Transcript Slide 1

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
Alcohol’s economic role
– Goods account balance €9bn
– Tax revenue (€24bn in EU15)
– Employment:
Industry say up to 3½ m jobs in EU15
The Alcohol Economy
But… tax not dependent on consumption
0.8%
Government alcohol tax revenue (%
of GDP)

0.7%
Ireland
UK
0.6%
0.5%
Sweden
0.4%
Denmark
0.3%
Beglium
Portugal
Greece
0.2%
Netherlands
Austria
0.1%
France
Luxembourg
Germany
Italy
0.0%
5
7
9
11
13
15
Annual adult alcohol consumption (litres)
17
19
The Alcohol Economy
…and jobs not dependent on consumption
250
16
14
200
12
150
10
100
Employment
Consumption
50
8
Consumption (l/adult)
Employment (000s)

6
1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001
Employment in the Hotels, Restaurants and Catering sector in Austria
The Alcohol Economy
Crime damage
€6bn
Traffic
accidents
damage
€10bn
Health
€17bn
Treatment/
prevention
€5bn
Mortality
€36bn
Crime defensive
€12bn
Crime - police
€14bn
Unemployment
€14bn
Absenteeism
€9bn
Total tangible costs – €135bn
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

Relative dispersion of EU consumption
60%
Coefficient of variation(CV)
55%
EU15
50%
EU10
45%
EU25
40%
35%
30%
25%
20%
15%
10%
1962
1967
1972
1977
1982
1987
1992
1997
2002
Binge drinking, men
at least six portions per one occasion
100
90
80
70
never
once a year
once a month
once a week
daily
60
%
50
40
30
20
10
0
Estonia
Latvia
Lithuania
Finland
Binge drinking, women
at least six portions per one occasion
100
90
80
70
never
once a year
once a month
once a week
daily
60
%
50
40
30
20
10
0
Estonia
Latvia
Lithuania
Finland
Use of alcohol
 Consumption-perdrinker:
– Much less variation
– EU range still 10-22 L
– Very high levels
overall:
5 countries > 20 L
Average 15 L
Consumption
(L per adult)
Less than 14
14 to 15
15 to 18½
More than 18½
Use of alcohol
35%
Malta
Ireland Denmark
Boys drunkenness 2003
30%
Trends in bingedrinking in 15-16
year old male
students, 19952003
Sw eden
Bulgaria
UK
Estonia
Norw ay
25%
Slovenia
Portugal
20%
Czech R,
Latvia
Romania
Italy
Slovakia
Lithuania
15%
Greece
Iceland
Finland
Poland
5+ drinks on a
single occasion
3+ times in last 4
weeks
Cyprus
France Hungary
10%
5%
5%
15%
25%
35%
Boys drunkenness 1995 ( 1999)
Structure of presentation
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.Choosingand
different
policy options
Alcohol
individuals
Alcohol-attributable deaths
as a % of all deaths
30
25
Males
20
Females
15
10
5
0
0-15
15-29
30-44
45-59
60-69
Age group
Cost of implementing same policy options per 100 people per year
(€) in sub-region A of EU25; Adapted from Chisholm et al 2004
Structure of presentation
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?
Alcohol and Europe
All occupational risks
Illicit drugs
Low fruit & veg intake
Physical inactivity
Cholestrol
Overweight
Alcohol
Blood pressure
Tobacco
0
1
2
3
4
5
6
Burden of ill-health (million DALYs lost)
7
8
Alcohol 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
The geographical relationship between alcohol
consumption and cirrhosis mortality
MEN (Rsq=0.75)
40
Est
Lith
30
De
Lat
Fin
20
Nor Swe
10
Ice
0
4
5
6
7
8
9
10
11
Per capita alcohol consumption
12
13
14
15
Structure of presentation
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?
Alcohol and southern Europe
50
20
45
18
40
16
35
14
30
12
25
10
Cirrhosis (male)
20
8
15
6
Cirrhosis (female)
10
4
5
2
0
0
1970
1975
1980
1985
1990
1995
2000
Alcohol consumption and cirrhosis rates in southern
Consumption (litres per adult)
Cirrhosis rate (SDR per 1000)
Alcohol consumption
Alcohol and southern Europe
Homicide per 100,000 population
Alcohol and violence in EU15 countries
1.8
Homicide
1.6
1.4
Attributable to
alcohol
1.2
1.0
0.8
0.6
50%
61%
0.4
55%
0.2
0.0
Northern Europe Central Europe Southern Europe
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
Pricing and Taxation
Regulating Physical Availability
Regulating Alcohol Promotion
Drinking-Driving Countermeasures
Treatment and Early Intervention
12.Choosing different policy options
Alcohol policy
1400
Brief interventions
DALYs prevented per million people per year
Drink drive measures
1200
Current tax + 25%
Restricted sales
Advertising ban
1000
800
600
400
200
0
Euro C
Impact of different policy options in preventing DALYs per million
people per year
12.Choosing different policy options
Alcohol policy
60
Brief interventions
Cost per 100 people per year(€)
Drink drive measures
50
Current tax + 25%
Restricted sales
40
Advertising ban
30
20
10
0
Euro C
Cost of implementing same policy options per 100 people per year (€)
Alcohol policy
10% in price:
consumption 2% to 8%
9,000 deaths
€3 billion in revenue
Alcopops in Switzerland
Apr-05
Jan-05
Oct-04
Jul-04
Apr-04
Jan-04
Oct-03
Jul-03
Apr-03
Jan-03
Oct-02
Jul-02
Apr-02
Jan-02
Oct-01
Jul-01
Apr-01
Jan-01
Imports of alcopops
(millions of 275ml bottles)
Alcohol policy
8.0
7.0
6.0
5.0
4.0
3.0
2.0
1.0
0.0
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)
Mediumterm
(1-3 years)
14
23
3
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?
Policy impact
Alcohol industry
10
9
8
7
6
5
4
3
2
1
0
NGO
GO
AI
Regulation
Education
Policy options
Implementation of law
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
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
TV advertising
– Stronger for spirits,
esp. in EU10
– 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
25
20
< 1 year
1-3 years
> 3 years
15
10
5
0
Partially
effective
Not
effective
Negative
effect
Policy impact
Alcohol industry
10
9
8
7
6
5
4
3
2
1
0
NGO
GO
AI
Regulation
Education
Policy options
Implementation of law