Guardians of the Nordic model

The Nordic countries have long shared a commitment to evidence-based alcohol policies, characterised by retail state monopolies, controlled availability and marketing, and taxation strategies aimed at reducing alcohol-related harm. These policies have been essential to safeguarding public health and sustaining the principles of our welfare states. According to WHO, alcohol per capita consumption is considered a reliable indicator for estimating alcohol-attributable harm. In the Nordic countries that maintain retail monopolies, consumption levels are well below the EU27 average of 11.0 litres of pure alcohol. As a result, these countries experience fewer years of life lost due to premature mortality and fewer years lived with disability caused by alcohol-related diseases, injuries, and conditions. This reflects a broader global understanding that population-level measures—such as those used in alcohol control—are among the most effective and cost-efficient strategies for reducing the burden of non-communicable diseases, as recognised in WHO’s global NCD strategy and recent international declarations.
 

Today, however, we face a critical moment that requires renewed attention and thoughtful action. Recent developments across our region raise serious concerns about a potential departure from this proven and effective model. We, the undersigned, bring decades of experience in public health, alcohol policy, and societal well-being, and write to express our deep concern about the direction of current developments.
 

Finland is currently experiencing policy changes that, although introduced gradually, add up to a substantial shift in direction. Starting with the increase in permitted alcohol strength in grocery stores from 5.5% to 8%, Finland is now considering further liberalisation measures such as allowing wine sales in grocery stores and expanding home delivery services. Equally concerning is the potential transfer of alcohol policy oversight from the Ministry of Social Affairs and Health to the Ministry of Economic Affairs and Employment. Such a move signals a shift in priorities from public health to economic and commercial considerations.
 

In Sweden, the proposal to introduce farm-sales is presented as a way to support rural tourism and local producers, but it poses a significant challenge to the fundamental legal premise underpinning the state monopoly system within the EU/EEA internal market. The introduction of any exceptions that favour domestic producers could undermine the legal basis of Systembolaget, potentially leading to broader liberalisation pressures.
 

Norway and Iceland have introduced separate, nuanced adjustments in alcohol availability, each carrying unique implications. Again, their cumulative impact could progressively alter the established framework that has proven effective in safeguarding public health. It increasingly resembles a game of Jenga, where policymakers remove one small piece at a time, believing the structure will hold—until, eventually, it does not.
 

It is this cumulative impact of individually minor policy adjustments that warrants careful scrutiny and consideration. Policymakers in each Nordic country should critically evaluate the combined public health consequences of these incremental changes. Public health strategies are most effective when maintained consistently over time; even modest relaxations can gradually erode the strength and effectiveness of our established alcohol control systems.
 

Policy development in the Nordic countries must remain guided by the principles of public health, social welfare, and evidence-based practice, rather than being influenced by short-term economic interests or political ideologies.
 

Our shared vision should also reflect broader regional goals. The Nordic prime ministers' joint ambition for the region to become the world’s most sustainable and integrated region by 2030, as outlined in "Our Vision 2030," provides a powerful and forward-looking framework. Strong alcohol policy contributes directly to the social sustainability of our societies, supporting health equity, reducing harm, and reinforcing the very foundations of the welfare state.
 

As senior experts across multiple disciplines, we emphasise the importance of preserving and reinforcing our evidence-based Nordic alcohol policy model. We call upon Nordic governments to carefully consider the long-term health, economic, and societal benefits of population-level alcohol control measures. Let us build upon our successes and strengthen our commitment to a policy framework admired globally for protecting the well-being and health of our societies.