. consequences Legislation and enforcement Social control and communication Alcohol: a systems model

8. Structure for community prevention of alcohol and drug problems  Support from political leadership  Municipal alcohol and drugs policy MVC/ / NGO:s Coordinator School Working life Work mates MCHC Primary care Family Youth culture Availability/ enforcement

9. Workshops 1 – 3 1.Reducing harm to children in families with alcohol problems 2. Early interventions 3. Prevention in the community

10. Challenges 1.Lack of public concern and support 2. Powerful commercial interests 3. Alcohol viewed as an ordinary commodity

11. Community Action and Prevention Lessons from International Projects Science-based interventions are essential Utilize local news media---media advocacy Community Mobilization  Environmental strategies are most effective Value of Evaluation—determine effects    Education alone has little effect— use in support of other components.

12. OUTRAGE

13. Once look at yourself in a mirror! Who has a “personal alcohol policy”?

14. ALCOHOL burden OOPS !