the health , social and economic impact of alcohol riga, 19 october 2005

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

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


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


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


1. Is the European Commission serious about alcohol policy?

2. Is alcohol good for the economy?

3. Is drinking different across Europe?


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



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?


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

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

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?


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


Impact of different policy options in preventing DALYs per million people per year


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


Cost of implementing same policy options per 100 people per year (€)


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



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


Education programmes in young people

Alcohol Alcohol industryindustry

0123456789

10

Po

licy

imp

act

Regulation Education Implementation of law

Policy options

NGO

GO

AI

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


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 EuropeEuropeVariation in alcohol policy…Variation in alcohol policy…

Policy score

Score (0-20) showing

strength of alcohol policy

< 9 9 – 12 > 12


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

the health , social and economic impact of alcohol riga, 19 october 2005

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