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Alcohol Consumption in Russia: Affordability of Alcohol, Changes and Effects of Alcohol Control Policy and Future Prospects Jacek Moskalewicz Esa Österberg (eds.) Changes in Alcohol Affordability and Availability Twenty Years of Transitions in Eastern Europe Jacek Moskalewicz, Esa Österberg (eds.) Österberg Esa Moskalewicz, Jacek Jacek Moskalewicz Esa Österberg REPORT (eds.) REPORT Changes in Alcohol Affordability and Availability Twenty Years of Transitions in Eastern Europe Changes in Alcohol Affordability and Availability and Affordability in Alcohol Changes The last twenty years of transitions have showed mixed results regarding econo- mic and health developments in Eastern Europe – an area which appears to be a unique laboratory for tracing the interplay between social change, alcohol policy, alcohol consumption and related harms. This book contains contributions from countries all over Eastern Europe; • Russia, Belarus and Ukraine which emerged as independent states after dissolu- tion of the Soviet Union but remains outside the European Union, • the three Baltic states which regained independence in the early 1990s and joined EU in 2004 and • Czech Republic, Hungary, Poland and Romania which also broke with their former political affiliations and economic ties with the Soviet Union in the early 1990s and joined the EU either in 2004 or 2007. However, this is not only a book of alcohol history and country specific develop- ments in Eastern Europe. It is also an attempt to gain a better understanding of why scientific knowledge of the effectiveness and cost-effectiveness of different alcohol control measures is not the only decisive factor for paving the way to the implementation of effective public health oriented alcohol control measures. Publication sales www.thl.fi/bookshop .!7BC5<2"HIKKEH! Phone: +358 29 524 7190 13 13 | 2016 2016 13| 2016 ISBN 978-952-245-771-4 Report 13/2016 Changes in Alcohol Affordability and Availability Twenty Years of Transitions in Eastern Europe Jacek Moskalewicz and Esa Österberg (eds.) © Authors and National Intitute for Health and Welfare Layout: Seija Puro ISBN 978-952-245-771-4 (printed) ISSN 1798-0070 (printed) ISBN 978-952-245-772-1 (online publication) ISSN 1798-0089 (online publication) http://urn.fi/URN:ISBN:978-952-245-772-1 Report 13/2016 Juvenes Print – Suomen yliopistopaino Oy Helsinki 2016 CONTENTS Contributors . 5 Introduction . 6 Jacek Moskalewicz & Esa Österberg & Mikaela Lindeman & Marta Welbel Alcohol consumption in Russia: affordability of alcohol, changes and effects of alcohol control policy and future prospects . 18 Artyom Gil & Daria Khaltourina & Andrey Korotayev Affordability of alcohol and alcohol-related problems in Belarus . 51 Yury E. Razvodovsky Alcohol control policies and alcohol consumption in Ukraine . 64 Konstantin S. Krasovsky Alcohol policy in Estonia – country in transition . 80 Lauri Beekmann Alcohol availability and affordability in Latvia . 86 Marcis Trapencieris & Sigita Sniķere The effects of Lithuanian alcohol control policy . 101 Aurelius Veryga & Mindaugas Štelemėkas Impact of rapid decline in alcohol consumption in Poland: Increase in overall consumption or shift from illicit to licit market . 108 Janusz Sieroslawski Czech Republic: Alcohol use and related harm in the period of transition . 117 Vendula Běláčková & Michaela Stefunkova Local-level alcohol regulation initiatives and duty free home distillation – two lessons from Hungary . 135 Tamas Koos Alcohol policy developments in Romania . 146 Andrei Botescu & Milica Georgescu Summary . 157 Jacek Moskalewicz & Esa Ősterberg & Yury E. Razvodovsky Report 13 | 2016 • THL 3 CONTRIBUTORS Beekmann, Lauri, Secretary General, Nordic Alcohol and Drug Policy Network (NordAN) . Bĕláčková, Vendula, Ph .D ,. Assistant Professor, Department of Addictology, 1st Faculty of Medicine, Charles University in Prague and General Teaching Hospital in Prague, Prague, the Czech Republic . Botescu, Andrei, Ph .D ,. National Antidrug Agency, Bucharest, Romania . Georgescu, Milica, Ph .D ,. National Antidrug Agency, Bucharest, Romania . Gil, Artyom, MD, MPH, Ph .D ,. Assistant Professor, I .M . Sechenov First Moscow State Medical University, Higher School of Health Care Administration, Moscow, Russia . Khaltourina, Daria, Ph .D ,. Research Fellow of the Department of the Integrated Prevention Programs, Federal State Institution “National Research Center for Preventive Medicine” of the Ministry of Healthcare of the Russian Federation, Moscow, Russia . Koos, Tamas, MD, MBA (health exec .), National Centre of Addictions - National Institute of Health Development, Budapest, Hungary . Korotayev, Andrey, Ph .D ,. Head of laboratory, National Research University, Higher School of Economics . Moscow, Russia . Krasovsky, Konstantin, Ph .D ,. Alcohol and Drug Information Center (ADIC-Ukraine), Kiev, Ukraine . Lindeman, Mikaela, MSc, Researcher, Alcohol and Drug Unit, National Institute for Health and Welfare, Helsinki, Finland . Moskalewicz, Jacek, Ph .D ,Head,. Department of Studies on Alcoholism and Drug Dependence, Institute of Psychiatry and Neurology, Warsaw, Poland . Österberg, Esa, MSc, Chief Specialist, Alcohol and Drugs Unit, National Institute for Health and Welfare, Helsinki, Finland . Razvodovsky, Yury, MD, Ph .D ,. Senior Research Scientist, Grodno State Medical University, Grodno, Belarus . Sierosławski, Janusz, M .A ,. Researcher, Institute of Psychiatry and Neurology, Warsaw, Poland . Sniķere, Sigita, MSc, Researcher, Institute of Philosophy and Sociology, University of Latvia, Riga, Latvia . Stefunkova, Michaela, Ph .D ,. Researcher, Institute of Criminology and Social Prevention, Prague, Czech Republic . Štelemėkas, Mindaugas, Ph .D ,. Lecturer, Junior Researcher, Health Research Institute at the Lithuanian University of Health Sciences, Kaunas, Lithuania . Trapencieris, Marcis, Ph .D ,. Researcher, Institute of Philosophy and Sociology, University of Latvia, Riga, Latvia . Veryga, Aurelijus, MD, Ph .D ,. Professor, Head of Health Research Institute of the Lithuanian University of Health Sciences, Kaunas, Lithuania . Welbel, Marta, M .A ,. Sociologist, Psychologist, Institute of Psychiatry and Neurology, Warsaw, Poland . Report 13 | 2016 • THL 5 Jacek Moskalewicz, Esa Österberg, Mikaela Lindeman and Marta Welbel INTRODUCTION lcohol Measures For Public Health Research Alliance (AMPHORA) was a four-year Aresearch project running from 2009 to 2012 co-financed by the Seventh Framework Programme of the European Commission. The project was split into nine areas of re- search in the form of work packages. A full description of the work undertaken within the project can be found in published article Alcohol Policy in Europe: Evidence from AMPHORA (Anderson et al. 2013). AMPHORA’s Work Package 5, entitled Economic and Physical Availability of Alco- hol, was dedicated to the study of changes and effects of alcohol availability in Europe. Measures changing the availability of alcohol can be divided into three categories. First, there are measures affecting economic availability, such as excise duties, value added tax- es, import duties, minimum prices, discount promotions and so forth. The second cat- egory contains measures affecting alcohol affordability, including both alcohol prices and consumers’ disposable incomes. The third category includes measures affecting the physical availability of alcohol, such as an alcohol monopoly or licensing systems for the on- and off-premise retail sale of alcoholic beverages, opening hours and sales days of al- cohol outlets, as well as sales practices and legal age limits or other personal controls for alcohol sales (Karlsson et al. 2013). A wealth of research has shown that restrictions on the physical and economic avail- ability of alcohol belong to the most effective and cost-effective policy measures when trying to lower total per-capita alcohol consumption and to reduce levels of alcohol- related harms (see e.g. Anderson 2009; Babor et al. 2010; WHO 2011; Anderson et al. 2012). In dealing with these restrictions, AMPHORA’s Work Package entitled Economic and Physical Availability of Alcohol dealt with a highly central topic that in one way or another affects health and welfare in every country in Europe. Two stages of the work package The work package involved researchers from Finland, Poland and Sweden working on the subject of alcohol availability in two stages. In brief, the first stage focused on studied cases of changes regarding alcohol availability, meaning the documentation and map- ping of published research and literature on the subject of alcohol availability from all over Europe. Altogether 383 publications were collected, from which a number of con- 6 Report 13 | 2016 • THL Introduction clusions could be drawn. One interesting feature that emerged from the gathered mate- rial was that different types of study interest could be identified in different corners of Europe. Many of the studies dealing with the Nordic countries were for example dom- inated by the physical availability of alcohol, whereas studies from Eastern Europe to a larger extent dealt with alcohol consumption and related harms (Karlsson et al. 2011). In the second stage, attention was focused towards unstudied cases, which refers to policy changes that have occurred in Europe during the last decade that had not yet been scientifically documented or analysed. These cases were identified through exten- sive searches that included national and international media, NGO’s newsletters and mailing lists, web portals, and information offered by Governmental and European in- stitutions and by other networks. We also received
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