New law on alcohol in Italy

Ennio Palmesino writes

The new law was originally planned in 1994 and so takes into account the European Action Plan of 1992. It was subsequently modified to incorporate the European Charter on Alcohol 1995. Since then it has been changed only to accommodate the compromises and shortcuts necessary for it to be accepted by the Industry, whilst the sponsors were hesitant to make any attempts at improvement or to update it since further modification would have made the Industry lobby more suspicious and consequently the implementation of the law even slower.

Discussing the law's shortcomings, let us briefly look at its main provisions.

• Education about alcohol related problems will concentrate on prevention: it is to be carried out in schools, universities, the armed forces, prisons, places where youngsters get together. University departments concerned with Health, Medicine, Psychology, and Social Affairs may be required to incorporate specialisation in alcohol related problems. These problems will have to be monitored and data shared on a national and regional basis.

• Urgent cases will be treated in appropriate medical units, hospitals, or approved private clinics. Thereafter, new services concerned with the rehabilitation of people with alcohol-related problems will be created. These will offer residential care for up to thirty days, before the patients are referred to day-hospitals or home treatment. Eventually, it is envisaged that the latter treatment will be effected in co-operation with private voluntary associations that specialise in alcohol-related problems. Anti-craving and other medicines used in alcohol therapy to be offered freely (with prescription). Medicines which interact with alcohol will have to carry warnings.

• Dangerous working environments (to be identified by the Ministry) will have to be alcohol free. There will be alcohol tests carried out by a specialised doctor. Fines will be up to a maximum of 2.500 Euros. Workers who wish to take advantage of treatment for alcohol-related problems will have access to the same facilities and will get the same allowances as drug addicted people.

• The law envisages tighter driving controls, together with more efficient testing equipment. Blood-alcohol content limit for driving is to be lowered from 0.8 gr/litre to 0.5 gr/l. On motorways the sale of beverages exceeding 21per cent alcohol content (spirits) is to be forbidden between 10pm and 6 am. Fines will be up to a maximum of 5.000 Euros. Driving schools teachers will have to provide information about drink-driving risks.

• Industry, television and radio are to adopt a self-regulating code regarding commercial advertisements for alcohol beverages. Such commercials to be banned within programmes aimed at youth. Advertisements will not be able to show youngsters drinking nor appear in places where youngsters get together. Commercials must not claim health benefits that are not acknowledged by the Ministry of Health, nor should they depict alcohol consumption as a positive life-style. TV commercials for alcohol are prohibited between 4PM and 7PM, when it is estimated that most youngsters are watching. They are also banned in papers and magazines intended for youth and in cinemas showing films aimed at young people. Penalties for the Industry and/or television, magazine, or cinema owners can reach 10.000 Euros for the first and double for each subsequent offence.

• The National Council on Alcohol-related Problems will be established, to be chaired by the Ministry of Social Affairs, and consisting of 18 members. Interestingly, two of them will have to be appointed by the same Ministry from among the voluntary associations and self-help-groups. However, two other members will be appointed by the Ministry of Agriculture and by the Alcohol Industry. The Council will provide a periodical report to the Ministry about the implementation of the law. It will also make proposals and provide opinions to the Ministry, as well as to local government. It will co-operate with international bodies, in particular the WHO.

Total budget for the first year is two million Euros.

So after six years we finally have a law in Italy concerning alcohol. We have fought a long battle, together with other associations, to make this law more effective in terms of changing the general culture about alcohol. An example is when the pitfall of article 7 of the new law came to light. We had proposed that there should be labels on every bottle with some kind of warnings about possible risks to health, even if they were not as stringent as those appearing on cigarettes. The Industry lobby voted an amendment to delete every reference to labels. We insisted that at least some risk categories, such as children, pregnant women, alcoholics, and drivers, should be warned on labels about the inherent risks. These efforts were to no avail: article 7 was amended, and the thousands of cables and e-mails coming from Clubs of Alcoholics in Treatment from all over Italy had no effect on members of parliament.

We are not particularly happy about the medical approach taken in the text of the law. We are of the opinion that other medical structures to assist people with alcohol-related problems are not needed: there are already too many and they are largely ineffective in dealing with this kind of problem. Our own expertise is there to show that there are more effective and less expensive ways to tackle problematic drinking behaviour.

Last but not least, the law still separates, in a number of instances, abuse from consumption. This ignores the fact that the "Population approach" has proved that it is necessary to lower per capita consumption, without distinguishing between moderate or sensible drinking and dangerous drinking. The division between the two is not clear-cut.

Despite these reservations, we now have a law. At least it is acknowledged that alcohol- related problems exist. Literature produced by the drink industry, however, was trying to establish that the problem was limited to a small percentage of the population, that it was possible to keep it under control, and that it was declining. Now we have a new tool to approach institutions, governments, and health professionals without being misjudged. We have to look forward though, and have already started planning how and when we can modify this law to make it more stringent, and in this respect we trust the European Community and WHO will provide us with the right ammunition to put more pressure on our politicians.

Ennio Palmesino - President Italian Association of Clubs of Alcoholics in Treatment.

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