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Aims: The study's aim is to identify and classify the most important alcohol control policies in the Baltic countries (Estonia, Latvia and Lithuania) and Poland between 2000 and 2020. Methods: Policy analysis of Baltic countries and Poland, predicting potential policy impact on alcohol consumption, all‐cause mortality and alcohol‐attributable hospitalizations was discussed. Results: All Baltic countries implemented stringent availability restrictions on off‐premises trading hours and different degrees of taxation increases to reduce the affordability of alcoholic beverages, as well as various degrees of bans on alcohol marketing. In contrast, Poland implemented few excise taxation increases or availability restrictions and, in fact, reduced stipulations on prior marketing bans. Conclusions: This classification of alcohol control policies in the Baltic countries and Poland provides a basis for future modeling of the impact of implementing effective alcohol control policies (Baltic countries), as well as the effects of loosening such policies (Poland). [ABSTRACT FROM AUTHOR]

Aim: To estimate whether large macroeconomic fluctuations in the 2000s affected inequalities in alcohol‐related mortality in the Baltic countries and Finland. Design Longitudinal register‐based follow‐up study. Setting: Estonia, Latvia, Lithuania and Finland. Participants: General population in the 35–74 age group. Measurements Socioeconomic status was measured by the highest achieved educational level and was categorised using the International Standard Classification of Education 2011 as low (included categories 0–2), middle (3–4), and high (5–8). Educational inequalities in alcohol‐related mortality in 2000–2003, 2004–2007, 2008–2011 and 2012–2015 were examined using census‐linked longitudinal mortality data. We estimated age‐standardised mortality rates and the relative and slope index of inequality. Findings Alcohol‐related mortality increased in all countries in 2004–2007 except among Estonian women and decreased/remained the same from 2008 onward except among Latvian men. By 2012–2015 alcohol‐related mortality was still higher than in 2000–2003 in Finland, Latvia and Lithuania (women only). Relative inequalities increased across the study period in all countries (significantly in Lithuania and Latvia). The 2004–2007 increase in relative inequalities was mostly driven by a larger mortality increase among the low educated, whereas in 2008–2011 and in 2012–2015 inequalities often increased because of a larger relative mortality decline among the high educated. However, these period changes in relative inequalities and between educational groups were often not statistically significant. Absolute inequalities were larger in 2012–2015 versus 2000–2003 in all countries except Estonia (decrease). Conclusion: In the Baltic countries and Finland, alcohol‐related mortality tended to increase faster among the low educated during a period of economic expansion (2004–2007) and decrease more among the high educated during a period of economic recession (2008–2011). [ABSTRACT FROM AUTHOR]

Within the global context, Eastern Europe has been repeatedly identified as the area with the highest levels of alcohol-related health harms. Although the Berlin Wall fell in 1989, and the Soviet Union collapsed soon afterwards, alcohol-related mortality in Eastern Europe remains far higher than in Western Europe. However, despite the high burden of alcohol harm and mortality in Eastern Europe, with the partial exception of Russia, relatively little is known about the country-specific impact of alcohol on health and mortality and the various policy responses to it. In response to this, an international symposium was held in Vilnius, Lithuania in June 2017 entitled Persisting burden of alcohol in Central and Eastern Europe: recent evidence and measurement issues. This special section of Drug and Alcohol Review is based on a selection of the papers presented at this symposium, providing for the first time a broad overview of the problem of alcohol-related mortality in a diverse range of Eastern European countries linked to a description and analysis of alcohol control initiatives that have been developed. While there is strong evidence of the influence of history, culture and education across European countries having a profound and persistent effect on differences in drinking patterns and preferences, there is, nevertheless, evidence that effective policy responses have been mounted in a range of countries. [ABSTRACT FROM AUTHOR]

Introduction and Aims. Globally, Czechia and Lithuania are among the top‐ranking countries in terms of high alcohol consumption. This study highlights notable contrasts in temporal trends in alcohol‐related mortality and identifies country‐specific patterns in educational differences. Design and Methods. The study uses harmonised cause‐of‐death series from the Human Cause of Death Database. Mortality disparities by education were assessed using census‐linked mortality data. Directly standardised death rates were used to estimate levels of national and group‐specific mortality. Relative and absolute mortality differences by education were assessed by range‐type measures (Poisson regression mortality ratios and rate differences) and Gini‐type measures. Results. Between 1994–1995 and 2016, the absolute difference between Czechia and Lithuania in terms of alcohol‐related age‐standardised death rates (per 1 000 000) decreased from 450 for males and 130 for females to 76 in males and 11 in females. In both countries, alcohol‐related mortality was markedly higher among persons of lower education levels. Lithuanian males experienced the highest absolute inequalities measured by rate difference between the low and high educated (740 per million), while Lithuanian females showed the most pronounced relative inequalities (6.70‐fold difference between low and high educated). The corresponding figures were less than half for Czechia. Discussion and Conclusions. Reducing educational disparities in alcohol‐related mortality within both countries would have a substantial impact on overall levels. Policies aimed at targeting the lowest priced and illegal alcohols and reducing levels of harmful drinking should be a priority, especially in Lithuania. [ABSTRACT FROM AUTHOR]

Introduction and Aims: Eastern Europe is known to suffer from a large burden of alcohol‐related mortality. However, persisting unfavourable conditions at the national level mask variation at the sub‐national level. We aim to explore spatial patterns of cause‐specific mortality across four post‐communist countries: Belarus, Lithuania, Poland and Russia (European part). Design and Methods: We use official mortality data routinely collected over 1179 districts and cities. The analysis refers to males aged 20–64 years and covers the period 2006–2014. Mortality variation is mainly assessed by means of the standardised mortality ratio. Getis‐Ord Gi* statistic is employed to detect hot and cold spots of alcohol‐related mortality. Results: Alcohol‐related mortality exhibits a gradient from very high levels in northwestern Russia to low levels in southern Poland. Spatial transitions from higher to lower mortality are not explicitly demarcated by national boundaries. Within these countries, hot spots of alcohol‐related mortality dominate the territories of northwestern and western Russia, eastern and northwestern Belarus, southeastern Lithuania, and eastern and central Poland. Discussion and Conclusions: The observed mortality gradient is likely associated with the spread of alcohol epidemics from the European part of Russia to the other countries, which appears to have started more than a century ago. Contemporary socioeconomic and demographic factors should be taken into account when developing anti‐alcohol policies. The same is true for the peculiarities of culture, norms, traditions and behavioural patterns observed in specific geographical areas of the four countries. Reducing alcohol‐related harm in the areas identified as hot spots should be prioritised. [ABSTRACT FROM AUTHOR]

Over the three last decades, Lithuania has reported some of the highest male suicide rates in the world. This paper relies on longitudinal census‐linked data for Lithuania covering the entire male population aged 30–64 years during the 2011–2017 period. The study uses multilevel modelling to examine the importance of the selected individual‐ and area‐level contextual characteristics. One of the key findings is the persistence of a suicide disadvantage among males living in rural areas. This disadvantage could not be explained by major sociodemographic characteristics and remained statistically significant for those individuals who migrated to urban areas. Unlike some other studies, we found that socio‐economic area‐level characteristics retained their significance after controlling for the major individual‐level characteristics. This evidence highlights the potential for policies aimed at improving area‐level conditions. [ABSTRACT FROM AUTHOR]

Introduction and Aims: Over the recent decades, Lithuania has reported very high alcohol-related harm and mortality indicators when compared to other countries. This, among other reasons, led to an adoption of comprehensive evidence-based alcohol control policy measures back in 2007 and 2016. The aim of this study is to examine alcohol-related male mortality in the context of changing alcohol control policies over the period 2000-2017.Design and Methods: The life table decomposition method was applied to estimate to what extent the age groups and causes of death are responsible for changes in male life expectancy in the period 2000-2017. Furthermore, a time series intervention model was used to study the impact of alcohol control measures on alcohol-related mortality. A seasonal autoregressive integrated moving average model was fitted.Results: Male life expectancy increased by 6.23 years in the period 2007-2017, mainly due to a decrease in mortality from external causes of death (2.12 years), cardiovascular diseases (1.84 years) and alcohol-related disorders (0.86 years). Reduced male mortality in the 30-64 years age group also contributed to a large increase in male life expectancy during the same period.Discussion and Conclusions: The greatest positive effect of reduced alcohol-related mortality to male life expectancy was observed during the period 2007-2009. It overlaps with the start of implementation of the comprehensive alcohol control measures. However, further research on the impact of different alcohol policy interventions on various outcomes is needed. [ABSTRACT FROM AUTHOR]

Lithuania represents one of the rare cases in which a state with relatively high standards for maintaining population statistics is experiencing mass emigration. In light of the policy initiatives undertaken by the Lithuanian government to address the issue of emigration, this study aims to improve our understanding of how, in this mass emigration context, emigration events are connected to specific socio-economic characteristics of individuals and variation in local socio-economic conditions. We analyse census and vital registration data covering the whole working-age population of Lithuania during the period 2011-2012. Our findings indicate that when assessing the likelihood of emigration events, individual-level characteristics such as employment status, educational attainment, and prior migration experience are highly relevant. However, the importance of these characteristics differs by gender. We also detect considerable spatial variation in emigration rates across Lithuanian municipalities. Our outcomes provide new insights for the development of cohesive migration policies in Lithuania. [ABSTRACT FROM AUTHOR]

Mortality data for 30 mostly developed countries available in the Kannisto–Thatcher Database on Old-Age Mortality (KTDB) are drawn on to assess the pace of decline in death rates at ages 80 years and above. As of 2004 this database recorded 37 million persons at these ages, including 130,000 centenarians (more than double the number in 1990). For men, the probability of surviving from age 80 to age 90 has risen from 12 percent in 1950 to 26 percent in 2002; for women, the increase has been from 16 percent to 38 percent. In the lowest-mortality country, Japan, life expectancy at age 80 in 2006 is estimated to be 6.5 years for men and 11.3 years for women. For selected countries, average annual percent declines in age-specific death rates over the preceding ten years are calculated for single-year age groups 80 to 99 and the years 1970 to 2004. The results are presented in Lexis maps showing the patterns of change in old-age mortality by cohort and period, and separately for men and women. The trends are not favorable in all countries: for example, old-age mortality in the United States has stagnated since 1980. But countries with exceptionally low mortality, like Japan and France, do not show a deceleration in death rate declines. It is argued that life expectancy at advanced ages may continue to increase at the same pace as in the past. [ABSTRACT FROM AUTHOR]

The author offers comments on the article "Alcohol control policy and changes in alcohol-related traffic harm" by J. Rehm, which appears in the current issue.