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What has happened since?

February 2022 - Alcohol policy is an ongoing process. There are several factors that influence it - changes in the related harm, the understanding of the problem, research developments, personal and subjective preferences, worldviews, political understandings and economic gain. Over the years, we have seen both positive and negative effects of these factors. Over the years, the Nordic Alcohol and Drug Policy Network has both raised and addressed a variety of issues. Through letters of concern as well as of support, reports and our annual conference, we have pushed and pulled towards evidence-based policies. In this report, we will revisit some of these cases, examining what has happened since then.

Oljefondets alkoholproblem-campaign in Norway

NordAN wrote to the Norway Ministry of Finance and the members of the Parliament's Standing Committee on Finance and Economic Affairs regarding the Norwegian Government's Oil Fund in April 2019. The media reported that the Fund had invested close to 1.4 billion NOK in five companies engaged in marijuana production. This is how NordAN responded - NordAN letter

The Norwegian Oil Fund announced at the end of May 2019 that they would no longer invest in companies that are directly involved in cannabis. "We have already decided not to invest in companies with direct exposure to cannabis," Communications Manager of Norges Bank Investment Management (NBIM), Thomas Sevang, told Norwegian media. KLP, Norway's largest pension fund, said that it would no longer invest in gambling companies and alcohol makers, and recently sold stocks and bonds in such firms worth about $320 million. Explaining its decision, KLP said it did not want to make money from products that can harm people who are vulnerable to addictions, adding that there are better ways in which pension savings can make a sustainable contribution to society.

In 2019, FORUT, IOGT, Juvente and Bla Kors launched a campaign on the Norwegian Oil Fund's almost NOK 90 billion investment into international alcohol sales. Campaigners are calling on the Norwegian government to pull the government pension fund out of the alcohol industry, as Norway did with the tobacco industry in 2009.

What is the latest?
oljefondetsalkoholproblem.no campaign manager Nils Johan Garnes

In 2019, Norway launched a new strategy to combat non-communicable diseases (NCDs) for its development policy and programmes. This strategy attracted attention as one of the very first strategies for NCDs in a development context. At the same time, Norway kept up its investment in the global alcohol industry through the Norwegian pension fund (SPU). By the end of 2020, the fund had more than 120 billion NOK invested in alcohol industry (12 billion EUR). The fund is now addressing its ethical standards by developing an initiative for better ethical screening before investing. However, as alcohol is no ordinary commodity, a screening of a company’s ethical standards would not be a sufficient protection for global health, as the product is one of the leading risk factors for NCDs. 

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Alcohol and flying

NordAN has been highlighting the issue of drinking and flying since 2012, when the General Assembly adopted a resolution urging the airline companies to ban free alcohol. Since then, we have participated in discussions around unruly passengers, drinking during flights and different legislation around that topic. One of the major step towards safer flying has been the process of Montreal Protocol 2014 (MP14).

Montreal Protocol is now explained to us by Tim Colehan, Assistant Director External Affairs at the The International Air Transport Association (IATA): “When an aircraft is inflight we can think of it being a piece of mobile sovereignty of the country where it is registered, so if there is an unruly

incident onboard, it is the courts, laws and law

enforcement of the state of registration that

have the jurisdiction to deal with the unruly

passenger, which causes an issue when the flight

lands at a foreign destination. So MP14 solves

that jurisdictional gap allowing the state of

landing to deal with the unruly passenger.”

The practical implication of MP14 is that it should help governments fill the legal gaps that allowed perpetrators to avoid prosecution. Tim Colehan: “In practice that should close the jurisdictional gap (which our members tell us is an issue in around 60% of cases not being prosecuted), but it doesn’t mean that every unruly passenger will now be prosecuted (which is down to the prosecuting authorities in each country). This bring us to another major element of enhancing the legal deterrent. In many cases, unruly passengers escape prosecution because it is not seen as in the public interest to do so (court time, evidentiary requirements, etc.). This is often because the offense may not be deemed serious enough to undertake a criminal prosecution. So we are urging governments, particularly in light of the face mask issue, to look again at the range of enforcement measures they have available. In particular, we believe there should be wider consideration of civil and administrative penalties that can be issued on the spot by police or aviation security officials in a similar approach to getting a speeding ticket in a car. These would be used for less serious cases. The International Civil Aviation Organization has produced expanded guidance on this in its Document Manual 10117. We believe this will lead to a much more powerful deterrent. So in simple terms, fix the jurisdictional gap by ratifying MP14 and then review enforcement mechanisms using Manual 10117 as a guide.”

Finland joined the ratifiers of the Montreal Protocol on August 1, 2021
The problem with the Montreal Protocol was that the governments, especially in our region, were not quick in ratifying it. It finally came into force on 1 January 2020, after 22 States ratified to trigger it. At the moment the list has 31 States, including several European States (including Finland). “Around 1/5th of global traffic is now covered by States that are party to MP14. I fully expect that number to grow with the UK, UAE and various other States in process, but also because the whole issue of unruly and disruptive passengers is a key focus due to the COVID-19 pandemic. The requirement to wear masks onboard are being deliberately flouted (even after crew warnings) by a small minority of passengers. Governments are looking at the issue – for example the number of cases reported to the US Federal Aviation Authority is around 4,000 so far in 2021 and they have implemented a zero tolerance approach with up to five years in prison or $35,000 fines. IATA member have also reported an increasing number of issues. IATA has submitted a working paper to the ICAO High Level Conference on COVID-19 taking place in October together with the International Federation of Airline Pilots Associations (IFALPA) and International Transport Workers Federation (ITF) calling for urgent action including the ratification of MP14 and a wider range of enforcement options to enhance the deterrent against such behaviour,” explained Mr Colehan.

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Alcohol policy plans struggling in Latvia

Latvia has a tradition of heavy drinking, with the weakest alcohol policy of all Baltic countries. In Lithuania and Estonia, alcohol policies have undergone significant changes, but Latvia hasn't followed suit. Latvia has, however, worked with a new draft. In July 2019, the Latvian Health Ministry announced plans to reform alcohol policy. The draft national alcohol strategy sought to completely ban alcohol advertisements on television, radio, and the internet, as well as restrict advertising of alcohol discounts. The plan also included steps to limit the availability of alcoholic beverages and tighten controls, such as prohibiting the sale of alcoholic beverages at service stations. On the other hand, it is planned to monitor more strictly to make sure no minors are buying alcohol, as well as to control the movement of illegal alcohol. In August 2019 NordAN responded to Latvia´s open consultation on the draft alcohol and alcoholism action plan with a letter of support encouraging the Latvian government to implement evidence-based policies. A new round of consultation took place in July 2021, where NordAN once again submitted its recommendations.

What is the situation in Latvia?
Elena Zviedre from the Ministry of Health:
"Latvia has developed and the government in summer 2020 adopted the

Plan on Alcoholic Beverages Consumption Reduction and Alcohol Use

Disorder Reduction for 2020 – 2022. The Plan provides tasks to be

implemented to reduce alcohol consumption and addiction in Latvia.

In June 2021 draft for amendments of "Handling of Alcoholic Beverages

Law" and also in the "Electronic Mass Media Law" were announced for

public discussion.
As we could have predicted, we have received a large number of objections and proposals from other ministries and the alcohol industry as well.
Unfortunately, one of the planned amendments related to the sales hours for alcoholic beverages - to shorten the sales hours for alcoholic beverages and forbid alcohol sales between 20.00 and 10.00 (instead of 22.00 to 8.00 as it is now) had been removed from the legislation draft projects at this time. This restriction was opposed by the industry (they argue that the reduction of the time frame of alcohol sales would only increase alcohol consumption, especially illegal alcohol consumption), and from public authorities and ministries representing the economic interests of trading and manufacturing companies as well. Finally, we didn’t receive political support as well for changing the sales hours for alcoholic beverages. Now the draft laws are being specified for further progress and will be submitted to other ministries for harmonization. 
I would like to add that the Ministry of Health plans to launch a study this year on the economic benefits of alcohol restrictions, which will examine, among other policy instruments, the impact of shortening alcohol trading hours, so this restriction could be included in the next legislation amendments."

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Alcohol and cancer

In 2020 and 2021, the NordAN project focused on the relationship between alcohol and cancer. In cooperation with European Alcohol Policy Alliance Eurocare and European Cancer Leagues website www.alcoholandcancer.eu was relaunched. In 2020, the General Assembly of NordAN adopted a resolution on the topic pointing out that it would be a mistake to consider it a well-known fact and that people are making informed choices when it comes to alcohol use and health risks. In the resolution, governments were urged to ensure this information about alcohol and cancer links goes beyond official documents, statements, and strategies that rarely reach the average person.


What are the most recent developments?
Europe beating cancer plan

On 3 February 2021, the European Commission presented its long-awaited Europe's Beating Cancer plan. The plan is major initiative under the European health union, a process launched by the Commission on 11 November 2020 with a first set of proposals to reinforce the EU's preparedness and response during health crises. The plan will make full use of all available EU funding instruments, with a total of €4 billion being earmarked for actions addressing cancer, including from the EU4Health programme, Horizon Europe and the Digital Europe programme. The cross-cutting actions will address key risk factors such as tobacco, harmful alcohol consumption, environmental pollution, and hazardous substances.
Europe’s Beating Cancer Plan emphasizes alcohol-related harm as a major public health concern in the EU and that cancer was the leading cause of alcohol-attributable deaths with a share of 29%, followed by liver cirrhosis (20%), cardiovascular diseases (19%) and injuries (18%). The target is to achieve a relative reduction of at least 10% in the harmful use of alcohol by 2025.

Effective public health prevention as listed below can reduce the social and economic losses caused by harmful use of alcohol.

  • Support to Member States and stakeholders for the implementation of best practice interventions and capacity building activities.

  • The Commission will review the EU legislation relating to the taxation of alcohol and on cross border purchases of alcohol by private individuals.

  • To reduce the exposure of young people to marketing of alcoholic beverages, the Commission will closely work with Member States to reduce online marketing and advertising of these products.

  • The Commission will also review its promotion policy on alcoholic beverages in the EU promotion programme for agricultural products.

  • Mandatory labelling of the list of ingredients and the nutrition declaration on alcoholic beverage labels before the end of 2022

  • The inclusion of health warnings on the labels of alcoholic beverages will be proposed before the end of 2023.

  • Support will be provided to Member States in the implementation of evidence-based brief interventions on alcohol in primary health care, workplace and social services.

BECA report
Parliament’s Special Committee on Beating Cancer (BECA) adopted in December 2021 its final proposals on how to strengthen the EU’s role in the fight against cancer.
The comprehensive strategy addressing cancer at EU level should serve as a model for other non-communicable diseases, MEPs add.

The report calls for stronger EU action to address key risk factors and social determinants of cancer, including:

recalls that alcohol consumption is a risk factor for many different cancers and calls for, inter alia:

- promotion of actions to reduce and prevent alcohol-related harm within the framework of a revised EU alcohol strategy, including a European strategy of zero alcohol consumption for minors
- better information to consumers by improving the labelling of alcohol beverages to include health warning labels and introducing the mandatory indication of ingredients and nutritional information
- prohibition of alcohol advertising at sport events when those events are mainly attended by minors and prohibition of alcohol sponsorship of sport.


The European Parliament discussed and voted on the report on February 15 and 16 in its plenary session. There were clear indications that some EU member states will attempt to amend the role and wording of alcohol in the report to "restore proper balance." South-European economical interests promised to "fight tooth and nail" against the measures suggested in the report. 

While the European Health NGO's supported the report's adoption without further amendments, the Parliament adopted several changes that diminished alcohol's role in the report. The final report can be found HERE.

These are the main changes:
Before
supports the provision of better information to consumers by improving the labelling of alcohol beverages to include health warning labels and introducing the mandatory indication of the list of ingredients and nutritional information, and in addition, by introducing digital labelling
After
supports the provision of better information to consumers by improving the labelling of alcohol beverages to include moderate and responsible drinking information and introducing the mandatory indication of the list of ingredients and nutritional information, and in addition, by introducing digital labelling
Before
recalls that alcohol consumption is a risk factor for many different cancers, such as oral cavity, pharynx, larynx, oesophagus, liver, colorectal and female breast cancer
After
underlines that harmful alcohol consumption is a risk factor for many different cancers, such as oral cavity, pharynx, larynx, oesophagus, liver, colorectal and female breast cancer
Before
underlines that tobacco and alcohol consumption, poor nutrition, a high body mass index, a sedentary lifestyle and environmental pollution are risk factors common to other chronic diseases
After
underlines that tobacco and harmful alcohol consumption, poor nutrition, a high body mass index, a sedentary lifestyle and environmental pollution are risk factors common to other chronic diseases
Before
recalls the study referred to by WHO which recognises that there is no safe level of alcohol consumption when it comes to cancer prevention, and stresses the need to take this into account when devising and implementing cancer prevention policy
After
recalls the study referred to by WHO which recognises that the safest level of alcohol consumption is none when it comes to cancer prevention, and stresses the need to take this into account when devising and implementing cancer prevention policy

 

Alcohol policy challenged in Lithuania

During the last few years, Lithuania has reformed its alcohol policies based on WHO recommendations. “Among further measures was a total ban of alcohol advertisement in the media, internet, billboards, etc., an increase of the minimum legal drinking age from 18 to 20 years, and a major increase in excise tax,” explained Dr Aurelijus Veryga, who defined the Lithuanian measures as Health Minister of the country in 2016–2020. In 2010, Lithuania had the highest rate of alcohol-attributable years of life lost in the European Union. As a result of effective alcohol control measures, this rate was reduced by 20% by 2016 and has continued to decline steadily since then. By 2018, the per capita consumption was down to 11.2 litres.
There is already evidence that Lithuania's new alcohol laws are working. 

 

The plans of the new government
In October 2020, conservative opposition Homeland Union-Lithuanian Christian Democrats (TS-LKD) won parliamentary elections with 50 seats. Prime Minister Saulius Skvernelis’ Union of Farmers and Greens came a distant second with just 32 seats. In November 2020, Ingrida Šimonytė became new prime minister, after forming a centre-right coalition government of her TS-LKD and two liberal parties. Immediately after taking office, the new government hinted at possible changes to alcohol policies. Finally the government proposed the reduction of legal age to 18 (from current 20) years, allowing brands advertising in social media and delivery platforms, prolonging retail time on Sundays.
In December 2021 NordAN expressed support for national efforts and sent a letter of concern to the Lithuanian parliament and parliamentary committees. The letter stated: “Every country should avoid policies based purely on ideologies, dominated by industry interests which are not helpful in reducing alcohol-related harm. Revoking evidence-based policies, or watering them down, does have negative effect on public health.”

 

Vote
On January 18th 2022, the bill was voted on in the Lithuanian Parliament. MPs rejected individual proposals as well as the amendment bill, which was voted down 63 to 51. 
The vote results were obviously welcomed by Lithuanian health campaigners. NordAN board member, NTAKK president Nijole Gostautaite Midttun: "Just minutes ago, during the plenary of the Lithuanian Parliament, ALL suggested changes for Alcohol Control Law were rejected and the project thrown out for now. No support even for "further improvements" of the project. For some time policy is safe: same proposals can't be registered/discussed for half a year."

Aurelijus Veryga posted on Facebook after the vote: "Common sense prevailed.
The Seimas did not support any proposal to liberalize alcohol control policy.
Thank you to all the colleagues who voted against liberalization."

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Revising tax rules for cross-border purchases

In December 2020 the European Commission published the first document in the process of revising tax rules for cross-border purchases for alcohol and tobacco and opened a roadmap for feedback. NordAN submitted its opinion on January 5th 2021. 

"NordAN wants to stress, especially based on the experience of Finland and Estonia, cross-border trade, as it has been regulated thus far, undermines the whole alcohol policy, not only the effectiveness of excise tax as a measure. The effectiveness of alcohol policies partly rely on the population’s support, but this is weakened by the situation caused by cross-border trade. It is easy to understand that citizens won’t support raising alcohol taxes in a case where tens of millions of tax money is left in a neighbouring country. To a certain extent, this dissatisfaction extends to the whole alcohol policy and governments ability to introduce new measures and explain the effectiveness of different interventions."

Where is the process now?

"The question has been heavily delayed by the Commission," explained Emil Juslin, European Policy Officer at the IOGT-NTO Brussels office.

"The original plan was to publish the Commission proposal in Q3 2021, but it was postponed. The Commission has told us that the issue is quite sensitive which has contributed to the delayed publication. 

Our latest indication is that the Commission aims to publish the proposal, as well as the impact assessment, before the summer. This might be because of France´s interest in the issue and their current presidency.

Also, just another short update is that the cross border study that we have conducted together with the researcher Håkan Leifman on cross-border trade of alcohol during the pandemic is finished. The article is currently in Peer review but we hope that it will be accepted to BMC Public Health soon. You can find the preprint of the study HERE."

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