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Anu Kasmel International Union for Health Promotion and Education

Enforcing nighttime alcohol sale ban in Estonia. Anu Kasmel International Union for Health Promotion and Education. Health systems. HEALTH PROMOTION. HEALTH PROTECTION. HEALTH CARE. REHABILITATSIOON. WHO Health For All database, 2009.

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Anu Kasmel International Union for Health Promotion and Education

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  1. Enforcing nighttime alcohol sale ban in Estonia Anu Kasmel International Union for Health Promotion and Education

  2. Health systems HEALTH PROMOTION HEALTH PROTECTION HEALTH CARE REHABILITATSIOON

  3. WHO Health For All database, 2009

  4. Life expextancy prognosis for Estonian women to be EU average in year 2030

  5. Life expextancy prognosis for Estonian men to be EU average requires miracle or responsible alcohol policy

  6. Alcohol related mortality • … is 3 times higher in Estonia than European average • 2000 deaths in a year connected with alcohol (population 1,3 million) • 50% of the car accidents, • 50% of the drownings, • 74% of the violence related crime and • 80% of the violent crime commited by the juveniles are connected with alcohol • Average lifetime of Estonian men - 12 years shorter than in EU countries

  7. Alcohol related mortality in Estonia and Nordic countriesper100 000 15 year and older Nordic Alcohol Statistics, 2001-2006

  8. Consumption of abs. alcohol in Europe litres per person

  9. Changes: drunk before 13 years of age % % Hibell B. The ESPAD Report 2003; 2004.

  10. Alcohol related harm

  11. Alcohol related harm Behavioral riskfactors Home Family Friends Neighbours School Workplace Leisuretime Infrastructure Economy Education Culture Politics and policies

  12. Alcohol related harm INDIVID COMMUNITY MUNICIPALITY GOVERNMENT Behavioral riskfactors Home Family Friends Neighbours School Workplace Leisuretime Infrastructure Economy Education Culture Politics and policies

  13. Alcohol related harm INDIVID COMMUNITY MUNICIPALITY GOVERNMENT Behavioral riskfactors Home Family Friends Neighbours School Workplace Leisuretime Infrastructure Economy Education Culture Politics and policies SOCIAL ENVIRONMENT PHYSICAL ENVIRONMENT

  14. Evidence based cost effective policy • Estonian research supports the international findings (Lai, 2005). • Most cost-effective political strategies to prevent alcohol harm are: • Raising taxes • Restriction availability • Banning alcohol advertising

  15. Alcohol policy – a Towerof Babel • No existing National Alcoholism Prevention Program - there was a National Alcoholism and Drug Prevention Program 1997-2007, which was closed in 2004. • In January 2010 MSA forwarded to the Government the principles of alcohol policy – these are not taken under the discussion. • No alcohol specialists in governmental structures • Alcohol not mentioned in Estonian Governments Coalition Agreement.

  16. Current situation • Alcohol excise duty was raised by 10% from January 2010, and yet the price of alcoholic beverages has increased less than standard of living • Estonian Parliament accepted (12.12.2004) the law that makes the second time alcohol selling to the minor a criminal act. Punishment for that crime is up to one-year imprisonment • Alcohol advertising Beer ads from 20.00 Strong alcohol from 21.00

  17. The case of restriction of the nighttime alcohol sale • Suggestions to elaborate alcohol policy 1993,(also availability of alcohol and restrictions connected with it has been important object for discussion; • Followed by the intense capacity building process in the communities and municipalities; • In 2004 first municipalities restricted nighttime alcohol sale; In 2006 MSA forwarded proposition to the Parliament - not accepted; more municipalities joined; • In 2007 Tallinn City Government accepted the ban to nighttime alcohol sale from 20.00-8.00; • In the Parliament in June 2008 accepted from 22.00-10.00; (barter: subsoil plots act for mining more oil-shale was an objective).

  18. Prerequisites for policy changes – capacity building of decisionmakers STRUCTURECAPACITY Government • to critically analyse • to have a vision • set priorities • to keep the mission • to mobilize stakeholders • to be able to reach consensus • To get social support Coordinating Centre County Municipality Community

  19. Alcohol related retail sites per 100000 inhabitants 1.01.2007 Nordic Alcohol Statistics, 2001-2006

  20. State total benefit and costs from alcohol • About 2 mio for health services 11% (Tikk, 2006) • Medicaments • Mortality • Disability • Workplace costs • Criminality • Harm to families • According to different calculation 20-40 milliard per year - About 2 milliard from excice taxes Nordic Alcohol Statistics, 2001-2006

  21. Selection of approaches Easy access and availability

  22. Selection of approaches

  23. The main obstacle - lack of consensus • Ministry of Justice, Economy and Internal Affairs opposed the governmental law that prohibits alcohol sale during night hours. • Ministry of Justice proposed to accept alcohol consumption in public places. • Ministry of Justice supported the raising of BAC of drivers to 0,49%. • Prime Minister comments: “We do not need restriction of the nighttime alcohol sale”; “In alcohol policy we are in right track”.

  24. Ultimative prerequisite for policy changes - Social responsibility

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