Alcohol Help

Community Action on Alcohol in Denmark

• No tradition for strong national alcohol control policy

• Traditionally the municipality strategy has been school education for children

• Focus on community/municipality action:

- evidence based methods

- systematic prevention and control policy, early detection, brief intervention, and referral to alcohol treatement

• 860.000 persons – 15% – with harmful use of alcohol or alcohol dependence

• 140.000 persons with alcohol dependence

• 122.000 children (0-18 years) in families with alcohol problems

• 632.000 persons in Denmark grew up in families with alcohol problems

• 12.000 persons per year get alcohol treatment

The social and health cost because of:

• people with alcohol dependence in alcohol treatment

• people in hospitals with alcohol related illnesses are:

Total 28,3 million Danish kroner per year:

4,2 million Danish kroner to finance the health care system
18,2 million Danish kroner for transfer payments
5,4 million Danish kroner for support to children and young people

Social and health costs for all municipalities

Social and health costs because of:

• People with alcohol depencence in treatment

• People in hospitals with alcohol related ilnesses:

• 3,1 billion Danish kroner per year

• Calculation for the 140.000 with alcohol depencence 7,8 billion per year

• Total cost for alcohol treatment 283,5 million Danish kroner

Building prevention structures and routines in the municipalities

• Alcohol policy in municipalities

o Building an organisation across the different branches of administration to coordinate implementation of the alcohol policy and action plan

• Alcohol policy in schools

o Agreement between parents in the 5th to 10th grade about postponing alcohol debut and handling parties for children and young people

• Early detection of parents with alcohol problems in the social sector, schools and kindergarten
o Support to the children and the parents

• Quality in alcohol treatment

Alkohol policy: Norm and frame setting

Alcohol policy consists of:

• Norm setting and reduction of the availability of alcohol

• Early detection/brief intervention

• Referral to alcohol treatment

Alcohol policy in 20 municipalities

• Alcohol policy for the municipality as such

• An alcohol organisation comprising the different branches of administration

• Alcohol policy for the municipality as a workplace

• Alcohol action plan for the professional work directed towards the citizens in the municipality: kindergartens, schools, institutions for the elderly, job centres

Reducing availability in 8 municipalities

The municipalities have the possibility to reduce availability:

• by reducing the numbers of places where alcohol is sold

• by securing that the alcohol licences are controlled and withdrawn when not followed

• by developing competences in responsible beverage serving

Early detection of alcohol problems in the social sector, kindergartens and schools in 78 municipalities

The task of pedagogues and teachers:

• To consider alcohol problems as a possible background factor if a child is not doing fine

• To combine the registration of the child with registration of the behaviour of the parent

• To talk with the parents about alcohol habits

• If necessary refer the parents to family alcohol treatment

Alcohol treatment for families

Evidence for alcohol treatment for families show:

• that partners are much more aware of the alcohol problem than the drinker

• partners need support or treatment when there is alcohol problems in the family

• support to partners alone motivates the drinker to go to treatment and stay in treatment

• alcohol treatment for families is more effective than individual treatment

Centrally formulated Action plans

Action plans for the municipalities with evidence based methods and material related to the traditional risk factors:
• Smoking
• Alcohol
• Nutrition
• Obesity
• Exercise
• Drugs
• Sexual health
• Indoor environment
• Mental health

National Board of Health, Denmark
Axel Heides Gade 1
DK-2300
Copenhagen S
Denmark

Phone +45 72 22 74 00

People in Europe consume more alcohol – 12.5 litres of pure alcohol equivalent per year on average – than in any other part of the world. How frequently, where and in what context alcohol is consumed influence the effect it has on health. “Alcohol in the European Union”, a new report by WHO co-sponsored by the European Commission, reveals significant subregional patterns of consumption and health effects across the European Union (EU).

“Europe’s dubious honour of having double the global average alcohol consumption has clear, recognized health consequences for drinkers, those around them and society,” said Zsuzsanna Jakab, WHO Regional Director for Europe. “Yet the take home message from this new report is that the alcohol-related burden on health in Europe is avoidable. For every facet of alcohol consumption, this report provides evidence-based conclusions for policy and practice, and I urge countries to review it carefully.”
Regional patterns

Social, cultural, geographic and economic variations in the countries of the EU have led to four distinct country groupings – central-eastern and eastern Europe, central-western and western Europe, the Nordic countries , and southern Europe – with different alcohol consumption patterns and trends.
Total consumption and the indicators of hazardous drinking

Although high in all cases compared to the global average, the breakdown of alcohol consumption by subregion reveals the highest consumption in central-eastern and eastern Europe (14.5 litres of pure alcohol per adult, per year), compared to 12.4 litres in central-western and western Europe, 11.2 litres in southern Europe and 10.4 litres in the Nordic countries.

When, however, these figures are weighted against the indicators of hazardous drinking – the proportion of drinking outside mealtimes, drinking in public places and irregular, heavy (binge) drinking – they reveal a different picture. The Nordic countries have a hazardous drinking score of 2.8 (from a range where 1 is least detrimental and 5 is most detrimental), compared to an only slightly higher score of 2.9 for central-eastern and eastern Europe, and significantly above central-western and western Europe (1.5) and southern Europe (1.1).
Consumption levels over time

Although European consumption of alcohol per capita has remained nearly constant over the past decade, at a subregional level, the Nordic countries and eastern Europe have seen an increase in adult consumption, while this has decreased in western and southern Europe.
Deaths from alcohol

The standardized alcohol mortality rate per 100 000 population across the EU was 57 for men and 15 for women in 2004. Yet subregional mortality rates varied widely, from 129 (men) and 27 (women) per 100 000 in central-eastern and eastern Europe, to the lowest rate of 30 (men) and 10 (women) in southern Europe.

In addition to these general differences, specific drinking tendencies in the subregions influence the causes of death. Deaths from cardiovascular diseases (excluding ischaemic heart disease) and injuries are proportionally higher in central-eastern and eastern Europe, owing to the high overall volume consumed in these countries, together with irregular heavy drinking sessions. In the Nordic countries, deaths from mental and neurological disorders are proportionally higher, owing to the high prevalence of alcohol dependence and alcohol-use disorders. Cancer is proportionally higher in southern Europe, as consumption levels were considerably higher two decades ago and cancer often takes a long time to develop.
Harm to others from alcohol consumption

As well as doing harm to drinkers themselves, alcohol consumption affects others. Again reviewing data from 2004, over 5500 deaths in men of all ages in the EU and over 2000 deaths in women were attributable to drinking by others. By far the greatest number of deaths and harm were the result of transport injuries, followed by violence as a distant second cause.

Southern Europe shows the greatest proportion of harm to others compared to the total alcohol-related harm for that subregion, as measured by deaths. In central-eastern and eastern Europe, however, calculations indicate that a greater proportion of motor vehicle crashes attributable to alcohol harm the drunk drivers themselves.
New report “Alcohol in the European Union”

The report “Alcohol in the European Union” produced by the WHO Regional Office for Europe and the European Commission analyses alcohol consumption patterns, the harm this causes to the health of both drinkers and non-drinkers, and what can be done to improve the health of Europe’s population. A number of cost-effective policies have proven that increased taxes, decreased availability and restrictions on marketing are effective in reducing the harmful use of alcohol. The policy options are all described in the report.

Quick facts

# Alcohol consumption by adults over 15 years in the EU is more than double the world average. It is the equivalent of 12.5 litres of pure alcohol a year, 27g of pure alcohol per day, or nearly 3 drinks daily.
# There are over 40 recognized alcohol-use disorders and conditions, including alcohol dependence and the harmful use of alcohol, alcoholic liver disease, alcohol-induced chronic pancreatitis, accidental alcohol poisoning, and fetal alcohol syndrome. There are many more health conditions where alcohol is a contributory cause, such as injuries and deaths from road traffic crashes.
# One in 10 cancers in men and 1 in 33 cancers in women are alcohol related.
# In the EU, 11.8% of all deaths in 2004 among those aged 15–64 were due to alcohol, the equivalent of 1 in 7 deaths in men and 1 in 13 deaths in women.
# A total of 3.3% of all deaths in 2004 among those aged 15–64 were due to alcohol consumed by others.

European action plan on alcohol

The European action plan to reduce the harmful use of alcohol 2012–2020, endorsed by the 53 Member States of the WHO European Region in September 2011, is the latest Region-wide policy response to reduce the health burden caused by alcohol. It gives a comprehensive overview of the problem and provides policy options proven to reduce alcohol-related harm. Policies such as regulating alcohol pricing, targeting drink–driving, and restricting alcohol marketing are known to be effective.

WHO Regional Office for Europe
Scherfigsvej 8
DK-2100 Copenhagen Ø
Denmark
Telephone: +45 39 17 17 17

Lately a ruling in Denmark – the first of its kind – provides that alcohol has no place in advertising targeted minors. The ruling is a victory for the Consumer Ombudsman, as well as for Alcohol and Society (former Danish Alcohol Policy Network) being the fruit of several complaints throughout the years.

New law stood its ground

Two years ago in 2008 the Danish Consumer Ombudsman clamped down on youth travel agencies with the law addition of 2006 as his legal basis. He thereby introduced a complete ban on alcohol in marketing targeted minors (below 18). December 2011 the law was put to the test and stood its ground. The court has sentenced the youth travel agency, Dansk Ungdomsferie Aps a 55.000 fine (7.000 Euros) for targeting minors and encouraging alcohol consumption.

Hereby the Consumer Ombudsman has been granted a court order, which implies a general prohibition against using alcohol as eye catcher in marketing aimed at minors. The case is a travel advert in the youth magazine “Chili”. The ad linked to the company web site, which featured several references to alcohol, for example: Photos of adolescents partying and expressions like: “pub crawl”, “we visit 5 bars in 4 hours each with its own specialty”, “one hour free Sangria”, “HAPPY HOUR on additional drinks and cocktails”, The Glass offers 3 hours free bar to light up the party, which soon reaches a boiling point”.

Mere presence of alcohol banned

The Consumer Ombudsman is satisfied with the result. Being the first verdict regarding a violation of the 2006 addition to the Marketing Practices Act, it assesses the ban on encouraging minors to drink alcohol. Moreover the ruling makes clear, that a marketing activity does not need to be gross or aggressive to be ruled out. The mere presence of alcohol in an advertisement is enough.

“This is a test case, and obviously I am pleased that the court agreed with our assessment that the marketing of Dansk Ungdomsferie Aps violates the provision regarding encouraging adolescents to drink alcohol” states the Consumer Ombudsman, Henrik Øe and continues: “I am also very content that it clearly appears from the ruling that the provision is not limited to apply to cases of gross or aggressive character only. This court ruling is of great consequence to similar cases in the future. “

The court rules that the description of the activities on the destination along with the pictures imply a direct or indirect encouragement to drink. The court considers the marketing in question to be targeted at youngsters below the age of 18. The court emphasizes that the advert was found in the youth magazine Chili, which is distributed in high schools, and that the agency had minors as their customers (today they only addresses a +18 clientele). On this basis the court find that the agency had violated the Marketing Practices Act, paragraph 8, 2 pursuant to which marketing targeted at children and adolescents are prohibited to encourage drinking directly or indirectly.

Fine doubles marketing budget

The agency is fined Danish Kroner 55.000 (Euros 7.000). By determining the fine the court used the company’s marketing expenses as basis, and doubled the amount.

The Marketing Practises Act § 8, 2

“Marketing targeted at children and young people is not allowed directly or indirectly to urge violence, use of drugs, including alcohol, or other dangerous or ruthless behaviours; or in any other way make improper use of violence, fear or superstition, for instance as a gimmick”

The provision came into force July 1. 2006
Source: Press release, The Consumer Ombudsman, Denmark

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