Action plan on youth drinking and on heavy episodic drinking (binge drinking) ( ) Related activities in Sweden 2014

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Action plan on youth drinking and on heavy episodic drinking (binge drinking) (2014 2016) Related activities in Sweden 2014

Area 1: Reduce heavy episodic drinking (binge drinking)

Knowledge support Systematic reviews Interventions to prevent misuse of alcohol, drugs and gambling in youth, Swedish Agency for Health Technology Assessment and Assessment of Social Services, 2015 to give an example of one type of knowledge support 2018-01-31 3

Activities, municipalities* (number) Activity 2011 2012 2013 2014 2015 2016 Alcohol policy in school -Includes preventive activities. Years 1 9. 160 160 156 167 157 166 ANDT policy in school -Includes preventive activities. Years 10 12. 133 147 133 136 134 140 Media advocacy -Active media work to put focus on alcohol - - - - 135 90 to name a few *290 municipalities in total in Sweden 2018-01-31 4

Perceived risk assoc. with weekly binge drinking, year 9* students (percentage) 100 90 80 70 60 50 Girls No risk Girls Small risk Girls Medium risk Girls Large risk Girls Risk Boys No risk 40 30 20 10 Boys Small risk Boys Medium risk Boys Large risk Boys Risk 0 2007 2008 2009 2010 2011 2012A 2012B 2013 2014 2015 2016 *Age ca 15 years Source: The Swedish Council for Information on Alcohol and Other Drugs 2018-01-31 5

Perceived risk assoc. with weekly binge drinking, year 11* students (percentage) 100 90 80 70 60 50 Girls No risk Girls Small risk Girls Medium risk Girls Large risk Girls Risk Boys No risk 40 30 20 10 Boys Small risk Boys Medium risk Boys Large risk Boys Risk 0 2007 2008 2009 2010 2011 2012A 2012B 2013 2014 2015 2016 *Age ca 17 years Source: The Swedish Council for Information on Alcohol and Other Drugs 2018-01-31 6

Perceived risk assoc. with weekly binge drinking, students (percentage) 100 90 80 70 60 50 40 30 20 Year 9 Girls Don't know Year 9 Boys Don't know Year 11 Girls Don't know Year 11 Boys Don't know 10 0 2007 2008 2009 2010 2011 2012A 2012B 2013 2014 2015 2016 Source: The Swedish Council for Information on Alcohol and Other Drugs 2018-01-31 7

Area 2: Reduce accessibility and availability of alcoholic beverages for youth

Alcohol retail monopoly Price No commercial interest, no marketing and no discounts Legal purchase age 20 years of age. No sales to persons intoxicated or suspected of peddling to underaged individuals Outlet density Regulated Hours and days of sale Regulated References: Booth et al., 2008, Sheffield Univ; Wagenaar et al., 2009, Addiction; Wagenaar et al., 2010, Am J Public Health; Elder et al., 2010, Am J Public Health 2018-01-31 9

Activities, municipalities (number) Activities 2011 2012 2013 2014 2015 2016 Parenting program -Structured parenting program with trained personnel. Years 6 9 193 164 150 143 118 79 Control purchase -Supervision of legal purchase age in supermarkets ( 18 years) by mystery shopping - - - 9 26 37 to name a couple 2018-01-31 10

Perceived availability of alcohol within 24 hours, year 9 students (percentage) 100 90 80 70 Girls Supermarkets (medium strong beer) Girls Systembolaget 60 50 40 30 20 10 0 2012B 2013 2014 2015 2016 Girls Smuggled alcohol Boys Supermarkets (medium strong beer) Boys Systembolaget Boys Smuggled alcohol Source: The Swedish Council for Information on Alcohol and Other Drugs 2018-01-31 11

Perceived availability of alcohol within 24 hours, year 11 students (percentage) 100 90 80 70 Girls Supermarkets (medium strong beer) Girls Systembolaget 60 50 40 30 20 10 0 2012B 2013 2014 2015 2016 Girls Smuggled alcohol Boys Supermarkets (medium strong beer) Boys Systembolaget Boys Smuggled alcohol Source: The Swedish Council for Information on Alcohol and Other Drugs 2018-01-31 12

Government inquiry (Fi 2015/05353/S3) To map illegal handling of products subject to excise tax to disclose and evaluate the effects of actions taken Spritbussar stopped by coordinated efforts from several government agencies. Focus on law enforcement. Resultant increase in myrtrafik 25 percent decrease in number of persons who report to have bought smuggled alcohol during eight week period of operations Final report Oct 2017 Source: Government Offices of Sweden 2018-01-31 13

Area 3: Reduce exposure of youth to alcohol marketing and advertising

Government inquiry (S 2016:06) To propose how alcohol marketing, primarily in digital media, can be limited to protect children and young people Interim report: Regulation of alcoholic ice cream and other products (SOU 2017:59) Pending: analyses and proposals on how to limit alcohol marketing in digital media Final report early 2018 Source: Government Offices of Sweden 2018-01-31 15

Area 4: Reduce harm from alcohol during pregnancy

National Guidelines for Methods of Preventing Disease Alcohol consumption during pregnancy Counselling (recommendation, level 2 out of 10) Dialogue between healthcare professional and patient Adaptation to the specific person s age, health, risk levels, etc Possible addition of various tools and devices, as well as special follow-up Advanced counselling (recommendation, level 9) Dialogue between healthcare professional and patient Adaptation to the specific person s age, health, risk levels, etc Possible addition of various tools and devices, as well as special follow-up Ordinarily theory-based or structured, such as motivational interviewing Source: National Board of Health and Welfare 2018-01-31 17

Knowledge support Systematic reviews Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Spectrum Disorders (FASD) conditions and interventions, Swedish Agency for Health Technology Assessment and Assessment of Social Services, 2016 to give an example of one type of knowledge support 2018-01-31 18

Area 5: Ensure a healthy and safe environment for youth

Activities, municipalities (number) Activities 2011 2012 2013 2014 2015 2016 Responsible beverage service -Method to reduce alcohol-related injuries 211 193 207 211 214 211 Kronoberg model -Police method to reduce alcohol-related violence SMADIT -Police method to prevent drunk drivers from relapsing 179 163 153 149 141 105 157 155 149 148 135 124 to name a few 2018-01-31 20

Area 6: Support monitoring and increase research

Indikatorlabbet Monitoring system with a large number of ANDT-related indicators describing the development in the following main areas: Access to alcohol and tobacco based on price, number of points of sale, opening hours, etc. Supervision of municipalities in accordance with the Alcohol act and Tobacco act Consumption/usage of alcohol, narcotics, doping and tobacco Preventive ANDT interventions among municipalities Injuries from personal use and use by others of alcohol and narcotics Access to healthcare and mortality caused by alcohol, narcotics and tobacco 2018-01-31 22

Funding of preventive activities The Public Health Agency of Sweden annually administrates 4+ million to projects on helth promotion and prevention in ANDT 2018-01-31 23

Thanks for listening!

Appendix A Situation in Sweden

Self-reported alcohol consumption, year 9 students (percentage) 100 90 80 70 60 50 40 30 20 10 0 Girls Debut Girls Drinking Girls Binge drinking Boys Debut Boys Drinking Boys Binge drinking Source: The Swedish Council for Information on Alcohol and Other Drugs 2018-01-31 26

Self-reported alcohol consumption, year 11 students (percentage) 100 90 80 70 60 50 40 30 20 10 0 2004 2005 2006 2007 2008 2009 2010 2011 2012A 2012B 2013 2014 2015 2016 Girls Debut Girls Drinking Girls Binge drinking Boys Debut Boys Drinking Boys Binge drinking Source: The Swedish Council for Information on Alcohol and Other Drugs 2018-01-31 27

Self-reported alcohol-related problems, female year 9 students (percentage) 100 90 80 70 60 50 40 30 20 10 0 Got in fight Injured/harmed Problems with parents Problems with police Stolen from/robbed Source: The Swedish Council for Information on Alcohol and Other Drugs 2018-01-31 28

Self-reported alcohol-related problems, male year 9 students (percentage) 100 90 80 70 60 50 40 30 20 10 0 Got in fight Injured/harmed Problems parents Stolen from/robbed Problems police Source: The Swedish Council for Information on Alcohol and Other Drugs 2018-01-31 29

Self-reported alcohol-related problems, female year 11 students (percentage) 100 90 80 70 60 50 40 30 20 10 0 2004 2005 2006 2007 2008 2009 2010 2011 2012A 2012B 2013 2014 2015 2016 Got in fight Injured/harmed Problems parents Stolen from/robbed Problems police Source: The Swedish Council for Information on Alcohol and Other Drugs 2018-01-31 30

Self-reported alcohol-related problems, male year 11 students (percentage) 100 90 80 70 60 50 40 30 20 10 0 2004 2005 2006 2007 2008 2009 2010 2011 2012A 2012B 2013 2014 2015 2016 Got in fight Injured/harmed Problems parents Stolen from/robbed Problems police Source: The Swedish Council for Information on Alcohol and Other Drugs 2018-01-31 31

Deaths in explicit alcohol diagnosis (ICD-10), 10 24 years 4,0 35 3,5 3,0 2,5 2,0 1,5 1,0 0,5 0,0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Girls Deaths per 100 000 Boys Deaths per 100 000 Girls Deaths Boys Deaths 30 25 20 15 10 5 0 Source: National Board of Health and Welfare 2018-01-31 32

Estimated alcohol-related disease burden, females, 10 24 years Source: Institute for Health Metrics and Evaluation, Seattle, WA, USA 2018-01-31 33

Estimated alcohol-related disease burden, males, 10 24 years Source: Institute for Health Metrics and Evaluation, Seattle, WA, USA 2018-01-31 34

Public support for alcohol retail monopoly (percentage) 100 90 80 70 60 50 40 30 20 10 0 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 Source: Systembolaget 2018-01-31 35

Investments in alcohol advertising, old media (SEK) Source: IQ 2018-01-31 36

Appendix B Information campaigns

Information campaigns Tänk om (Think again) (2010 2015) Parents of adolescents Hejdå alkoholskador (Good bye alcohol-related harm) (2014 ) Brothers, sisters and older peers of adolescents Don t drink & drive (2003 ) Students Tala om alcohol (Talk about alcohol) (2006 ) Students to name a few 2018-01-31 38