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Background and aims: Previously identified national drinking patterns in Europe lack comparability and might be no longer be valid due to changes in economic conditions and policy frameworks. We aimed to identify the most recent alcohol drinking patterns in Europe based on comparable alcohol exposure indicators using a data‐driven approach, as well as identifying temporal changes and establishing empirical links between these patterns and indicators of alcohol‐related harm. Design: Data from the World Health Organization's monitoring system on alcohol exposure indicators were used. Repeated cross‐sectional hierarchical cluster analyses were applied. Differences in alcohol‐attributable harm between clusters of countries were analyzed via linear regression. Setting: European Union countries, plus Iceland, Norway and Ukraine, for 2000, 2010, 2015 and 2019. Participants/Cases: Observations consisted of annual country data, at four different time points for alcohol exposure. Harm indicators were only included for 2019. Measurements Alcohol exposure indicators included alcohol per capita consumption (APC), beverage‐specific consumption and prevalence of drinking status indicators (lifetime abstainers, current drinkers, former drinkers and heavy episodic drinking). Alcohol‐attributable harm was measured using age‐standardized alcohol‐attributable Disability‐Adjusted Life Years (DALYs) lost and deaths per 100 000 people. Findings The same six clusters were identified in 2019, 2015 and 2010, mainly characterized by type of alcoholic beverage and prevalence drinking status indicators, with geographical interpretation. Two‐thirds of the countries remained in the same cluster over time, with one additional cluster identified in 2000, characterized by low APC. The most recent drinking patterns were shown to be significantly associated with alcohol‐attributable deaths and DALY rates. Compared with wine‐drinking countries, the mortality rate per 100 000 people was significantly higher in Eastern Europe with high spirits and 'other' beverage consumption [ β^ = 90, 95% confidence interval (CI) = 55–126], and in Eastern Europe with high lifetime abstainers and high spirits consumption (β^ = 42, 95% CI = 4–78). Conclusions: European drinking patterns appear to be clustered by level of beverage‐specific consumption, with heavy episodic drinkers, current drinkers and lifetime abstainers being distinguishing factors between clusters. Despite the overall stability of the clusters over time, some countries shifted between drinking patterns from 2000 to 2019. Overall, patterns of drinking in the European Union seem to be stable and partly determined by geographical proximity. [ABSTRACT FROM AUTHOR]

Objective To validate a Russian-language version of the World Health Organization's Alcohol Use Disorders Identification Test (AUDIT). Methods We invited 2173 patients from 21 rural and urban primary health-care centres in nine Russian regions to participate in the study (143 declined and eight were excluded). In a standardized interview, patients who had consumed alcohol in the past 12 months provided information on their sociodemographic characteristics and completed the Russian AUDIT, the Kessler Psychological Distress Scale and the Composite International Diagnostic Interview to identify problem drinking and alcohol use disorders. We assessed the feasibility of administering the test, its internal consistency and its ability to predict hazardous drinking and alcohol use disorders in primary health care in the Russian Federation. Findings Of the 2022 patients included in the study, 1497 were current drinkers with Russian AUDIT scores. The test was internally consistent with good psychometric properties (Cronbach's a : 0.842) and accurately predicted alcohol use disorders and other outcomes (area under the curve > 75%). A three-item short form of the test correlated well with the full instrument and had similar predictive power (area under the curve > 80%). We determined sex-specific thresholds for all outcomes, as non- specific thresholds resulted in few women being identified. Conclusion With the validated Russian AUDIT, there is no longer a barrier to introducing screening and brief interventions into primary health care in the Russian Federation to supplement successful alcohol control policies. Objectif Valider une version russe du test AUDIT (Alcohol Use Disorders Identification Test) de l'Organisation mondiale de la Sante. Methodes Nous avons invite 2173 patients originaires de 21 centres de soins de sante primaires repartis dans neuf regions du pays, tant en milieu rural qu'urbain, a participer a cette etude (143 ont refuse et huit ont ete exclus). Lors de chaque entretien standardise, les patients ayant consomme de l'alcool au cours des 12 derniers mois ont fourni des informations sur leurs caracteristiques sociodemographiques et complete l'AUDIT russe, l'Echelle de detresse psychologique de Kessler ainsi que le Questionnaire composite international pour le diagnostic afin d'identifier les problemes de boisson et les troubles lies a l'abus d'alcool. Nous avons evalue la faisabilite du test, sa coherence interne et sa capacite a predire toute consommation dangereuse ou trouble lie a l'abus d'alcool dans le cadre des soins de sante primaires en Federation de Russie. Resultats Sur les 2022 patients inclus dans l'etude, 1497 se sont vus octroyer un score par l'AUDIT russe. Le test a fait preuve de coherence interne et affiche de bonnes proprietes psychometriques (Cronbach a: 0,842). Il a egalement predit avec justesse les troubles lies a l'abus d'alcool, mais aussi d'autres consequences (aire sous la courbe > 75%). Une version plus courte du test, comportant seulement trois elements, s'est bien accordee avec l'instrument complet et offrait une valeur predictive similaire (aire sous la courbe > 80%). Pour l'ensemble des observations, nous avons determine des seuils en fonction du genre car dans le cas contraire, le nombre de femmes identifiees etait peu eleve. Conclusion Grace a la validation du test AUDIT russe, aucun obstacle ne subsiste en matiere de depistage et d'intervention rapide dans les centres de soins de sante primaires de la Federation de Russie. Ces derniers peuvent ainsi s'ajouter aux politiques efficaces de lutte contre l'alcoolisme. Objetivo Validar una version en ruso del Test de Identificacion de Trastornos debidos al Consumo de Alcohol (AUDIT, por sus siglas en ingles) de la Organizacion Mundial de la Salud. Metodos Invitamos a participar en el estudio a 2.173 pacientes de 21 centros de atencion primaria rurales y urbanos de nueve regiones rusas (143 se negaron y ocho fueron excluidos). En una entrevista estandarizada, los pacientes que habian consumido alcohol en los ultimos 12 meses proporcionaron informacion sobre sus caracteristicas sociodemograficas y completaron el AUDIT ruso, la Escala de malestar psicologico de Kessler y la Entrevista Diagnostica Internacional Compuesta para identificar el consumo problematico de alcohol y los trastornos por consumo de alcohol. Se evaluo la viabilidad de la administracion de la prueba, su consistencia interna y su capacidad para predecir el consumo peligroso de alcohol y los trastornos por consumo de alcohol en los centros de atencion primaria de la Federacion Rusa. Resultados De los 2.022 pacientes incluidos en el estudio, 1.497 eran consumidores de alcohol con puntuaciones en el AUDIT. La prueba demostro consistencia interna con buenas propiedades psicometricas (Cronbach a : 0,842). Tambien predijo con precision los trastornos por abuso de alcohol, pero tambien otras consecuencias (area bajo la curva > 75%). Una version mas corta de la prueba con solo tres items se correlaciono bien con el instrumento completo y ofrecio un valor predictivo similar (area bajo la curva > 80%). Se determinaron umbrales especificos por sexo para todos los resultados, ya que los umbrales no especificos identificaron a pocas mujeres. Conclusion Con la validacion del AUDIT ruso, ya no existe ningun obstaculo para el cribado y la intervencion temprana en los centros de atencion primaria de la Federacion Rusa. Estas pueden anadirse a las politicas eficaces de control del consumo de alcohol., Introduction In September 2018, the World Health Organization (WHO) released SAFER, a new initiative and technical package outlining five high-impact strategies that can help governments to reduce the harmful use [...]

Objectives: This paper describes the design and implementation of an online survey experiment to investigate the effects of alcohol warning labels on alcohol‐related knowledge, risk perceptions and intentions. Method: The survey collected self‐reported data from 14 European countries through two waves of data collection with different recruitment strategies: dissemination via social media and public health agencies was followed by paid‐for Facebook ads. The latter strategy was adopted to achieve broader population representation. Post‐stratification weighting was used to match the sample to population demographics. Results: The survey received over 34,000 visits and resulted in a sample size of 19,601 participants with complete data on key sociodemographic characteristics. The responses in the first wave were over‐representing females and higher educated people, thus the dissemination was complemented by the paid‐for Facebook ads targeting more diverse populations but had higher attrition rate. Conclusion: Experiments can be integrated into general population surveys. Pan‐European results can be achieved with limited resources and a combination of sampling methods to compensate for different biases, and statistical adjustments. [ABSTRACT FROM AUTHOR]

Objective: To inform strategies aimed at improving blood pressure (BP) control and reducing salt intake, we assessed educational inequalities in high blood pressure (HBP) awareness, treatment and control; physician's advice on salt reduction; and salt knowledge, perceptions and consumption behaviours in Eastern Europe and Central Asia. Design: Data were collected in cross-sectional, population-based nationally representative surveys, using a multi-stage clustered sampling design. Five HBP awareness, treatment and control categories were created from measured BP and hypertension medication use. Education and other variables were self-reported. Weighted multinomial mixed-effects regression models, adjusted for confounders, were used to assess differences across education categories. Settings: Nine Eastern European and Central Asian countries (Armenia, Azerbaijan, Belarus, Georgia, Kyrgyzstan, Republic of Moldova, Tajikistan, Turkey and Uzbekistan). Participants: Nationally representative samples of 30 455 adults aged 25–65 years. Results: HBP awareness, treatment and control varied substantially by education. The coverage of physician's advice on salt was less frequent among participants with lower education, and those with untreated HBP or unaware of their HBP. The education gradient was evident in salt knowledge and perceptions of salt intake but not in salt consumption behaviours. Improved salt knowledge and perceptions were more prevalent among participants who received physician's advice on salt reduction. Conclusions: There is a strong education gradient in HBP awareness, treatment and control as well as salt knowledge and perceived intake. Enhancements in public and patient knowledge and awareness of HBP and its risk factors targeting socio-economically disadvantaged groups are urgently needed to alleviate the growing HBP burden in low- and middle-income countries. [ABSTRACT FROM AUTHOR]

Background Alcohol increases cancer risk, but less is known about public awareness of this link. This scoping review summarizes recent findings on the public awareness of alcohol as a cancer risk factor in European Union and UK. Methods Four databases (Web of Science, MEDLINE, PsycInfo, CINAHL) were searched for papers containing data on awareness of alcohol as cancer risk factor in EU or UK published between January 2017 and December 2022, and complemented with grey literature searches. Results In total, 45 studies were included covering 18 EU countries (Austria, Belgium, Cyprus, Czechia, Denmark, Finland, France, Germany, Hungary, Ireland, Italy, Netherlands, Poland, Romania, Slovakia, Slovenia, Spain, Sweden) and UK, presenting data collected between 2009 and 2022. Studies covered general population (17 studied a nationally representative sample), women, health professionals, patients and young people. Awareness of alcohol causing cancer in general was higher and studied more often than awareness of alcohol's impact on specific cancers. Among the EU general population, awareness of the link between alcohol and breast cancer ranged between 10% and 20%, head and neck cancer 15–25%, colorectal and oesophagus cancer 15–45% and liver cancer 40%. Awareness was higher among young people and specialized health professions and lower among women (the latter specifically for the breast cancer). Conclusions While awareness rates varied depending on the exact question wording, many studies showed low awareness of the alcohol-cancer link, especially for specific types such as breast and colon cancer. Public should be better informed about alcohol consumption-related cancer risk. [ABSTRACT FROM AUTHOR]

Aims: The Alcohol Use Disorders Identification Test (AUDIT) is one of the most widely used screening instruments worldwide. Although it was translated into many languages, not many country-specific adaptations exist, and a formal validation procedure of the Russian version has been carried out only recently. The present contribution documents the different steps taken to formally translate and adapt a Russian-specific version of the AUDIT (RUS-AUDIT). Methods: The AUDIT was translated into Russian following an established protocol, revised and adapted to the country context using an expert panel, and field-tested in an iterative approach, in line with WHO rules on instrument translation and adaptation A total of three pilot phases were carried out on 134 patients from primary healthcare (PHC) and 33 patients from specialised alcohol treatment facilities (narcology), guided by a specially established advisory board. Changes in each version were informed by the findings of the previous pilot phase and a thorough panel discussion. Results: Based on the findings of three different pilot phases, the RUS-AUDIT was developed as a paper-and-pencil interview for PHC professionals. Since various issues with representation and counting of standard drinks for the second test item arose, a special show card was developed to support the assessment. Preliminary AUDIT-C scores indicated that more than one-third of the screened women (34.2%) and about half of the screened men (50.9%) from PHC facilities have exceeded risk thresholds. Conclusions: The RUS-AUDIT was constructed as a feasible assessment tool for interviewers and patients. The large number of PHC patients who exceed the risk threshold has corroborated the need for formal validation and Russia-specific cut-off scores, considering the specific drinking patterns. [ABSTRACT FROM AUTHOR]

Introduction: There is an ongoing policy debate in the European Union regarding the best method of providing information to consumers on the health risks of alcohol use. One of the proposed channels is via the provision of QR codes. This study tested the usage rate of QR codes placed on point‐of‐sale signs in a supermarket in Barcelona, Catalonia over a 1‐week period. Methods: Nine banners with beverage‐specific health warnings in large text were prominently displayed in the alcohol section of a supermarket. Each banner provided a QR code of relatively large image size that linked to a government website providing further information on alcohol‐related harms. A comparison was made between the number of visits to the website and the number of customers in the supermarket (number of unique sales receipts) in a single week. Results: Only 6 out of 7079 customers scanned the QR code during the week, corresponding to a usage rate of 0.085%, less than 1 per 1000. The usage rate was 2.6 per 1000 among those who purchased alcohol. Discussion and Conclusions: Despite the availability of prominently displayed QR codes, the overwhelming majority of customers did not make use of the QR codes to obtain further information on alcohol‐related harms. This corroborates the results from other studies investigating customers' use of QR codes to obtain additional product information. Based on the current evidence, providing online access to information through QR codes will likely not reach a significant portion of consumers. [ABSTRACT FROM AUTHOR]

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]

Background: Despite a considerable reduction in alcohol consumption, Russia has one of the highest levels of alcohol-attributable burden of disease worldwide due to heavy episodic drinking patterns. Further improvement of alcohol control measures, including early provision of screening and brief interventions (SBI), is needed. The legislative framework for delivering SBI in Russia was introduced in 2013. As part of the creation and validation of a Russian version of the Alcohol Use Disorders Identification Test (AUDIT), the present contribution explored challenges in using the AUDIT in Russia to inform a subsequent validation study of the tool. Methods: Qualitative in-depth expert interviews with patients and healthcare professionals from four primary healthcare and narcology facilities in Moscow. A total of 25 patients were interviewed, 9 from a preventive medicine hospital, 8 from a polyclinic, and 9 from narcology clinics. Also, 12 healthcare professionals were interviewed, 5 of whom were primary healthcare doctors and 7 were narcologists. Results: Patients and healthcare professionals expressed difficulties in dealing with the concept of a "standard drink" in the AUDIT, which is not used in Russia. Various patients struggled with understanding the meaning of "one drinking occasion" on the test, mainly because Russian drinking patterns center around festivities and special occasions with prolonged alcohol intake. Narcology patients had specific difficulties because many of them experienced zapoi–a dynamic drinking pattern with heavy use and a withdrawal from social life, followed by prolonged periods of abstinence. Surrogate alcohol use was described as a common marker of alcohol dependence in Russia, not accounted for in the AUDIT. Conclusions: The provided analyses on the perception of the Russian AUDIT in different patient and professional groups suggest that a series of amendments in the test should be considered to capture the specific drinking pattern and its potential harms. [ABSTRACT FROM AUTHOR]

Background The Health in Prisons European Database (HIPED) aims to periodically collect data on prison health systems, services and health outcomes to inform equivalence of care for people living in prison. Recognized as the United Nations hub for health data in prisons, HIPED lacked an established framework to define its domains and indicators to measure progress. Therefore, the objectives of developing this framework were to inform surveillance systems at prison, local, regional, national and international level and to use it to guide improvement of prison health systems and cross-country comparison. Methods The framework was conceptualized through identification of policy priorities and existing frameworks, notably the WHO Health System Framework. A consultation with a range of WHO stakeholders was conducted evaluating the components of existing frameworks and their relevance to the prison health context, as well as identifying areas needing further emphasis. The final stage identified the structure of the framework. Results The framework consists of three main building blocks. The first captures the system-level aspects of prison health care (or inputs) whilst the second captures delivery aspects of prison health care (or outputs). These building blocks are in turn modified by two influencing factors. Ultimately, all these elements impact on the third building block, health outcomes. In addition, two cross-cutting principles associated with all these building blocks and influencing factors are included. Conclusions A new framework for assessing prison health system performance is now available, crucial to support informed decision-making for policy design and implementation for prisons and other places of detention. [ABSTRACT FROM AUTHOR]

Aims: To estimate prevalence of alcohol use disorders (AUD) and alcohol dependence (AD) for Russia in 2019, based on clients in primary health‐care facilities. Design Cross‐sectional assessment of AUD and AD. Prevalence estimates were cross‐validated using a treatment multiplier methodology. Setting: A total of 21 primary health‐care facilities, including dispanserization units (population health preventive care settings). Participants: A total of 2022 participants (986 women and 1036 men) 18 years of age and older. Measurements Composite International Diagnostic Interview. Findings The prevalence of AD and AUD was 7.0% [95% confidence interval (CI) = 5.9–8.1%] and 12.2% (95% CI = 10.8–13.6%), respectively. Marked sex differences were observed for the prevalence of AD (women: 2.8%; 95% CI = 1.7–3.8%; men: 12.2%; 95% CI = 10.3–14.1%) and AUD (women: 6.1%; 95% CI = 4.6–7.7%; men: 19.5%; 95% CI = 17.2–21.8%). Age patterns of AD and AUD prevalence were sex‐specific. Among women, the prevalence of AUD and AD was highest in the youngest age group and decreased with age. Among men, the prevalence of AUD and AD was highest among men aged 45–59 years. Sensitivity analyses indicated that the prevalence of AD as estimated using a treatment multiplier (6.5%; 95% CI = 5.0–8.9%) was similar to the estimates of the main analysis. Conclusions: Even though alcohol use has declined since 2003 in Russia, the prevalence of alcohol use disorders and alcohol dependence remains high at approximately 12 and 7%, respectively. [ABSTRACT FROM AUTHOR]

Background: Accurate and user-friendly assessment tools for quantifying alcohol consumption are a prerequisite for effective interventions to reduce alcohol-related harm. Digital assessment tools (DATs) that allow the description of consumed alcoholic drinks through animation features may facilitate more accurate reporting than conventional approaches. Objective: This review aims to identify and characterize freely available DATs in English or Russian that use animation features to support the quantitative assessment of alcohol consumption (alcohol DATs) and determine the extent to which such tools have been scientifically evaluated in terms of feasibility, acceptability, and validity. Methods: Systematic English and Russian searches were conducted in iOS and Android app stores and via the Google search engine. Information on the background and content of eligible DATs was obtained from app store descriptions, websites, and test completions. A systematic literature review was conducted in Embase, MEDLINE, PsycINFO, and Web of Science to identify English-language studies reporting the feasibility, acceptability, and validity of animation-using alcohol DATs. Where possible, the evaluated DATs were accessed and assessed. Owing to the high heterogeneity of study designs, results were synthesized narratively. Results: We identified 22 eligible alcohol DATs in English, 3 (14%) of which were also available in Russian. More than 95% (21/22) of tools allowed the choice of a beverage type from a visually displayed selection. In addition, 36% (8/22) of tools enabled the choice of a drinking vessel. Only 9% (2/22) of tools allowed the simulated interactive pouring of a drink. For none of the tools published evaluation studies were identified in the literature review. The systematic literature review identified 5 exploratory studies evaluating the feasibility, acceptability, and validity of 4 animation-using alcohol DATs, 1 (25%) of which was available in the searched app stores. The evaluated tools reached moderate to high scores on user rating scales and showed fair to high convergent validity when compared with established assessment methods. Conclusions: Animation-using alcohol DATs are available in app stores and on the web. However, they often use nondynamic features and lack scientific background information. Explorative study data suggest that such tools might enable the user-friendly and valid assessment of alcohol consumption and could thus serve as a building block in the reduction of alcohol-attributable health burden worldwide. [ABSTRACT FROM AUTHOR]

Aims: The aim of this contribution was to estimate the impact of the last significant alcohol taxation increase in Lithuania in 2017 on alcohol consumption, incident cancer cases, and cancer mortality, as well as the number of cancer outcomes that could have potentially been averted in 2018 had larger increases in alcohol excise taxation been applied. Design: Statistical modelling was used to estimate the change in alcohol per capita consumption following the tax increase, and alcohol-attributable fraction methodology was then used to estimate the associated cancer incidence and mortality. Potential increases of current excise duties were modelled in two steps. First, beverage-specific price elasticities of demand were used to predict the associated decreases in consumption and cancer outcomes, and second, the outcomes arising from the actual numbers and the modelled numbers were compared. Method: Data were taken from the following sources: alcohol consumption data from Statistics Lithuania and the WHO, cancer data from the International Agency of Research on Cancer, and risk relations and elasticities of demand from published meta-analyses. Results: A total of 15,857 new cancer cases (8,031 in women and 7,826 in men) and 8,534 cancer deaths (3,757 in women and 4,777 in men) were recorded in Lithuania in 2018. Using the attributable fraction methodology, we estimate that 4.8% of 761 of these new cancer cases were attributable to alcohol use (284 in women; 477 in men), as well as 5.5% or 466 cancer deaths (115 in women; 351 in men). With the taxation increase of 2017, 45 new cases and 24 deaths will be averted over the next 10 years. Further taxation increases of 100% could double the number of new cancer cases averted or saved. Conclusion: In a high-consumption European country like Lithuania, alcohol use is an important and avoidable risk factor for cancer. Taxation is an important measure to reduce the alcohol-attributable cancer burden. [ABSTRACT FROM AUTHOR]

Based on a literature search undertaken to determine the impacts of past public health crises, and a systematic review of the effects of past economic crises on alcohol consumption, two main scenarios-with opposite predictions regarding the impact of the current COVID-19 pandemic on the level and patterns of alcohol consumption-are introduced. The first scenario predicts an increase in consumption for some populations, particularly men, due to distress experienced as a result of the pandemic. A second scenario predicts the opposite outcome, a lowered level of consumption, based on the decreased physical and financial availability of alcohol. With the current restrictions on alcohol availability, it is postulated that, for the immediate future, the predominant scenario will likely be the second, while the distress experienced in the first may become more relevant in the medium- and longer-term future. Monitoring consumption levels both during and after the COVID-19 pandemic will be necessary to better understand the effects of COVID-19 on different groups, as well as to distinguish them from those arising from existing alcohol control policies. [ABSTRACT FROM AUTHOR]

The Alcohol Use Disorders Identification Test (AUDIT) is one of the most frequently used screening instrument for hazardous and harmful use of alcohol and potential alcohol dependence in primary health care (PHC) and other settings worldwide. It has been translated into many languages and adapted and modified for use in some countries, following formal adaptation procedures and validation studies. In the Russian Federation, the AUDIT has been used in different settings and by different health professionals, including addiction specialists (narcologists). In 2017, it was included as a screening instrument in the national guidelines of routine preventive health checks at the population-level (dispanserization). However, various Russian translations of the AUDIT are known to be in use in different settings and, so far, little is known about the empirical basis and validation of the instrument in Russia-a country, which is known for its distinct drinking patterns and their detrimental impact on health. The present contribution is the summary of two systematic reviews that were carried out to inform a planned national validation study of the AUDIT in Russia.Two systematic searches were carried out to 1) identify all validation efforts of the AUDIT in Russia and to document all reported problems encountered, and 2) identify all globally existing Russian translations of the AUDIT and document their differences and any reported issues in their application. The qualitative narrative synthesis of all studies that met the inclusion criteria of the first search highlighted the absence of any large-scale rigorous validation study of the AUDIT in primary health care in Russia, while a document analysis of all of the 122 Russian translations has revealed 61 unique versions, most of which contained inconsistencies and signaled obvious application challenges of the test.The results clearly signal the need for a validation study of the Russian AUDIT. [ABSTRACT FROM AUTHOR]

Background and aims: Alcohol use has been identified as a major risk factor for burden of mortality and disease, particularly for countries in eastern Europe. During the past two decades, several countries in this region have implemented effective alcohol policy measures to combat this burden. The aim of the current study was to measure the association between Lithuania's alcohol control policies and adult all‐cause mortality. Design Interrupted time–series methodology by means of general additive models. Setting: Lithuania. Participants: Adult population of Lithuania, aged 20 years and older. Measurements Alcohol control policies were ascertained via a document review of relevant legislation materials. Policy effects were evaluated as follows: (1) slope changes in periods of legislative (non‐)activity with regard to alcohol control policy (analysis 1); (2) level changes of three interventions following recommendations of the World Health Organization (analysis 2); and (3) level changes of seven interventions judged a priori by an international panel of experts (analysis 3). Mortality was measured by sex‐stratified and total monthly age‐standardized rates of all‐cause mortality for the adult population. Findings During the period 2001–18, effective alcohol control policy measures were implemented on several occasions, and in those years the all‐cause mortality rate declined by approximately 3.2% more than in years without such policies. In particular, the implementation of increased taxation in 2017 was associated with reduced mortality over and above the general trend for men and in total for all analyses, which amounted to 1452 deaths avoided (95% confidence interval = −166 to –2739) in the year following the implementation of the policy. Conclusions: Alcohol control policies in Lithuania appear to have reduced the overall adult all‐cause mortality over and above secular trends. [ABSTRACT FROM AUTHOR]

Introduction: Prevention of cancer has been identified as a major public health priority for Europe, and alcohol is a leading risk factor for various types of cancer. This contribution estimates the number of cancer cases that could have potentially been averted in 2018 in 4 European countries if an increase in alcohol excise taxation had been applied.Methods: Current country and beverage-specific excise taxation of 4 member states of the WHO European Region (Germany, Italy, Kazakhstan, and Sweden) was used as a baseline, and the potential impacts of increases of 20, 50, and 100% to current excise duties were modelled. A sensitivity analysis was performed, replacing the current tax rates in the 4 countries by those levied in Finland. The resulting increase in tax was assumed to be fully incorporated into the consumer price, and beverage-specific price elasticities of demand were obtained from meta-analyses, assuming less elasticity for heavy drinkers. Model estimates were applied to cancer incidence rates for the year 2018.Results: In the 4 countries, >35,000 cancer cases in 2018 were caused by alcohol consumption, with the highest rate of alcohol-attributable cancers recorded in Germany and the lowest in Sweden. An increase in excise duties on alcohol would have significantly reduced these numbers, with between 3 and 7% of all alcohol-attributable cancer cases being averted if taxation had been increased by 100%. If the 4 countries were to adopt an excise taxation level equivalent to the one currently imposed in Finland, an even higher proportion of alcohol-attributable cancers could be avoided, with Germany alone experiencing 1,600 fewer cancer cases in 1 year.Discussion/conclusion: Increasing excise duties can markedly reduce cancer incidence in European countries. [ABSTRACT FROM AUTHOR]

The article presents an update on the European Public Health Association (EUPHA) in Europe as of April 2021. Topics discussed include the discussion of public health futures and opportunities at the virtual European Public Health Conference 2021, plan of the EUPHA to adopt the open access model for the "European Journal of Public Health," and significance change in leadership at the EUPHAnxt network.

Issues The last Soviet anti‐alcohol campaign of 1985 resulted in considerably reduced alcohol consumption and saved thousands of lives. But once the campaign's policies were abandoned and the Soviet alcohol monopoly broken up, a steep rise in mortality was observed in many of the newly formed successor countries, although some kept their monopolies. Almost 30 years after the campaign's end, the region faces diverse challenges in relation to alcohol. Approach: The present narrative review sheds light on recent drinking trends and alcohol policy developments in the 15 Former Soviet Union (FSU) countries, highlighting the most important setbacks, achievements and best practices. Vignettes of alcohol control policies in Belarus, Estonia, Kazakhstan, Lithuania and Uzbekistan are presented to illustrate the recent developments. Key Findings: Over the past decade, drinking levels have declined in almost all FSU countries, paralleled by the introduction of various alcohol‐control measures. The so‐called three 'best buys' put forward by the World Health Organization to reduce alcohol‐attributable burden (taxation and other measures to increase price, restrictions on alcohol availability and marketing) are relatively well implemented across the countries. Implications: In recent years, evidence‐based alcohol policies have been actively implemented as a response to the enormous alcohol‐attributable burden in many of the countries, although there is big variance across and within different jurisdictions. Conclusion: Strong declines in alcohol consumption were observed in the 15 FSU countries, which have introduced various alcohol control measures in recent years, resulting in a reduction of alcohol consumption in the World Health Organization European region overall. [ABSTRACT FROM AUTHOR]

The article discusses that the alcohol adversely affects people around the world on a large scale even in nonpandemic times, with several deaths attributed to alcohol use each year. Topics discussed include during the pandemic, several countries have introduced total bans on alcohol sales, mainly aiming to minimize the risks of alcohol-fueled domestic violence under lockdowns, and reduce the burden to the healthcare system from alcohol-related health emergencies.

Aims: To study the impact of alcohol control policy measures (i.e. increases in taxation, restrictions on availability, including minimum purchasing age regulations, legislation on drink driving and advertisement bans) on alcohol‐related traffic harm in Lithuania between January 2004 and February 2019. Design Analyses of trend data on the proportion of alcohol‐related collisions and crashes, injury and mortality, adjusting for secular trends, seasonality, periods of alcohol control measure implementation and economic development. Generalized additive mixed models were used. Multiple sensitivity analyses were conducted. Setting: Lithuania. Cases Monthly number of alcohol‐related cases of traffic collisions and crashes, injuries and deaths. Interventions and comparators: Periods of time during which new alcohol control measures were implemented and/or augmented compared to periods when they were not. Measurements Monthly data for 2004 to 2019 from routine statistics of the Lithuanian Road Police Service. Findings All indicators decreased consistently and significantly after the implementation of alcohol control measures, including increased taxation, reduction of availability and a ban on advertisement, starting in 2014. On average, each implemented policy measure permanently reduced the proportion of alcohol‐attributable crashes by 0.55% [95% confidence interval (CI) = 0.21–0.90%; P = 0.002], the proportion of alcohol‐attributable injuries by 0.60% (95% CI = 0.24–0.97%; P = 0.001) and the proportion of alcohol‐attributable deaths by 0.13% (95% CI = 0.10–0.15%; P < 0.001). Conclusions: Alcohol control policy measures, including measures to reduce overall level of alcohol consumption, were associated with a marked decrease in alcohol‐related traffic harm. [ABSTRACT FROM AUTHOR]

Background This paper examines changes in substance use, and compares the resulting attributable burden of disease in the WHO European Region between 2010 and 2016. Methods Data for 2010 and 2016 on the number of deaths, years of life lost (YLL) and disability-adjusted life years (DALYs) lost were obtained by sex and country from the 2016 Global Burden of Disease (GBD) study. Exposure data for all substances except alcohol were obtained from the same study, while alcohol data were obtained from the WHO. Proportional changes were calculated for the WHO European Region as a whole to identify trends and for sub-regions to identify which regions contributed most to trends. Results In the WHO European Region in 2016, substance use caused 2.1 million deaths, 48.6 million YLL and 57.9 million DALYs lost, representing 22.4, 29.0 and 20.4% of all deaths, YLL and DALYs, respectively. The substance-attributable burden of disease was higher among men than women and highest in the eastern parts of the WHO European Region. Changes in the number of deaths, YLL and DALYs lost between 2010 and 2016 were almost uniformly downward, with the largest proportional changes observed for men. Exposure to tobacco, alcohol and illicit drugs also decreased uniformly. Conclusions Substance use and its attributable mortality and burden of disease have decreased in the WHO European Region since 2010. However, overall levels of substance use and the resulting burden of disease in the Region remain high compared with other regions of the world. [ABSTRACT FROM AUTHOR]

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Copyright of Portuguese Journal of Public Health / Revista Portuguesa de Saúde Pública is the property of Revista Portuguesa de Saúde Pública - Escola Nacional de Saúde Pública and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article reports on the decline of mortality rates in Russia, according to the Global Burden of Disease (GBD) 2016 Study. Topics mentioned include the contribution of substance, tobacco, and alcohol control policies in the reduction of mortality rates, the Federal Law (No. 15-FZ) which include smoke-free policy to public places, increased taxes for tobacco products, and sponsorhip bans that contributes in the reduction of smoking rates, and the importance of smoking prevention.