Alcohol control policy: are Baltic countries turning Nordic?

Oct. 2015 alcohol policy trends were analysed in depth in the annual conference “Alcohol, Drugs and Media Scene” of the Nordic Alcohol and Drug Policy Network (NordAN) in Helsinki. Organizations from all Nordic and Baltic countries shared insights and experience, while expert speakers addressed methods by which the alcohol industry exploits media for social image and promotion.
After the conference we collected comments regarding development of alcohol control policy from Lauri Beekman (Estonia), the general secretary of NordAN; Nijole Gostautaite Midttun from the Lithuanian Tobacco and Alcohol Control Coalition (NTAKK); and Romualds Razuks, a Latvian Parliament member.

Lauri Beekman

Estonia just announced the new Nordic style alcohol policy measures. How unexpected is this?
It is a relatively consistent process over time. Strengthening control approach is part of the commitment towards Baltic-Nordic integration. Background to the latest proposals is Alcohol Policy Green Book adopted by the Estonian government in Feb. 2014. Ministry of Social Affairs signalled political will to implement comprehensive recommendations, including progressive introduction of specialized departments, banning alcohol sales in petrol stations, broader mandate for local governments to impose additional restrictions. Promotion and marketing will be further limited by (a) ban on open air advertisement, degustation events in the shops and happy hours. Current proposal regarding advertising content provides (a) frame for allowed information and format, rather than lists (of) what is not allowed. For example, alcohol marketing information should be presented on single colour background, without sound and visual design elements.  

Please elaborate on the ban of alcohol sales in petrol stations. Why petrol stations?
This change should take place from the beginning of 2017. Maris Jesse, the director of the Institute for Health Development, in the recent TV interview mentioned that the proposal was introduced by an unnamed representative of one of the petrol station chains ... Two reasons are cited justifying the ban. One is obviously … road safety, since Estonia still has a serious problem of drinking and driving. Only last year a baby and four young people were killed in separate accidents caused by drunk drivers. Such events shake public opinion, strengthen calls for action. It is logical to separate drinking and driving. Also, mystery shopping experiments by Institute for Health Development have shown that gasoline stations are more likely than other vendors sell alcohol to minors.  

(Regarding these bans, Lithuanian) media is full of messages of doom about increase in illegal market, loss of jobs. Are reactions similar in Estonia?
There are striking similarities and some differences between Lithuania and Estonia. Initially it was quite similar: the TV3 network claimed that they might leave Estonia, company Liviko threatened a lawsuit. However, our government is determined. Somewhat harshly Estonian minister Jevgeni Ossinovski summed it up in a Facebook post: “I understand alcohol producers are standing up for their interests, but I believe their financial interests do not outweigh the health of the Estonian people. A sector which makes a profit from killing the Estonian people must also understand this.” Tough statement alleging that measures will be implemented not through cooperation with the industry, but despite it.
The preferred statement from the industry is that advertising does not increase consumption, only provides consumer choice.

Well, that is not carved in stone. Hando Sinisalu, the CEO of Best Marketing International, wrote (on the) company blog: “Let’s finish this rubbish and speak honestly about these things. Advertising (including alcohol advertising) is effective and increases consumption.” And he is not alone. As time passes (the) alcohol industry will meet more resistance from marketing professionals on the ridiculous claims. Media polarisation on this is (a) quite new phenomenon. Yesterday Estonian Media (one of the two largest media groups) expressed support for the government plan: “If experts have found that limiting of alcohol advertising would decrease alcohol consumption in our society and with that help our public health, then Eesti Meedia supports these further restriction for alcohol advertising.”  However, Ekspress Group, which own TV3 and Delfi, have been much more critical. But as in case of industry, there is no more united front.

Is there overall support in Estonia for measures suggested?
Civil society is firmly behind the proposals: public sector, NGO, health professionals. Major coalition with ten national organisations including Child Protection Union and Union of Estonian Doctors is backing the proposals. Individual journalists, opinion leaders, and celebrities are joining in. Historian Aro Velmet published in Postimees (part of Eesti Meedia) detailed analysis on how the editorial of Eesti Paevaleht (Daily belonging to Ekspress Group) is used to stifle healthy discussion. And according to the Estonian Alcohol Yearbook 82 per cent of Estonians support restrictions on alcohol advertising.

Nijole Gostautaite Midttun

What is the situation and newest developments in alcohol control policy in Lithuania?
Over the course of (the) past several years there was a large number of proposals regarding alcohol control measures of varying value, some similar to the current Estonian proposal. All these are trapped at different stages of legislative process.
(The) situation in Lithuania continues to be complicated. On one hand we have a relatively comprehensive Alcohol Control Law, which for now is too weak to significantly lower consumption. The result is high availability and affordability of alcohol, low protection of children from manipulative and pervasive advertising, and enormous industry leverage towards politicians.
Besides small positive developments, (the) overall picture is quite bleak. Lithuanian population is decreasing, while alcohol consumption stabilized at a breathtaking 15 litres of pure alcohol per capita.

Is there political reaction to such a bleak situation?
The political response to the situation is shamefully vulture-like. Instead of consistent strengthening of evidence-based alcohol control measures proposed by civil society and scientists, politicians are racing for attention by introducing (a) number of meaningless “control” amendments, yet continuing the practice of revoking adopted legal acts in Lithuania. Just as in 2011 with revoking of alcohol advertising ban, just now there was (an) unsuccessful attempt to revoke ban on alcohol sales in petrol stations, with less than eight weeks (before it comes) into effect. Last week the Parliamentary committee on Economics supported the proposal to revoke the ban; pressure from alcohol (lobbyists) was severe. However, Nov. 10 eventually the Parliament voted to uphold the ban. This required intense NGO involvement in debate, presence in the committees, mobilizing local and international networks, civil society, politicians, and presence during actual voting. This time civil society was able to protect public health interest.   

In Estonia there seems to be varied response from business and media towards stricter alcohol control, some supportive, some adverse. What is the situation in Lithuania?
So far delusional self-interest at the cost of overall society seems to be the common denominator of anti-control lobby. The arguments employed would be funny, if not in full seriousness repeated by politicians with special interests. They claim that petrol stations will not be able to make money, will have to close and fire people, old ladies in the villages will die in droves, since they will be forced to buy moonshine. In contrast most of the young and old ladies in Lithuania are killed by men drunk with cheap and available alcohol. There are also articles in media casting doubt about the levels of harm and consumption. Yet, small differences seem to be appearing in the way the alcohol issue is reported in internet channels, but they do not constitute a trend yet. They might signal a separation between oligarch type of media and modern means of information. At the same time progress in ethics and social responsibility in the business community is lacking. On the contrary – unrelated industries such as Nordic Banks get involved in promotion of alcohol brands in sports events. Even the supposedly ethical chain Statoil blackmailed Lithuanian government demanding to allow alcohol sales at night in 2008, at the time when Norwegian state had shares there. Now it is fully owned and operated by a Canadian retail chain.

How relevant are Nordic style alcohol policy restrictions for Lithuania?
As a country we’re experiencing enormous amounts of mortality, health, and social costs due to alcohol. Nordic model therefore would be evidence-based and cost-effective measure to reduce this harm. The political will for it, however, seems to be uncertain. Lithuania is moving towards the Nordic model, it’s just that the progress is painstakingly slow. When we eventually get there, there might be too few benefactors left. However, to ensure (the) future of this model in Baltic countries, we need to protect it in the countries of origin. Despite evidence of its effectiveness, there are attempts to subvert the measures, even in Iceland where population strongly supports alcohol monopoly. The conclusions of the article in 2014 “Overturn of the proposed alcohol advertising ban in Lithuania” calling for international regulation and systematic monitoring of industry’s influence on lawmaking are still very relevant today.    

Romualds Razuks

The WHO Report shows that legal alcohol consumption and harm in Latvia is increasing. Is there political will to tackle this problem?  
Increasing alcohol consumption in Latvia might be due to restored economic growth in Latvia, which helped reduce unemployment and poverty. There are fewer people with very low income, therefore fewer buy illegal alcohol. I believe that total consumption is relatively stable ... Latvian public is highly supportive of control policies, together with dozens of NGOs, medical, and academic societies. During my political career I have never experienced a protest from general public against political decisions to curb alcohol use.  
Of course, our society still has faulty traditions pertaining to alcohol. Thus during Latvian European Council Presidency in 2015 there was a scandal about (a) special souvenir produced for that occasion: bottles of high-quality strong alcohol called “Vodka.”  Astonishingly most reacted to the name, rather than content. General public perceives vodka as a Russian and not a Latvian drink, therefore unsuitable. This attests just how important is readiness of the society. Politicians can’t afford to run more than (a) few steps ahead. I would say that there is a strong political will and readiness to tackle alcohol problem among politicians and civil society in Latvia.

What are the newest initiatives in the Latvian Parliament regarding alcohol control?
On Nov. 2 in the Latvian Parliament we adopted our budget for 2016 in parallel with the midterm budgets for 2016, 2017, and 2018 during the first reading. Both budgets include proposals to increase excise tax for alcohol ... One of the latest debates is also regarding prohibition of alcohol sales in petrol stations. Due to very active interference from alcohol lobbyists, we have failed on this issue before, but we are ready to proceed with this initiative again. Hopefully the proposed and those already-implemented measures will help decrease the shocking numbers of lung cancer, alcoholic psychosis, and alcohol related liver diseases. Sadly, Latvian indicators in this area are among the worst in the world.  

Is there an interest to implement Nordic style control for alcohol?
Since declaration of independence 25 years ago, alcohol has been sold with few constraints, so state monopoly on alcohol as in Nordic countries is not very likely any time soon. Instead Latvia is building a system of restrictions. We are similar to the Nordic model in advertising and time of sale restrictions, steady increase in prices of alcoholic beverages. The trend will continue in our region (in the near) future.

What are the main challenges for stricter controls?
The main challenge is the strong lobby of alcohol producers and importers. Traditionally we had many enterprises for production of strong alcohol, champagne, breweries of varied size. Together they can afford to fund campaigns, pay lobbyists, and forward their agenda politically ... The progress is slow.
Latvia, together with other Baltic countries, has huge potential for additional restrictive measures against alcohol, especially the availability. To put things in perspective, immediately after independence alcohol shops were open 24/7, but gradually time limits were introduced and now alcohol is sold from 8:00 to 22:00 in Latvia and Lithuania and from 10:00 to 22:00 in Estonia.

Vaida Liutkute is a junior researcher at the Lithuanian University of Health Sciences