52006SC1358

SEC(2006) 1358

COMMISSION STAFF WORKING DOCUMENT

Document accompanying the COMMUNICATION FROM THE COMMISSION TO THE COUNCIL, THE EUROPEAN PARLIAMENT, THE EUROPEAN ECONOMIC AND SOCIAL COMMITTEE AND THE COMMITTEE OF THE REGIONS ON ALCOHOL AND HEALTH An EU strategy to support Member States in reducing alcohol related harm Report on the Implementation of the Council Recommendation of 5 June 2001 on the drinking of alcohol by young people, in particular children and adolescents

{COM(2006) 625 final}{SEC(2006) 1360}{SEC(2006) 1411}

INTRODUCTION

The Council Recommendation of 5 June 2001 (attached) urges Member States to initiate or develop public health-promoting efforts directed at young people and encourage Member States, in cooperation with the producers and the retailers of alcoholic beverages and relevant non-governmental organisations, to establish effective mechanisms in the field of promotion, marketing and retailing.

The European Commission was invited to follow-up, assess and monitor the developments and measures undertaken in the Member States and at Community level for the implementation of the 2001 Council Recommendation on Young People and Alcohol, especially children and adolescents. The Council repeated its request at its meeting on June 2004. Furthermore, the Commission was invited to report on the implementation of the proposed measures on the basis of information provided by Member States and to consider the extent to which the proposed measures are working effectively and the need for further action.

This document has been prepared on the basis of a questionnaire that was sent out to the Member States in July 2005 and on the contributions of the Amsterdam Group and the Brewers of Europe. The Member States came up also with additional country reports describing in details the activities undertaken at the national level.

Summary

Twenty-four (24) Member States responded to the questionnaire[1]. Luxembourg has not answered to the questionnaire, but has informed the Commission on the latest developments.

The first part of the questionnaire is focused on the policy decisions taken at national level since 2001 in accordance with the Council Recommendation. Table 1 shows the numbers of positive replies regarding the policy decisions taken at national level of each Member State. Four countries Ireland, Netherlands, Portugal and Sweden have done the most mandatory or statutory changes on national level which contribute to the different actions in the Council Recommendation. The results of the figure show clearly that the Council Recommendation has instigated most of the Member States to undertake certain policy changes on national level.

Table 1: Policy decisions taken at National level

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Under- age drinking

Fifteen Member States (Austria, Cyprus, Denmark, Finland, Germany, Ireland, Italy, Latvia, Lithuania, Netherlands, Poland, Slovenia, Spain, Sweden, and UK) reported changes in regulations or better enforcement on current regulations/self-regulations on under age drinking. Early February 2006 the Luxembourg Ministry of Health submitted a draft statute (projet de loi) to the parliament with a proposal to prohibit the sale of alcohol to those under 16 years of age in all general commercial establishments. The law is expected to be adopted before the end of this year. Three MS reported increased taxes on Alco-pops (Ireland, France and Germany) and three MS reported that they are planning to increase taxes on Alco-pops (Denmark and Sweden). Luxembourg grand-ducal regulation (28 December 2005) provides a dissuasive tax of an amount of 600 euro per hectoliter (or 6 euro per liter) for alcopops.

Drink-driving

All Member States reported awareness raising campaigns on the danger of drink-driving. Six Member States (Austria, Belgium, France, Lithuania, Spain and Slovenia) reported better enforcement of current regulations and five Member States (Austria, Cyprus, Latvia, Slovenia and Netherlands) reported changes in Blood Alcohol Concentration (BAC) limits for young/novice drivers. One Member State (Lithuania) reported that they are planning to lower the BAC limit for young drivers.

Table 2 shows that UK, Finland, Ireland and Netherlands have the most affirmative answers to the questions regarding the adoption of national initiatives involving alcohol industry since 2001.

Table 2: National initiatives involving alcohol industry

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Commercial Communication

Twelve Member States (Austria, Estonia, Finland, France, Italy, Poland, Portugal, Slovenia, Sweden, Latvia, Lithuania, and Netherlands) reported changes in regulations/self-regulations to restrict alcohol advertising targeting young people. Five Member States reported to having introduced health warnings on alcoholic beverages containers or advertisements (Germany, France, Slovenia, Sweden and Finland).

Education/information

All Member States, the Amsterdam Group[2] and the Brewers of Europe reported increased educational activities to prevent alcohol-related harm. The main target groups are parents, teachers, children and adolescents.

Most Member States have implemented the Council Recommendation. When comparing the results of the old and new Member States, the old Member States by far offset the new ones. This is understandable as the new Member States only joined the EU in 2004. Moreover there has been a visible liberalisation of the alcohol market in the new Member States and most of the new Member States still lack a new infrastructure to regulate or self-regulate the market. They also report that they lack resources and expertise in public health alcohol policy. This has also been reported as a common obstacle in several Member States. It appears to be a need of further logistical/financial support in undertaking certain alcohol policy changes on national level.

3. COUNTRY REPORTS

BELOW FOLLOWS DETAILED REPORTS OF ACTIVITIES UNDERTAKEN IN 24 MEMBER STATES.

3.1. Austria

Policy decisions at National level

Austria does not have an alcohol policy in terms of a “national alcohol strategy” but at federal level there are concrete plans to draw up a nation-wide alcohol strategy in the very near future. The strategy intends to specify the objectives and fields of intervention of alcohol policies and set the frame for coordinated and national efforts to reduce alcohol related harm. Young people and alcohol will play a major role. Several symposiums involving health care professionals and key players have taken place to prepare the proposal.

Although Austria does not have a national alcohol strategy, several alcohol-related laws, taking into account actions required in the Council Recommendation, have been adopted.

For example; a maximum blood alcohol concentration limit of 0,1 g/L has been introduced for novice drivers; violation of the Road Traffic Act, such as several aspects of misuses of alcohol is registered and could finally result in obligatory driver education and licenses suspension; the sale of alcoholic beverages to people under the legal purchasing age is strictly forbidden (strengthen recently), promotion of alcohol in television and radio must not address minors and Austria has statutory legislation prohibiting spirits advertising on television and radio. The general protection of minors lies with the federal provinces there are 9 different “youth protection laws” stipulating different age limits for purchasing and consuming alcohol in Austria. Concrete discussions about harmonisation of these laws are going on.

Preventing addiction is regarded as an integral part of health promotion and is laid down as a statutory educational principle. Prevention measures in schools are implemented in cooperation with teachers, parents and pupils together with prevention specialists. The interventions are focused on training of life skills (from kindergarden and forward), parental training. To prevent different forms of addiction special competence centres for addiction prevention have been set up in recent years (one in each federal province). A prevention program of the Federal Ministry of Health and Women and the Federal Ministry of Education, Science and Culture are also developed in line with the health promotion concept of the WHO. An important task of the specialized agencies in Austria has been to ensure a more professional level and increased quality on the prevention field.

The results from the WHO HBSC school survey and the ESPAD study have been used as evidence and Austria conducted the first national study on consumption patterns concerning psychoactive substances, including alcohol, in 2004. Austria is also actively participating in the ENCARE-Project (European Network for Children Affected by Risky Environments within the family).

The Ministry of Health and Women has established a Centre for alcohol-coordination and –information (AKIS) aimed to collect and disseminate alcohol relevant information. The information is disseminated (for free) via internet as well as by a “Handbook Alcohol – Austria”. There were alcohol campaigns (such as the „Alcohol Self Control” campaign, launched by the Ministry of the Interior).

There are no concrete examples on involvement of young people in alcohol related policies but the issue is discussed in Austria for the moment.

National initiatives involving the wider alcohol industry .

Mechanisms to ensure that producers do not produce or market alcoholic beverages targeted at children were introduced before 2001. The Austrian Broadcasting Acts regulates and prohibits alcohol promotion in television and radio addressing minors. The Austrian Advertising Council, a tri-partite organisation and an independent body has the responsibility for the implementation of the Austrian Self-regulatory Code.

3.2. Belgium

Policy decisions at National level

In Belgium, a federal plan on drugs (an integrated alcohol and drugs health policy including alcohol) was adopted in the year 2001. This plan includes regulating alcohol policy actions required in the Council Recommendation.

To implement the plan a Drugs Health Policy Committee was created. The Ministers of Health of the different Governments in Belgium are represented in the Committee. The Committee has the mandate to work on a national alcohol action plan with the task to implement WHO’s European alcohol action plan 2000 – 2005. The Committee is, among other things, analyzing current regulations on alcohol advertising and events.

No dissemination of evidence on the factors which motivate children and adolescents to start drinking or promotion of research or awareness raising activities has been conducted on national level. Some work has been done by other actors on the alcohol field. For example the Association for Alcohol and other Drug problems (Dutch acronym = VAD) have launched campaigns, presented research and a web site has been developed. The VAD is officially appointed and financed by the Flemish Community.

At national level there are no actions to involve of young people in alcohol policy but pupils are active in policy development in some schools.

Belgium changed the Traffic Law in 2003 and 2005. Fines for infringing the rules was increased and today the fine if you are driving with 0.5 – 0.8 BAC is between €137, 50 and €2750 and from 0.8 BAC €11.000.

Belgium is part of the BOB-campaign (designated driver) and in the responsible Young Drivers campaign.

No national actions have been taken against the illegal sale of alcohol to under-age consumers but VAD has spread a leaflet on Alco-pops.

Additionally, within the Flemish community, the Flemish Government adopted Government Agreement (plan) for the period 2004 to 2009. Concerning alcohol policy this Government Agreement states the following: data is collected on health risks and a global integrated prevention policy on drugs (alcohol, tobacco and drugs) is in place.

At the level of the Flemish ministry of health a Wellness, Health and Family Policy Note has been adopted for the period of 2004 to 2009. The main focus is on health improvement, also including alcohol prevention, and support of parents and people living with a drug/alcohol addict. Furthermore alcohol policy topics for the period of 2005 to 2006 are specified in the policy letter. Special attention goes to the gathering of evidence on effective strategies and their implementation, effective alcohol and drug policies for schools and companies and actions for children of problematic alcohol users.

In November 2006 the Flemish minister of Health organises a health conference on tobacco, alcohol and drugs. This process results in a formulation of health strategies coupled to a mix of effective strategies and a financial plan. Afterwards this proposition has to be approved by the Flemish Government and the Flemish Parliament.

National initiatives involving the wider alcohol industry

In 2005, a contract on a code of conduct for advertising alcoholic beverages called “Agreement on behaviour and advertising of drinks containing alcohol” was concluded under impulse of the federal Minister of Public Health, between the jury of honest practices (JEP), representatives of the alcohol industry, distribution horeca sector and consumer organisations. The agreement introduced a new mechanism to ensure that producers do not produce or market alcoholic beverages (with more than 1.2% alcohol per volume) to minors. The agreement also introduced measures to ensure that complaints against products can be effectively handled and rules to suspend media campaigns. The Federal Minister of Public Health plans to transpose this agreement into a federal law. This would mean that if somebody breaks the codes, the violator can be imposed a fine of 1000 euros/day.

No national wide specific training for servers and sales persons has been introduced in Belgium but VAD has developed a training programme called “Train de trainer”.

3.3. Cyprus

Policy decisions at National level

In 2004 Cyprus adopted National Drug Strategy, which includes alcohol abuse in the wider anti drug activities of Government and non Governmental Services. The duration of the strategy is 2004-2008. Health education programme in schools and ad hoc seminars of groups of adolescent parents and teachers through Governmental and non-Governmental projects were introduced.

Cyprus is planning to carry out dissemination of evidence on the factors which motivate children and adolescents to start drinking. Presently the supreme mechanism of coordination is conducting the first National trial survey which includes questions on alcohol abuse.

Research has been promoted since 2003 through the EDDRA information system.

There has been no national wide awareness. But regional and local actors have started to conduct awareness raising activities such as Annual conference for Alcohol Abuse. NGO KENTHEA organises open conference every year with the participation of adolescents, teachers, parents and community groups.

There are no activities to increase young people’s involvement in youth alcohol policy and actions in the Cyprus’ national strategy. But the NGO ASPIS organised a national workshop for alcohol abuse for adolescents where alcohol related problems were discussed and prevention activities were suggested. Similar activities are planned to be conducted in schools.

Specific initiatives addressing young people on the danger of drink-driving are conducted regularly on national level, such as prevention spots on TV and mass media, seminars in schools and the army, reduction of the Alcohol test level since March 2006 from 0.39mg/lt to 0.22mg/lt.

The police have taken certain actions such as supervising for illegal sale of alcohol to adolescents less than 18 years old and implementing the existing law.

National initiatives involving the wider alcohol industry

Cyprus has not introduced or enforced any mechanism to ensure that producers do not produce or market alcoholic beverages specifically targeted to children and adolescents due to lack of expertise and infrastructure. In the near future changes on this issue are planning.

No national/regional/local programmes of specific training for servers and sales persons with regard to the protection of children and adolescents and the existing licensing restrictions have been introduced. National wide initiatives are planned within the framework of the National Drug Strategy.

Police services are responsible for handling the complaints against products which are not being promoted, marketed or retailed in accordance with the national legislation. Legal and police regulations have been introduced to remove such products.

3.4. Czech Republic

Policy decisions at National level

The Czech Republic has not adopted any national alcohol strategy or any comprehensive health promotion policy and programmes where actions required in the Council Recommendation are included. In 1989 the Czech Republic introduced an Act on “Protection against alcoholism and other addictions”. Since then the only national actions have been other types of public health plans and strategies, like the National Drug Policy Strategy (2005 -2009). Hence, the Czech Republic is planning to implement one in the near future.

There has been no promotion of research, no national wide awareness raising activities, no national campaigns against drink-driving or youth activities in the Czech Republic since 2001.

National initiatives involving the wider alcohol industry

In 2002 an amendment of the Act on regulation of advertising was introduced and a control mechanism of observance of the Act on regulation of advertising is in place to intervene against inappropriate marketing or promotional practices.

3.5. Denmark

Policy decisions at National level

Denmark has a Public Health plan where alcohol is a part but Denmark has focused on under-age drinking as the results from school surveys has shown that youth in Denmark is among the most frequent binge-drinkers in Europe.

The most important change in Denmark was the introduction of a regulation to prohibit the selling of alcohol to children under the age of 16 (2004). After the introduction of the regulation the consumption of alcohol by under-age drinkers declined. Denmark has introduced a special identity card for young people that they must buy if they would like to purchase alcoholic beverages. There have also been campaigns in stores and supermarkets to announce the new legislation i.e. that is forbidden to sell alcohol to children under the age of 16.

In Denmark it was decided upon a tax on alcopop in 2005. The extra tax is used for prevention purpose in relation to alcohol i.e. a campaign directed towards young people, an initiative aiming at introducing alcohol policies in the high-schools, an initiative which shall promote the alcohol preventing competences of the municipalities and the quality of the alcohol treatment.

Since 2000 teachers and parents annually have received material/programmes on the importance of parents as role-models and norm setters. The aim of the activity is to postpone the age of alcohol debut. The disseminated material gives advices on how to agree on alcohol policies in schools and parents agreements/contracts on rules for parties and alcohol use for children in 5 – 10 grades. It also presents information on the risk factors that motivates children to drink. The role of the parents has been the theme of a yearly alcohol campaign in the beginning of October since 2002. The campaign is supported by TV-spots, advertisements and an interactive homepage where parents can train dialog with children around alcohol. The campaign has been observed by media. Denmark also has joined the ESPAD research and the HBSC research. Besides that Denmark makes its own yearly monitoring of the 10-15 year old children and the 16-20 year old young people.

Denmark’s national initiative concerning support to children to alcoholics in the treatment sector, the pedagogical sector and the social sector is part of the preventing initiative directed towards children.

The combination of new legislation, national awareness campaigns targeting parents and the cooperation with retailers have resulted in essential reduced alcohol consumption among youth in Denmark.

National initiatives involving the wider alcohol industry

No new mechanism to ensure that producers do not produce or market alcoholic beverages has been introduced since 2001 because the industry has made an agreement with the Ministry of Health on self –regulation already in 1999. In 2000 the industry, the retailers and the advertising companies created a “body” to handle complaints against products.

3.6. Estonia

Policy decisions at National level

Estonia has not yet adopted alcohol policy and wide action plan but several suggestions have been worked out and introduced in order to change alcohol legislation- Alcohol Act and Advertisement Act that are currently under change.

Although, there is no nationwide alcohol strategy, there are some inter-sector strategies emphasizing alcohol related issues e.g. “Action Plan for Economic Growth and Employment 2005 – 2007, which stresses the need of reducing the burden caused by the consumption of alcohol through increasing public awareness and reduce alcohol availability.

National strategy for preventing cancer will be adopted 2006 where some alcohol specific measures will be planned in order to spread out clear messages into the society about relations between cancer and harmful drinking.

Specific actions required in the Council Recommendation on the drinking of alcohol by young people, in particular children and adolescents have been taken into consideration and into several health promotion projects action plans.

National Institute for Health Development is the main actor in child health promotion in Estonia. It coordinates the activities of networks of health-promoting kindergartens and schools. Schools, which belong into the network, initiate projects in order to prevent alcohol related problems among children much more than schools that are not yet in health promoting network.

National Institute for Health Development coordinates the conduction of the following regular nationwide studies like Health Behavior in School-aged Children (HBSC) and HIV/AIDS-related knowledge and behavior among youth. Both of these studies include data on children’s harmful drinking habits which has grown lately enormously and therefore some strong and effective measures need to be taken into action in this field in Estonia.

In February 2005 a survey was conveyed in Estonia with the objective to get information on the risks derived from the consumption of alcohol and tobacco. According to public opinion in Estonia youth are motivated to drink from peer culture, accessibility of alcoholic beverages and overall values of society.

In 2005, the National Institute for Health Development presented the results from a nation wide research on problems related to alcohol consumption. There have been several awareness raising activities on the effect of alcohol consumption but none have had particular emphasize on children and alcohol.

In 2006, there will be conducted two health promotion projects financed by EHIF (Estonian Health Insurance Fund): Media project for Youth, aiming to change youth attitudes toward alcohol in order to reduce drinking habits; and project on social coping at school, which aims to teach social skills among children years 15-24, who tend to behave destructive and risk taking, also decrease youth alcohol consumption and injuries in school and home settings.

In addition, the Estonian Road Administration is conducting annual public campaigns on drink driving.

National initiatives involving the wider alcohol industry .

Mechanisms to control marketing of alcoholic beverages as sale are not yet worked out.

Direct advertisement of alcoholic beverages to youth is prohibited and sales of alcohol to under-age are criminalized.

Self-regulation: In 2005 Estonian beer industry adopted an ethical codex on youth alcohol consumption.

3.7. Finland

Policy decisions at National level

In October 2003 the Government in Finland presented the main objectives and priorities for actions on alcohol. One, among several other, objective is to reduce the harmful impact of drinking on the welfare of children and families. The Ministry of Social Affairs and Health is responsible for the implementation of a comprehensive alcohol programme for the period 2004 to 2007.

The programme will be implemented in collaboration with a great number of stakeholders. The aim is to coordinate and combine measures to prevent alcohol related harm in a structured way with joint goals and co-operation based on voluntary partnership corroborated through formally singed agreements.

A sum of one million € has been allocated to the Ministry of Social Affairs fro the period 2004 to 2005.

The Government is for the moment considering limiting or prohibiting advertising targeted especially at young people.

The Parliament has also adopted a Health 2015 Resolution that provides a broad framework for health promotion in various areas of society. Health problems associated with young peoples alcohol consumption is one specific target area in the Resolution. The main prevention activities are carried out at local level as the municipalities have a central role in welfare in Finland.

A Local Alcohol Policy and Research- project (PAKKA) will be carried out during the period 2004 to 2009. One main goal is to decrease under-age drinking. The project is a community based project to change the local social, economic and physical environment related to risky and underage drinking.

The national alcohol programme is implemented in collaboration with public administration, municipalities, churches and NGOs (124 partners) and a variety of activities will be carried out regionally. One good example is from Eastern Finland. Students research the local alcohol situation and produce information to schools, polytechnic and caterers and alcohol retailers.

The Central Organization for Traffic Safety produces continually educational traffic safety material, guides and brochures for schools, garrisons and youth, sport and other leisure time organisations.

National initiatives involving the wider alcohol industry

The major retailing and hospitality industry organisations have defined the intensified age control and the promotion of the implementation of self-control procedures as targets for their own work in connection with the national Alcohol Programme. The state alcohol retail monopoly is asking for proof of age card from all customers looking under 25 years old. Every check is registered and the total number was 1 256 000 in 2004 (Finland has approximately 7 – 8 million habitants)

In Finland the full use of existing legislation is used to ban products targeting young people from entering the market. The distinctive features include packaging in an appealing way, advertising in the Internet and contend of the products. In 2004 four products were banned.

A new alcohol act requires every restaurant to have a trained server present in the premises at all times. The HoReCa –schools all over the country are authorized to arrange examinations and give certificates to servers. According to the Alcohol Law the authorities have the right to ban any unlawful advertising or products from the market.

Comments from the Ministry

The excise duty directive and the threat of illegal trade forced the Finnish Government to lower the excise duty on alcohol. Two groups have suffered the most, poor and young people.

3.8. France

Policy decisions at National level

France adopted a national alcohol strategy in 2001 for the period 2002 to 2004. The strategy targets the whole population but contains of specific actions aimed at young people. For example: health education and actions on drink-driving to combat drunk-driving after night time activities. For example, national campaign on the dangers of drink driving named Route des Jeunes has been conducted. Several other plans have also been adopted concerning young people and alcohol: A Cancer plan (2003), a road security plan and a plan to combat illicit drugs.

In 2004 France adopted a law on public health, including a decision to increase excise duties on Alco-pops. In 2005 a proposal to introduce health warning labels on alcohol beverages cans and bottles on alcohol and pregnancy. The introduction of a higher excise duty on Alco-pops resulted in a decrease in consumption of Alco-pops. France has also improved the enforcement of current regulations on under-age drinking.

In the General Public Health plan increased information and educational activities are launched in schools on the risk connected with alcohol and addiction. This educational programme has been prepared by the Ministry of Education in cooperation with the Inter ministerial group on Drugs (Mildt) and the National Institute of Prevention and Education (INPES).

France has conducted several surveys and studies to monitor consumption trends and patterns among young people and the problems related to alcohol consumption. The results of the research and studies indicate that young people in France are changing their alcohol consumption habits and that young people around 18th are tending to establish a sort of “Anglo-Saxon” drinking pattern (drinking in week-ends, binge-drinking and poly-drug use). At the opposite, the youngest, around 13th have a lower consumption in 2003/2004 than in 1999. In June 2005 a national study on the implementation of the law on legal purchasing age (16 year) showed that 7 out of 10 respondents affirms not to sell alcohol to young people when he/she has doubts on the age.

National initiatives involving the wider alcohol industry

In 2004 a mechanism was introduced to ensure that producers do not produce or market alcoholic beverages at children and adolescents. To ensure the implementation of the legislation the ministry of budget (consumer office) and some national associations, as the ANPAA, are quite involved.

3.9. Germany

Policy decisions at National level

On federal level an Action Plan Drugs and Addiction was adopted in June 2003, alcohol is part of the strategy. On federal level the Länder adopted a National Plan on Alcohol in 1997; the Youth Protection Act was revised in 2003, part of it is now a ban on advertising of alcoholic drinks in cinemas before 18.00 hours. Additionally Germany adopted an Act improving the protection of young people from the dangers of alcohol and tobacco consumption in 2004.

In Germany 6 Bundesländer took part for the first time in the ESPAD survey in 2003. The results were published by the Federal Ministry for Health and Social Security at Federal level and also by the participating Länder .

The Bundeszentrale für gesundheitliche Aufklärung (BZgA ) (Federal Centre for Health Education), a lower authority of the Federal Ministry for Health and Social Security, carried out a nationwide survey of alcohol consumption among 12-25 year olds between March and April 2005; a total of 3001 people from the age-group in question were consulted. The investigation focused on alcopop consumption. The purpose of the survey was to determine the effects of the “Alcopop Act” of 2 August 2004 which imposes a special tax and compulsory labelling on alcopops containing alcohol. The results of the survey show that both alcopop and alcohol consumption overall has declined among young people. The proportion of 12-17 year olds who drank alcohol-containing alcopops at least once a month fell from 28% in 2004 to 16% in 2005. There was an even sharper drop in consumption among the 12-15-year-old age-group: from 20% in 2004 to 10% in 2005. The main reasons for this are the increased prices of such drinks introduced by the Alcopop Act and greater awareness of the risks to health.

As preparation for the development of material to promote abstinence from alcohol during pregnancy, the Federal Centre for Health Education commissioned a report on the consequences of alcohol consumption during pregnancy and the basis for alcohol prevention during pregnancy.

The Federal Centre of Health education organizes especially during summer a campaign under the motto: "Are you stronger than alcohol?" "Peer" teams are deployed throughout Germany at large events, music concerts and sporting events. Specially developed material is produced to inform young people to provide information specifically targeted at young people on subjects such as alcohol and sport, alcohol and sex, alcohol and weight gain, alcohol content of various drinks, as well as the effects on health of excessive alcohol consumption. In 2004 this concept was used to seriously discuss the subject of alcohol with almost 25 000 young people.

A Pilot programme for early intervention to assist children and young people suffering from alcohol abuse was developed, focusing advice and discussion with children/young people and parents at the hospital, group therapy offered to reflect on the reasons and background to alcohol abuse and raising public awareness: alcohol must not be sold to persons under the prescribed age at parties and events organised in the community.

Numerous measures have been carried out on national level in Germany since 2001 concerning “Alcohol and young drivers”. There have also been numerous other measures mainly at regional level. For example during the period 2003 to 2005 specially trained young adults, “peer-educators” have given a “lesson” as part of the driving school training, during which they discuss with the learner-drivers the subject of “Alcohol, drugs and driving”. A comparative study showed that young, newly qualified drivers who had been involved in the peer project at driving school had fewer alcohol-related traffic offences than those who had not been involved in the project.

In 2002 a campaign to raise awareness on the so-called Apple Juice Act (part of the Restaurant Licensing Act) took place in Berlin. The Act states that catering establishments must offer at least one non-alcoholic drink which is no more expensive than the same quantity of the cheapest alcoholic drink. Young people acted as “experts“, questioning restaurant owners about their knowledge of the Act and checking its implementation. It turned out that numerous restaurant owners were totally unfamiliar with the Act and many had also not yet implemented it. The objective of the Act is to ensure that adolescents and young adults are not obliged to consume alcoholic drinks for cost reasons.

Through the action “ Jugendschutz – wir halten uns dran “ (Protection of minors - we stick to it), the Federal Ministry for Family Affairs, Senior Citizens, Women and Youth, together with the Hauptverband des Deutschen Einzelhandels (HDE) (main German retail trade association), the German Hotel and Restaurant Association, the Federal Association of Filling Station and Commercial Vehicle Washing Plants in Germany and the Federal Association for the Protection of Children and Young People draw attention to the provisions of the Youth Protection Act and make the public aware of the importance of youth protection.

The campaign targets operators of restaurants, discothèques, filling stations and the retail trade. Those responsible are encouraged by posters, stickers and leaflets to ascertain the age of young people, asking them for proof if there is any doubt, thereby observing the Youth Protection Act and actively and effectively implementing the protection of children and young people. Restaurants, retail shops and filling stations are participating in the operation extensively nationwide.

National initiatives involving the wider alcohol industry

To ensure that producers do not produce or market alcoholic beverages specifically targeted at children and adolescent a Working Group has been set up for the promotion of a responsible attitude to alcoholic drinks comprising representatives from the Federal Government (Ministry of Health - BMGS) , the Länder and the alcohol industry and other associations.

Comments from the Ministries of the Länder

The Health Ministries of the Länder assume that there are two approaches to reduce alcohol consumption among young people: prevention by reducing demand and prevention by reducing supply. Generally speaking, both strategies are being implemented in the individual Bundesländer .

There is agreement in particular that measures to reduce supply are essential for the target group “young people” who are under the special protection of the State; a clear distinction must be made between such measures and the general alcohol policy.

The Health Ministries of the Länder suggest that the following questions be examined relating to alcohol consumption among young people in order to facilitate the planning of policies, in particular supply policy:

- Are the alcohol consumption habits of young people in the EU Member States changing (i.e. is there a reduction)?

- Is it appropriate to launch EU-wide campaigns to give young people more comprehensive information about the effects of alcoholic drinks?

3.10 . Greece

Policy decisions at National level

Greek Action Plan on Drugs was adopted in 2002 and will last to 2006. Alcohol activities are either implicitly mentioned or with regard to prevention interventions and the support of self-help groups. The need for a Greek Action Plan on Alcohol has been pointed out in the Annual Report of the Greek REITOX Focal Point for Drugs 2004.

The prevention agencies in most of the cases implement alcohol-related interventions as part of a broader mobilisation strategy regarding substance use.

In addition, the Ministry of Education and Religious Affairs implements Health Promotion Programs in Primary and Secondary Education with a specific focus on alcohol use prevention. Some prevention agencies organise special alcohol-focus activities in schools addressing educators, pupils and parents.

The University Mental Health Research Institute (UMHRI) conveys regular nationwide epidemiological surveys among students (11-18 years old) by applying the methodology of ‘Health Behaviour in School-aged Children’ (HBSC-WHO) survey and the ‘European School Survey Project on Alcohol and Other Drugs’ (ESPAD). The results are published in the Annual Reports of the Greek REITOX Focal Point of the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) and disseminated to a national network of policy makers and professionals in the drug and alcohol field.

Strategic Inter-Ministerial Road Safety Programme “On the Road 2001-2005” was launched to promote information campaigns against driving under the influence of alcohol (financed by the European Commission) and the reduction of the number of deaths related to road accidents. Since May 2002 the message “Enjoy with responsibility” is included in the advertisements of alcoholic beverages. The legal BAC in certain categories of drivers (professional and novice drivers) was reduced from 0.50 to 0.20 gr of ethanol per litre of blood.

In May 2005 the Laboratory of Communication, Media and Culture of Panteion University in collaboration with the alcoholic beverage company DIAGEO Hellas produced a CD-ROM titled ‘What counts in entertainment…’ with useful information with regards to alcohol consumption. One of the six sectors is dedicated to Alcohol and Driving. The CD-ROM is addressed to university level students.

Presidential Decree 36 was launched in 1994 to prohibit minors under 17 from entering nightclubs and bars or from consuming alcoholic beverages in other licensed public establishments, when unaccompanied by their parents of guardians.

National initiatives involving the wider alcohol industry

The Ministry of Health and Social Solidarity is in the process of discussion in order to suggest effective ways and mechanisms to monitor and evaluate the situation of alcohol use and abuse in Greece.

Within the framework of a recent European Research Institute on Risk Factors in Childhood and Adolescence project (IREFREA) a prevention kit for substance use in recreational settings will be developed which will include a training manual for professionals working in such settings.

The General Chemistry State Laboratory and Customs is responsible for the removal of products which are not being promoted, marketed or retailed in accordance to the national legislation. The content of media advertisements (Law 2328/1995, Presidential Decree 100/2000) is legally restricted.

3.11. Hungary

Policy decisions at National level

National Public Health Programme as a framework, with alcohol components was adopted in April 2003 with a 10-year duration.

Detailed Alcohol Policy Action Plan (based on and within the frame of National Public Health Strategy) is being prepared, taking into account the Recommendation.

Model projects on local alcohol policies and early treatment programmes have been implemented at local level in 2005-2006.

Research into the different aspects of problems associated with alcohol consumption by children and adolescents and awareness raising activities of the effects of alcohol consumption are planned to be promoted on national level within the frame of National Alcohol Action Plan.

The Communication of National Road Safety Committee under the Ministry of Internal Affairs (2002-2004) has addressed the young people on the dangers of drink-driving.

Legislation against the illegal sale of alcohol to under-age consumers has been already in effect. In addition, the National Consumers’ Protection Board performs occasional supervision of selling practices.

National initiatives involving the wider alcohol industry

Restriction on advertising alcoholic beverages is in practice (partial ban in electronic media). Existing legislation is thought to be sufficient by many. Regulation should be lightened.

3.12. Ireland

Policy decisions at National level

In January 2002, the Minister for Health and Children established a Strategic Task Force on Alcohol (STFA) to bring forward recommendations on specific, evidence-based measures to prevent and reduce alcohol related harm. The STFA, published two reports (May 2002 and September 2004) and when taken together contains 100 recommendations. The Government approved the recommendations. Several of the recommendations relate to young people and are linked to actions in the EU Council recommendation for example: the involvement of young people, multi-sectoral approach, access, availability, pricing and marketing, drink driving, early intervention, education and awareness and research. No specific budget has been allocated for implementation and many of the recommendations have yet to be implemented.

Since 2003, health education (social, personal and health education) in the school curriculum is a mandatory requirement at primary level and up to junior grade at secondary level. At third level (college setting), a comprehensive approach has taken place with the development of college alcohol policies in almost all colleges.

Several national and regional projects (National Youth Council of Ireland, National Children Office, and National Children’s Advisory Council) have explored with young people their relationship with alcohol and the factors which motivate children and adolescents to start drinking. Young People, through the Dáil na nÓG (Youth Parliament), have also identified and discussed many of the factors influencing youth drinking in Ireland. A national study involving young people (2001), commissioned by the Department of Health, found that adolescents (12-17years) were strongly attracted to alcohol advertisements and played a role in their beliefs, expectation and knowledge about alcohol use and for some (especially girls) a source of encouragement to drink (Dring & Hope 2001). A national study among young college students (21 years of age) explored past and current risk taking behaviours (including high risk drinking) and their links to student well being and welfare (Hope et al 2005). The findings have been disseminated to all colleges.

The HBSC and the ESPAD surveys were repeated in 2002 and 2003 which looked at drinking patterns and the consequences of drinking among school children (11-17years) such as poor school performance, accidents, relationship problems and delinquency problems. Problems associated with high risk drinking among college students were also reported in the CLAN survey (Hope et al 2005). Research studies have examined alcohol use as a factor for risky sexual behaviour (STFA 2002, Hope et al 2005), during pregnancy (Barry et al in press) and in juvenile diversion programmes for high risk youth (An Garda Siochána).

A three-year alcohol awareness campaign (2001-2003), Less is More (less alcohol . . . more money, more energy, more control) , implemented by the HPU in the Department of Health was developed to raise awareness and create debate on alcohol issues and to highlight the necessity for a public health and multi-sectoral approach to reducing alcohol problems. Specific for young people were seminars for those working with young people, an alcohol advertisement campaign (poster, radio) targeted those who buy/supply/sell alcohol to minors. A framework for developing a College alcohol policy was developed and a number of community programmes were piloted.

Giving youth a voice in matters which affect them is a key goal of the National Children’s Strategy in Ireland (2001-2011). Dáil na nÓG (Youth Parliament) selected alcohol as one of their key topics for debate in 2003 and again in 2005. Their main recommendations relating to alcohol were: stricter enforcement of the law on selling alcohol to minors, community support to address access to alcohol and treatment for users, more government funding for alcohol-free facilities in communities, effective information advertising campaigns aimed at young people, and more education about the harmful effects on alcohol.

The National Safety Council has extensive media campaigns each year (TV, Radio, Billboards) highlighting the dangers of driving after drinking. Some of the safety messages depict young people. The clear message is don’t drink and drive.

A provision under the Intoxicating Liquor Act 2000, allows for the temporary closure of premises found selling or serving alcohol to those under the legal age of 18 years. This measure is currently being enforced with media coverage (name and shame) of those found guilty. Between July 2000 and February 2004 there were 714 prosecutions taken to the courts and 275 closure orders were obtained.

National initiatives involving the wider alcohol industry

In 2003 the Minister for Health and Children received Government approval for the drafting of the Alcohol Products Bill (Control of Advertising, Sponsorship and Marketing Practices/Sales Promotions) which will restrict where alcohol advertisements can be placed, limit content, ban drinks industry sponsorship of youth leisure activities and require a health warning on alcohol advertisements.

In 2003 the Drinks Industry established a company Central Copy Clearance Ireland (CCCI) to vet alcohol advertisements prior to airing or publication to ensure content compliance with the ASAI code.

The Broadcasting Commission of Ireland ( BCI), a statutory agency, published a Children’s Advertising Code (2004) which prohibits alcohol ads around children’s programmes. Children’s programmes are those where over 50% of audience are under 18.

In 2002 the Drinks Industry established a social aspects organisation called MEAS (mature enjoyment of alcohol in society). In 2004 MEAS published a revised Voluntary Code of Practice on the Naming, Packaging and Promotion of Alcohol Drinks which now applies to all drinks (previously applied only to single serve drinks).

In January 2005 the drinks, advertising and media industries launched a new Voluntary Code (TV, Radio, Outdoor, Cinema) on alcohol advertising with audience profiling (33%) as the key measure. This new Voluntary Code was accepted by the HPU in the Department of Health and Children. In September 2005 the government decided to postpone the publication of the Alcohol Products Bill to allow the Industry to implement their new Voluntary Code on alcohol advertising.

The Broadcasting Commission of Ireland monitors compliance with the Children’s Advertising Code (2004) and has a complaints procedure for the public. Broadcasting Commission of Ireland has the statuary power to issue a breach of contract warning to the media channel (TV, Radio) if the Children’s Advertising Code is found to have been breached. Such a breach could be taken into consideration when license renewal is under review, although a review only occurs every seven years.

The self regulation codes – ASAI and the MEAS codes have Independent Complaint Committees. A member of the public can make a complaint to these various groups. On self-regulation, voluntary withdrawal and pressure from the trade organizations (ASAI, CCCI, MEAS) are the methods used. However, removal of offending products or marketing practices cannot be guaranteed.

In December 2005, the Department of Health and Children established a Monitoring Body with the key stakeholders to oversee compliance with the various self regulatory codes.

The Responsible Serving of Alcohol (RSA) programme was developed (2001) by the HPU in cooperation with the bar trade. The programme is now run by the national hospitality training school. However, to date the numbers trained are very low. One of the regional health agencies has developed a more comprehensive server training programme for their region.

Comment from Ireland : In Ireland the price of alcohol, namely alcopops (spirit based drinks) and spirits, were substantially increased in December 2002. As a result alcohol consumption and related harm decreased across a range of health and social measures in the following year (2003). Spirits consumption decreased by 21%, overall alcohol consumption by 6%. Alcohol poisoning deaths decreased by 14% and suicide by 3%. Public order offences decreased by 6%, serious assaults by 23%, minor assaults by 22% and drink driving arrests by 16%. Illustrating that high alcohol prices can act as a deterrent and reduce alcohol related problems.

3.13. Italy

Policy decisions at National level

Since 2001 Italy has introduced two main policy and legislative measures to tackle alcohol problems among young people. The law on Alcohol and Alcohol related problems (2001) and the National Health Plan (NHO) 2000-2003 and 2003-2006. A new NHP 2006-2008 has been endorsed in 2006 with a specific and comprehensive frame of identified priorities. The new NHP should be complemented by the first National Alcohol and Health Plan (PNAS) that is currently discussed in the State-Regions Conference and hopefully adopted during the 2006. Since 2001 yearly targeted budget has been made available by the law 125/2001: 1 million € per year for education and prevention activities, 500 000 € for control activities and 500 000 € to monitor the implementation of the law.

Current alcohol legislation defines the objectives, aims, competences of the Italian alcohol policy as well as the rules for alcohol advertising (article 13). Alcohol advertising is forbidden; in programmes specifically devoted to children and adolescents (and 15 minutes before/after); in case the message suggests that alcohol has therapeutic properties; where advertising shows children and adolescents consuming alcohol. Direct or indirect advertising is forbidden in environments mainly attended by under-aged people and radio and television advertisement of spirits is forbidden between 4 and 7 p.m. and in press targeting children and adolescents. Violations are punishable with fines from € 2. 500 - € 10.000.

To enforce the current minimum age-limit for serving alcohol (16) the Government has taken initiatives to improve the compliance of legal age-limits.

Each year the Minister of Health (MOH) presents an annual report on the implementation and enforcement of the articles in the new Law to the Parliament.

The NHP is the framework for actions in main key areas aimed at life skills, risk-taking cultures, special settings, vulnerable groups, inequality in health. One of the main objectives in the last ongoing plan was to delay the age of onset of drinking by young people, to reduce the prevalence of drinkers among adolescents particularly of those exceeding moderate quantities or consuming alcohol between meals.

A National Committee on Alcohol was set up by law 125/2001 and a Commission on Alcohol by the MOH with a specific scientific and technical mandate to identify priorities to be adopted in the context of collaboration with the formal activities performed by the Centro Controllo Malattie (CCM) usually by mean the Active Prevention Plan. The Ministry of Health and the Ministry for Transport boost initiatives to raise young people’s awareness on the dangers of drink-driving; they have produced media campaigns (http://www.epicentro.iss.it/temi/alcol/apd06_comunicazione.asp) to reduce young people’s mortality and morbidity rates due to alcohol-related road accidents the last campaign “La bottiglia non un gioco” - The bottle it’s not a joke- was launched in year 2006. Since 2001 a National focus day on prevention of alcohol related problems (Alcohol Prevention Day) is supported by the Minister of Health and promoted by the Istituto Superiore di Sanità (ISS) in collaboration with the Società Italiana di Alcologia and the AICAT (Alcoholics in Treatment Association) involving all the Italian Regions and the Municipalities. Since 2003 the MOH has provided funding for the activities of the Telefono Verde Alcol at the ISS, a national toll-free phone line service oriented to reply to the citizens' and particularly young's people information needs.

In year 2006 the Ministry of Health has funded the Alcohol Prevention Day (fifth edition) organised at the ISS by the Osservatorio Nazionale Alcol and the WHO CC for Research and Health Promotion on Alcohol and Alcohol-related problems (http://www.epicentro.iss.it/temi/alcol/Alcohol_prevention_day.asp)

Since 2001 several campaigns have been conduced also at local and regional level in Italy. Some of them have been developed and disseminated by the Osservatorio Nazionale Alcol at the ISS together with young people ("Io c'ero..." and ”Conta i bicchieri perchè loro contano") and following specific MOH guidelines. The campaigns have been used to disseminate information on the factors which motivate young people to start drinking as well as to raise awareness of the effects of alcohol, for example “Amici… ma non dell’alcol” (Friends … but not alcohol friends) in 2004 and 2005. During the period 2001 to 2005 several national research projects have been promoted by ISS to increase knowledge on young people’s drinking habits. Some of the research results have been used to produce educational “kit” for high schools that was sent by MOH to the high-schools. A pilot monitoring system based on WHO and EU Health indicators is currently evaluated to be tested to follow the trends in Italy.

National initiatives involving the wider alcohol industry

Alcohol advertising is regulated in the law on Alcohol and alcohol related problems (2001) and in the Code of Italian Advertising (Self-Regulation). The self-regulatory code was updated and strengthened in 2005. Article 22 in the self-regulatory code indicates that advertisements for alcoholic beverages must not target or refer to minors, even only indirectly, or depict minors consuming alcohol. Infringement of self-codes can lead to a removal of the advertisement.

Comments by Italy : Since 2001 the following results have been observed. People in Italy are more aware of the problems of young people’s drinking. Italy has seen an increase in the number of women drinking more than ½ litre of wine daily (for young women beer and spirits); a change in the traditional “Mediterranean” habit of consuming moderate quantities of wine at meals to an increasing habit (young and women particularly) of drinking other alcoholic beverages between meals. Furthermore, the Annual Report on Drug Dependency confirmed the use of alcohol as the “gateway” drug and the yearly MOH reports to the Parliament highlighted the rise in binge drinking culture among youth and the need to tackle this health threatening trend.

An agreement at EU level on a core set of indicators that could form the basis for a EU monitoring and reporting system in the future should be a priority in terms of subsidiarity as well as the adoption of communication measures adopted by the Community which support healthy lifestyles (for example in the fields of alcohol harm reduction campaigns) as recalled in the Council Conclusion on "Healthy lifestyles: education, information and communication" ( Brussels, 1 and 2 December 2003) focusing on the need to tackle particularly the binge drinking culture among youth. Further priorities to be dealt with are specific targeted preventive initiative on alcohol and pregnancy, drink-driving, alcohol in the workplaces, training programme on early identification of alcohol abuse and brief intervention for the GP’s, health promoting and information initiatives in the schools integrating the parental involvement.

3.14. Latvia

Policy decisions at National level

In January 2005 the Latvian Cabinet of Ministers approved “Program for Reduction of Alcohol Consumption and Restriction of Alcohol Addiction for 2005 – 2008”. The Program was developed on the basis of the objective of the 12th target of the “Public Health Strategy of Latvia” approved by the Cabinet of Ministers on March 6, 2001, pronouncing that the consumption of absolute alcohol per capita should not exceed 6 liters per year and addressing the age from which regular alcohol consumption is practiced.

The solution proposed for the implementation of the program is to direct activities along three major lines, namely, restriction of supply, reduction of demand and reduction of hazardous and harmful use. It involves multi – sector cooperation between the Ministry of Health and 10 other ministries and 16 institutions.

The Ministry of Health is the responsible institution for monitoring the results and the impact of implementing the Program.

In 1995 the National Council of alcohol restriction has been established. The Council takes part in working out the State policy of alcohol restriction and diminishing its consequences, coordinates the activities of state and regional institutions.

On the 22nd 04, 2004 the Parliament adopted “Handling of Alcoholic Beverages Law”. This law regulates any activities with alcoholic beverages, as well as the advertising of alcoholic beverages.

Retail trade of alcohol is prohibited on the premises and territory of educational institutions, and medical treatment institutions, in automatic vending machines, from 10 p.m. to 8 a.m., etc. The law prohibits to involving persons under18 years of age in the handling of alcoholic beverages.

In 2004 a number of relevant amendments have been adopted:

- on April 8 the Parliament adopted “Amendments to Administrative Violations Code”, where Article 172 has been introduced “Involving minors in the use of alcoholic or reducing minors to a state of drunkenness”; in Article 173 “Non – compliance with the obligation of child care”;

- on June 3 The Parliament adopted amendments to the Law “On the application of educational compulsory measures to minors”. Article 8 of the Law states that corrective educational establishments should in case of necessity provide treatment for addiction to alcohol, narcotic, psychotropic or toxic substances and other conditions to minors.

A multi – disciplinary approach is used in addiction prevention and it is important to develop cooperation between different institutions and specialists (ministries, governmental and non-governmental organizations, municipalities). There were developed training programmes for different target audience, informative materials, and programmes of local governments.

Given the high incidence of road traffic accidents and for improving road traffic safety the Road Traffic law has been amended. By law drivers with less than two years’ experience in driving motor vehicles may not drive a motor vehicle if the alcohol content in their blood circulation exceeds 0.2 promille.

The Road Traffic Safety Board together with the Road Police provides campaigns on the danger of drink- driving (including drugs) and the public has been informed about the results of the implementation. The number of accidents caused by drivers under the influence of alcohol has decreased.

In 2003 the ESPAD survey took place in Latvia for the third time running. The survey differing from the two previous ones carried out in 1995 and 1999 respectively in that parallel to the ESPAD project within the framework of the “Survey of the population of Latvia on the prevalence of drugs”, was carried out in Latvian schoolchildren in forms 5-12. The size of sample allows detailed analysis of the prevalence of legal and illegal addictive substances and the attitudes, values and opinions of minors belonging to different age groups.

National initiatives involving the wider alcohol industry

The biggest producer of alcoholic beverages in Latvia “The Latvian Balsam” has elaborated the “Communication Code of Ethical marketing” in 2005. It describes several ethical aspects – moderate drinking habits, drinking at a legal age, encouraging positive traditions.

3.15. Lithuania

Policy decisions at National level

A 12 year comprehensive State Programme for Alcohol Control was adopted in 1999. The Lithuanian Health Programme is linked with State Programme for Alcohol Control adopted in 1999. The main objective of the program is to ensure that the purpose of the Law on Alcohol Control to reduce alcohol consumption and decrease alcohol abuse and its damage to health and economy. The principal executor of the Program is Ministry of Health, other ministries (ten) and agencies, training and scientific institutions (Vilnius University, Kaunas Medical University, NGO’s, Municipalities, Confederation of Manufactures, Association of Journalists, students, schoolchildren, the Church, etc.

Public education and prevention is carried out all over the country with particular emphasis on the training of children, schoolchildren and young people by special programmes. The youth telephone line is operating every day in Vilnius from 16 p.m. till 7 a.m. Schoolchildren, students and youth can get free help about the harm done by alcohol, 28 “Healthy School” events 672 agencies implemented educational activities.

ESPAD (The European School Survey Project on Alcohol and other Drugs) has carried out a survey in Lithuania about the factors which motivate 15-16 years old children to start drinking. According to this survey more than a half of teenagers (both girls and boys) think that alcohol can help them to relax. 45,3 percent of teenagers hope that consumption of alcoholic beverages can help them to forget their problems, 48,2 percent think that they would be more friendly and ingenuous, 22,3 percent believe that they would have much pleasure and 35 percent think that they would feel happy then. The results of this survey were published in many newspapers, health journals, data was used in conferences.

On Commercial Communication: Lithuanian National Radio and Television must transmit broadcasts, which propagate a healthy lifestyle and provide information regarding the damage caused through the consumption of alcohol, and the broadcast must be transmitted at least twice weekly and for at least 5 minutes from 18:00 to 22.30 hrs.

Young people are involved in several activities: “State Youth Affairs Council” is organising and taking part in projects related with alcohol prevention. In 2002 this Council has published and presented the results of research called “Shift of Youth Policy”. This research includes the paragraph about alcohol: “Abuse of Alcohol and the Means of Prevention”.

Lithuania is currently planning to reduce the BAC limits from 0, 4 to 0, 2 for all drivers and 0, 0 for the novice drivers, heavy vehicles drivers and public transport drivers.

The illegal sale of alcohol to under-age consumers is regulated in the Law on Alcohol Control adopted in 2004. The salespersons of alcoholic beverages have the right to demand a proof of age, (even when doubts exist that a person is younger then 18 years of age). Should a person fail to show a document indicating his age, the alcoholic beverage salespersons must refuse to sell him alcoholic beverages.

Many restrictions of alcohol advertising were formulated before the year 2001 in the Law on Alcohol Control. After 2001 there was an amendment of Law on Alcohol Control (article 29) which legitimated that alcohol advertising shall be prohibited in youth sport and leisure time events except for retail outlets located at sites of such events

National initiatives involving the wider alcohol industry

Commercial communication is regulated in the Law on the Amendment of the Law on Alcohol Control adopted in 2004; Restriction of Promotion of Sale and Advertising of Alcoholic Beverages. For example a lcohol advertising of all forms shall be prohibited in the Republic of Lithuania if it: 1) aims at children and adolescents up to 18 years of age; 2) features persons under 18 year of age in promotion campaigns.

In Lithuania products can be removed if they are not promoted in accordance with the principles in the national legislation. Compliance with the requirements is controlled by the Service (except for violations in mass media), municipal institutions (violations of prohibitions in outdoor advertising), and the National Consumer Rights Protection Board (violations in the mass media).

3.16. Luxembourg

Luxembourg has not answered to the questionnaire, but has informed the Commission on the latest developments.

Luxembourg has implemented the 2001 recommendation by a grand-ducal regulation dated 28 December 2005. This text provides for a dissuasive tax of an amount of 600 euro per hectoliter (or 6 euro per liter) for those products commonly referred to as alcopops, particularly liked by young people. Article 3 contains a very large definition of those products.

Early February 2006 the Ministry of Health submitted a draft statute (projet de loi) to the Luxembourg parliament with a proposal to prohibit the sale of alcohol to those under 16 years of age. This text provides for an extension of the existing prohibition, which exists currently for restaurants, cafés, bars, to all general commercial establishments such as supermarkets and gas stations, etc. It is expected to be adopted before the end of this year.

3.17. Malta

Policy decisions at National level

In Malta prior to 2001, legal provisions, which relate to drinking by minors had already been enacted. Since 2001 the following legislation has also been enacted:

(a) the Trading Licences (Amendment) Regulations (LN 1/06). One of the conditions is that no alcohol can be sold to underage persons;

(b) the Activities Requiring Permit by Local Councils (Amendment) Regulations (LN 119/02), also prohibits the sale of alcohol to underage persons in any activity which is organised (in accordance with these regulations) and requires a local council’s permit;

(c) the Tourism Operations (General) Regulations (LN 128/02) provide that no place licensed by the Malta Tourism Authority shall serve alcoholic beverages to underage persons;

(d) the Beverages in Glass Containers (San Giljan Local Council) Bye- Laws (LCBL 52/7/2004) regulate drinking in public places and in and around main places of entertainment within the respective local council.

The Code for Advertisements, Teleshopping and Sponsorships in the Broadcasting Act was amended in 2002. There also exist other legal provisions related to the protection of minors in broadcasting which were enacted prior to 2001.

A national Alcohol Policy is currently being drafted. The Cabinet of Ministers has decided that the necessary legislation will be amended accordingly to establish a minimum age for the consumption of alcohol. The national Alcohol Policy will partly be based on the EU Alcohol Charter of 1995 and the results of the European School Survey Project on Alcohol and Other Drugs (ESPAD), the Population survey and the Health Behaviour in School Aged Children Study (WHO).

In Malta, school programmes are in place as well as limited community programmes.

The National Commission on the Abuse of Drugs, Alcohol and other Dependencies, as well as SEDQA will continue to disseminate evidence on the factors which motivate children and adolescents to start drinking.

Research is being carried out by the University of Malta through its Psychology Department and its Youth Studies Programme under the Faculty of Education. Malta is also planning to promote research on this issue by linking its projects to some of those of the European Union, such as the Daphne Programme.

In Malta, awareness campaigns are conducted by the National Drug and Alcohol Agency (SEDQA), the Health Promotion Department within the Ministry of Health, the Elderly and Community Care and the Sense Group on a regular basis through recurrent inserts in print media and advertising campaigns through the radio, TV, billboards, posters and the cinema screens. Earlier this year, the Cabinet of Ministers decided that a permanent focus group, made up of representatives of the Ministry for the Family and Social Solidarity, the Ministry of Education, Youth and Employment and the Ministry of Health, the Elderly and Community Care will be set up with a view to preparing a national educational campaign.

Initiatives aiming to address young people on the dangers of drink driving are carried out more consistently during the holiday season through specific campaigns, communicating the dangers and possible consequences of drink driving.

Action taken against the illegal sale of alcohol to underage consumers in Malta is carried out through the enforcement of already existing national law. The Cabinet of Ministers has earlier this year decided that there should also be established an age under which persons cannot consume alcohol and to whom alcohol cannot be served. The proposed amendments will be presented to Parliament for discussion therein within the coming months.

National initiatives involving the wider alcohol industry

Enforcement of existing legislation is continuous.

The packaging and labelling of alcohol products is also regulated by the Trade Descriptions Act (Cap. 313) and the Food Safety Act (Cap. 449).

Plans of specific training for servers and sales persons are envisaged for future initiatives based on a more national approach through consultations with the alcohol industry.

Mechanisms to market alcoholic beverages, to handle complaints and to remove products, which are being promoted, marketed or retailed in accordance with the national legislation are to be introduced through the implementation of the national Alcohol Policy.

3.18. Netherlands

Policy decisions at National level

In June 2005 the Netherlands adopted an Alcohol and Young People Strategy Document for the period of 2005 to 2007 with actions such as: educational slogan in every TV commercial; more education targeted at parents; more attention to alcohol and violence (Extra budget: € 680.000). Alcohol prevention is also a part of Netherlands national prevention strategy and programme “Living longer in good health”.

In 2004 media put emphasis on new evidence on the factors which motivate children and adolescents to start drinking on in Netherlands.

Since 1997 the Addiction Programme of NWO and ZONMw has funded 88 projects. Projects focus on mechanisms of addiction, treatment, prevention and care.

One chapter of the Alcohol and Young People Strategy Document (2005) is focussing on youth participation. With the intention to involve young people the Netherlands Institute for Health Promotion and Disease Prevention is every summer carrying out a peer education project targeted at youngsters spending their holiday on tourist resorts.

To combat drink driving Netherlands has participated in the BOB campaign since 2002. As from January 2006 the BAC for novice drivers will be 0, 2 ‰. For other drivers the BAC remains 0, 5‰.

Since January 2002 current regulations of age-limits are stricter enforced. More than 70 extra surveillance officials are appointed mainly for controlling under-age sales of alcohol.

National initiatives involving the wider alcohol industry

The Dutch Foundation for Responsible Alcohol Use introduced in may 2005, on request of the Minister of Health, vetting of every radio and TV-commercial for alcoholic drinks by an independent committee.

The Dutch Foundation for Responsible Alcohol Use also asked the Advertising Code Commission to introduce a system of fines for all offences of the self-regulation code. Maximum penalty is € 50.000. In the self-regulation code there are several mechanisms to intervene against inappropriate marketing (including promotional practices). Even removal of products is possible, but only if the product is against the self-regulation code. The Netherlands has mandatory training for all licence-holders and managers of liquor shops and pubs. The law obliges too that voluntary workers in canteens of sport clubs get a short “responsible serving” instruction. Since 2002 the rules are strictly enforced.

3.19. Poland

Policy decisions at National level

Financial resources are allocated by the State Agency for the Prevention of Alcohol-Related Problems (PARPA) from the budget of the Ministry of Health to prevention activities

A National Health Programme was adopted by the Council of Ministers in 1996, which sets out Polish national health policy up to 2005. The aim is “to reduce, and change the structure of, alcohol consumption and reduce the damage to human health caused by alcohol”. This is implemented, inter alia , by the provision of preventive educational programmes for adolescents and high-risk groups and training for members of various professions involved in alcohol-related problems.

The activities undertaken in the field of prevention targeted at children and adolescents are also consistent with the National Programme for the Prevention of Social Maladjustment and Juvenile Crime. The programme incorporates strategies linked to public primary education, including courses of training for persons involved in youth work and in tackling social maladjustment.

Workshops and other courses on life skills are available for schoolchildren, and psychological-educational counselling is available to children and adolescents over the telephone.

As a result of several conferences and other initiatives Poland has adapted state-of-the-art techniques and preventive programmes. The programmes are implemented in schools supported by different actions to improve teachers’ skills and expertise on which factors motivates children to drink.

Poland has participated in the ESPAD survey (once every 4 years) and in the HBSC survey (once every 4 years): The results of the surveys have been presented at press conferences, annual academic conferences for professionals involved with adolescents, and academic seminars. Annual meetings with the Network of Municipalities (about 150 municipalities) have been arranged to disseminate the result and recommendations are issued annually to 2 500 municipalities. One important result is that since 2001, the Decree of the Minister of National Education obliges schools to design a school prevention programme, which has significantly increased the activities of schools in this area.

Several national campaigns have taken place since 2000: For example one campaign entitled "Alcohol steals your freedom". One goal was to launch a public debate on the problems associated with alcohol consumption by young people between the ages of 12 and 18 and encouraging adults to react when they see alcohol being sold to minors. Approximately 750 “ambassadors” and 10 000 activity leaders took part in the campaign, 20 000 discussions for adolescents and 2 000 discussions for adults were held, 500 000 adolescents and 43 000 adults took part in the discussions, 188 radio stations, 108 television channels and more than 300 newspapers and magazines took part in the campaign.

In 2003 a campaign entitled “Alcohol: Access Denied to Minors”, jointly organised by PARPA and the Polish Brewing Industry Association (ZPPP). The purpose of the campaign activities was to limit the sale of alcohol to minors. Municipalities performed activities such as checks on points of sale of alcohol, courses of training for alcohol retailers, surveys and research, and organising a range of events and projects for the local media. Educational material was sent out to 80 000 retail outlets selling alcohol. The checks performed in the period from January to April of this year resulted in 1 395 “Trustworthy Retailer Certificates” being awarded to shops which comply with the legal ban on selling alcohol to minors and 2 196 yellow warning cards handed to shops which defied the ban.

In 2005, youths from the Powiat School for Youth Leaders had a discussion with representatives of the Senate, the Ministry of Health, the Ministry of National Education and Sport and the Ministry of Social Affairs. The topic of discussion was the use of mind-altering substances by adolescents and the options for appropriate activities by institutes and organisations. The draft National Programme for Preventing and Combating Alcohol-Related Problems in the period 2006 - 2010 includes tasks in support of activities initiated and implemented by adolescents.

Several preventive activities have been conducted in Poland. For example the introduction of a specialised prevention campaign targeted at young men working as drivers in the Polish Army and PARPA organises a compulsory block of driving-school courses on the impact of alcohol on drivers of road vehicles.

National initiatives involving the wider alcohol industry

Under the Polish legal system, only beer might be advertised, and even that is subjected to numerous limitations designed to prevent such advertising form targeting teenagers. Among other things, there is a ban on advertising alcohol in magazines, etc. targeted at adolescents or children, and the advertising and promotion of beer targeted at minors. Moreover, it is not permissible to advertise beer in the mass broadcasting media between 6 a.m. and 8 p.m. The question of advertisements targeted at minors is also regulated in the “Polish Brewers’ Advertising Standards Code”, which states that the advertising of beer must not in any way contravene its provisions or be targeted at persons under 18 years of age.

More than 300 instructors have been trained nationwide. Implementation of these training courses by local authorities is recommended. Every year, some 400 municipalities organise courses on compliance with the law on the sale and serving of alcohol. More than 10 000 salespersons took part in these courses in 2004.

3.20. Portugal

Since 2004 Portugal has a national health plan with 7 years duration, which includes a national program on alcohol related problems (ARP) prevention. It relates to the school health program, the health determinants program and the adolescents health program among others. This new national program on ARP is within an alcohol package with an emphasis on the drinking of alcohol by young people and reinforces the national alcohol plan that was adopted in 2000.

Several research studies are ongoing projects conducted by, universities and research agencies, alcohol regional centres and other alcohol services, NGOs and governmental organisations such as the Directorate-General of Health / Ministry of Health which has also an important dissemination role of good practices in this field at a national level.

Since 2001, Portugal has increased the number of awareness raising activities such as school education, health professionals training, responsible alcohol service and server training.

Several programs, specifically targeted to young people, are being planned and developed, namely a collaborative project involving the Institute on Drugs and Drug Addiction, the Portuguese Red Cross and the Directorate-General of Health. Other activities are being planned within the Ministry of Health in articulation with other sectors, in closeness with the National Youth Council, NGOs related to alcohol and the Portuguese representative of Eurocare.

Legislation on specific initiatives for young people is being prepared.

Portugal is paying more attention to the enforcement of current age-limits to sell and serve alcohol.

Portugal is also involved as a partner in European Projects namely the “Pathways for Health Project” - PHP which includes innovative activities to reduce under-age drinking, especially binge-drinking, and the “Enforcement of National Laws and Self -Regulation on Advertising and Marketing of Alcohol” – ELSA project.

National initiatives involving the wider alcohol industry

Portugal has both self-regulatory codes by the industry and the advertisements industry organisations and the regulatory code approved by government. Both have been changed according to the council recommendation.

The national institute of hospitality and tourism has developing server training programs in some of their schools.

3.21. Slovak Republic

Policy decisions at National level

The Slovak Republic has no current national alcohol policy. Hence a National Action Plan on Alcohol is planned for the period 2006 to 2008.

The results from the European School Survey on Alcohol and other Drugs have been used to disseminate evidence on young people’s drinking and in May 2005 a national campaign was launched to raise the awareness of problems related to alcohol. For the moment the Republic is planning to initiate activities to increase young people’s involvement in alcohol policy.

National initiatives involving the wider alcohol industry

The Slovak Republic is planning to introduce mechanisms to ensure that producers do not produce or market alcoholic beverages specifically to children and adolescents.

3.22. Slovenia

Policy decisions at National level

The Act Restricting the Use of Alcohol (2003) sets the framework for Slovenia alcohol policy. The Ministry of health shall, in cooperation with other relevant Ministries and Organisations, develop programmes for the limitation of alcohol consumption and reduction of harmful effects of alcohol consumption. Most measures address youth, for example: The packaging of foodstuffs containing alcohol must display the alcohol content and a warning that the foodstuff is not suitable for children; The sale and provision to persons under the age of 18 of alcoholic drinks or drinks to which alcoholic drinks are added shall be prohibited; It is prohibited to sell or provide alcoholic drinks to persons who it is possible to assume justifiably will pass them on to persons under the age of 18; The sale or provision of alcoholic drinks shall be prohibited in buildings and their functional areas where education and health-care activities take place; The sellers of alcoholic drinks must sell at least two different types of non-alcoholic drinks that have an equal or lower price than the cheapest alcoholic drink.

For the moment (2005) a two year National Action Plan is in preparation by a Working Group and Council for Alcohol Policy, established by the Ministry of Health in 2004. The Plan is planned for 2006 and it will include actions targeting children and young people. The above mentioned Working Group will monitor the implementation of the plan.

In the National plan of health care of the Republic of Slovenia ( 2000-2004), one of the priority objectives is to change patterns of behaviour harmful to health, applying also to prevention of excessive consumption of alcoholic beverages and illicit drugs. The plan is primarily oriented towards young people, families and schools. The plan announces a national programme to prevent excessive consumption of alcoholic beverages and illicit drugs (National Strategy on Drugs accepted in 2004 - mainly covering illicit drugs, Alcohol Action Plan in preparation). A part of excise duty from sales of alcohol was to be used for healthcare activities (very limited in 2002).

A Healthy Schools Pilot Project was developed and tested in about 150 schools in the 1990s. The project is now being introduced at national level by the Ministry of Health, Public Health Institutes and Ministry of Education and Sport. A school programme “Alcohol? Parents can influence!" has also been carried out nation-wide. It includes booklets and poster for parents and handbook for teachers and is based on peer education.

The National Public Health Institute has responsibility for the dissemination of evidence relevant to public health and to support policy makers in decisions making. The institute has taken part in ESPAD and HBSC international studies and is publishing the results and presenting them in press conferences.

Since 2001 several activities are organized all year round, at different levels and by several actors, to raise awareness on alcohol and harm. The beginning of the school year, the month of November (Drug Prevention Month) and the period around New Year are the preferred periods for action.

NGOs in Slovenia have many nation-wide programmes that are targeting young people. One of them is "A message in the bottle" where young people are actively included in its implementation. The activity is co-financed by the Ministry of health and is based on events, exhibitions and workshops organized by young people themselves and well covered by media. Local activities involving local communities and schools are also launched by Regional Public Health Institutes and through Health City Network.

Also Student organisations, well funded and organised, have a so called "Minister of Health and Health Administration" in charge of programs targeting students and their health behaviour (tobacco, alcohol, sexual behaviour, illegal drugs).

NGO "Be smart, don't drink" promoting concerts, parties and other social gatherings for young people without alcohol has been very successful.

Article 3 of the Road Safety Act (OJ RS No. 30/98) established Slovene Road Safety Council as the holder of prevention and road safety education. An Act Amending the Road Traffic Safety Act (2005) introduced Zero BAC for young drivers. Special programmes for young drivers have been introduced in driving schools.

One of the lessons in driving school is dedicated to alcohol and drinking and driving and is organized as a discussion based on the educational movie. A media campaign "Drink or live" (posters, TV Spots) launched by the Ministry of health in 2004 will be repeated this year.

The Act restricting the consumption of alcohol (2003) also defines provisions for the sale of alcoholic drinks and proposes measures for the prevention of illegal sale of alcoholic drinks (including to minors). Supervision of the enforcement of this Act is carried out by the Health Inspectorate of the Republic of Slovenia, the Labour Inspectorate, the Market Inspectorate, the Police and the Inspectorate for Education and Sport. The supervision also includes surreptitious sale and other provisions related to alcohol.

National initiatives involving the wider alcohol industry

Regulation of alcohol beverages advertising is assured in the Order on the Promulgation of the Act regulating Health Suitability of Foodstuffs (2002). Supervision of the enforcement of the Order is carried out by the Market Inspectorate.

Advertising of alcohol beverages with more than 15% of alcohol is banned. Other alcohol beverages (15% and less) can be advertised in all media except on billboards and other types of advertising beside roads. Regarding young people advertising of all alcohol beverages is banned on TV and radio between 7 am and 9.30 pm and in the cinema before 10 pm. All advertisements must be in line with very concrete criteria, the following specially addresses young people: not to promote excessive drinking and linking alcohol with success; not to address young people; not to show in the advertisement people younger than 25; not to create the image that alcohol contributes to success in social and sexual life; not to appear in the places where health, educative and sport activity is conducted; not to appear on boards or panels closer than 300 to a school or a kindergarten; not to appear in arrangements primary devoted to youth or sport arrangements; not to contain symbols, images or youth cartoon or other heroes.

Advertisements must contain the warning "Minister of health warns: Alcohol consumption may damage health" or "Minister of health warns: Excessive alcohol drinking damages health”.

3.23. Spain

Policy decisions at National level

A National Drug Strategy (2000-2008) was approved in 1999 and a new Action Plan was recently introduced for the period 2005 to 2008. The objective of the plan is to “carry out specific actions aimed at reducing the consumption of alcoholic beverages among the public at large, particularly among the young, establish self-regulatory mechanisms and, wherever applicable, provisions of law restricting the promotion and advertising of alcohol consumption targeted the young will be promoted. And actions and programs will be supported aimed at reducing drinking and driving." Additional to the National Action Plan, regional Drug-Dependency Plans and autonomic legislation are in place.

The objectives concerning information, education and prevention are dealt with within the framework of Interdepartmental Agreements between The Spanish Ministry of Health and Consumer Affairs and the Spanish Ministry of Education. The agreements are within the framework of the new National Drug Strategy and the National Drug Plan. Within this framework, the "building health" project, which is a life skills training programme, is currently being carried out. To compliment the school based interventions leisure- and free-time activities are carried out outside of school hours with the collaboration of specialised NGOs, which is referred to as the "Open-Doors Programme".

The Spanish Ministry has also produced an Alcohol and Smoking education guide and a Driving and Health Education notebook for Compulsory Secondary Education teachers. The guides include a classroom instruction section consisting of information for teachers and a practical section including specific activities for working with the students.

Spain, together with 31 other European countries are members of The "Bridging the Gap" project which falls within the framework of the European project "Alcohol Policy Making in the Context of a Larger Europe” subsidised by the European Commission. The Spanish partner is "Socidrogalcohol".

The Government Delegation of the Spanish National Drug Plan subsidises research projects on drug dependencies by means of Grant Orders announced annually since 2000 , for public and private non-profit organisations. Research has been carried out on for example: young people and preventing alcohol consumption, comparison of the effect of different health messages, identification of risk factors, weekend binge drinking, and analysis of the determining psychosocial factors on the onset of the Youth Drinking.

To coordinate research at National level a National Institute for Drug Research and Training was created in 2004, as the joint body of the Government Delegation for the National Drug Plan, to which the exercise of the state authorities attributed with regard to drug-related research and training falls.

Several national campaigns have been launched in Spain. In 2002 a National Congress on Youth, Night-time and Alcohol took place. The main outcome was the declaration of a Social Commitment on the part of all the agents involved, such as the Municipal, Autonomous Community and Central Governments, parents and the schools. The declaration raised a major media debate. In 2004 and 2005 the Spanish Ministry of Health and Consumer Affairs has conducted campaigns on youth, alcohol and driving. Under the slogan "Alcohol takes it toll. Watch out", it was attempted to increase awareness of youths as to the dangers of driving under the influence of alcohol.

In 2005 the Spanish Ministry of the Interior and the Spanish Ministry of Health and Consumer Affairs signed a framework working agreement on traffic accident prevention to reduce the number of traffic accidents related to drinking and the use of psychoactive drugs. The agreement includes several activities targeting young drivers.

In Spain current age-limits is controlled on a random basis or as a result of reports and evident signs. Retailers of alcoholic beverages are obliged to have a sign in an easily visible location in establishments where alcoholic beverages are sold and consumed patently stating the prohibition of selling or serving alcoholic beverages to minors.

National initiatives involving the wider alcohol industry

A training project is promoted by the Public Health Agency of Barcelona and the Promotion and Social Development Association for training waiters. The objective is to avoid serving alcohol to drunken customers (youths or adults) in some districts of Barcelona. The objectives of this project include: preventing minors from drinking, refusing to serve any further alcoholic beverages to drunken customers, preventing driving under the influence of alcohol.

Several different self-regulatory codes exist in Spain: Self-regulatory advertising code of the Spanish Alcoholic Beverage Federation; Self-regulatory advertising code of the Beer Producers of Spain, signed with the Consumer and User Confederation and Self-regulation.

The Spanish Ministry has also the intention to regulate and harmonise some key alcohol policy-related aspects by means of a Law, with the objective to safeguarding minors and reducing the problems stemming from juvenile alcohol consumption.

3.24. Sweden

Policy decisions at National level

The Government Bill entitled a National Action Plan for preventing Alcohol-related Harm (2001 – 2005) reports on the goals and orientation of the Government’s overall endeavour to prevent alcohol-related harm and the measures that the Government and Swedish Parliament consider are required to ensure to make these goals attainable. The basis of the Swedish alcohol policy is set out in this action plan. It’s main focus is to strengthen the future alcohol policy both at international and national, notably local level.

In the last couple of years there has been a decline both in the number of children reporting alcohol consumption (under-age drinking) and the percentage of 15 an 18 years old school children reporting binge-drinking during the last month. This may not entirely be the result of the national action plan and all the different actions taken on all levels in society. A similar trend can be seen also in other countries. Yet it is likely that the action plan has played an important role especially in the preventive work among adolescents, and it has been followed by a new action plan for the period 2006-2010 that recently was accepted by the Parliament (Government Bill 2005/06:30)

The new action plan also emphasises the importance of building up long-term, structured and coordinated preventive work at the local lever. There is a new overall objective for the Swedish alcohol policy that more strongly emphasises the link between alcohol and public health. The goal is To promote public health by reducing the harmful medical and social effects of alcohol. The strategy for attaining this goal is, as before, based on reducing total alcohol consumption, preventing people from becoming heavy drinkers and influencing heavy drinker’s consumption behaviour. In these respects, the strategy focuses particularly on adolescents and young adults. Another part of the strategy is the attempt to eliminate the use of alcohol entirely in certain environments or during certain stages of people’s lives, such as transport contexts, at workplaces, during pregnancy and during adolescence.

To implement the first Action Plan, the Government allocated SEK 940 million over 5 years (approximately €95 million). Of this sum, SEK 530 million (approximately €55 million) has been used to reinforce measures in the municipalities. The remaining amount has been spent on opinion-moulding and provision of information’s, supporting voluntary organisations, research and skills development, inputs for the children of alcohol abusers and international cooperation. Approximately 500 million SEK has so far been allocated by the Government for the implementation of the new action plan.

To protect young people in particular, measures have been taken to prevent circumvention of the rules for advertising alcohol by marketing drinks of low alcoholic content (marketing of low alcohol beer in cans/bottles with the same design as “normal” beer).

The objective to reduce alcohol consumption is also one of the eleven target areas for work in the field of public health presented in a bill entitled Public health objectives 2002.

A committee has been appointed to coordinate the preventive measures at national level and, in cooperation with municipalities and county councils, encourage the measures at regional and local level. In doing so the committee is collaborating with voluntary associations, popular movements, trade organizations, companies, authorities, etc.

In 2005 there are some reinforced measures in place regarding: Special support for groups and individuals at risk; Building public opinion and providing information; Restricted marketing of alcoholic beverages; Improved skills in those professional groups that can prevent the harmful effects of alcohol.; Monitoring patterns of consumption and damage to health.

Certain general measures to support children and young people have been reinforced and improved in order to prevent the consumption of alcohol by these groups. In collaboration with the National Agency for Education and in consultation with the Swedish Association of Local Authorities, the National institute for public health was given the task of analyzing which measures might reinforce efforts in schools to prevent alcohol damage. As a result, several new methods are now underway within schools.

A specific action targeting parents is the book “Tonårsparlören” (The teen-age phrase-book), which during the last four years has been sent nationwide, a new edition every year, to all parents that have a child who turns 13.

Evidence on factors which motivate children and adolescents to start drinking is currently disseminated at national level. One of the most important tasks of the public authority the Swedish National Institute of Public Health is to gather and arrange research results on methods and strategies in the public health field and disseminate the results to regional and local authorities.

Research by the Municipality of Stockholm (FOU-enheten), points at several specific risk (and protective) factors that motivate children and adolescents to start drinking. This has been a foundation in the development of methods and preventive measures, and has to be part of all fields of action, within schools, organizations, associations and authorities on all community levels. The risk and protective factors have also been communicated to target groups in the national information campaigns, especially to parents with children in their teens.

In the last couple of years there has been a decline both in the number of children reporting alcohol consumption (under-age drinking) and the percentage of 15 an 18 years old school children reporting binge-drinking during the last month. This may not entirely be the result of the national action plan and all the different actions taken on all levels in society. A similar trend can be seen also in other countries. Yet it is likely that the action plan has played an important role especially in the preventive work among adolescents, and it will be followed by a new action plan for the period 2006-2010.

The Government currently refers to/promotes research results as a basis for the policy work aiming at bridging the gap between research results and the receivers. Centralförbundet för alkohol- och narkotikaupplysning (CAN) is an association of several Swedish non-governmental organizations. CAN collects, processes and disseminates facts on alcohol and narcotic drugs to stakeholders in Sweden. The Government consequently links research results when informing on the Swedish alcohol policy irrespective of the choice of channel: Internet, fact sheet, publication etc.

There have been reinforced efforts, both at national and local level, to provide information and build public opinion about the risks and harmful effects of the consumption of alcohol in the hope that this will lead to individuals taking greater responsibility for their drinking habits. The message promotes moderation (among adults), an alcohol-free environment during childhood, in traffic, in workplaces and during pregnancy, and reduced consumption of illegal alcohol. The media campaign by the national alcohol commission has especially been targeting young adults aged 18-25.

As part of the information campaigns, an interactive consumption test was created on the internet, aiming to increase the awareness of young adults aged 18-25 about the harmful effects of alcohol, especially targeting those with high consumption levels. By 2005, over one million visitors has completed this test, around two thirds are people in the targeted age group.

The national action plan states that young people should have a big influence on the preventive activities, by engagement in the planning as well as in the accomplishment of the activities. And most importantly, young people have to be a part of all fields of action, on all community levels.

“Don´t Drink & Drive” is a campaign on a national level in Sweden, run by the National Road Administration in cooperation with the National Alcohol Commission. It is targeted to young people aged between 18-25. The activities that are connected to the campaign are dependent on an involvement of several instances of the community, like fire departments, police, public schools, sport clubs etc. The consequences of driving under the influence of alcohol are communicated through movies, commercials, exhibitions and seminars, where victims of drunk driving often appear. The purpose is to make people think and to start talking to each other about the dangers of drunk driving.

The National Alcohol Commission, the national institute for public health and the national association of retail companies (Svensk Dagligvaruhandel) have produced a tool, which describes the legislations and responsibilities regarding sales of alcoholic beverages. The material has been distributed to the municipalities, to local police authorities and to retailers of alcoholic beverages (department stores etc.) throughout the country. This measure aims to aid local authorities in their preventive work, and to prevent illegal sale to under-age consumers. New legislation regarding illegal sale of alcohol to under-age consumers with increased maximum penalties has strengthened these efforts.

On 1 July 2005, new laws came into effect, which criminalized storage of illegally imported alcoholic beverages and increased maximum penalties for illegal sale of imported alcohol.

The National Institute of public Health has conducted a national investigation in order to find out whether the shops follow the regulations on sales to minors. Under aged persons visited shops in order to buy alcoholic beverages. If they succeeded in this task the shop was given a warning. Similar investigations have been conducted at local level.

National initiatives involving the wider alcohol industry

Amendments (2004:1045) to the Alcoholic Beverages Act (1994:1738) prohibit by law to advertise alcoholic beverages of any alcoholic content on television. In periodic press it is forbidden to advertise alcoholic products above 15 percent. The amendments were made after the Swedish Market Court found that the previous Swedish legislation was not in accordance with the EC legislations and clarifies that the marketing must not address or describe children or youth under the age of 25.

Since 2003, the National Institute for Public Health has been responsible for national dissemination of a Responsible Beverage Service program. The program consists of a combination of policy development in the municipalities and training in responsible beverage service for licensees and their staff. The program has been scientifically evaluated, with studies published in peer-reviewed journals reporting significant improvements following implementation.

The Swedish Brewer’s Association, the trade organizations of the Swedish breweries, has developed a code for the line of business. The code is of course subsidiary to the legislation of which the Swedish Consumer Agency is responsible of supervising. The Swedish Brewer’s Association can however give fines to members of the association when breaking the code, which is a more severe repercussion than the under penalty of a fine which is given by the legislation. . The Association of Swedish Advertisers, Swedish Brewer’s and Swedish Spirits and Wine suppliers has also adopted a recommendation on advertising for alcohol beverages and low-alcohol beverages with the basic principle of moderation for all marketing of alcoholic beverages.

3.25. UK

England

Policy decisions at National level

In March 2004 the Alcohol Harm Reduction Strategy for England was adopted. The strategy is due for review in 2007. The strategy has four main work streams: Improving Identification & Treatment; Reducing Crime and Disorder; Education and Communication and Working with the Drinks Industry. The Public Health White Paper Choosing Health (November 2004) has reinforced and deepened aspects of the cross-Government Strategy and Department of Health’s commitment.

There was a specific commitment in the alcohol strategy that required a fundamental review of the code rules on alcohol advertising that alcohol advertisements should not target young people below 18 years of age. The review has been completed and new guidelines have been issued.

Nationwide projects targeted at children, adolescents, their parents, teachers and carers have been implemented and some are in development. Alcohol education is now a part of the PSHE curriculum and alcohol education campaigns are being developed.

The Licensing Act 2003 enhances the legislation on the sale of alcohol to young people. The Act has given police greater powers to close down problem premises, increased penalties for premises that sell to underage drinkers.

Since 2004 there have been four Alcohol Misuse Enforcement Campaigns. These campaigns have focused on tackling alcohol related anti social behaviour and targeting those selling alcohol to children.

The results from a national study on smoking, drinking and drug use among young people have been disseminated in England in 2004 but there have been no national wide awareness raising activities so far. England has no plans to increase young people’s involvement in youth alcohol related policies.

National initiatives involving the wider alcohol industry

Working with the Drinks Industry is a part of England’s alcohol strategy.

The Standards and Principles for the Production and Sale of Alcoholic Drinks in the UK were published in November 2005. The Standards enforce existing principles and training for servers and sales persons with regard to under-age selling. In this document the industry committed them to including a sensible drinking message on packaging, advertising and at the point of sale. Department of Health are currently working with the industry to ensure this is implemented.

A new independent charitable trust aimed at positively changing the UK's drinking culture and tackling alcohol-related harms was officially given the go-ahead in June 2006 by Ministers, the alcohol industry and key stakeholders.

The Trust is voluntarily funded by the alcohol industry and is a unique initiative born from the Government’s 'Choosing Health' White Paper and Alcohol Harm Reduction Strategy. The Trust will bring together industry, charities, lobby groups, medical professionals and experts in the field to address alcohol misuse and promote sensible drinking across the UK.

This is a UK-wide initiative that has gained the support of the Devolved Administrations (Scotland, Wales and Northern Ireland). The Industry has committed a significant initial funding stream of £12 million over the first three years to finance the new Trust’s activities. Work by the Trust, includes educational campaigns to promote sensible drinking among the general public, project aid for local and national initiatives, and the running and evaluation of pilot programmes to tackle alcohol related harm.

Wales

Alcohol is already included in the current Welsh substance misuse strategy “Tackling Substance Misuse: A Partnership Approach”, published in 2000. ‘Substance misuse’ means both drugs and alcohol. One of the key aims of the strategy is to help children and young people resist substance misuse in order to achieve their full potential in society and to promote sensible drinking in the context of a health lifestyle. This includes ensuring they have access to education programmes that help them understand the risks associated with alcohol misuse, especially the dangers of binge drinking. Amongst the schemes that the Assembly has supported is the All Wales Schools programme run by police officers along with personal social education teachers. This aims to educate children and young people in an interactive and imaginative way about the many risks and dangers they may face as they develop in to adults including alcohol misuse. The Assembly also supported a national broadcaster’s binge drinking campaign that targeted young people.

Though the Alcohol Harm Reduction Strategy is an English strategy many of the subjects it covers impact in Wales. The Welsh Assembly Government supports the aims of the strategy, particularly those focussing on the role of the drinks industry. The Assembly is also working with the other UK regions in taking forward some aspects.

When the review of the standards for advertising alcohol on television was undertaken, Wales responded separately. The Welsh Assembly Government position was that there should be a complete ban on advertising alcohol on TV or at least a restriction on alcohol advertisements until after the watershed of 9pm.

Rules on the sales of alcohol to young people as described for England apply to Wales.

Northern Ireland

In May 2006 Northern Ireland launched a New Strategic Direction for Alcohol and Drugs 2006-2011 (NSD). This contains a number of key priorities and outcomes related to alcohol.

These include addressing binge drinking, alcohol-related social disorder and under-age drinking. Targets have been set in respect of reducing adult binge drinking and teenage drunkenness. In support of the NSD local Drug and Alcohol Co-ordination teams have developed local plans with local outcomes; alcohol is a key priority within these as well with local outcomes being developed in respect of for example street-drinkers and alcohol education.

In October 2006 Phase 3 of a public information campaign addressing adult binge drinking will commence. A survey on drinking patterns in Northern Ireland has been completed and should report in the autumn. Consultation on new proposals concerning liquor licensing regulations in Northern Ireland has just finished.

Scotland

Policy approach

The Scottish Executive published a Plan for Action on Alcohol in 2002 and is due to launch an update to this plan later in the year. This will provide commitments to a range of actions for the next three years on prevention, education, treatment, protection and controls that are all designed to reduce alcohol related harm across Scotland.

The updated Plan will set out to build a Scotland in which people treat alcohol more appropriately and understand the potential consequences of excessive drinking; and acknowledges that whilst Government does have a role to play in tackling alcohol related problems, each and every one of Scotland’s citizens has a responsibility to recognise the effects of alcohol and to drink sensibly. This is a reflection of the Executive’s desire to see substantial action in Scotland which meets the extent of the problem; and its commitment to continue educating people and ensuring that appropriate help is available for those who need it. The updated Plan will retain a focus on promoting a cultural shift away from binge drinking and putting into place specific actions that are aimed at helping more Scots to adopt a responsible approach to alcohol consumption. It will deliver a greater range and quality of services to help those individuals and families for whom that harm is already a reality and to actively support local communities in their efforts to tackle alcohol-related crime and antisocial behaviour.

Reducing harmful drinking by children and young people is also one of the key priorities in the Plan for Action on Alcohol Problems. The Executive is, for example, currently exploring how to better engage with Scotland’s youth to ask them to consider what a sensible future for alcohol in Scottish society might be. We are also looking to improve school and community based education – informed by independent research looking at the effectiveness of current curriculum activities - and to ensure young people affected by alcohol problems have access to appropriate services. Resources for parents have also been developed to help them discuss alcohol issues with their children and to instil a culture of sensible drinking in young people which serves them well in later life.

Funding

Nearly £12m has been made available during 2005/06 and 2006/07 to tackle alcohol problems and to fund prevention, education and treatment services.

Communication

Communications remain an essential part of a wider programme of action to change Scotland’s harmful drinking cultures; and the Executive is implementing a communications strategy that promotes positive lifestyles and choices in a relevant, appealing and creative way. Recent advertising work has been aimed at cutting binge drinking in young people and the longer term aim is to create a culture in which the safe and sensible consumption of alcohol is recognised as being compatible with a healthy lifestyle. This will include working with the media, the alcohol industry and the licensed trade to tackle the irresponsible promotions which can foster binge drinking; and ensuring that people have access to information, support and advice to help them make and sustain healthy choices.

Licensing Act

Legislation has also been introduced in Scotland which will, among other things, outlaw irresponsible drinks promotions which can lead to binge drinking and violence and tackle under-age drinking. Measures now exist in the Licensing (Scotland) Act 2005 specifically to tackle under-age drinking, for example: -

- It will be a condition of holding a licence for all licensed premises that they operate a no-proof no-sale system. This means requesting proof where age is in doubt and displaying nationally approved signage.

- There is a clear requirement for both On and Off Sales premises to operate on a no-proof sale basis.

- On sale licensed premises will in future be required to opt in to access arrangements for children. This will not only offer protection for children but will clearly support work in tackling under age drinking.

- Deal with irresponsible shopkeepers selling drink to under-18s through development and piloting of test purchasing protocols. While satisfied, in principle, that alcohol test purchasing would be an effective enforcement tool, the Lord Advocate in Scotland has asked that a pilot be undertaken to enable common procedures and operating protocols to be developed which will ensure alcohol test purchasing is carried out safely, fairly and effectively in a Scottish context. This work is currently underway in Fife, Scotland and is due to conclude in 2007. A further decision will then be reached on whether the relevant provisions of the new Licensing (Scotland) Act 2005 should be generally commenced in 2009.

- Offences relating to children will be updated. For example, ensuring that it is an offence for anyone anywhere to sell alcohol to a child and an offence for a child to buy or attempt to buy alcohol anywhere.

Contact:Maria Renstrom, maria.renstrom-tornblom@cec.eu.int

Wilfried Kamphausen, Wilfried.Kamphausen@cec.eu.int

[1] Most Member States responded in January 2006, while Cyprus on 25/04/2006 and Malta on 28/04/2006.

[2] New name: European Forum for Responsible Drinking (EFRD)