The Health Social and Economic Impact of Alcohol

The Health, Social and Economic Impact of Alcohol Riga, 19 October 2005

Structure of presentation 1. Is the European Commission serious about alcohol policy? 2. Is alcohol good for the economy? 3. Is drinking different across Europe?

Structure of presentation 1. Is the European Commission serious about alcohol policy? 2. Is alcohol good for the economy? 3. Is drinking different across Europe?

The Alcohol Economy n Alcohol’s economic role – Goods account balance € 9 bn – Tax revenue (€ 24 bn in EU 15) – Employment: Industry say up to 3½ m jobs in EU 15

The Alcohol Economy n But… tax not dependent on consumption

The Alcohol Economy n …and jobs not dependent on consumption Employment in the Hotels, Restaurants and Catering sector in Austria

The Alcohol Economy Total tangible costs – € 135 bn

Structure of presentation 1. Is the European Commission serious about alcohol policy? 2. Is alcohol good for the economy? 3. Is drinking different across Europe?

Use of alcohol n Relative dispersion of EU consumption

Binge drinking, men at least six portions per one occasion %

Binge drinking, women at least six portions per one occasion %

Use of alcohol n Consumption-perdrinker: – Much less variation – EU range still 10 -22 L – Very high levels overall: n 5 countries > 20 L n Average 15 L Consumption (L per adult) Less than 14 14 to 15 15 to 18½ More than 18½

Use of alcohol Trends in bingedrinking in 15 -16 year old male students, 19952003 5+ drinks on a single occasion 3+ times in last 4 weeks

Structure of presentation 4. Is alcohol important for social wellbeing and health 5. Is alcohol an important European public health issue? 6. Is it better to drink like southern Europeans?

12. Choosing different policy options Alcohol and individuals Cost of implementing same policy options per 100 people per year (€) in sub-region A of EU 25; Adapted from Chisholm et al 2004

Structure of presentation 4. Is alcohol important for social wellbeing and health 5. Is alcohol an important European public health issue? 6. Is it better to drink like southern Europeans?

Alcohol and Europe

Alcohol and Europe Each year, alcohol causes: Ø Ø Ø Ø 17, 000 road traffic accidents 27, 000 accidental deaths 2, 000 murders 10, 000 suicides 50, 000 cancer deaths, of which 11, 000 female breast cancer deaths 17, 000 psychiatric deaths 45, 000 deaths from liver cirrhosis

The geographical relationship between alcohol consumption and cirrhosis mortality

Structure of presentation 4. Is alcohol important for social wellbeing and health 5. Is alcohol an important European public health issue? 6. Is it better to drink like southern Europeans?

Alcohol and southern Europe Alcohol consumption and cirrhosis rates in southern

Alcohol and southern Europe Alcohol and violence in EU 15 countries Alcohol consumption (litres per capita) 5. 6 9. 3 10. 4

Structure of presentation 7. Is alcohol policy effective? 8. Is there a role for the alcohol industry? 9. Is alcohol policy very different across Europe?

Alcohol policy Education and Persuasion n Pricing and Taxation n Regulating Physical Availability n Regulating Alcohol Promotion n Drinking-Driving Countermeasures n Treatment and Early Intervention n

12. Choosing different policy options Alcohol policy Impact of different policy options in preventing DALYs per million people per year

12. Choosing different policy options Alcohol policy Cost of implementing same policy options per 100 people per year (€)

Alcohol policy Ý 10% in price: Þconsumption 2% to 8% Þ 9, 000 deaths Ý€ 3 billion in revenue

Alcohol policy Alcopops in Switzerland

Effectiveness Breadth of Research Support Cost Efficiency Lowered BAC levels +++ +++ Random breath testing (RBT) +++ ++ + License suspension +++ ++ ++ Graduated licensing ++ ++ +++ Low BAC for youth +++ ++ +++ Server training + ++ Designated drivers and ride services O + ++

Alcohol policy Education programmes in young people Follow-up: Partially effective Ineffective “Negative” effect Short-term (1 year or less) 14 23 3 Mediumterm (1 -3 years) 13 19 2 Long-term (over 3 years) 3 6 0

Structure of presentation 7. Is alcohol policy effective? 8. Is there a role for the alcohol industry? 9. Is alcohol policy very different across Europe?

Alcohol industry

Structure of presentation 7. Is alcohol policy effective? 8. Is there a role for the alcohol industry? 9. Is alcohol policy very different across Europe?

Alcohol policy in Europe Tax levels Average effective tax adjusting for purchasing power PP € <400 PP € 400 – 1000 PP € > 1000

Alcohol policy in Europe Legal purchase age of 18 20 16 16 17, or 16 (B) and 18 (S) Buying any drink from bars None Buying beer from shops

Alcohol policy in Europe n TV advertising – Stronger for spirits, esp. in EU 10 – Stronger than for other media, such as billboards, print, sponsorship etc. Complete ad ban Voluntary agreements Legal restriction (not just content) Nothing Beer advertising on television

Alcohol policy in Europe Variation in alcohol policy… Policy score Score (0 -20) showing strength of alcohol policy <9 9 – 12 > 12

Alcohol policy Education programmes in young people

Alcohol industry