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A Tool for Measuring Alcohol Policy Implementation

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Policy in action Policy Policy in action A tool for measuring alcohol policy implementation World Health Organization Regional Office for Europe UN City, Marmorvej 51, DK-2100 Copenhagen Ø, Denmark Tel.: +45 45 33 70 00 Fax: +45 45 33 70 01 E-mail: [email protected] Website: www.euro.who.int POLICY IN ACTION A tool for measuring alcohol policy implementation Policy in action ABSTRACT Europe has the highest alcohol consumption and alcohol-attributable disease burden in the world. In 2011, all 53 Member States of the WHO European Region endorsed the European action plan to reduce the harmful use of alcohol 2012–2020 (EAPA), which provides a portfolio of evidence-based policy options for mitigating alcohol-associated problems. To assess the extent to which Member States have adopted the recommended policy standards, the WHO Regional Office for Europe has developed 10 composite indicators, one for each action area of the EAPA. This document describes the construction of the EAPA composite indicators and presents an evaluation of the performance of Member States in the European Region in implementing the 10 action areas. The composite indicators measure not only the presence of alcohol policies but also their strictness and comprehensiveness. Keywords Alcohol Drinking - adverse effects Alcohol Drinking - prevention and control Alcohol-Related Disorders - prevention and control Alcoholism - prevention and control Regional Health Planning Europe Address requests about publications of the WHO Regional Office for Europe to: Publications WHO Regional Office for Europe UN City, Marmorvej 51 DK-2100 Copenhagen Ø, Denmark Alternatively, complete an online request form for documentation, health information, or for permission to quote or translate, on the Regional Office web site (http://www.euro.who.int/pubrequest). Photo: Chiyacat/Shutterstock.com © World Health Organization 2017 All rights reserved. The Regional Office for Europe of the World Health Organization welcomes requests for permission to reproduce or translate its publications, in part or in full. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either express or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. The views expressed by authors, editors, or expert groups do not necessarily represent the decisions or the stated policy of the World Health Organization. CONTENTS Acknowledgements. v Abbreviations ........................................................................vi Foreword ...........................................................................vii Introduction ..........................................................................1 Alcohol consumption and harm ......................................................1 Global context of alcohol policy ......................................................2 Aims of the composite indicators. 3 Methods ............................................................................4 Background ......................................................................4 Data sources .....................................................................5 Construction of scoring scheme. .5 Generation of scores ...............................................................8 Scoring scheme rationale ...........................................................9 Results ...........................................................................12 Scoring scheme ..................................................................12 Regional scores ..................................................................13 Discussion ..........................................................................18 Summary of findings ..............................................................18 Improvements from previous composite indicators ......................................18 Policy interactions ................................................................19 Robustness of the EAPA composite indicators ..........................................19 Strengths and limitations of the EAPA composite indicators ..............................20 Future work .....................................................................21 Conclusion ..........................................................................22 References .........................................................................23 Annex 1. List of survey questions used for the EAPA composite indicators arranged by SIs ..........28 Annex 2. Detailed scoring rubrics for the EAPA composite indicators ...........................41 ACKNOWLEDGEMENTS This first draft of this report was prepared by Genim Tan, Consultant, WHO Regional Office for Europe. Technical editing was provided by: Julie Brummer, Consultant; Lisa Schölin, Consultant; Lars Møller, Programme Manager; and Gauden Galea, Director, Division of Noncommunicable Diseases and Promoting Health through the Life-Course, WHO Regional Office for Europe. The project was carried out in association with Thomas Karlsson, Esa Österberg and Mikaela Lindeman of the WHO Collaborating Centre on Alcohol Policy Implementation and Evaluation, Finland. The project had an expert advisory group with the following members: Thomas Babor, University of Connecticut School of Medicine, Department of Community Medicine & Health Care, United States of America; Bernt Bull, Ministry of Health and Care Services, Department of Public Health, Norway; Vesna-Kerstin Petri, Division for Health Promotion and Prevention of Noncommunicable Diseases, Ministry of Health, Slovenia; Emanuele Scafato, WHO Collaborating Centre for Research and Health Promotion on Alcohol and Alcohol-Related Health Problems, National Observatory on Alcohol, National Health Institute, Italy; Esa Österberg, National Institute for Health and Welfare, Finland; Tatiana Klimenko and Konstantin Vyshinskiy, Federal Medical Research Centre for Psychiatry and Narcology, Ministry of Health, Russian Federation; Vladimir Poznyak, WHO headquarters; Gauden Galea, Lars Møller and Julie Brummer, WHO Regional Office for Europe; and Jürgen Rehm, Pan American Health Organization/WHO Collaborating Centre for Mental Health and Addiction, Canada; Institute for Mental Health Policy Research and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Canada; Institute of Medical Science, Department of Psychiatry and Dalla Lana School of Public Health, University of Toronto, Canada; Institute for Clinical Psychology and Psychotherapy, Technical University, Dresden, Germany. Imke Seifert, Intern, and Renée Bouhuijs, Consultant, WHO Regional Office for Europe, assisted with data collection and verification. The document benefited from input from the following peer reviewers: Charlie Foster, Associate Professor of Physical Activity and Population Health and Deputy Director, British Heart Foundation Centre on Population Approaches for NCD Prevention, Nuffield Department of Population Health, University of Oxford, United Kingdom; and Emma Plugge, Senior Clinical Research Fellow, Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, United Kingdom. The project was carried out by the WHO Regional Office for Europe in the context of the Project on the Prevention and Control of NCDs, financed by the Ministry of Health of the Russian Federation. v ABBREVIATIONS AMPHORA Alcohol Measures for Public Health Research Alliance APC adult per capita consumption APS Alcohol Policy Scale ATLAS-SU ATLAS on Substance Use BAC blood alcohol concentration EAPA European action plan to reduce the harmful use of alcohol 2012−2020 EISAH European Information System on Alcohol and Health EU European Union GDP gross domestic product ICD-10 International Classification of Diseases, 10th revision OECD Organisation for Economic Co-operation and Development PDS pattern of drinking score PPP purchasing power parity RSUD System on Resources for the Prevention and Treatment of Substance Use Disorders SI summary indicator TEASE Toolkit for Evaluating Alcohol policy Stringency and Enforcement vi FOREWORD In September 2011, the European action plan to reduce the harmful use of alcohol 2012–2020 (EAPA) was endorsed by all 53 Member States in the WHO European Region. The action plan lays out a range of evidence-based policy options aimed at restricting the supply of, and reducing the demand for, alcohol. It is the latest in a series of policy instruments developed to guide Member States
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