. 2023 Apr 18;13(1):6326.

doi: 10.1038/s41598-023-32926-5.

Alcohol control policies reduce all-cause mortality in Baltic Countries and Poland between 2001 and 2020

Justina Vaitkevičiūtė¹, Inese Gobiņa^{2

3}, Kinga Janik-Koncewicz^{4

5}, Shannon Lange^{6

7

8}, Laura Miščikienė^{9

10}, Janina Petkevičienė^{9

11}, Ričardas Radišauskas^{12

13}, Rainer Reile^{9

14}, Mindaugas Štelemėkas^{9

11}, Relika Stoppel^{9

15}, Tadas Telksnys⁹, Alexander Tran⁶, Jürgen Rehm^{6

7

8

16

17

18

19

20

21}, Witold A Zatoński^{4

5}, Huan Jiang^{6

16}

Affiliations

¹ Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181, Kaunas, Lithuania. justina.vaitkeviciute@lsmu.lt.
² Department of Public Health and Epidemiology, Riga Stradiņš University, Kronvalda Boulevard 9, Riga, 1010, Latvia.
³ Institute of Public Health, Riga Stradiņš University, Kronvalda Boulevard 9, Riga, 1010, Latvia.
⁴ European Observatory of Health Inequalities, Calisia University, Nowy Swiat 4, 62-800, Kalisz, Poland.
⁵ Health Promotion Foundation, Mszczonowska 51, 05-830, Nadarzyn, Poland.
⁶ Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada.
⁷ Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, ON, M5T 1R8, Canada.
⁸ Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, ON, M5T 1R8, Canada.
⁹ Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181, Kaunas, Lithuania.
¹⁰ Department of Health Management, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181, Kaunas, Lithuania.
¹¹ Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181, Kaunas, Lithuania.
¹² Department of Environmental and Occupational Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181, Kaunas, Lithuania.
¹³ Institute of Cardiology, Lithuanian University of Health Sciences, Sukilėlių av. 15, 50162, Kaunas, Lithuania.
¹⁴ Department for Epidemiology and Biostatistics, National Institute for Health Development, Hiiu 42, 11619, Tallinn, Estonia.
¹⁵ Department of Economics, University of Potsdam, August-Bebel-Straße 89, 14482, Potsdam, Germany.
¹⁶ Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 1P8, Canada.
¹⁷ World Health Organization/Pan American Health Organization Collaborating Centre, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada.
¹⁸ Institute of Clinical Psychology and Psychotherapy, Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany.
¹⁹ Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany.
²⁰ Faculty of Medicine, Institute of Medical Science, University of Toronto, Medical Sciences Building, 1 King's College Circle, Room 2374, Toronto, ON, M5S 1A8, Canada.
²¹ Program on Substance Abuse, Public Health Agency of Catalonia, Program on Substance Abuse & designated WHO CC, Public Health Agency of Catalonia, 81-95 Roc Boronat St., 08005, Barcelona, Spain.

PMID: 37072446
PMCID: PMC10112307
DOI: 10.1038/s41598-023-32926-5

Alcohol control policies reduce all-cause mortality in Baltic Countries and Poland between 2001 and 2020

Justina Vaitkevičiūtė et al. Sci Rep. 2023.

. 2023 Apr 18;13(1):6326.

doi: 10.1038/s41598-023-32926-5.

Authors

Affiliations

¹ Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181, Kaunas, Lithuania. justina.vaitkeviciute@lsmu.lt.
² Department of Public Health and Epidemiology, Riga Stradiņš University, Kronvalda Boulevard 9, Riga, 1010, Latvia.
³ Institute of Public Health, Riga Stradiņš University, Kronvalda Boulevard 9, Riga, 1010, Latvia.
⁴ European Observatory of Health Inequalities, Calisia University, Nowy Swiat 4, 62-800, Kalisz, Poland.
⁵ Health Promotion Foundation, Mszczonowska 51, 05-830, Nadarzyn, Poland.
⁶ Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada.
⁷ Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, ON, M5T 1R8, Canada.
⁸ Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, ON, M5T 1R8, Canada.
⁹ Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181, Kaunas, Lithuania.
¹⁰ Department of Health Management, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181, Kaunas, Lithuania.
¹¹ Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181, Kaunas, Lithuania.
¹² Department of Environmental and Occupational Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181, Kaunas, Lithuania.
¹³ Institute of Cardiology, Lithuanian University of Health Sciences, Sukilėlių av. 15, 50162, Kaunas, Lithuania.
¹⁴ Department for Epidemiology and Biostatistics, National Institute for Health Development, Hiiu 42, 11619, Tallinn, Estonia.
¹⁵ Department of Economics, University of Potsdam, August-Bebel-Straße 89, 14482, Potsdam, Germany.
¹⁶ Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 1P8, Canada.
¹⁷ World Health Organization/Pan American Health Organization Collaborating Centre, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada.
¹⁸ Institute of Clinical Psychology and Psychotherapy, Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany.
¹⁹ Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany.
²⁰ Faculty of Medicine, Institute of Medical Science, University of Toronto, Medical Sciences Building, 1 King's College Circle, Room 2374, Toronto, ON, M5S 1A8, Canada.
²¹ Program on Substance Abuse, Public Health Agency of Catalonia, Program on Substance Abuse & designated WHO CC, Public Health Agency of Catalonia, 81-95 Roc Boronat St., 08005, Barcelona, Spain.

PMID: 37072446
PMCID: PMC10112307
DOI: 10.1038/s41598-023-32926-5

Abstract

Alcohol consumption in the Baltic countries and Poland is among the highest globally, causing high all-cause mortality rates. Contrary to Poland, the Baltic countries have adopted many alcohol control policies, including the World Health Organization (WHO) "best buys". The aim of this study was to evaluate the impact of these policies, which were implemented between 2001 and 2020, on all-cause mortality. Monthly mortality data for men and women aged 20+ years of age in Estonia, Latvia, Lithuania, and Poland were analysed for 2001 to 2020. A total of 19 alcohol control policies, fulfilling an a-priori defined definition, were implemented between 2001 and 2020 in the countries of interest, and 18 of them could be tested. Interrupted time-series analyses were conducted by employing a generalized additive mixed model (GAMM) for men and women separately. The age-standardized all-cause mortality rate was lowest in Poland and highest in Latvia and had decreased in all countries over the time period. Taxation increases and availability restrictions had short-term effects in all countries, on average reducing the age-standardized all-cause mortality rate among men significantly (a reduction of 2.31% (95% CI 0.71%, 3.93%; p = 0.0045)). All-cause mortality rates among women were not significantly reduced (a reduction of 1.09% (95% CI - 0.02%, 2.20%; p = 0.0554)). In conclusion, the alcohol control policies implemented between 2001 and 2020 reduced all-cause mortality among men 20+ years of age in Baltic countries and Poland, and thus, the practice should be continued.

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Conflict of interest statement

The authors declare no competing interests.

Figures

**Figure 1**
Standardized all-cause mortality rates (per 100,000) across time: the yellow shadow represents the occurrence of policy interventions.

**Figure 2**
Mortality gains in age-standardized all-cause mortality rates per 100,000 population in the 11 interventions in Lithuania and Estonia, by broad causes of death. *LTU* Lithuanian, *EST* Estonian, *IHD* ischemic heart disease, *GID* gastrointestinal diseases.

See this image and copyright information in PMC

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Alcohol control policies reduce all-cause mortality in Baltic Countries and Poland between 2001 and 2020

Affiliations

Alcohol control policies reduce all-cause mortality in Baltic Countries and Poland between 2001 and 2020

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

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