1. Are alcohol problems best solved by educating young people – an implementation study Fredrik Spak, Per Blanck University of Gothenburg Mandurah West Australia, March 2004

2. National Action Plan for Alcohol and Drug Prevention, areas that concern local municipalities, 2001 Support to risk groups and individuals with risk behaviours Treatment efforts Influence the public opinion Restricted accessibility to alcohol beverages Competence enhancement Monitoring trends

3. Method 49 municipalities 1.9 million inh. Range: 475 000 – 5 000 61 % < 20 000 Base-line interview Follow process 4 municipalities studied more closely Comming up: Follow-up interview

4. Substance coordinators In 34 of 49 municipalities, else public health officer Tasks Monitor substance use Develop or enforce policy programs Promote preventive efforts Unclear expectations, low sustainability

5. Organization Broad co-operation, but Consultative Non-financial Health care and police not represented Minimal economical resources for activities

6. Policy programs 39 municipalities, But 27 of these ”outdated” policy never accepted policy not known old

7. Information to teenage parents Lecture series Study circles few But: lacks sustainability

8. Education Efforts in all municipalities wide variety usually grade 7-9 Often a part of ”Health promoting schools” undocumented No well documented program

9. Sales restrictions Controlling (low alcohol) beer sales regulation adherence = 50% Restuarant and bar license increase (per 10.000 inh.) 1998: 9.8 2003: 12.4

10. Secondary prevention in health care/ primary health care New parents Yes Early secondary intervention No

11. Activities in the traffic area Swedish police active, activities increasing No community cooperation

12. Conclusions + strong state support large freedom considerable efforts on many arenas broad solutions where co- operation is a key topic – conflict between public health interests – other pressures groups? lack of knowledge- competence co-operation non-financial resources shattered on too many fronts

13. Conclusions, further shortcomings Imbalance between expectations and results Few activity resources Health care hardly involved Responsible alcohol serving: very large efforts are needed How to convince? Low sustainability