The Health, Social and Economic Impact of Alcohol Riga, 19 October 2005
1. Is the European Commission serious about alcohol policy?
2. Is alcohol good for the economy?
3. Is drinking different across Europe?
Structure of Structure of presentationpresentation
1. Is the European Commission serious about alcohol policy?
2. Is alcohol good for the economy?
3. Is drinking different across Europe?
Structure of Structure of presentationpresentation
Alcohol’s economic roleAlcohol’s economic role– Goods account balance €9bn Goods account balance €9bn – Tax revenue (€24bn in EU15)Tax revenue (€24bn in EU15)– Employment:Employment:
Industry say up to 3½ m jobs in EU15Industry say up to 3½ m jobs in EU15
The Alcohol EconomyThe Alcohol Economy
But… tax not dependent on But… tax not dependent on consumptionconsumption
The Alcohol EconomyThe Alcohol Economy
Denmark
Italy
Sweden
UK
Austria
Beglium
France
Germany
Greece
Ireland
Luxembourg
Netherlands
Portugal
0.0%
0.1%
0.2%
0.3%
0.4%
0.5%
0.6%
0.7%
0.8%
5 7 9 11 13 15 17 19
Annual adult alcohol consumption (litres)
Go
ve
rnm
en
t a
lco
ho
l ta
x r
ev
en
ue
(%
o
f G
DP
)
……and jobs not dependent on and jobs not dependent on consumptionconsumption
The Alcohol EconomyThe Alcohol Economy
50
100
150
200
250
1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001
Em
plo
ymen
t (0
00s)
6
8
10
12
14
16
Co
nsu
mp
tion
(l/adu
lt)
Employment
Consumption
Employment in the Hotels, Restaurants and Catering sector in Austria
Total tangible costs – €135bn
Crime - police€14bn
Unemployment€14bn
Crime - defensive
€12bn
Traffic accidents damage€10bn
Crime - damage
€6bn
Treatment/prevention
€5bn
Health€17bn
Absenteeism€9bn
Mortality€36bn
The Alcohol EconomyThe Alcohol Economy
1. Is the European Commission serious about alcohol policy?
2. Is alcohol good for the economy?
3. Is drinking different across Europe?
Structure of Structure of presentationpresentation
Relative dispersion of EU consumptionRelative dispersion of EU consumption
Use of alcoholUse of alcohol
10%
15%
20%
25%
30%
35%
40%
45%
50%
55%
60%
1962 1967 1972 1977 1982 1987 1992 1997 2002
Co
eff
icie
nt
of
va
ria
tio
n (C
V) EU15
EU10
EU25
Binge drinking, menBinge drinking, menat least six portions per one occasionat least six portions per one occasion
%
0
10
20
30
40
50
60
70
80
90
100
Estonia Latvia Lithuania Finland
never
once a year
once a month
once a week
daily
Binge drinking, womenBinge drinking, women at least six portions per one at least six portions per one occasionoccasion
%
0
10
20
30
40
50
60
70
80
90
100
Estonia Latvia Lithuania Finland
never
once a year
once a month
once a week
daily
Consumption-per-Consumption-per-drinker:drinker:
– Much less variationMuch less variation
– EU range still 10-22 EU range still 10-22 LL
– Very high levels Very high levels overall:overall:
5 countries > 20 5 countries > 20 LL
Average 15 LAverage 15 L
Consumption (L per adult)
Less than 14
14 to 1515 to 18½ More than 18½
Use of alcoholUse of alcohol
Use of alcoholUse of alcohol
Bulgaria
Cyprus
Czech R, Latvia
Denmark
Estonia
Finland
France
Greece
Hungary Iceland
Ireland
Italy
Lithuania
Malta
Norw ay
Poland
Portugal Romania
Slovakia
Slovenia
Sw eden UK
5%
10%
15%
20%
25%
30%
35%
5% 15% 25% 35%
Boys drunkenness 1995 ( 1999)
Bo
ys d
run
ken
nes
s 20
03 Trends in binge-drinking in 15-16 year
old male students, 1995-
2003
5+ drinks on a single occasion 3+ times in last
4 weeks
4. Is alcohol important for social well-being and health
5. Is alcohol an important European public health issue?
6. Is it better to drink like southern Europeans?
Structure of Structure of presentationpresentation
12.Choosing different policy options
Cost of implementing same policy options per 100 people per year (€) in sub-region A of EU25; Adapted from Chisholm et al 2004
Alcohol and individualsAlcohol and individuals
0
5
10
15
20
25
30
0-15 15-29 30-44 45-59 60-69
Age group
Males
Females
Alc
oh
ol-
attr
ibu
tab
le d
eath
s as
a %
of
all
dea
ths
4. Is alcohol important for social well-being and health
5. Is alcohol an important European public health issue?
6. Is it better to drink like southern Europeans?
Structure of Structure of presentationpresentation
Alcohol and EuropeAlcohol and Europe
Each year, alcohol causes:
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
Alcohol and EuropeAlcohol and Europe
The geographical relationship between The geographical relationship between alcohol consumption and cirrhosis alcohol consumption and cirrhosis mortalitymortality
MEN (Rsq=0.75)
Per capita alcohol consumption
151413121110987654
Live
r ci
rrho
sis
mor
talit
y40
30
20
10
0
Ice
Lith
Lat
Est
Nor Swe
Fin
De
4. Is alcohol important for social well-being and health
5. Is alcohol an important European public health issue?
6. Is it better to drink like southern Europeans?
Structure of Structure of presentationpresentation
0
5
10
15
20
25
30
35
40
45
50
1970 1975 1980 1985 1990 1995 2000
Cir
rho
sis
rate
(S
DR
per
1000)
0
2
4
6
8
10
12
14
16
18
20
Co
nsu
mp
tion
(litres p
er a
du
lt)
Alcohol consumption
Cirrhosis (male)
Cirrhosis (female)
Alcohol consumption and cirrhosis rates in southern
Alcohol and southern Alcohol and southern EuropeEurope
0.0
0.2
0.4
0.6
0.8
1.0
1.2
1.4
1.6
1.8
Northern Europe Central Europe Southern EuropeHo
mic
ide
pe
r 1
00
,00
0 p
op
ula
tio
n
Homicide
Attributable toalcohol
50%61%
55%
Alcohol and violence in EU15 Alcohol and violence in EU15 countriescountries
Alcohol consumption 5.6 9.3 10.4 (litres per capita)
Alcohol and southern Alcohol and southern EuropeEurope
7. Is alcohol policy effective?
8. Is there a role for the alcohol industry?
9. Is alcohol policy very different across Europe?
Structure of Structure of presentationpresentation
Education and Persuasion Education and Persuasion Pricing and Taxation Pricing and Taxation Regulating Physical AvailabilityRegulating Physical Availability Regulating Alcohol PromotionRegulating Alcohol Promotion Drinking-Driving CountermeasuresDrinking-Driving Countermeasures Treatment and Early InterventionTreatment and Early Intervention
Alcohol Alcohol policypolicy
12.Choosing different policy options
Impact of different policy options in preventing DALYs per million people per year
Alcohol Alcohol policypolicy
0
200
400
600
800
1000
1200
1400
Euro C
DA
LY
s p
reve
nte
d p
er
mill
ion
pe
op
le p
er
yea
rBrief interventions
Drink drive measures
Current tax + 25%
Restricted sales
Advertising ban
12.Choosing different policy options
Cost of implementing same policy options per 100 people per year (€)
Alcohol Alcohol policypolicy
0
10
20
30
40
50
60
Euro C
Cos
t pe
r 10
0 pe
ople
per
yea
r(€)
Brief interventions
Drink drive measures
Current tax + 25%
Restricted sales
Advertising ban
10% in price:
consumption 2% to 8%
9,000 deaths
€€3 billion in revenue
Alcohol Alcohol policypolicy
Alcohol Alcohol policypolicy
Alcopops in Switzerland
0.0
1.0
2.0
3.0
4.0
5.0
6.0
7.0
8.0Jan-0
1
Apr-
01
Jul-01
Oct-
01
Jan-0
2
Apr-
02
Jul-02
Oct-
02
Jan-0
3
Apr-
03
Jul-03
Oct-
03
Jan-0
4
Apr-
04
Jul-04
Oct-
04
Jan-0
5
Apr-
05
Imp
ort
s o
f a
lco
po
ps
(mill
ion
s o
f 27
5m
l bo
ttle
s)
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 + ++
Follow-up: Partially effective
Ineffective “Negative”effect
Short-term (1 year or less)
14 23 3
Medium-term (1-3 years)
13 19 2
Long-term (over 3 years)
3 6 0
Alcohol Alcohol policypolicy
Education programmes in young people
7. Is alcohol policy effective?
8. Is there a role for the alcohol industry?
9. Is alcohol policy very different across Europe?
Structure of Structure of presentationpresentation
Alcohol Alcohol industryindustry
0123456789
10
Po
licy
imp
act
Regulation Education Implementation of law
Policy options
NGO
GO
AI
7. Is alcohol policy effective?
8. Is there a role for the alcohol industry?
9. Is alcohol policy very different across Europe?
Structure of Structure of presentationpresentation
Alcohol policy in Alcohol policy in EuropeEurope
Tax levels
Average effective tax adjusting for
purchasing power
PP € <400PP € 400 – 1000 PP € > 1000
Legal purchase age of 18
17, or 16 (B) and 18 (S)
16
Legal purchase age of 18
20
16
None
Buying any drink from Buying any drink from barsbars
Buying beer from shopsBuying beer from shops
Alcohol policy in Alcohol policy in EuropeEurope
TV advertisingTV advertising– Stronger for Stronger for
spirits, esp. in spirits, esp. in EU10EU10
– Stronger than for Stronger than for other media, such other media, such as billboards, as billboards, print, sponsorship print, sponsorship etc.etc.
Complete ad ban
Legal restriction (not just content)
Voluntary agreements
Nothing
Beer advertising on televisionBeer advertising on television
Alcohol policy in Alcohol policy in EuropeEurope
Alcohol policy in Alcohol policy in EuropeEuropeVariation in alcohol policy…Variation in alcohol policy…
Policy score
Score (0-20) showing
strength of alcohol policy
< 9 9 – 12 > 12
Alcohol Alcohol policypolicy
Education programmes in young people
0
5
10
15
20
25
Partiallyeffective
Noteffective
Negativeeffect
< 1 year
1-3 years
> 3 years
Alcohol Alcohol industryindustry
0123456789
10
Po
licy
imp
act
Regulation Education Implementation of law
Policy options
NGO
GO
AI