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Alcohol Policy Network

The Bridging the Gap project (2004-2006) is co-financed by the European Commission, the Norwegian Policy Network on Alcohol and Drugs (ACTIS), IOGT-NTO Sweden, the Government of Norway and Eurocare, in partnership with the European Cultural Foundation, the European Public Health Alliance, the European Youth Forum and the World Health Organization. The partners represent governmental, non-governmental, health professional and research organisations from Austria, Belgium, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Latvia, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Romania, Slovak Republic, Slovenia, Spain, Sweden, Switzerland, Turkey and the United Kingdom.

The remit of the project is to create a European Alcohol Policy Network, to report on alcohol policy in partner countries, to convene a European conference, “Bridging the Alcohol Policy Gap in Europe”, to convey complex policy issues in an innovative way to young people through theatre sketches contrasting stakeholder views on alcohol policy, to prepare an alcohol policy questionnaire for young people by young people, to prepare an alcohol advocacy policy manual and training school, and toprovide alcohol policy support to new Member States.

Since its first meeting in Warsaw, in June 2004, the Policy network has produced a statement in which it proposes that a Policy on Alcohol for Europe and its countries1 address the following issues:

I. Reduction in drinking driving

1. Recognising the heavy burden that drinking and driving2 places on premature mortality, harm to people other than the driver and economic costs to society;

2. Effective legislative, executive, administrative and other measures necessary to reduce drinking and driving should be implemented;

3. Drinking driving policies should take into account the following principles:

  • A maximum blood alcohol concentration limit of 0.5 g/L (and breath equivalent) should be introduced throughout Europe with immediate effect; a lower limit of 0.2 g/L should be introduced for novice drivers and drivers of public service and heavy goods vehicles,with immediate effect; countries with existing lower levels should not increase them;

  • Reducing the maximum blood alcohol concentration for all drivers to 0.2g/L would significantly further reduce the harm done by drinking and driving;

  • Unrestricted powers to breath test, using breathalysers of equivalent and agreed standard, should be implemented throughout Europe;

  • Common penalties for drinking and driving, with clarity and swiftness of punishment, should be introduced throughout Europe; penalties should be graded depending at least on the BAC level, and should include license penalties, license suspensions, fines, prison sentences, ignition locks and vehicle impoundment; all drivers on European roads with a BAC level greater than 0.5 g/L should have an unconditional license suspension for a minimum period of 6 months; and

  • Driver education, rehabilitation and treatment schemes, linked to penalties, including the return of suspended licences, need to be strengthened and implemented throughout Europe for drinking and driving offenders, including those with evidence of dependence on alcohol, based on agreed evidence based guidelines and protocols.

II. Education, communication, training and public awareness

1. Recognising that education and information approaches can be effective in countering the marketing practices of the commercial alcohol industry and in mobilising public support for alcohol policy measures, but that unfortunately, in general, it is difficult to show any long-lasting effects of school based education in reducing the harm done by alcohol;

2. Effective and impartial3 education, communication, training, school, college and university-based programmes, and other alternative forms of education, including culture and the arts, and informal youth based initiatives should be implemented to empower and enable all people to make healthy choices and to raise public awareness;

3. Impartial education, communication and training, should take into account the following principles:

  • Public awareness of alcohol policy issues should be strengthened and promoted using all available communication tools;

  • Broad access to effective and comprehensive school, college and university-based education and on the health risks including the intoxicating and addictive characteristics of alcohol consumption should be provided, based on evidencebased health promotion principles;

  • Public awareness on the health risks including the intoxicating and addictive characteristics of alcohol consumption and on the benefits of reducing hazardous and harmful alcohol consumption should be increased;

  • Public access, in accordance with national law, to a wide range of information on the commercial alcohol industry as relevant to the implementation of alcohol policy should be provided;

  • Effective and appropriate training or sensitisation and awareness programmes on alcohol policy to persons such as health workers, community workers, social workers, media professionals, educators, decision-makers, administrators and other concerned persons should be addressed;

  • Education on the harm done by alcohol and what can be done to reduce it should be provided to all involved in the alcohol production, sales and supply chain; and

  • Awareness and participation of public and private agencies and nongovernmental organisations not affiliated with the commercial alcohol industry in developing and implementing intersectoral programmes and strategies for alcohol policy should be promoted.

III. Regulation of the alcohol market
III.1 Packaging and labelling of alcohol products

1. Recognising the importance of appropriate packaging and labelling4 of alcohol products;

2. Effective legislative, executive, administrative and other measures necessary to ensure appropriate packaging and labelling should be implemented;

3. Packaging and labelling policy should take into account the following principles

  • Alcohol product packaging and labelling should not promote an alcoholic product by any means that are false, misleading, deceptive or likely to create an erroneous impression about its characteristics or health effects, including any term, descriptor, trademark, figurative or any other sign that directly or indirectly creates the impression that a particular alcoholic product is more attractive or
    healthier than another alcoholic product;

  • Alcohol product packaging and labelling should not promote an alcoholic product by any means, including any term, descriptor, trademark, figurative or any other sign that directly or indirectly appeals to minors5;

  • Each unit package of alcoholic products should carry warnings determined by ministries of health, describing the harmful effects of alcohol when driving or operating machinery, and during pregnancy or other appropriate messages determined by ministries of health; and

  • Each unit packet and package of alcoholic products and any outside packaging and labelling of such products should, in addition to health warnings, contain information on its alcohol concentration (per cent by volume), alcohol content (grams of alcohol), calorific value and ingredients that might lead to allergies.

III.2 Price and tax measures to reduce the harm done by alcohol

1. Recognising that price and tax measures are a highly costeffective and important means of reducing the harm done by alcohol to all segments of the population, including young people and heavier drinkers;

2. Tax policies and, where appropriate, price policies, on all alcohol products, including wine and wine based products, should be introduced by all Member States and the Community as a whole so as to contribute to the health and economic objectives aimed at reducing the harm done by alcohol;

3. Tax policies and tax levels should take into account the following principles:

  • The price of alcohol should take into account the external costs of consumption, the inadequate knowledge that consumers have about the harm done by alcohol and its dependence producing properties;

  • The price of alcohol should be increased in line with inflation;

  • Taxes should be proportional to the alcoholic content of alcoholic beverages, including all beverage types and with no threshold. Higher alcohol concentration beverages such as liquors and spirits should be taxed at a disproportionally higher level, in view of their high alcohol concentration;

  • Countries should retain the flexibility to use taxes to deal with specific problems that may arise with specific alcoholic beverages, such as designer drinks aimed at young people;

  • Taxes should be increased throughout Europe up to a minimum level. Countries with higher taxation should not reduce their taxation levels; and

  • A proportion of alcohol taxescan be earmarked (hypothecated tax) to fund programmes to reduce the harm done by alcohol.

III.3 Illicit trade in alcoholic products

1. The elimination of all forms of illicit trade in alcoholic products, including smuggling, illicit manufacturing and counterfeiting are essential components of alcohol policy;

2. Effective legislative, executive, administrative or other measures should be implemented to ensure that all unit packages of alcoholic products and any outside packaging of such products are marked to assist in determining the origin of alcoholic products and any point of diversion and to monitor, document and control the movement of alcoholic products and their legal status.

III. 4 Travellers allowances within the European Union

1. Recognising the failure of an upward harmonisation of alcohol taxes within the European Union resulting in a cross-border disparity in alcohol taxes, and Recognising that the standard guidance for individuals to carry across European Union borders without paying excise tax in the country of residence is currently 10 litres of spirits, 20 litres of intermediate products, 90 litres of wine and 110 litres of beer (overall equivalent to about 270 bottles of wine), resulting in a substantial increase in alcohol consumption in some countries that is not reflected in official statistics;

2. Effective legislative, executive, administrative and other measures should be implemented to progressively reduce the personal allowance to about one seventh of the current limit, the equivalent of 40 bottles of wine (a 40 day supply for a heavy drinker, which is equivalent to the current allowance of tobacco which represents a 40 day supply of 20 cigarettes a day).

III. 5 Restrictions on the availability of alcohol

1. Recognising that reducing the number and density of outlets, including availability in supermarkets and general retail stores, changing the location of outlets and reducing the days and hours of opening can all reduce the harm done by alcohol;

2. Countries that regulate outlets through number and density, location and hours and days of sale should not relax their regulations; countries without such regulations or with very liberal regulations should consider introducing them or strengthening them.

3. Measures to manage the availability of alcohol should take into account the following principles:

  • Impact assessments on health and the social environment should be undertaken when opening new or changing existing outlets.

III. 6 Sales to minors

1. Recognising that alcohol consumption, the harm done by alcohol and binge drinking amongst young people is increasing at an alarming rate;

2. Effective legislative, executive, administrative and other measures necessary to restrict sales to minors should be implemented;

3. Measures to restrict sales to minors should take into account the following principles:

  • The sales of alcoholic products to persons under the age set by domestic law, national law or eighteen years, whichever is the higher, should be prohibited;

  • All sellers of alcoholic products should place a clear and prominent indicator inside their point of sale about the prohibition of alcohol sales to minors and, in case of doubt, request that each alcohol purchaser provide appropriate evidence of having reached full legal age;

  • Within supermarkets and other general retail stores, alcoholic products should be placed in a section clearly separated from the sale of other products that might appeal to minors, such as sweets, snacks, toys, or soft drinks;

  • The distribution of free alcoholic products (including brand related paraphernalia such as tshirts, ashtrays, glasses, caps, etc.) should be prohibited to minors; and

  • Penalties against sellers and distributors, such as withdrawal of licence or temporary and permanent closures, in order to ensure compliance with relevant measures should be implemented.

III.7 Alcohol advertising, promotion and sponsorship

1. Recognising that a comprehensive ban on advertising, promotion and sponsorship would reduce the harm done by alcohol, and that self-regulation is an ineffective mechanism to reduce the harm done by alcohol;

2. Effective legislative, executive, administrative and other measures necessary to strictly regulate advertising, promotion and sponsorship of alcohol products through statutory controls should be introduced both within and across borders;

3. Regulation of advertising, promotion and sponsorship should take into account the following principles:

  • All forms of alcohol advertising, promotion and sponsorship that promote an alcoholic product by any means that are false, misleading or deceptive or likely to create an erroneous impression about its characteristics, health effects, or hazards should be prohibited;

  • All forms of alcohol advertising, promotion and sponsorship that promote an alcoholic product to minors should be prohibited;

  • Appropriate health warnings or safety messages should accompany all alcohol advertising and, as appropriate, promotion and sponsorship;

  • The use of direct or indirect incentives that encourage the purchase of alcohol products (sales promotion) should be prohibited;

  • Expenditures by the alcohol industry on advertising, promotion and sponsorship should be disclosed to relevant governmental authorities;

  • Article 15 of the Television Without Frontiers Directive should be enforced in all Member States under statutory control. Article 15 should be strengthened by adding time limits, programme limits, and limits on concentration of alcohol advertising;

  • All alcohol advertising, promotion and sponsorship on radio, television, print media and, as appropriate, other media, such as the internet, where not part of a comprehensive ban, should be restricted to information about the product only, with messages and images only referring to the origin, composition, means of production, and patterns of consumption;

  • Technologies and other means necessary to regulate crossborder advertising, promotion and sponsorship should be developed;

  • Countries which have a ban on certain forms of alcohol advertising, promotion and sponsorship have the sovereign right to ban those forms of crossborder alcohol advertising, promotion and sponsorship entering their territory and to impose equal penalties as [sic] those applicable to domestic advertising, promotion and sponsorship originating from their territory in accordance with their national law; and

  • A proportion of the total expenditure by the alcohol industry on advertising, promotion and sponsorship can be considered for earmarking to fund independent public health programmes to reduce the harm done by alcohol.

IV. Reducing harm in drinking and surrounding environments

1. Recognising that drinking and surrounding environments can impact on the harm done by alcohol;

2. Effective legislative, executive, administrative and other measures necessary to improve drinking and surrounding environments to reduce the harm done by alcohol should be implemented;

3. Measures to improve drinking and surrounding environments should take into account the following principles:

  • Urban planning, community strategies, licensing regulations and restrictions, transport policies and management of the drinking and surrounding environments should ensure that all peoples, and in particular local residents, are free from the injurious, noxious and polluting effects, including noise pollution, that result from alcohol intoxication;

  • Introduction and strengthening of alcohol sales and licensing laws which prohibit the sales of alcohol to minors and intoxicated persons;

  • Adequate policing and enforcement of alcohol sales and licensing laws;

  • Effective and appropriate training for the hospitality industry and servers of alcohol to reduce the harmful consequences of intoxication, harmful patterns of drinking and the risk of drinking and driving; and

  • Server training programmes can be backed up by civil liability for subsequent alcohol related accidents, including drinking driving accidents to increase their effectiveness.

V. Interventions for individuals and families
V. 1 Interventions for hazardous and harmful alcohol consumption and alcohol dependence

1. Recognising the heavy burden that hazardous and harmful alcohol consumption and alcohol dependence place on the health care sector, individuals, families and societies, and Recognising that brief interventions for hazardous and harmful alcohol consumption are amongst the most cost effective of all health sector interventions;

2. Effective legislative, executive, administrative and other measures necessary to promote the widespread delivery of interventions for hazardous and harmful alcohol consumption and alcohol dependence should be implemented;

3. The following principles should be taken into account:

  • Appropriate, comprehensive and integrated guidelines based on scientific evidence and best practices to promote reductions in hazardous and harmful alcohol consumption and adequate treatment for alcohol dependence should be developed, disseminated and implemented;

  • Effective programmes aimed at promoting the reduction in hazardous and harmful alcohol consumption, in such locations as educational institutions, health care facilities and workplaces6 should be designed and implemented;

  • The identification and management of hazardous and harmful alcohol consumption should be included in national health and education programmes, plans and strategies, with the participation of health workers, community workers and social workers as appropriate; and

  • Programmes for diagnosing, counselling, preventing and treating hazardous and harmful alcohol consumption and alcohol dependence should be established in statutory and nonstatutory health care facilities, specialised centres and rehabilitation centres.

V. 2 Interventions and assistance for family members of people with alcohol dependence

  • Recognising that harmful alcohol consumption and alcohol dependence can harm the health, safety and development of family members;

  • Effective legislative, executive, administrative and other measures necessary to promote the widespread delivery of support and help for the family members of people with harmful alcohol consumption and alcohol dependence should be implemented;

  • The following principles should be taken into account;

    • A comprehensive communitybased system which includes close cooperation between the police, social workers, the courts and judicial system, nongovernmental organisations and professional diagnostic and counselling services for family members who suffer alcoholrelated violence, should be developed;

    • Children of parents with harmful alcohol consumption and alcohol dependence should be a high priority for psychosocial assistance and programmes to prevent social exclusion; and

    • Programmes for diagnosing and counselling adult family members of people with harmful alcohol consumption and alcohol dependence should be established in health care facilities, specialised centres and rehabilitation centres to prevent and help with emotional and psychological disorders.

VI. Implementing policies

1. Each European country (and, where relevant, local community, municipality and region within a country), and the European Union as a whole, should develop, implement, periodically update and review comprehensive multisectoral alcohol policy strategies, plans and programmes;

2. When developing and implementing comprehensive multisectoral alcohol policy strategies, plans and programmes, the following principles should be taken into account:

  • Country and European (and where relevant local community, municipal and regional) coordinating mechanisms or focal points for alcohol policy should be established or reinforced and financed7;

  • Effective legislative, executive, administrative and/or other measures in developing appropriate policies for preventing and reducing the harm done by alcohol, and the harm done by other people’s drinking should be adopted and implemented;

  • The setting and implementing of public health policies with respect to alcohol policy should be protected from commercial and other vested interests of the alcohol industry;

  • Cross-border cooperation in the formulation of proposed measures, procedures and guidelines for the implementation of policies, plans and programmes to reduce the harm done by alcohol should be adopted;

  • Cooperation, as appropriate, should be made with competent international and regional intergovernmental organisations and other bodies to achieve the implementation of policies, plans and programmes to reduce the harm done by alcohol, including the European Commission and the World Health Organization;

  • The effective implementation of policies, plans and programmes to reduce the harm done by alcohol should be adequately financed; and

  • For the purpose of effective alcohol policy, legislative action or the implementation of existing laws should be used to deal with criminal and civil liability, including compensation where appropriate.

VII.Research, surveillance and exchange of information

1. Research and research programmes, surveillance, and exchange of information at the local, regional, country and European levels in the field of alcohol policy should be developed and promoted;

2. Principles should include:

  • The initiation, promotion and encouragement of transparent and independent research that addresses the determinants and consequences of alcohol consumption, the harm done by alcohol, the effectiveness of polices and programmes to reduce the harm done by alcohol, and the effectiveness of strategies and approaches to implement effective policies and programmes to reduce the harm done by alcohol;

  • The promotion and strengthening of training and support for all those engaged in alcohol policy activities, including research, implementation and evaluation;

  • A system for the epidemiological surveillance of alcohol consumption and related social, economic and health indicators should be established;

  • Cooperation should be made with the European Commission and World Health Organization in the development of general guidelines or procedures for defining the collection, analysis and dissemination of alcoholrelated surveillance data;

  • Establishment of programmes for regional, country, and European surveillance of the magnitude, patterns, determinants and consequences of alcohol consumption and the harm done by alcohol. Alcohol surveillance programmes should be integrated into regional, national, and European health surveillance programmes so that data are comparable and can be analysed at the regional, country and European levels, as appropriate;

  • Alcohol surveillance and exchange of information between regions and countries should be established;

  • The exchange of publicly available scientific, technical, socioeconomic, commercial and legal information, as well as information regarding practices of the alcohol industry should be promoted and facilitated;

  • Annual reports of the alcohol industry for shareholders should include reports on how the alcohol industry has minimised the harm from its products in terms of production, marketing and sale, and any infringements of existing laws, regulations and codes of practice;

  • An updated database of laws and regulations on alcohol policy and, as appropriate, information about their enforcement, as well as pertinent jurisprudence, and cooperation in the development of programmes for regional, country and European alcohol policy should be established and maintained;

  • Updated data from regional, country and European surveillance programmes should be maintained; and

  • A Europe wide system to regularly collect and disseminate information on alcohol production, manufacture and the activities of the alcohol industry which have an impact on alcohol policy activities should be established and maintained.

References

1. The partners recognise that the policies stated in this document must be developed and implemented according to the circumstances, perspectives, legislative, executive and administrative structures, and interpretation of the evidence appropriate for each country.

2. Notwithstanding that drinking can be an important cause of boat, plane and train accidents in some communities, attention is placed on drinking and driving in this policy since alcohol related road accidents far outweigh other alcohol related transport accidents in the Community as a whole.

3. Impartial education would preclude, for example, school based education provided by the commercial alcohol industry.

4. “packaging and labelling” means each unit container (bottle, can, box or other type of container), text, characters or graphics on the unit container, labels on the unit container, and any outside packaging and labelling, where a number of unit containers can be placed in wrapping or in a box.

5. “minor” is a person under the age set by domestic law, national law or eighteen years, whichever is the higher, to whom the sale of alcoholic products is prohibited

6. Special attention should be paid to the alcohol industry, whose employees are at particular risk of harmful alcohol consumption and alcohol dependence, and which was one of the first industries to implement successful workplace programmes.

7. Where mechanisms, structures or organisations currently exist, these should not be replaced, but rather strengthened or redefined as appropriate.