Research

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53 pages, 2001 KiB

Open AccessArticle

Russia’s National Concept to Reduce Alcohol Abuse and Alcohol-Dependence in the Population 2010–2020: Which Policy Targets Have Been Achieved?

by Maria Neufeld, Anna Bunova, Boris Gornyi, Carina Ferreira-Borges, Anna Gerber, Daria Khaltourina, Elena Yurasova and Jürgen Rehm

Int. J. Environ. Res. Public Health 2020, 17(21), 8270; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17218270 - 09 Nov 2020

Cited by 22 | Viewed by 5234

Abstract

In the 2000s, Russia was globally one of the top 5 countries with the highest levels of alcohol per capita consumption and prevailing risky patterns of drinking, i.e., high intake per occasion, high proportion of people drinking to intoxication, and high frequency of [...] Read more.

In the 2000s, Russia was globally one of the top 5 countries with the highest levels of alcohol per capita consumption and prevailing risky patterns of drinking, i.e., high intake per occasion, high proportion of people drinking to intoxication, and high frequency of situations where alcohol is consumed and tolerated. In 2009, in response to these challenges, the Russian government formed the Federal Service for Alcohol Market Regulation and published a national strategy concept to reduce alcohol abuse and alcohol-dependence at the population level for the period 2010–2020. The objectives of the present contribution are to analyze the evidence base of the core components of the concept and to provide a comprehensive evaluation framework of measures implemented (process evaluation) and the achievement of the formulated targets (effect evaluation). Most of the concept’s measures were found to be evidence-based and aligned with eight out of 10 areas of the World Health Organization (WHO) policy portfolio. Out of the 14 tasks, 7 were rated as achieved, and 7 as partly achieved. Ten years after the concept’s adoption, alcohol consumption seems to have declined by about a third and alcohol is conceptualized as a broad risk factor for the population’s health in Russia. Full article

(This article belongs to the Special Issue Alcohol Control Policy and Health in Europe)

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20 pages, 1949 KiB

Open AccessArticle

Implementing Health Warnings on Alcoholic Beverages: On the Leading Role of Countries of the Commonwealth of Independent States

by Maria Neufeld, Carina Ferreira-Borges and Jürgen Rehm

Int. J. Environ. Res. Public Health 2020, 17(21), 8205; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17218205 - 06 Nov 2020

Cited by 9 | Viewed by 3062

Abstract

Despite being a psychoactive substance and having a major impact on health, alcohol has to date escaped the required labeling regulations for either psychoactive substances or food. The vast majority of the countries in the WHO European Region have stricter labeling requirements for [...] Read more.

Despite being a psychoactive substance and having a major impact on health, alcohol has to date escaped the required labeling regulations for either psychoactive substances or food. The vast majority of the countries in the WHO European Region have stricter labeling requirements for bottled water and health warning provisions for over-the-counter medications than for alcoholic beverages. However, more progress in implementing health warnings has been made in the eastern part of the WHO European Region, largely because of the recent technical regulation put in place by the newly formed Eurasian Economic Union. The present contribution provides an overview of the existing legislation regarding the placement of alcohol health warnings on advertisements and labels on alcohol containers in the countries of the Commonwealth of Independent States (CIS; Armenia, Azerbaijan, Belarus, Kazakhstan, Kyrgyzstan, Moldova, Russia, Tajikistan, Turkmenistan, and Uzbekistan) and discusses their potential gaps and shortfalls. It also reviews the evolution of the Eurasian Economic Union Technical Regulation 047/2018, which is, to date, the only international document to impose binding provisions on alcohol labeling. The technical regulation’s developmental process demonstrates how the comprehensive messages and strong requirements for health warnings that were suggested initially were watered down during the consultation process. Full article

(This article belongs to the Special Issue Alcohol Control Policy and Health in Europe)

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16 pages, 1166 KiB

Open AccessArticle

Review of the Lithuanian Alcohol Control Legislation in 1990–2020

by Laura Miščikienė, Nijolė Goštautaitė Midttun, Lukas Galkus, Gražina Belian, Janina Petkevičienė, Justina Vaitkevičiūtė and Mindaugas Štelemėkas

Int. J. Environ. Res. Public Health 2020, 17(10), 3454; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17103454 - 15 May 2020

Cited by 35 | Viewed by 4059

Abstract

Since the early 1990s, Lithuania has experienced an increasing level of alcohol consumption and a heavy burden of alcohol-related harm, which is associated with the development of alcohol policies. The aim of this analysis was to provide a chronology of change of Lithuanian [...] Read more.

Since the early 1990s, Lithuania has experienced an increasing level of alcohol consumption and a heavy burden of alcohol-related harm, which is associated with the development of alcohol policies. The aim of this analysis was to provide a chronology of change of Lithuanian alcohol control legislation and to present several other detailed examples of the political processes. The data were collected using document reviews. During the last three decades, the Lithuanian alcohol control policies have undergone several cycles of stricter control and liberalizations. Some of the limitations of the study are the exceptional focus on the public health perspective and the inclusion of policies targeting the population as a whole. The strength of the study is in providing a detailed background for future policy effectiveness studies. Some of the recent periods when a series of ‘best buy’ interventions were implemented during a short period are of particular importance, constituting a natural experiment, whose effects need to be studied in more detail in the future. Full article

(This article belongs to the Special Issue Alcohol Control Policy and Health in Europe)

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14 pages, 641 KiB

Open AccessArticle

Meeting the Global NCD Target of at Least 10% Relative Reduction in the Harmful Use of Alcohol: Is the WHO European Region on Track?

by Charlotte Probst, Jakob Manthey, Maria Neufeld, Jürgen Rehm, João Breda, Ivo Rakovac and Carina Ferreira-Borges

Int. J. Environ. Res. Public Health 2020, 17(10), 3423; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17103423 - 14 May 2020

Cited by 10 | Viewed by 2867

Abstract

Background: The Global Action Plan for the Prevention and Control of Noncommunicable Diseases set the target of an “at least 10% relative reduction in the harmful use of alcohol, as appropriate, within the national context”. This study investigated progress in the World Health [...] Read more.

Background: The Global Action Plan for the Prevention and Control of Noncommunicable Diseases set the target of an “at least 10% relative reduction in the harmful use of alcohol, as appropriate, within the national context”. This study investigated progress in the World Health Organization (WHO) European Region towards this target based on two indicators: (a) alcohol per capita consumption (APC) and (b) the age-standardized prevalence of heavy episodic drinking (HED). Methods: Alcohol exposure data for the years 2010–2017 were based on country-validated data and statistical models. Results: Between 2010 and 2017, the reduction target for APC has been met with a decline by −12.4% (95% confidence interval (CI) −17.2, −7.0%) in the region. This progress differed greatly across the region with no decline for the EU-28 grouping (−2.4%; 95% CI −12.0, 7.8%) but large declines for the Eastern WHO EUR grouping (−26.2%; 95% CI −42.2, −8.1%). Little to no progress was made concerning HED, with an overall change of −1.7% (−13.7% to 10.2%) in the WHO European Region. Conclusions: The findings indicate a divergence in alcohol consumption reduction in Europe, with substantial progress in the Eastern part of the region and very modest or no progress in EU countries. Full article

(This article belongs to the Special Issue Alcohol Control Policy and Health in Europe)

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6 pages, 300 KiB

Open AccessArticle

Is There a Need for Alcohol Policy to Mitigate Metal Contamination in Unrecorded Fruit Spirits?

by Dirk W. Lachenmeier

Int. J. Environ. Res. Public Health 2020, 17(7), 2452; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17072452 - 03 Apr 2020

Cited by 8 | Viewed by 2317

Abstract

Unrecorded alcohol comprises all types of alcohol that is not registered in the jurisdiction where it is consumed. In some countries in Central and Eastern Europe as well as the Balkans, the majority of unrecorded alcohol consumption may derive from the home production [...] Read more.

Unrecorded alcohol comprises all types of alcohol that is not registered in the jurisdiction where it is consumed. In some countries in Central and Eastern Europe as well as the Balkans, the majority of unrecorded alcohol consumption may derive from the home production of fruit spirits. Some studies found a high prevalence of lead and cadmium in such spirits. This article provides a quantitative comparative risk assessment using the margin of exposure (MOE) methodology for lead and cadmium, compared to ethanol, for unrecorded fruit spirits. For average concentration levels, the lowest MOE (0.8) was calculated for ethanol (alcohol itself). For lead, the MOE was 13 for moderate daily drinking and 0.9 for the worst-case scenario. For cadmium, the MOE was 1982 for moderate daily drinking and 113 for the worst-case scenario. The results of this study are consistent with previous comparative risk assessments stating that ethanol itself comprises by far the highest risk of all compounds in alcoholic beverages. Regarding metal contaminants, the risk of cadmium appears negligible; however, lead may pose an additional health risk in heavy drinking circumstances. Strategies to avoid metal contamination in the artisanal home production of spirits need to be developed. Full article

(This article belongs to the Special Issue Alcohol Control Policy and Health in Europe)

13 pages, 858 KiB

Open AccessArticle

How Attitudes toward Alcohol Policies Differ across European Countries: Evidence from the Standardized European Alcohol Survey (SEAS)

by Carolin Kilian, Jakob Manthey, Jacek Moskalewicz, Janusz Sieroslawski and Jürgen Rehm

Int. J. Environ. Res. Public Health 2019, 16(22), 4461; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16224461 - 13 Nov 2019

Cited by 13 | Viewed by 3123

Abstract

Alcohol policy endorsements have changed over time, probably interacting with the implementation and effectiveness of alcohol policy measures. The Standardized European Alcohol Survey (SEAS) evaluated public opinion toward alcohol policies in 20 European locations (19 countries and one subnational region) in 2015 and [...] Read more.

Alcohol policy endorsements have changed over time, probably interacting with the implementation and effectiveness of alcohol policy measures. The Standardized European Alcohol Survey (SEAS) evaluated public opinion toward alcohol policies in 20 European locations (19 countries and one subnational region) in 2015 and 2016 (n = 32,641; 18–64 years). On the basis of the SEAS report, we investigated regional differences and individual characteristics related to categories of alcohol policy endorsement. Latent class analysis was used to replicate cluster structure from the SEAS report and to examine individual probabilities of endorsement. Hierarchical quasi-binomial regression models were run to analyze the relative importance of variables of interest (supranational region, gender, age, educational achievement, and drinking status) on class endorsement probability, with random intercepts for each location. The highest support for alcohol control policies was recorded in Northern countries, which was in contrast to the Eastern countries, where the lowest support for control policies was found. Across all locations, positive attitudes toward control policies were associated with the female gender, older age, and abstaining from alcohol. Our findings underline the need to communicate alcohol-related harm and the implications of alcohol control policies to the public in order to increase awareness and support for such policies in the long run. Full article

(This article belongs to the Special Issue Alcohol Control Policy and Health in Europe)

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Review

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14 pages, 815 KiB

Open AccessReview

Alcohol Control Policy in Europe: Overview and Exemplary Countries

by Nino Berdzuli, Carina Ferreira-Borges, Antoni Gual and Jürgen Rehm

Int. J. Environ. Res. Public Health 2020, 17(21), 8162; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17218162 - 04 Nov 2020

Cited by 16 | Viewed by 5003

Abstract

Alcohol is a major risk factor for burden of disease. However, there are known effective and cost-effective alcohol control policies that could reduce this burden. Based on reviews, international documents, and contributions to this special issue of International Journal of Environmental Research and [...] Read more.

Alcohol is a major risk factor for burden of disease. However, there are known effective and cost-effective alcohol control policies that could reduce this burden. Based on reviews, international documents, and contributions to this special issue of International Journal of Environmental Research and Public Health (IJERPH), this article gives an overview of the implementation of such policies in the World Health Organization (WHO) European Region, and of best practices. Overall, there is a great deal of variability in the policies implemented between countries, but two countries, the Russian Federation and Lithuania, have both recently implemented significant increases in alcohol taxation, imposed restrictions on alcohol availability, and imposed bans on the marketing and advertising of alcohol within short time spans. Both countries subsequently saw significant decreases in consumption and all-cause mortality. Adopting the alcohol control policies of these best-practice countries should be considered by other countries. Current challenges for all countries include cross-border shopping, the impact from recent internet-based marketing practices, and international treaties. Full article

(This article belongs to the Special Issue Alcohol Control Policy and Health in Europe)

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17 pages, 363 KiB

Open AccessEditor’s ChoiceReview

Regulatory Policies for Alcohol, other Psychoactive Substances and Addictive Behaviours: The Role of Level of Use and Potency. A Systematic Review

by Jürgen Rehm, Jean-François Crépault, Omer S.M. Hasan, Dirk W. Lachenmeier, Robin Room and Bundit Sornpaisarn

Int. J. Environ. Res. Public Health 2019, 16(19), 3749; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16193749 - 04 Oct 2019

Cited by 19 | Viewed by 5995

Abstract

The object of this contribution based on a systematic review of the literature is to examine to what degree the level of use and potency play a role in regulatory policies for alcohol, other psychoactive substances and gambling, and whether there is an [...] Read more.

The object of this contribution based on a systematic review of the literature is to examine to what degree the level of use and potency play a role in regulatory policies for alcohol, other psychoactive substances and gambling, and whether there is an evidence base for this role. Level of use is usually defined around a behavioural pattern of the user (for example, cigarettes smoked per day, or average ethanol use in grams per day), while potency is defined as a property or characteristic of the substance. For all substances examined (alcohol, tobacco, opioids, cannabis) and gambling, both dimensions were taken into consideration in the formulation of most regulatory policies. However, the associations between both dimensions and regulatory policies were not systematic, and not always based on evidence. Future improvements are suggested. Full article

(This article belongs to the Special Issue Alcohol Control Policy and Health in Europe)

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