alcohol policy in lithuania - tai.ee
TRANSCRIPT
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Alcohol policy in Lithuania
Aurelijus Veryga, assoc.prof.
Lithuanian University of Health Sciences
Health Research Institute
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Epidemiology
2
Health Research Institute
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3
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Harmful use of alcohol with potential risk of dependence among 15-74 years old Lithuanians according to age and gender
(AUDIT ≥ 8)
25
34,6
43,3
32,527,7
20,2
7,714,3
8,8 9,3 8,1 9,2
0
10
20
30
40
50
15-24 25-34 35-44 45-54 55-64 65-74
%
Man Woman n = 3302
VPSC, LSMU 2007
Health Research Institute
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Prevalence of 11-15 years old children, reported 2 or more lifetime
drunkenness episodes (1998)
HBSC, 2006
Izraelis 4
Šveicarija 6
Portugalija 7
Prancūzija 8
Lietuva 9
Vengrija 9
Graikija 9
Lenkija 9
Estija 9
Fl.Belgija 10
Čekija 10
Latvija 10
Rusija 12
Airija 13
Vokietija 13
JAV 14
Pr.Belgija 14
Švedija 15
Norvegija 15
Austrija 15
Slovakija 17
Kanada 19
Š.Airija 21
Suomija 25
Anglija 26
Škotija 27
Danija 29
Grenlandija 30
Velsas 35
10 Izraelis
11 Šveicarija
12 Graikija
13 Prancūzija
15 Norvegija
15 Rusija
16 Vokietija
16 Portugalija
16 Švedija
16 Fl.Belgija
17 JAV
18 Lietuva
19 Vengrija
19 Lenkija
19 Čekija
20 Kanada
20 Estija
21 Airija
22 Austrija
22 Latvija
22 Pr.Belgija
24 Suomija
28 Š.Airija
29 Grenlandija
29 Slovakija
30 Škotija
31 Anglija
34 Danija
40 Velsas
1
2
5
3
6
4
7
18
19
20
21
22
23
24
25
26
27
28
11
12
13
14
15
16
17
8
9
10
Mergaitės Berniukai
0 030 3010
%%
50
29
10 502040 4020
Health Research Institute
Girls Boys
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Prevalence of 11-15 years old children, reported 2 or more lifetime
drunkenness episodes (2006)
HBSC, 2006
8,93 JAV 9,43 Malta
9,80 Norvegija 10,00 Ispanija
10,13 Graikija 10,33 Švedija
11,10 Makedonija 11,27 Italija
11,73 Liuksemburgas 11,90 Prancūzija
12,27 Islandija 12,30 Šveicarija
12,53 Izraelis 12,60 Portugalija
12,67 Nyderlandai 13,33 Vokietija
15,33 Belgija 15,70 Airija
16,07 Kanada 17,37 Čekijos Respublika
17,77 Austrija 18,37 Vengrija
18,73 Grenlandija 19,30 Slovakija
19,63 Suomija 19,77 Lenkija
21,10 Slovėnija 22,30 Ukraina
22,40 Rusijos Federacija 25,00 Kroatija
25,30 Rumunija 25,40 Jungtinė Karalystė
25,53 Danija 27,27 Latvija
27,60 Bulgarija 29,00 Lietuva
29,33 Estija n/d Turkija
Izraelis 4,83
Makedonija 4,97
Malta 7,07
Šveicarija 7,37
Graikija 7,40
Italija 7,43
Prancūzija 8,03
JAV 8,27
Portugalija 8,43
Liuksemburgas 8,53
Nyderlandai 8,97
Rumunija 9,57
Švedija 9,83
Belgija 10,03
Ispanija 10,23
Vokietija 11,27
Norvegija 11,67
Islandija 12,17
Slovėnija 12,33
Lenkija 12,43
Airija 12,83
Kroatija 13,70
Čekijos Respublika 13,87
Vengrija 13,90
Austrija 14,13
Ukraina 14,77
Slovakija 15,10
Kanada 16,63
Suomija 18,53
Rusijos Federacija 18,53
Latvija 19,17
Grenlandija 19,20
Estija 19,67
Bulgarija 20,27
Danija 21,77
Lietuva 22,13
Jungtinė Karalystė 25,10
Turkija n/d
12
5
3
6
4
7
18192021
22232425262728
11121314151617
89
10
Mergaitės Berniukai
0 030 3010
%%
31
3332
3435
2930
10
36
3738
20 20
Girls Boys
Health Research Institute
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Prevalence of 9-14 years old children alcohol intoxications (T-51) (hospital cases)
19
36
84
149
206
269
329
246
4,6 921,9
40,6
58,9
81,1
105,2
81,2
0
50
100
150
200
250
300
350
2001 2002 2003 2004 2005 2006 2007 2008
Number of cases
Cases per 100.000 population
17,3 times increase in 6 years
SVEIDRA, Institute of Hygiene
Health Research Institute
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Alcohol use and suicide attempts among 15-74 years old Lithuanians
1
0,6
1,5
3
3,1
3,2
2,3
3,1
4,1
10,4
0 2 4 6 8 10 12
Nevartoja alkoholinių gėrimų
Vartoja kartą per mėnesį ar rečiau
Vartoja du - keturis kartus per mėnesį
Vartoja du - tris kartus per savaitę
Vartoja keturis ar daugiau kartų per savaitę
Bandė žudytis anksčiau nei per paskutinius 12 mėn.
Bandė žudytis per paskutinius 12 mėn.
Reported attempt to commit suicide earlier thank during last 12 months
Reported attempt to commit suicide during last 12 months
VPSC, LSMU 2008
N = 3302
Health Research Institute
Frequency of alcohol use
4 or more times per week
2-3 times per week
2-4 per month
Once or les then once per month
Do not use alcohol
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Is there any relation of the trends to alcohol control policy?
9
Health Research Institute
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Correlation of alcoholic psychosis with alcohol policy measures
10
Health Research Institute
LSMU, 2012
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What was done on national level (starting from the year 2008)
Advertisement Price (excise) Night sale
Health Research Institute
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Pure alcohol consumption per capita in Lithuania 2000-2011
7,8
8,5
99,2
9,910,2
10,6
11,2 11,2
10,610,9
11,9
11,88
12,47
14,55
13,18
10,8
11,3
12,6
7
8
9
10
11
12
13
14
15
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Suvartotas absoliutus alkoholis litrais tenkantis vienam gyventojui (Statistikos departamento duomenimis)
Suvartotas absoliutus alkoholis litrais tenkantis vienam gyventojui (NTAKD duomenimis)
Pu
re a
lco
ho
l co
nsu
mp
tio
n p
er c
ap
ita
Source: Statistics Lithuania; Drug, Tobacco and Alcohol Control Department
Health Research Institute
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Relative price of alcohol beverages
Source: Statistics Lithuania
47,6 48,8
40,7
45,2
51,8
66,7
80,3 80,2
73,7
69,6
12,6 13,014,4
16,8
31,2
42,2 42,841,5
35,634,2
15,618,6 20,0 21,1
23,227,4
32,235,5
32,4 32,0
0
10
20
30
40
50
60
70
80
90
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
Nespirituoto vynuogių vyno litrai, kuriuos galima nupirkti už vidutines disponuojamas mėnesines pajamas (Liters of wine)
Importuojamos ir Lietuvoje gaminamos degtinės litrai, kuriuos galima nupirkti už vidutines disponuojamas mėnesines pajamas (Liters of Vodka)
Importuojamo ir Lietuvoje gaminamo alaus dekalitrai, kuriuos galima nupirkti už vidutines disponuojamas mėnesines pajamas (Decaliters of beer)
Lite
rs o
f al
coh
olic
bev
erag
es, t
hat
per
son
can
bu
y w
ith
av
erag
e m
on
thly
sal
ary
Health Research Institute
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Source: Institute of Hygiene
Mortality from selected alcohol related causes in Lithuania 2000-2010
8,9
11 11,3
13,312,5
16
20,4
25,5
20,7
14,22 13,5
6,5
7,4 7,37,9
9,2
10,7
15,5
19,2 18,8
15,2415,9
9,8
12,2 1212,6 12,5
13,3 14,3 14,3 13,8
10,39,4
1,1 1,30,6 0,8 0,8 0,7 1 1,2 1,1 0,9 0,7
0
5
10
15
20
25
30
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
Alkoholinė kepenų liga (K70)/Alcoholic liver disease
Kepenų cirozė ir fibrozė (K74)/Fibrosis and cirrhosis of liver
Atsitiktinis apsinuodijimas alkoholiu (X45)/Accidental poisoning by and exposure to alcoholų
Psichikos ir elgesio sutrikimai vartojant alkoholį (F10)/Mental and behavioural disorders due to use of alcohol
Mo
rta
lity
per
10
0 0
00
po
pu
lati
on
Health Research Institute
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Alcohol consumption vs. alcohol attributable mortality
1631 1626
1808
2120
2545
2112
1380 1424
976 9631096
1308
1549
1295
872 842
395 375464
586662
566418
323
0
2
4
6
8
10
12
14
0
500
1000
1500
2000
2500
3000
2003 2004 2005 2006 2007 2008 2009 2010
Suvartotas absoliutus alkoholis litrais tenkantis vienam gyventojui (Statistikos departamento duomenimis)
Suvartotas absoliutus alkoholis litrais tenkantis vienam gyventojui (NTAKD duomenimis)
Vyrų prarastų potencialaus gyvenimo metų skaičius per 100 tūkst. Gyventojų (Men)
Bendras prarastų potencialaus gyvenimo metų skaičius per 100 tūkst. Gyventojų (Total)
Moterų prarastų potencialaus gyvenimo metų skaičius per 100 tūkst. Gyventojų (Women)
Pu
re a
lco
ho
l co
nsu
mp
tio
n p
er c
ap
ita
Po
ten
tia
l yea
rs o
f lif
e lo
st p
er 1
00
00
0
Health Research Institute
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http://www.ntakd.lt/index.php/naujienos/pranesimai-spaudai/1181-neteisetos-alkoholio-apyvartos-lietuvoje-ivertinimo-tyrimo-rezultatai
Health Research Institute
Unrecorded alcohol a big issue !?
Recorded alcohol Unrecorded alcohol Total
Pure alcohol consumption age 15 +, 1991-2011
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<= 5000
<= 4000
<= 3000
<= 2000
<= 1000
Nėra duomenų
Min = 0
PYLL(15-75), alkoholio salygotos mirties priežastys, metai / 100000 gyv.
2003
Lietuva
975.6
PYLL (15-75) in Lithuania per 100 000 population (2003 m.)
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<= 5000
<= 4000
<= 3000
<= 2000
<= 1000
Nėra duomenų
Min = 0
PYLL(15-75), alkoholio salygotos mirties priežastys, metai / 100000 gyv.
2004
Lietuva
962.72
PYLL (15-75) in Lithuania per 100 000 population (2004 m.)
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<= 5000
<= 4000
<= 3000
<= 2000
<= 1000
Nėra duomenų
Min = 0
PYLL(15-75), alkoholio salygotos mirties priežastys, metai / 100000 gyv.
2005
Lietuva
1096.25
PYLL (15-75) in Lithuania per 100 000 population (2005 m.)
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<= 5000
<= 4000
<= 3000
<= 2000
<= 1000
Nėra duomenų
Min = 0
PYLL(15-75), alkoholio salygotos mirties priežastys, metai / 100000 gyv.
2006
Lietuva
1308.05
PYLL (15-75) in Lithuania per 100 000 population (2006 m.)
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<= 5000
<= 4000
<= 3000
<= 2000
<= 1000
Nėra duomenų
Min = 0
PYLL(15-75), alkoholio salygotos mirties priežastys, metai / 100000 gyv.
2007
Lietuva
1548.74
PYLL (15-75) in Lithuania per 100 000 population (2007 m.)
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<= 5000
<= 4000
<= 3000
<= 2000
<= 1000
Nėra duomenų
Min = 0
PYLL(15-75), alkoholio salygotos mirties priežastys, metai / 100000 gyv.
2008
Lietuva
1294.73
PYLL (15-75) in Lithuania per 100 000 population (2008 m.)
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<= 5000
<= 4000
<= 3000
<= 2000
<= 1000
Nėra duomenų
Min = 0
PYLL(15-75), alkoholio salygotos mirties priežastys, metai / 100000 gyv.
2009
Lietuva
871.92
PYLL (15-75) in Lithuania per 100 000 population (2009 m.)
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<= 5000
<= 4000
<= 3000
<= 2000
<= 1000
Nėra duomenų
Min = 0
PYLL(15-75), alkoholio salygotos mirties priežastys, metai / 100000 gyv.
2010
Lietuva
842.24
PYLL (15-75) in Lithuania per 100 000 population (2010 m.)
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Alcohol advertisement case
25
Health Research Institute
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26
Health Research Institute
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Short prehistory
• Total ban of alcohol advertisement was proposed to Lithuanian Alcohol Control Law in the year 2008 as alternative to alcohol advertisement restriction.
• Restrictions for day time TV and radio advertisement enforced from January 1st 2008.
• Total ban was scheduled for January 1st 2012.
Health Research Institute
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Alcohol industry and media meeting “behind closed doors” November 2010
• Strategic meeting
• Not all participants still known
• Biggest alcohol producersimporters and mediaowners or headsparticipated
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Strategic steps made by media and alcohol industry
• Bloc all possible NGO access to media and notallow discussion about attempt to cancelalcohol advertisement ban
• Try to show NGO’s as extremely marginal(“talibanic”) organizations
• Deny any information about evidence onalcohol advertisement effect on childrendrinking behavior
Health Research Institute
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Political influence• Financial support to political parties
• Top members of leading party has signed amendment to the law to cancel advertisement ban despite promises in election program to ban advertisement.
• NGO’s were not allowed to discuss position with political parties in contrast to alcohol industry representatives.
• Aggressive pressure
Health Research Institute
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Signature of the President
• Signed the same day
• Kept silent for almost two weeks: when 256 signatures of NGO’s were collected
• Norway was named as only example with ban and this example was not good enough for Lithuania
Health Research Institute
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Lessons learned
• Ad ban in one country without broader regulation in Europe was shown as radical by industry and politicians;
• Geopolitical arguments were used;
• Partial regulation of restrictions are ineffective and hard to regulate by state;
• Self regulation has no sense because industry is finding ways to bypass even legal regulation;
• Pan European initiative to ban alcohol advertisement
is needed.
Health Research Institute
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Thank you
Health Research Institute