Memorandum
20 August 2001
Ministry of Health and Social European Commission Affairs Directorate General Health & Consumer Stockholm, Sweden Protection
Public Health Unit Directorate F – Public Health Unit F3
Report from the WHO Ministerial Conference on Young People and Alcohol (2000/PRO/2181)
Summary and Conclusions
Some 600 people from 47 European countries attended the conference and approximately 30 ministers and deputy ministers took part in the discussions. The European governments represented at the conference gave their support to a declaration on young people and alcohol. In addition, both the European Commission and all the EU ministers attending the conference expressed their support for the Swedish Presidency’s initiative concerning an EU strategy in the alcohol policy field. They endorsed the main idea of the Swedish plan during the informal talks they held with Lars Engqvist, Swedish Minister for Health and Social Affairs.
The declaration constitutes an important document for two primary reasons.
1. It offers the health ministers of the WHO and the EU Member States valuable support in their work to reduce the harmful effects of alcohol. Several ministers stated that with this declaration at their disposal they would be able to win backing for policy measures on the domestic front. 2. The declaration provides backing for policy efforts on behalf of European youth. In it, the various governments specify that young people are to be actively involved in the preparation, resolution, implementation and evaluation of measures directly relating to their age group.
The need for alcohol policy action became evident at the conference. A new WHO study was presented, showing that one death in four among young men aged 15–29 in Europe is alcohol-related. In parts of Eastern Europe, the figure is as high as one in three. A total of 55 000 young people in the WHO’s European region died from alcohol-related causes in 1999.
Figures from the European School Survey Project on Alcohol and Other Drugs, ESPAD, show that young people across Europe are increasingly drinking to get drunk. 2
The European Comparative Alcohol Study, ECAS, shows that there is convergence in per capita alcohol consumption, beverage preferences, alcohol-related mortality and the extent of alcohol policy measures.
The declaration, therefore, is designed to protect European youth from the harmful effects of alcohol and includes the following objectives:
- to delay the age of the onset of drinking by young people, - to reduce substantially the number of young people who start consuming alcohol, - to reduce substantially the occurrence and frequency of high-risk drinking among young people, especially adolescents and young adults, - to provide and/or expand meaningful alternatives to alcohol and drug use and increase education and training for those who work with young people, - to increase young people’s involvement in youth health-related policies, - to minimise the pressures on young people to drink, especially in relation to alcohol promotions, free distribution, advertising, sponsorship and availability, with particular emphasis on special events.
The conclusions of the EU working group focused mainly on the need for, and the value of, action at community level:
- more comparable data about young people is needed, - there is need for some sort of structure to collect and evaluate the information, - actions are needed at both national and community level, - multi-disciplinary actions are required, - alcohol is an important health determinant and cannot therefore be treated merely as a common commodity, - the situation has become worse – in all countries and in all age groups, - there is some convergence in the Union but, at the same time, there are still differences, - EU action is needed to minimise the pressures to drink among young people
Commissioner David Byrne, who spoke at the closing session of the conference, stressed two important guiding principles for the continuing work of the Commission and the EU Member States.
1. The rules and laws already in existence with regard to young people and alcohol, such as age limits and constraints on advertising, must be enforced. 2. The alcohol industry must now take responsibility for its actions. The draft recommendations on young people and alcohol contain 3
unequivocal rules concerning the way in which the alcohol industry should behave.
Commissioner Byrne appealed explicitly to representatives of the alcohol industry to take the opportunity to show that they can abide by voluntary agreements:
“Let me pass on a clear message to industry – this recommendation is a challenge for the alcohol industry in Europe today. It is a challenge to demonstrate that voluntary codes can work. A chance to show that you can take a responsible attitude to young people and alcohol in your marketing and promotion. A chance to convince regulators at national and European level that dialogue produces positive results on the ground. And I call on the industry at all levels – whether it is producers, advertisers or retailers – to seize this opportunity to show their commitment to the responsible promotion of alcohol. It is not an opportunity to be taken lightly. So, industry, if you are listening, the ball is now in your court.”
Dr Gro Harlem Brundtland, who was one of the opening speakers, also noted that the behaviour of the industry has made it increasingly difficult to protect children and adolescents from the promotion of alcoholic beverages.
“Not only are children growing up in an environment where they are bombarded with positive images of alcohol, but our youth is a key target of the marketing practices of the alcohol industry. By mixing alcohol with fruit juices, energy drinks and pre-mixed “alcopops”, and by using advertising that focuses on youth lifestyle, sex, sports and fun, the large alcohol manufacturers are trying to establish a habit of drinking alcohol at a very young age. We need to strengthen our work to counter these influences.”
Mr Engqvist closed the conference by giving his own impressions and summed up the meeting in the following words:
“Alcohol concerns everybody – all have some experience of alcohol. It is something very personal and private and, at the same time, alcohol is a political issue dealt with by ministers. Most times these worlds never meet. But this conference has from the very beginning been a conference where these two perspectives have lived side by side. Despite the complexity of the alcohol issue, the mixture of different personal experiences, cultural differences and age differences, a dialogue has been developed at the conference. The result has been the decision to have a common approach and a common position to minimise the harm done by alcohol to young people. And for the first time, a declaration on young people and alcohol has been developed and adopted together with young people themselves.” 4
1. Introduction
1.1 What, where, when… A total of approximately 600 delegates, temporary advisers, youth meeting messengers, observers, conference staff and journalists from almost all 51 WHO Member States gathered in Stockholm on 19–21 February 2001 to work out and agree on a plan of action for reducing alcohol-related harm in society, especially with a view to protecting young people and young adults. The conference addressed the issue of the drinking habits and lifestyles of the young generation in the context of current social, cultural and economic conditions. The conference involved young people themselves in the discussion and decisions, and young people played an important role at the conference.
The conference was organised five years after the European Conference on Health, Society and Alcohol held in Paris in 1995, when the European Charter on Alcohol was adopted
As well as being a WHO ministerial conference, the meeting was also an official part of the Swedish programme for the presidency of the European Union, in the form of a working group session on future EU action on alcohol.
The conference was hosted by the Swedish Government and was developed in cooperation with the European Commission, France, the Council of Europe, UNICEF and other international partners including the European Forum of Medical Associations, EUROCARE and WHO Headquarters.
The conference took place at Norra Latin, situated in the heart of Stockholm.
2. Preparations
2.1 The process The project consisted of several separate “mini-projects”. The ultimate goal was for all projects to “fall into place” and become the final building – to be entitled the WHO Conference. Actors from all over Europe took part in the building of the conference. One important purpose was to provide the opportunity for all actors involved to be a part of the process. Another was to create a network that could live on even after the conference. To make this possible, the preparations were begun two years prior to the conference and they proceeded in three phases.
1. Preparatory work for outlining the strategy, for building networks and for producing material for the conference and for the EU working group
To prepare the WHO Conference and the EU working group, several meetings and activities took place. 5
Throughout the project there was ongoing cooperation with the WHO Regional Office for Europe. Several meetings were held in Stockholm and Copenhagen to coordinate the conference programme, documents, young people’s involvement, practical preparations, etc.
Parallel to the cooperation and preparatory work with the WHO, there was also an ongoing dialogue between the Swedish organisers, European Commission Services and representatives and experts from the EU Member States.
Sweden’s local organising committee and the WHO Regional Office for Europe held an expert meeting in Stockholm on 28–29 April 1999 (not included in the application for funding). The participants were selected to represent a range of academic disciplines and different European countries. The purpose of the meeting was to discuss and establish the background and justification for the conference, to identify the major components and agenda items and to determine the best possible outcome of the conference1.
Two meetings with an international advisory group were held in Copenhagen. Representatives from Commission Services, France, WHO, Sweden, the European Council, Poland, UNICEF and EUROCARE participated in the meetings.
Two meetings with the WHO National Counterparts, international organisations, non-governmental organisations and representatives of the Commission (approximately 60 people) were held in Poland and in Germany. The purpose of the first meeting was to discuss the scope and objectives of the conference, the programme and the involvement of young people. The purpose of the second meeting was to discuss the draft declaration and to prepare the youth meeting in Stockholm.
The Commission’s Working Group on Alcohol and Health was involved in the discussions on the draft programme, the preparations of the EU working group and the cooperation between the WHO and the EU Member States.
In Brussels, several meetings were held with the health attachés from the EU Member States. At the meetings, the Swedish initiatives relating to alcohol and public health (alcohol strategy, the WHO Conference and the EU working group) were discussed and processed together with experts and representatives from the Member States.
A meeting was held and preparations took place together with the Council of Europe to prepare and implement the conference working group on Alcohol Policy and Youth Participation.
A meeting was held and ongoing cooperation established with schools in the European Network for Health Promoting Schools (ENHPS) to initiate and conduct different activities administrated by the network coordinators.
1 Report, expert meeting 28-29 April 1999, Skarpö, Sweden (Encl. NR 1) 6
Through the national coordinators in the European Network, schools in the WHO Member States were invited to participate in three different activities in connection with the conference in February: a poster exhibition, an IT project and a video project.
Cooperation with the European Health Communications network (1 200 people) was established to identify youth media, key persons and focal points.
A first announcement and conference information were sent out to all EU and WHO Member States2.
Several studies and surveys, overviews of current practice and knowledge were initiated or supported by, for example, the Swedish Government, the Commission and the WHO3.
Two separate meetings were held with the contact persons for the European Comparative Alcohol Study.
2.2 The EU working group WHO and the Swedish organisers initiated seven parallel working group sessions at the conference. The working groups were prepared and organised together with different organisations and stakeholders. One of the working groups was organised by the Swedish Presidency of the EU and co- sponsored by the EU Commission. The working group was an EU session and the main theme was to discuss an EU strategy on alcohol and public health.
To prepare the evidence base for the discussions in the working group, close cooperation was established with the researchers from the European Comparative Alcohol Study (ECAS). The aim was to make it possible to present the results of one of the two studies at the working group session during the conference. Another aim was to give support to the ongoing work at EU level. The working group programme and background documents were prepared together with the EU Member States, the ECAS researchers and Commission Services. The Swedish Presidency processed and presented a background paper about alcohol and public health in the Union and the WHO counterparts from Italy and Spain prepared presentations about alcohol and alcohol policies in Italy and Spain.
2.3 Preparations for the youth meeting
The active involvement of young people in the preparations and in the conference itself was essential. To achieve this, the Swedish Government arranged a separate youth meeting in Stockholm in November 2000. A total of 67 young people from 36 European countries gathered in Stockholm on 16–18 November 2000 to give their opinions on alcohol policies in Europe
2 First announcement and conference information booklet (Encl. NR 2) 3 Background documents from the Conference (Encl. NR 4) 7 today. They were invited to participate by the Swedish Ministry of Health and Social Affairs as an important part of the preparations for the WHO Conference in February. The youth meeting was arranged in consultation with the WHO Regional Office for Europe, the Council of Europe and UNICEF, and was prepared in cooperation with the Swedish International Development Cooperation Agency (SIDA), the National Board for Youth Affairs, the International Federation of Medical Student Associations, the Ministry of Culture and the Swedish Public Health Institute. SIDA and the European Commission provided financial support for the meeting.
The working group sessions at the youth meeting had the same themes as the working group sessions at the WHO Conference. The underlying intention was to give young people an opportunity to discuss and give their opinions on the suggested future plan of action for reducing alcohol-related harm.
A group of twenty participants from different countries were appointed as youth meeting messengers. They participated at the ministerial conference in February and presented the results of the youth meeting to the conference4.
3. The organisation of the WHO Ministerial Conference on Young People and Alcohol.
3.1 International organising committee WHO Regional Office for Europe, Alcohol, Drugs and Tobacco Unit Swedish Government, Ministry of Health and Social Affairs
3.2 International advisory group WHO Regional Office for Europe Swedish Government Représentation permanente de la France auprès de l’Union européenne EU Commission Council of Europe UNICEF Polish State Agency for the Prevention of Alcohol-Related Problems Latvian Ministry of Welfare
3.3 Conference secretariat – WHO WHO Regional Office for Europe.
Technical coordination Cees Goos
Conference administration Majlis Jepsen Pauline Glover Nina Kerimi (working group preparations)
Communication and media matters
4 report from youthmeeting.se Ministry of Health and Social Affairs (Encl. NR 3) 8
Franklin Apfel Annette Andkjaer Dag Rekve
3.4 Swedish organising committee Ministry of Health and Social Affairs Division for Public Health
Preparations and coordination Maria Renström Törnblom
Communication and media matters Bo Alm
Conference administration Berit Lundberg Katarina Cederlöf Wenger
Conference administration (youth meeting) Marino Wallsten
At the end of 1999, the Swedish Government established a Swedish organising committee with a full-time project manager and staff.
A number of Swedish partners were involved in the preparations.
- A steering group within the Government Offices was responsible for the budget and overall policy. - A reference group was set up with representatives of Swedish authorities and non-governmental organisations. - A separate steering group was established to prepare the youth meeting. - A young person began work as project coordinator together with a youth reference group.
4. Participants
4.1 Invitations All the 51 member countries in the WHO European Region were invited to send a delegation consisting of up to five people. The Regional Director of WHO Europe, the Prime Minister of Sweden and Sweden’s Minister for Health and Social Affairs signed the invitation. It was addressed to the Minister for Health in each country. WHO and the Swedish Government proposed that each delegation should be a cross-sectional team which, in addition to the Minister for Health and other officials from the ministry, could include the national counterpart for the European Alcohol Action Plan, young people and delegates drawn from other ministries, parliamentary committees and key governmental or non-governmental organisations dealing with alcohol policies. 9
A special invitation was sent out to the youth meeting messengers, the European Commission, the Council of Europe, UNICEF, and the Working Party to the Council of the European Union (Health Group), among others.
Non-governmental organisations and other organisations were invited as observers5.
The Swedish Minister for Health and Social Affairs, Mr Engqvist, invited his EU colleagues and representatives of the Commission to participate in an informal discussion on a future community alcohol strategy
4. 2. Outcome Delegations from 47 countries participated. Several countries sent more than the suggested 5 delegates (an average of 5.5 people per country). The largest delegation came from the United Kingdom (14 people), the smallest from Israel (1).
111 delegates came from EU Member States (an average of 7.4 people). 51 delegates came from the candidate countries (an average of 4.5).
Among the conference working groups, the EU working group attracted the highest number of participants (60–70 people).
Ministers, or representatives appointed by ministers, from all 15 EU Member States and a representative from the Commission took part in the informal discussions chaired by the Minister for Health and Social Affairs, Mr Engqvist.
As a whole, the conference attracted many more people than expected. More than 600 people took part in the opening session on the first day. The media coverage was among the most extensive ever at a WHO conference6. A total of 73 national and international media companies covered the event, resulting in a great number of newspaper articles and radio and television broadcasts all over Europe.
5. Purposes and aims
One important purpose was to provide the opportunity for all actors involved to be a part of the process. Another was to create a network that could live on even after the conference. When the project started in 1999 several project aims were established.
5.1 Overall aim
To contribute to a European policy on alcohol and young people.
5 List of participants (Encl. NR 5) 6 Copies of media coverage (Encl. NR 6) 10
5.2 Outcome The result of the conference gave input important for the WHO and for future EU policy. It provided a high-level political platform for a European debate on alcohol and youth policies. It strengthened international cooperation and provided common scientific ground for future action. In the process of developing and agreeing on a plan to reduce the harm done by alcohol, the different levels of competence and experience available were taken into consideration. The conference was a positive meeting and a fruitful dialogue took place between the adult and younger members of society.
The optimal result of the creative and positive atmosphere at the conference was the adoption of a WHO Stockholm declaration by all WHO Member States. Other important outcomes were the discussions and conclusions from the EU working group. The working group made a valuable contribution to the future work of the EU. There was strong support for a common comprehensive community strategy to minimise the harm done by alcohol within the Union and the candidate countries.
5.3 Additional aims
5.3.1 Alcohol as a key health determinant
To raise the awareness of and focus on alcohol as a key determinant during the Swedish Presidency.
5.3.1.1 Outcome During the process leading up to the conference, several activities were initiated to present new findings and to provide the opportunity to discuss alcohol and its effect on public health and, most importantly, to discuss cooperation and added value at community level. The purpose of the process was to prepare and finalise the necessary background documents before the Swedish Presidency and to receive feedback from other EU Member States, the Council working party and Commission Services. The two important documents now on the agenda of the Council in June are the outcome of the process: the Commission’s proposal for a Council recommendation on the Drinking Habits of Children and Adolescents and the Presidency’s suggestion for Council conclusions on a community strategy to reduce alcohol-related harm.
5.3.2 To stimulate new activities and involve young people
To stimulate new activities that lead to a high level of human health protection for young people and young adults
To seek new ways to reach and involve young people in preventive efforts using new communication channels and information technology.
One important ambition was to involve young people in the conference work and to encourage them to contribute to future alcohol preventive work. 11
The presence and participation of young people was organised and prepared in four main ways.
- Each of WHO Europe’s Member States was urged to include one or two young persons in its delegation. - The Council of Europe engaged a group of young people to prepare and implement the conference working group on Alcohol Policy and Youth Participation. - Schools in the European Network for Health Promotion Schools were involved in different projects. - A preparatory youth meeting was held in Sweden.
5.3.2.1 Young people in the delegations The aim was to have at least one young person in each country delegation.
Outcome Young people were not included in all delegations. Of 47 delegations, approximately 30 included one or two young delegates. The outcome was, however, acceptable bearing in mind this was the first occasion on which national delegations were urged to include young people, and also bearing in mind the restriction on the number of participants.
5.3.2.2 The youth meeting The specific aims of the youth meeting were:
- to give young people an opportunity to contribute to the outcome of the conference by preparing them for their participation in working groups and other conference sessions; - to give young people the opportunity to formulate a message to be presented at the WHO ministerial conference; - to discuss how young people could contribute to future work in their own countries and give them an opportunity to contribute to the implementation and realisation of policies, strategies and other outcomes of the Stockholm conference.
Outcome A good number of countries from all parts of the European region were represented at the meeting. The participants were all very dedicated and took an active part in the discussions at the meeting. The result was evidence that the youth meeting was a useful way of preparing young people. Involving young people in the development of policies and strategies concerning their own age group can help improve the quality of policies and also increase young people’s trust and faith in policy makers. Many of the young participants have continued to work at national level and have built a network on the Internet to communicate and exchange experience and knowledge. The conference encouraged many national delegations to take the Stockholm conference as an example for future action at both national and international level.
5.3.2.3 Health promoting schools 12
One important arena for future preventive work is the network of health promoting schools. Our aim was to involve the network in the preparations for the conference and to lay the basis for future work by involving the network in the implementation of the conference declaration, for example.
Outcome The European Network of Health Promoting Schools presented results of three special projects designed for the conference in Stockholm:
- a poster exhibition with posters produced by schools all over Europe - a website www.young-minds.net with information and “chat” - a video project – the video films were shown in the plenary session at the conference.
5.3.2.4 Exhibitions with good examples The aim was to provide an opportunity for non-governmental organisations, youth organisations and different European projects to present their work at the conference. Another aim was to make the conference venue more lively and to make it possible for young people to meet and discuss with the ministers and other key persons.
Outcome Alongside the conference a number of exhibitions were held showing good examples of preventive work and providing information about ongoing work from all over Europe7. Around 40 different exhibitions were displayed around the conference venue.
Registration is normally a long and frustrating process. In order to spread out the process, with the purpose of avoiding long queues to the registration desks and to create a lively and open atmosphere from the very beginning, an exhibition was held during the special registration session on Sunday before the conference started. A majority of the conference participants took advantage of the opportunity to register on Sunday and visit the exhibition.
In connection with the WHO reception at the Cultural Centre in Stockholm, a special showing of the Eldvatten (Firewater) exhibition – an exhibition about alcohol – was arranged. In the exhibition, a total of 86 well-known and not so well-known Swedes discussed their relationship to, and experiences with, alcohol and alcoholism. The photographer Albert Viking presented the exhibition in which approximately 400 people took part.
5.3.3 To generate knowledge about young people’s drinking habits and lifestyles
To generate knowledge about young people’s drinking habits and lifestyles in the context of current social, cultural and economic conditions and to present the results from the European Comparative Alcohol Study.
7 List of exhibitions (Encl. NR 7) 13
Outcome A number of papers and studies were presented at the conference. Some of them were based on new research. One of them was the EU comparative alcohol study. As a whole, the presentations, the papers and the studies provided better knowledge about drinking levels, harm and patterns relating to young people than had previously been available. They also revealed important information about where there is a lack of information and research, thus presenting important input for further research and data collection. More details about the documents are shown under Chapter 9. -Background documents and studies.
6. The programme The conference consisted of plenary sessions as well as a number of parallel working groups8. The Swedish television journalist Jens Orback moderated the conference.
6.1. Office holders President of the Conference Lars Engqvist, Minister for Health and Social Affairs, Sweden Co-presidents Dr Bernard Kouchner, Minister for Health, France and Dr Vitaliy Moskalenko, Minister for Health, Ukraine Rapporteur Professor Zeljko Reiner, and co-rapporteurs Dr Sina Bugeja and Dr Ann Hope
6.2 Opening session The conference was opened on Monday 19 February. Opening addresses were given by:
HM Queen Silvia of Sweden Lena Hjelm-Wallén, Deputy Prime Minister of Sweden, Dr Fernand Sauer, Director, European Commission, Dr Gro Harlem Brundtland, Director-General, WHO, Dr Marc Danzon, Regional Director, WHO Europe Amina Mehic, youth meeting messenger Alexander Rossu, youth meeting messenger
6.3 Plenary sessions Introduction of the Draft Conference Declaration and establishment of a drafting group
Youth cultures in Europe: young people’s views on alcohol
Drinking and other forms of risky behaviour among young people
Investing in a healthy young generation
Forum discussion on results of working groups
8 The conference programme (Encl. NR 8) 14
Adoption of Conference Declaration
Ministers’ Forum on the Conference Declaration
Closing session (speakers: President, Mr Engqvist, Commissioner Byrne, Dr Danzon)
6.4 Working groups Working group sessions discussed the following themes that reflected the draft declaration. The results of the working groups are presented in more detail in the conference report 9.
6.4.1 A safe and supportive environment Organised by UNICEF
The group discussed the most efficient approaches for creation and promotion of a safe and supportive environment, with the aim of providing greater protection of children and young people from health hazards including pressure to drink and exposure to alcohol-related harm. Approaches for tackling the problems, with prevention in the workplace, including vocational training, higher education training and employment settings were presented.
6.4.2 Information, communication and advocacy Organised by the European Health Communication Network, WHO
The role of the mass media and communication in the prevention of alcohol- related harm to young people, with the aim of enhancing communicative strategies, was the theme of this working group. The topics discussed were: mechanisms for the promotion of alcoholic beverages to young people, current regulations on alcohol advertising and alcohol-related health communications in the mass media. Preventive communicative approaches proved to be effective were presented.
6.4.3 Alcohol policy and youth participation Organised by the Council of Europe
The working group discussed how young people could participate in alcohol policy making, how to stimulate community and civic action in addressing alcohol policy issues and how young people could act towards the policies of the alcohol industry. During the working group session experts made presentations and received feedback from the youth meeting messengers.
6.4.4 Health systems and alcohol Organised by the European Forum of Medical Associations.
9 Report from the WHO European Conference on Young People and Alcohol 15
The focus of the group was to discuss the role of health systems in reducing harm related to alcohol use and ways of achieving a better model for its involvement in prevention and treatment. For example, the role of primary health care and requirements for professional education.
6.4.5 The family Organised by EUROCARE
The family and the well-being of children was the focal point of this group. The family’s impact, the family as a resource for prevention and the family and the community were the issues addressed. The group put forward ways of building a stronger alliance between families and education, health care, the workplace and non-governmental organisations to protect young people.
6.4.5 Global perspectives Organised by WHO Headquarters
The focus for discussion in this group was the globalisation of alcohol production, trade, distribution, marketing and advertising and its influence on human and social development. The global implications of the European Alcohol Action Plan and European alcohol policies were discussed. The aim was to outline ways to strengthen inter-country partnership and international cooperation.
6.4.6 EU strategy on alcohol We have chosen to make a more detailed description of the EU working group, it being one of the main issues of this project.
The working group was organised by the Swedish Presidency of the EU, and was co-sponsored by the EU Commission and France. Anna Hedborg, Director-General and former Minister for Health, chaired the group. Facilitators were Dominique Martin and Maria Renström.
The main theme was to discuss an EU strategy on alcohol and public health. The working group intended to add value to the development of such a strategy. The results of ECAS and the ongoing work at EU level were presented during the session.
ECAS, study period 1950–1995 The ECAS study has not focused on young people but on the total population. In almost all EU countries, the level of alcohol consumption is at its highest ever and the negative consequences of drinking have been concentrated on adults, especially males between 30 and 40 years of age.
Looking at the adult population, there is convergence in per capita consumption, beverage preferences, alcohol-related mortality and the extent of alcohol policy measures, but not much in drinking patterns (there has been no special study among young people). 16
Over the last 15–20 years the increased homogenisation can be explained mainly by a drastic reduction in wine consumption in the Mediterranean wine-drinking countries. Patterns of work, leisure and sociability in daily life, as well as cultural interchanges, have all vastly changed the context in which drinking takes place. Drinking patterns are slowly changing but there is still not enough data to provide any exact answers.
The ECAS study found that strong links prevailed between alcohol consumption and alcohol-related mortality in all EU countries. No benefit to the heart from alcohol consumption could be found at population level (not to be confused with individual level). A positive and significant alcohol effect on liver cirrhosis mortality for males was found. After pooling information, this statistically significant and positive alcohol effect was discovered in all three groups of countries – northern Europe, central Europe and southern Europe. The strongest effects were found in the north.
An increasing number of policy measures are being adopted but, at the same time, the strictest control policies have been liberalised. Measures targeted at the regulation of alcohol consumption are technically effective, but it is politically difficult to have them approved and enforced. No universal best policy profiles can be identified, according to the ECAS researchers.
Emanuele Scafato gave a presentation of alcohol as a health target in public policy. During the past few years, most national health plans produced by Member States have followed a general population approach. The change in terminology from “risk factors” to “health determinants” is an example of this. Dr Scafato stressed that the new model gave more attention to the need for a reduction of exposure to the determinants of disease and injury. Italy has developed a new national health plan for 2000–2003 and is setting new targets for alcohol. Dr Scafato expressed the need for the development and harmonisation of a common core set of indicators for data collection in priority areas, a monitoring system on alcohol burdening issues (young people, pregnancy, alcohol-related fatalities), studies and research focusing on patterns and on the distribution of alcohol consumption and an EU periodical report on alcohol.
Teresa Robledo de Dios talked about Alcohol – an important health determinant in Spain. She presented data on developments in Spain and gave information on national policy actions, targets and problems in Spain. She underlined the importance of international cooperation and the implementation of the WHO Alcohol Action Plan.
Ceferino Jose Sanchez Fernandez presented the message from the youth meeting held in Stockholm in November 2000. Ceferino asked the European Union to take action towards common limits on alcohol for drivers and age limits on buying and serving alcohol in order to avoid the confusing variability of legislation in different countries. The youth meeting messengers asked for a common European policy for young people. The most important message from the young people was about the advertising 17 and promotion of alcohol. They would like to see global action which can reach where national governments cannot.
7. Communication and media The communicative work relating to the conference had a number of different targets:
• to create awareness of and interest in the conference among potential participants and to stimulate their interest in participating; • to contribute to the work of putting the alcohol issue on the political and general agenda in Europe; • to create awareness of the conference and the alcohol issue among young people in Europe and to stimulate their interest in being involved in the preparations for and the implementation of the conference; • to give participants easy access to good and relevant information about technical and practical matters relating to the conference; • to create awareness of the conference and its messages among the general public in Europe.
One part of the strategy was to use the Internet and other “new” communication channels as much as possible in order to reach the different target groups. The other part of the strategy was to communicate through the different existing European networks.
Two specific websites were established in connection with the conference.
The official conference website www.youngalcohol.who.dk was administrated by the WHO Regional Office for Europe in Copenhagen. This site contained official documents, background papers, press releases, speeches, practical information, etc.
The other website www.youthmeeting.se was specifically aimed at young people and was established in connection with the preparatory youth meeting in Stockholm in November 2000. This site was administrated by the Swedish National Board for Youth Affairs, and contained information about the youth meeting, the ministerial conference, a discussion forum, etc.
An equivalent forum was established on another website which was created by one of the projects administrated by the European Network for Health Promoting Schools, described in another section of this report.
As the conference was also an official meeting within the Swedish EU Presidency programme, a lot of official and media information connected with the conference was published on the Swedish Presidency website www.eu2001.se/calendar.
The conference attracted a huge amount of media attention. A total of 73 different Swedish and European media companies were accredited and covered the conference. 18
Video footage of the conference, collected by ECHN broadcasters and compiled in video news releases, was used by broadcasters across Europe to illustrate the news and feature stories relating to the conference’s key messages. As a result, the conference received news coverage unprecedented in the history of the WHO Regional Office for Europe. The video news releases about alcohol and young people, including the conference logotype, were also broadcast on CNN in the summer of 2001.
8. Practical arrangements
8.1 The venue, travel arrangements and information desks The conference took place at Norra Latin, which is an integral part of the Stockholm City Conference Centre – one of the largest conference centres in Europe. A conference bureau, Nyman & Schultz, was responsible for the practical arrangements concerning hotel and travel reservations, the meeting venue, badges, and the social programme.
Preliminary reservations were made for conference participants at hotels within easy walking distance of the congress facilities. Travel arrangements were made for both the outward and return journeys to Arlanda Airport, the WHO reception and the dinner hosted by the Swedish Minister for Health and Social Affairs.
A reception desk at Arlanda Airport was staffed on Saturday 17 February, Sunday 18 February and Monday 19 February. Hostesses assisted with enquiries concerning hotel reservations, transport, etc.
Registration took place at the conference venue, Norra Latin. Registration began on Sunday 18 February and continued throughout the conference.
At Norra Latin a hospitality desk staffed by hosts and hostesses was set up to assist the participants with all practical matters connected with their stay in Stockholm. General tourist information about Stockholm and the surrounding area was also available.
The conference was open to the media. A fully equipped media centre was available at the conference venue.
Outcome The venue and all practical arrangements surrounding the conference worked very well. The hosts and hostesses took care of the participants at all times and the venue proved to be an excellent setting for the working groups and plenary sessions.
8.2 Working languages
WHO sessions The working languages of the conference were English, French, German and Russian. Simultaneous interpretation into these four languages was provided 19 during all plenary sessions. Spanish interpretation was provided during the last day of the conference.
EU sessions The working languages were English, French, German, Greek, Portuguese and Spanish in the EU working group. During the informal discussions between EU ministers the working languages were the same as during the EU session.
Language hosts During the youth meeting and the WHO conference, Sweden invited students from Stockholm University and some international schools in Stockholm to assist participants with language-related problems and issues connected with the conference.
Documents The main documents were translated into English, French, German and Russian.
Outcome In general the translations and interpretations functioned well. There was only one complaint and that was from the Russian participants. Not all working groups could provide them with simultaneous interpretation to Russian. There were no complaints from the EU sessions.
8.3 Social events A welcome reception was held on Sunday 18 February in connection with registration. The delegations and conference participants were offered refreshments, and exhibitions, video shows and entertainment were arranged.
The Swedish Minister for Health and Social Affairs hosted a dinner at the Vasa Museum, where the Romeo and Juliet Choir provided musical entertainment.
The Regional Director, WHO EURO, held a reception at the Cultural Centre in Stockholm with an exhibition, a musical performance by Spiral Motion and a buffet dinner.
The Swedish Minister for Health and Social Affairs also hosted a special lunch for the heads of delegation.
Throughout the conference, lunch, coffee and other refreshments were offered to all participants free of charge.
Outcome All the social events were greatly appreciated, especially the dinner at the Vasa Museum.
9. Background documents and studies 20
9.1 The ESPAD study The second European School Survey Project on Alcohol and Other Drugs is a comparative study on young people’s relation to alcohol and other drugs in 30 European countries. The study showed among other things that binge- type drinking as well as the frequency of drunkenness has increased among young people 10.
9.2 The ECAS study The European Comparative Alcohol Study (ECAS) has collected information in EU Member States on:
- national alcohol policies - trends in overall alcohol consumption - drinking patterns - alcohol-related mortality.
The period studied is 1950–2000 (although for some of the studies, the studied period may be different). The study showed that there is a link between the total consumption of alcohol in a country and the total mortality. It also showed that there has been some harmonisation between the EU Member States regarding alcohol consumption levels, beverage preferences as well as alcohol policies 11.
9.3 The WHO Global Burden of Disease 2000 study Alcohol-related burden of disease in young people in Europe. A comparative risk analysis, based on data from the WHO Global Burden of Disease 2000 study, preliminary findings on alcohol and young people (focus on mortality rates, the effects of drinking patterns and unrecorded consumption)12.
9.4 Keynote papers Drinking among young Europeans (Settertobulte, Bruun Jensen, Hurrelmann)
Alcohol and its social consequences – the forgotten dimension (Klingemann)
Alcohol in the European Region – consumption, harm and policies (Rehn, Room and Edwards)
Besides the keynote papers, 37 abstracts were prepared and presented in the conference working groups13.
10 ESPAD 11 ECAS 12 Abstract 13 Working group abstracts etc. 21
Table of contents
1. Introduction
2. Preparations Preparatory work to outline policies and strategy, build networks and produce material.
3. The conference organisation WHO Sweden EU working group
4. Participants Invitations Outcome
5. Purpose and aims Outcome
6. The programme Working groups EU session Plenary
7. Communication and media
8. Practical arrangements Working languages Conference venue Social events Transportation Support
9. Background and studies
This report was produced by a contractor for Health & Consumer Protection Directorate General and represents the views of the contractor or author. These views have not been adopted or in any way approved by the Commission and do not necessarily represent the view of the Commission or the Directorate General for Health and Consumer Protection. The European Commission does not guarantee the accuracy of the data included in this study, nor does it accept responsibility for any use made thereof.