Impact of the WHO "best buys" for alcohol policy on consumption and health in the Baltic countries and Poland 2000-2020

Jürgen Rehm^{1

2

3

4

5

6

7

8}, Robertas Badaras⁹, Carina Ferreira-Borges¹⁰, Lukas Galkus¹¹, Nijole Gostautaite Midttun^{12

13}, Inese Gobiņa^{14

15}, Kinga Janik-Koncewicz^{16

17}, Domantas Jasilionis^{18

19}, Huan Jiang^{1

5}, Kawon Victoria Kim¹, Shannon Lange^{1

3

6

7}, Vaida Liutkutė-Gumarov¹¹, Jakob Manthey^{4

20}, Laura Miščikienė¹¹, Maria Neufeld¹⁰, Janina Petkevičienė^{11

21}, Ričardas Radišauskas^{22

23}, Rainer Reile^{11

24}, Robin Room^{25

26}, Relika Stoppel¹¹, Ilona Tamutienė^{11

27}, Alexander Tran^{1

3}, Justina Trišauskė¹¹, Mateusz Zatoński¹⁶, Witold A Zatoński^{16

17}, Ingrida Zurlytė²⁸, Mindaugas Štelemėkas^{11

21}

Affiliations

¹ Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada.
² World Health Organization/Pan American Health Organization Collaborating Centre, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada.
³ Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, Ontario M5T 1R8, Canada.
⁴ Faculty of Medicine, Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, Hamburg 20246, Germany.
⁵ Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 1P8, Canada.
⁶ Institute of Medical Science, University of Toronto, Medical Sciences Building, 1 King's College Circle, Room 2374, Toronto, Ontario M5S 1A8, Canada.
⁷ Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, Ontario M5T 1R8, Canada.
⁸ Program on Substance Abuse & WHO CC, Public Health Agency of Catalonia, 81-95 Roc Boronat St., Barcelona 08005, Spain.
⁹ Faculty of Medicine, Clinic of Anaesthesiology and Intensive Care, Centre of Toxicology, Vilnius University, M. K. Čiurlionio g. 21, Vilnius LT-03101, Lithuania.
¹⁰ World Health Organization, Regional Office for Europe, UN City, Marmorvej 5, Copenhagen DK-2100, Denmark.
¹¹ Faculty of Public Health, Health Research Institute, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania.
¹² Lithuanian Tobacco and Alcohol Control Coalition, Stikliu 8, Vilnius 01131, Lithuania.
¹³ Mental Health Initiative, Teatro 3-10, Vilnius 03107, Lithuania.
¹⁴ Department of Public Health and Epidemiology, Riga Stradiņš University, Kronvalda Boulevard 9, Riga LV-1010, Latvia.
¹⁵ Institute of Public Health, Riga Stradiņš University, Kronvalda Boulevard 9, Riga LV-1010, Latvia.
¹⁶ Institute - European Observatory of Health Inequalities, Calisia University, Nowy Swiat 4, Kalisz 62-800, Poland.
¹⁷ Health Promotion Foundation, Mszczonowska 51, Nadarzyn 05-830, Poland.
¹⁸ Max Planck Institute for Demographic Research, Laboratory of Demographic Data, Konrad-Zuse-Str. 1, Rostock 18057, Germany.
¹⁹ Vytautas Magnus University, Demographic Research Centre, Jonavos g. 66, Kaunas 44191, Lithuania.
²⁰ Medical Faculty, Department of Psychiatry, University of Leipzig, Semmelweisstraße 10, Leipzig 04103, Germany.
²¹ Faculty of Public Health, Department of Preventive Medicine, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania.
²² Faculty of Public Health, Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania.
²³ Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu Ave. 15, Kaunas 50162, Lithuania.
²⁴ Department for Epidemiology and Biostatistics, National Institute for Health Development, Hiiu 42, Tallinn 11619, Estonia.
²⁵ Centre for Alcohol Policy Research, La Trobe University, Melbourne, Victoria 3086, Australia.
²⁶ Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, Stockholm University, Stockholm 106 91, Sweden.
²⁷ Department of Public Administration, Faculty of Political Science and Diplomacy at Vytautas Magnus University, V.Putvinskio Str 23, Kaunas LT-44243, Lithuania.
²⁸ WHO Country Office Lithuania, A. Jakšto g. 12, LT-01105 Vilnius, Lithuania.

PMID: 37953993
PMCID: PMC10636269
DOI: 10.1016/j.lanepe.2023.100704

Review

Impact of the WHO "best buys" for alcohol policy on consumption and health in the Baltic countries and Poland 2000-2020

Jürgen Rehm et al. Lancet Reg Health Eur. 2023.

. 2023 Aug 31:33:100704.

doi: 10.1016/j.lanepe.2023.100704. eCollection 2023 Oct.

Authors

Affiliations

¹ Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada.
² World Health Organization/Pan American Health Organization Collaborating Centre, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada.
³ Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, Ontario M5T 1R8, Canada.
⁴ Faculty of Medicine, Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, Hamburg 20246, Germany.
⁵ Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 1P8, Canada.
⁶ Institute of Medical Science, University of Toronto, Medical Sciences Building, 1 King's College Circle, Room 2374, Toronto, Ontario M5S 1A8, Canada.
⁷ Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, Ontario M5T 1R8, Canada.
⁸ Program on Substance Abuse & WHO CC, Public Health Agency of Catalonia, 81-95 Roc Boronat St., Barcelona 08005, Spain.
⁹ Faculty of Medicine, Clinic of Anaesthesiology and Intensive Care, Centre of Toxicology, Vilnius University, M. K. Čiurlionio g. 21, Vilnius LT-03101, Lithuania.
¹⁰ World Health Organization, Regional Office for Europe, UN City, Marmorvej 5, Copenhagen DK-2100, Denmark.
¹¹ Faculty of Public Health, Health Research Institute, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania.
¹² Lithuanian Tobacco and Alcohol Control Coalition, Stikliu 8, Vilnius 01131, Lithuania.
¹³ Mental Health Initiative, Teatro 3-10, Vilnius 03107, Lithuania.
¹⁴ Department of Public Health and Epidemiology, Riga Stradiņš University, Kronvalda Boulevard 9, Riga LV-1010, Latvia.
¹⁵ Institute of Public Health, Riga Stradiņš University, Kronvalda Boulevard 9, Riga LV-1010, Latvia.
¹⁶ Institute - European Observatory of Health Inequalities, Calisia University, Nowy Swiat 4, Kalisz 62-800, Poland.
¹⁷ Health Promotion Foundation, Mszczonowska 51, Nadarzyn 05-830, Poland.
¹⁸ Max Planck Institute for Demographic Research, Laboratory of Demographic Data, Konrad-Zuse-Str. 1, Rostock 18057, Germany.
¹⁹ Vytautas Magnus University, Demographic Research Centre, Jonavos g. 66, Kaunas 44191, Lithuania.
²⁰ Medical Faculty, Department of Psychiatry, University of Leipzig, Semmelweisstraße 10, Leipzig 04103, Germany.
²¹ Faculty of Public Health, Department of Preventive Medicine, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania.
²² Faculty of Public Health, Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania.
²³ Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu Ave. 15, Kaunas 50162, Lithuania.
²⁴ Department for Epidemiology and Biostatistics, National Institute for Health Development, Hiiu 42, Tallinn 11619, Estonia.
²⁵ Centre for Alcohol Policy Research, La Trobe University, Melbourne, Victoria 3086, Australia.
²⁶ Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, Stockholm University, Stockholm 106 91, Sweden.
²⁷ Department of Public Administration, Faculty of Political Science and Diplomacy at Vytautas Magnus University, V.Putvinskio Str 23, Kaunas LT-44243, Lithuania.
²⁸ WHO Country Office Lithuania, A. Jakšto g. 12, LT-01105 Vilnius, Lithuania.

PMID: 37953993
PMCID: PMC10636269
DOI: 10.1016/j.lanepe.2023.100704

Abstract

Alcohol use is a major risk factor for burden of disease. This narrative review aims to document the effects of major alcohol control policies, in particular taxation increases and availability restrictions in the three Baltic countries (Estonia, Latvia, and Lithuania) between 2000 and 2020. These measures have been successful in curbing alcohol sales, in general without increasing consumption of alcoholic beverages from unrecorded sources; although for more recent changes this may have been partly due to the COVID-19 pandemic. Moreover, findings from time-series analyses suggest improved health, measured as reductions in all-cause and alcohol-attributable mortality, as well as narrowing absolute mortality inequalities between lower and higher educated groups. For most outcomes, there were sex differences observed, with alcohol control policies more strongly affecting males. In contrast to this successful path, alcohol control policies were mostly dismantled in the neighbouring country of Poland, resulting in a rising death toll due to liver cirrhosis and other alcohol-attributable deaths. The natural experiment in this region of high-income European countries with high consumption levels highlights the importance of effective alcohol control policies for improving population health.

Keywords: Alcohol; All-cause mortality; Availability; Ban on marketing; Control policies; Taxation.

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Conflict of interest statement

The authors except J. Manthey and S. Lange declare no competing interests. J. Manthey declares consulting fees, honoraria and travel support from German and international public health agencies, unrelated to the current manuscript. S. Lange declares funding from the National Institutes of Health for conducting the study; and further funding from the Canadian Institutes of Health Research, and consulting fees from the Pan American Health Organization, unrelated to the current manuscript.

References

1. Rehm J., Imtiaz S. Alcohol consumption as a risk factor for global burden of disease. A narrative review. Subst Abuse Treat Prev Pol. 2016;11(1):37. doi: 10.1186/s13011-016-0081-2. - DOI - PMC - PubMed
1. Shield K., Manthey J., Rylett M., et al. National, regional, and global burdens of disease from 2000 to 2016 attributable to alcohol use: a comparative risk assessment study. Lancet Public Health. 2020;5(1):e51–e61. - PubMed
1. World Health Organization . World Health Organization; Geneva, Switzerland: 2023. Global information system on alcohol and health (GISAH)https://www.who.int/data/gho/data/themes/global-information-system-on-al... Available from:
1. World Health Organization . WHO; Copenhagen: 2021. Regional Office for Europe. Making the WHO European Region SAFER: developments in alcohol control policies, 2010–2019.
1. Chisholm D., Moro D., Bertram M., et al. Are the "Best Buys" for alcohol control still valid? An update on the comparative cost-effectiveness of alcohol control strategies at the global level. J Stud Alcohol Drugs. 2018;79(4):514–522. - PubMed

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Impact of the WHO "best buys" for alcohol policy on consumption and health in the Baltic countries and Poland 2000-2020

Affiliations

Impact of the WHO "best buys" for alcohol policy on consumption and health in the Baltic countries and Poland 2000-2020

Authors

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Abstract

Conflict of interest statement

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