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Alcohol policy in Lithuania Aurelijus Veryga, assoc.prof. Lithuanian University of Health Sciences Health Research Institute
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Page 1: Alcohol policy in Lithuania - tai.ee

Alcohol policy in Lithuania

Aurelijus Veryga, assoc.prof.

Lithuanian University of Health Sciences

Health Research Institute

Page 2: Alcohol policy in Lithuania - tai.ee

Epidemiology

2

Health Research Institute

Page 3: Alcohol policy in Lithuania - tai.ee

3

Page 4: Alcohol policy in Lithuania - tai.ee

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

Page 5: Alcohol policy in Lithuania - tai.ee

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

Page 6: Alcohol policy in Lithuania - tai.ee

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

Page 7: Alcohol policy in Lithuania - tai.ee

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

Page 8: Alcohol policy in Lithuania - tai.ee

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

Page 9: Alcohol policy in Lithuania - tai.ee

Is there any relation of the trends to alcohol control policy?

9

Health Research Institute

Page 10: Alcohol policy in Lithuania - tai.ee

Correlation of alcoholic psychosis with alcohol policy measures

10

Health Research Institute

LSMU, 2012

Page 11: Alcohol policy in Lithuania - tai.ee

What was done on national level (starting from the year 2008)

Advertisement Price (excise) Night sale

Health Research Institute

Page 12: Alcohol policy in Lithuania - tai.ee

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

Page 13: Alcohol policy in Lithuania - tai.ee

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

Page 14: Alcohol policy in Lithuania - tai.ee

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

Page 15: Alcohol policy in Lithuania - tai.ee

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

Page 16: Alcohol policy in Lithuania - tai.ee

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

Page 17: Alcohol policy in Lithuania - tai.ee

<= 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.)

Page 18: Alcohol policy in Lithuania - tai.ee

<= 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.)

Page 19: Alcohol policy in Lithuania - tai.ee

<= 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.)

Page 20: Alcohol policy in Lithuania - tai.ee

<= 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.)

Page 21: Alcohol policy in Lithuania - tai.ee

<= 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.)

Page 22: Alcohol policy in Lithuania - tai.ee

<= 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.)

Page 23: Alcohol policy in Lithuania - tai.ee

<= 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.)

Page 24: Alcohol policy in Lithuania - tai.ee

<= 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.)

Page 25: Alcohol policy in Lithuania - tai.ee

Alcohol advertisement case

25

Health Research Institute

Page 26: Alcohol policy in Lithuania - tai.ee

26

Health Research Institute

Page 27: Alcohol policy in Lithuania - tai.ee

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

Page 28: Alcohol policy in Lithuania - tai.ee

Alcohol industry and media meeting “behind closed doors” November 2010

• Strategic meeting

• Not all participants still known

• Biggest alcohol producersimporters and mediaowners or headsparticipated

Page 29: Alcohol policy in Lithuania - tai.ee

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

Page 30: Alcohol policy in Lithuania - tai.ee

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

Page 31: Alcohol policy in Lithuania - tai.ee

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

Page 32: Alcohol policy in Lithuania - tai.ee

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

Page 33: Alcohol policy in Lithuania - tai.ee

Thank you

Health Research Institute


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