Perspectives and Best Practices regarding Alcohol Prevention.

Transcription

1 Perspectives and Best Practices regarding Alcohol Prevention. Picture: Porin Pakka

2 Alcohol Harm Alcohol is the 3 rd top risk factor in Europe for ill health and NCDs such as cancer and cardiovascular disease the negative health impact of alcohol consumption is 31.6 times higher than benefit 12 million people in the EU are dependent on alcohol Annually 3,3 Million people worldwide die of alcohol Around 9 million children in the EU are living with one parent addicted to alcohol The global level of alcohol consumption in 2016 was 6.4 litres of pure alcohol per person aged 15 years or older. The social cost attributable to alcohol is 155,8 billion Euro yearly

3 Per Capita Consumption Sweden 8,8 Switzerland 10 Denmark 10,1 Finland 10.9 Germany 11,4 Latvia 12,3 Estonia 12,8 Russia 13,9 Lithuania 18,2 WHO SDG Indicators 2017

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5 What is Preventative Action? Healthy public policy puts health on the agenda of policy makers in all sectors and at all levels, directing them to be aware of the health consequences of their decisions and to accept their responsibilities for health Ottawa Charter (of health promotion) 1986 A focus on the general population to understand alcohol problems; A broad definition of health; Alcohol-related harm To address the larger population with interventions

6 The Full Picture of Alcohol Harm Acute consequences from intoxication Harm to the users Accidents Injuries HIV infection Alcohol poisoning and other acute effects Harm to others Alcohol related social harms including traffic and other accidents, Injuries Violence, vandalism, public disorders Insecurity Nuisance Long-term consequences Neuropsychiatric conditions, including dependence Harm to organs Cancers Cardiovascular disease Financial problems and poverty Neglect of children and spouse Family breakdown Work related problems Endal 2014

7 Reduce Consumption and Minimise Harm Alcohol Intoxication Potential harm Reduce consumption Harm reduction

8 Control policies Education Mobilization

9 Effective Prevention Methods Refers to the likely effectiveness of the intervention in real world settings Reflects the strength of scientific evidence WHOs Global and Regional Strategies to reduce the harmful use of alcohol recommend these

10 Rating scales used Effectivenes: 0 Lack of effectiveness + Limited effectiveness ++ Moderate effectiveness +++ High degree of effectiveness (?) No studies have been undertaken Cost: Low, Moderate, High

11 Regulating Physical Availability Strategy or Intervention Effectiveness Research Support X- National Testing Cost Total ban on sales High Minimum legal Low purchase age Rationing High Government Low monopoly of retail sales Hours and days of Low sale restrictions Restrictions on density of outlets Low Different availability by alcohol strength Low

12 Community Prevention Works Show your ID, are you old enough? Pakka prevention The law enforcement and sanctions were strengthened through test purchases. Drama-based training courses to shop and restaurant workers. Parents educational events through schools. Structures for local co-operation. Schools, police, health and social sector workers, NGO s. Public awareness of problems was raised combining community actions and with media campaigns. Young adults and parents were involved in the activities. Creating communication between municipal actors, alcohol inspection and alcohol trade

13 Taxation/Pricing Controls Strategy or Intervention Effectiveness Research Support Cross national testing Cost Alcohol Taxes Low

14 Regulating Alcohol Promotion Strategy or Intervention Legal restrictions on exposure Voluntary controls by alcohol industry Effectiveness Research Support X- Cultural Testing Cost +/ Low Low

15 Industry Self Regulation Does Not Work! Drink Responsibly and Other Campaigns The alcohol industry s selfregulation efforts have historically focused on three main areas drunk driving, underage drinking, problem drinking The extent to which the alcohol industry is willing to police itself is a minimal. They have vested interests.

16 Drinking-Driving Countermeasures Strategy or Intervention Sobriety check points Random breath testing (RBT) Lowered BAC Limits Administrative license suspension Low BAC for young drivers ( zero tolerance ) Graduated licensing for novice drivers Designated drivers and ride services Severity of punishment Effectiveness Research Support X- Cultural Testing Cost Moderate Moderate Low Moderate Low Low O + + Moderate 0/

17 Education and Persuasion Strategy or Intervention Alcohol education in schools College student education Mass media campaigns Warning labels Social marketing Effectiveness Research Support X- Cultural Testing Cost O High O + + High O Moderate O + + Low

18 Despite their good intentions, media campaigns by governments and NGO s are an ineffective antidote to the high-quality pro-drinking messages that appear much more frequently as paid advertisements in the mass media. The impact of education and persuasion programs tends to be small at best. When positive effects are found, they do not persist. Among the hundreds of studies, only a few show lasting effects (after 3 years) (Foxcroft et al. 2003). The time is past for arguments on behalf of substituting education for other, more effective approaches. If educational approaches are to be used, they should be implemented within the framework of broader environmental interventions that address their environment, policy and availability of alcohol.

19 Treatment and Early Intervention Strategy or Intervention Brief intervention with at-risk drinkers Alcohol problems treatment Mutual help/selfhelp attendance Mandatory treatment of repeat drinkingdrivers Effectiveness Research Support X- Cultural Testing Cost Moderate High Low Moderate

20 Strong Strategies Alcohol marketing restrictions Restrictions on affordability, availability, and accessibility, as well as drink-driving deterrence measures Treatment and early intervention services Altering the drinking context

21 Least effective practices Voluntary codes of bar practice Promoting alcohol-free activities Alcohol education in schools College student education Public service messages Warning labels Designated drivers and ride services

22 The Best Measures for Prevention Regulating and restricting availability of alcoholic beverages; Minimum legal purchase age, Government monopoly of retail sales, Restrictions on hours and days of sale, Reducing demand through alcohol taxation and pricing mechanisms; Minimum tax rates for all alcoholic beverages Regulating the marketing of alcoholic beverages (in particular to younger people); - Legal restrictions on advertising and promotions, Enacting appropriate drink-driving policies; - Administrative license suspension, - Graduated licensing for novice drivers, Raising awareness and support for effective policies. Implementing screening programmes and brief interventions for hazardous and harmful use of alcohol. - Brief interventions with at-risk drinkers.

23 WHICH OUTWEIGHS THE OTHER? Joanne Corrigal

24 News from Baltic Region On 16 th May 2017 the health ministries of Estonia, Latvia and Lithuania on Tuesday agreed on common plans for developing alcohol, tobacco and healthy eating policies, including the exchange of information related to these issues. Finland is reviewing its alcohol policy in opposite trend to other countries

25 The recommended knowledge base

26 References Anderson P., Baumberg B. Alcohol in Europe: A Public Health Perspective: A Report for the European Commission. Luxembourg: Institute of Alcohol Studies, European Communities; Babor T., Caetano R., Casswell S., Edwards G., Giesbrecht N., Graham K. et al. Alcohol: No Ordinary Commodity Research and Public Policy. Oxford, UK: Oxford University Press; WHO, World Health Statistics 2017: Monitoring health for the SDGs WHO, Global status report on alcohol and health 2014 WHO, The ASSIST-linked brief intervention for hazardous and harmful substance use: manual for use in primary care / prepared by R. Humeniuk [et al]

27 Thank You! Go out there and raise the issue, advocate, enable brief interventions and stay active! We can make a difference together! Anne Babb a.babb@ifbc.info