Alcohol-related harm in Europe and the WHO policy response

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1 Alcohol-related harm in Europe and the WHO policy response Lars Moller Programme Manager World Health Organization Regional Office for Europe Date of presentation

2 NCD global monitoring framework: alcohol-related targets and indicators One target: At least 1% relative reduction in the harmful use of alcohol, as appropriate, within the national context. Indicators: Total (recorded and unrecorded) alcohol per capita (15+ years old) consumption Age-standardized prevalence of heavy episodic drinking Alcohol-related morbidity and mortality Alcohol Date and of harm presentation

3 3.5 Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol Alcohol and harm Date of presentation

4 SDG 215: 17 goals (1 health), 169 targets (13 health) adopted at the United Nations Sustainable Development Summit September Coverage of treatment interventions (pharmacological, psychosocial and rehabilitation and aftercare services) for substance use disorders Harmful use of alcohol, defined according to the national context as alcohol per capita consumption (aged 15 years and older) within a calendar year in litres of pure alcohol Past 12 month prevalence of alcohol and drug use (still under negotiation) Alcohol Date and of harm presentation

5 New data Alcohol and harm Date of presentation

6 Alcohol Date and of harm presentation

7 Total average alcohol per capita consumption, recorded and unrecorded, 214, men and women Litres of pure alcohol Turkey Tajikistan Azerbaijan FYR Macedonia Israel Turkmenistan Uzbekistan Kyrgyzstan Armenia Bosnia Herzegovina Albania Italy Iceland Georgia Norway Malte Kazakhstan Greece Sweden Netherlands Europe Switzerland Spain Denmark Ireland Finland Andorra Slovenia Serbia Portugal Luxembourg Germany Montenegro France Great Britain Austria Cyprus Slovakia Latvia Croatia Hungary Poland Belgium Bulgaria Ukraine Estonia Czech Republic Romania Russian Federation Republic of Moldova Belarus Lithuania

8 Alcohol use during the past 3 days, boys (ESPAD, 215) % Alcohol Date and of harm presentation

9 Alcohol use during the past 3 days, girls (ESPAD, 215) % Alcohol Date and of harm presentation

10 Being drunk during the past 3 days, boys (ESPAD, 215) % Alcohol Date and of harm presentation

11 Being drunk during the past 3 days, girls (ESPAD, 215) % Alcohol Date and of harm presentation

12 Age standardized alcohol-attributable mortality, 214 (rate per million) Alcohol and harm Date of presentation

13 Alcohol attributable liver cirrhosis mortality. Rates per million Kyrgyzstan Republic of Moldova Kazakhstan Uzbekistan Romania Hungary Turkmenistan Lithuania Slovakia Ukraine Georgia Belarus Slovenia Croatia Russian Federation Azerbaijan Poland Armenia Bulgaria Tajikistan Estonia Czech Republic Finland Latvia Portugal Denmark Austria Germany France Belgium United Kingdom Spain Italy Serbia Bosnia and Herzegovina Ireland Switzerland Montenegro Sweden Netherlands Greece Malta The former Yugoslav Republic of Cyprus Norway Israel Turkey Iceland Albania

14 Alcohol attributable CVD mortality. Rates per million Belarus Ukraine Republic of Moldova Russian Federation Kyrgyzstan Kazakhstan Bulgaria Montenegro Turkmenistan Georgia Uzbekistan Tajikistan Romania Lithuania Poland Serbia Estonia Azerbaijan Bosnia and Herzegovina Armenia Portugal Albania Slovakia Greece Malta Turkey Ireland Croatia Hungary Spain Slovenia The former Yugoslav Republic of Cyprus France Sweden Italy Germany Austria United Kingdom Belgium Netherlands Israel Denmark Czech Republic Finland Latvia Switzerland Iceland Norway

15 Alcohol attributable cancer mortality. Rates per million Hungary Slovakia Belarus Lithuania Croatia Kazakhstan Czech Republic Romania Republic of Moldova Ukraine Poland France Estonia Russian Federation Bulgaria Slovenia Portugal Serbia Latvia Turkmenistan Belgium Germany United Kingdom Netherlands Spain Denmark Montenegro Ireland Austria Georgia Switzerland Italy Armenia Bosnia and Finland Greece Kyrgyzstan Sweden Malta Uzbekistan Norway The former Yugoslav Albania Cyprus Azerbaijan Iceland Israel Tajikistan Turkey

16 Alcohol attributable injury mortality. Rates per million Belarus Russian Federation Ukraine Lithuania Kazakhstan Republic of Moldova Estonia Latvia Poland Romania Georgia Hungary Slovenia Slovakia Belgium France Czech Republic Turkmenistan Finland Kyrgyzstan Armenia Austria Bulgaria Croatia Germany Uzbekistan Montenegro Ireland Greece Sweden Denmark Portugal Spain Iceland United Kingdom Norway Netherlands Switzerland Italy Albania Cyprus Azerbaijan Malta Bosnia and Herzegovina Serbia Israel The former Yugoslav Republic of Tajikistan Turkey

17 The WHO Policy Response Alcohol Date and of harm presentation

18 Global strategy and European action plan Alcohol Date and of harm presentation

19 European action plan to reduce the harmful use of alcohol (EAAP) action areas Leadership, awareness and commitment, as sustainable intersectoral action requires strong leadership and a solid base of awareness and political will Health services response, as these services are central to tackling health conditions in individuals caused by harmful alcohol use Community action, as governments and other stakeholders can support and empower communities in adopting effective approaches to prevent and reduce harmful alcohol use Policies and countermeasures on drink driving, as it is extremely dangerous to drivers, passengers and other people using the roads Availability of alcohol, as public health policies to regulate commercial or public availability have proved to be very effective in reducing the general level of harmful use and drinking among minors Alcohol Date and of harm presentation

20 EAAP action areas Marketing of alcoholic beverages, as systems are needed to protect people, particularly children and young people, from advanced advertising and promotion techniques Pricing policies, as most consumers, particularly heavy drinkers and young people, are sensitive to changes in the prices of alcohol products Reducing the negative consequences of drinking and alcohol intoxication, in order to minimize violence, intoxication and harm to intoxicated people Reducing the public health impact of illicit and informally produced alcohol, as its consumption could have additional negative health consequences due to its higher ethanol content and potential contamination with toxic substances Monitoring and surveillance, as relevant data create the basis for the appropriate delivery and success of responses Alcohol Date and of harm presentation

21 Alcohol policy scoring Strengths The role of governments in reducing population exposure to modifiable risk factors is emphasized. Political accountability is promoted. A rounded evaluation of national alcohol strategies is provided. A big picture for each overarching policy area is presented. Comparisons between countries are facilitated. Monitoring of a country s progress over time is facilitated. Communication with stakeholders is simplified. Limitations Enforcement of policies is not measured. Some aspects of the methodology (such as policy weights) are potentially contentious. Data for some indicators (such as pricing estimates) are less reliable. Aggregated information does not reflect subnational variations in alcohol policies. Summary measures are prone to being misinterpreted. Alcohol and harm Date of presentation

22 Leadership, awareness and commitment (n=29) Score

23 Health services response (n=18) Score

24 Community and workplace action (n=29) Score

25 Drink driving policies and countermeasures (n=3) Score

26 Availability of alcohol (n=3) Score

27 Marketing of alcoholic beverages (n=3) Score

28 Pricing policies (n=27) Score

29 Reducing the negative consequences of drinking and alcohol intoxication (n=31) Score

30 Reducing the public health impact of illicit alcohol and informally produced alcohol (n=53) Score

31 Monitoring and surveillance (n=3) Score

32 Our publications Alcohol and harm Date of presentation

33 More information on the WHO website Alcohol and harm Date of presentation