EG on Alcohol and Substance Abuse (ASA EG)

Fourth working Meeting

Moscow, Russia

12-13 March, 2012

Title / Minutes from the 4th Meeting of ASA EG
Submitted by / ITA in Coordination with the Chair
Summary / Note / This document recalls the main discussion points and decisions
made during the 4th Meeting of ASA EG

1.  Opening of the meeting and welcome

The Host, Prof.Eugenia Koshkina, National Research Center on Addictions, Russian Federation, opened the meeting and welcomed the participants. In her opening remarks she, inter alia, emphasized that the main goal of the meeting was to discuss the development of report by National Research Center on Addictions, Russian Federation. This activity is supported by the EUSBSR technical assistance and will be carried out in close collaboration with WHO Euro office.

, The Chair, Mr. Bernt Bull welcomed the participants and wished a successful meeting. He also gave some practical information related to the meeting.

The ASA EG welcomes a new member, nominated to the EG by Latvia, Mr. Mārcis Trapencieris. Mr.Trapencieris introduced himself. He is working at the National Health Service Center, in the department of addictions monitoring. He is also coordinator of ESPAD research in Latvia.

2.  Adoption of the Agenda

Meeting adopted the agenda (with timetable) with proposed additions and changes (submitted as document ASA 4/2/1).

3.  Country reports on recent developments in the field of Alcohol and Substance abuse policy developments

Before going to the agenda item, the Chair and ITA of the ASA EG, had briefed the EG members on the NDPHS issues and activities, which had taken place sincethe last meeting of the ASA EG.

In November 2011, the 8th Partnership Annual Conference (PAC) and its side event took place. The PAC discussed the outcome of a side event "Healthy lifestyle – the cornerstone of public health" that was organized by the NDPHS the day before the PAC and endorsed the NDPHS Action Statement for implementation of the European Strategy for prevention of NCDs.

One of the major events at the PAC was the signing of the Agreement on the Establishment of the Secretariat of the Northern Dimension Partnership in Public Health and Social Well-being.

In February, 2012, the meeting of the NDPHS EGs Chairs and ITAs took place in Helsinki. Among the several issues discussed were the implementation of the NDPHS Strategy and the Monitoring and reporting on the NDPHS progress. The last one was seen as a promising signal to review the reporting system by making it easier and less time consuming to develop.

Ms.Triinu Taht (Estonia) informed that Estonia is developing a Green Paper on alcohol Policy. 7 working groups are created to elaborate measures in accordance with WHO action plan. The inclusion of industry representatives from the very beginning of development of above mentioned document is considered as one of the strengths of proposed measures. It is foreseen that document will be ready within the one year. Estonia is also in the process of reorganization of National Health Plan, making it more flexible and more action oriented.

Mr.Bernt Bull (Chair, Norway) asked to clarify if the Green paper was to presented for and discussed by the Parliament.

Ms.Karin Nilsson-Kelly (Sweden) asked if plan was only for national level, or if it has components for local activities as well?

Ms.Triinu Taht (Estonia), clarified that document will be prepared for Government, but not for Parliament. It will have separate paragraphs on action both for the national and for the local level.

Mr.Janusz Sieroslawski (Poland) informed that Poland was organizing a presentation on the results of ESPAD study. The study shows increase in usage of cannabis, which raised a debatein the Country. A scientific seminar will be organized in order to analyze those developments. The project on Standardizing Measurement of Alcohol Related Troubles (SMART), funded within the framework of Public Health Programme, has finished in Poland. The aim of this project was to develop standardized comparative surveys methodology on heavy drinking, binge drinking (episodic heavy drinking), drunkenness, context of drinking, alcohol dependence and unrecorded consumption, as well as public support for alcohol policy measures, and to develop standardized methodology of cost-benefit analyses of alcohol policies to evaluate the economic impact of existing alcohol policies in the EU.

Mr.Bernt Bull (Chair), remarked that Norway is facing the stabilization of situation with harmful use of alcohol in the population concerning theESPAD age group, but there is a warning situation with elderly and grown up women age groups. So, follow up surveys on the developments within the current ESAPD groups, would be very interesting.

Mr.Janusz Sieroslawski (Poland), agreed and clarified that due to above mentioned reason, it is planned that the future SMART surveys will cover all age groups. He also added that according the results from the ESPAD study, there were changes in the drinking patters. If in the early 70-80s of last century, there were differences on alcohol consumption among the boys and girls, now this difference has disappeared.

Prof.Eugenia Koshkina (Russia), briefed the participants about the developments in the Russian Federation. She informed that Health promotion is prioritized in the agenda of current activities and as a result of that more than 500 new Health Prevention Centers for adults and 300 Centers for Children were opened on the whole territory of Russian Federation. One of the main functions of those centers is to offer risk factors assessment to the population and then implement preventive activities. Those centers are also carrying out early detection of substance addictions. The National Research center is now tasked to organize trainings for the health staff of those centers and develop special questionnaires/tests for the early detection of addiction. However, sample questionnaires for youth and children are problematic to find, in order to use them while developing the Russian analogues.

Ms.Triinu Taht (Estonia), informed that during the last several years, Estonia has become part of the so called FinBalt study (Finland plus 3 Baltic Countries). This study has some questions on youth health behaviour, which might be used by the Russian colleagues.

Ms.Karin Nilsson-Kelly (Sweden) raised the question if the Regional health Centers were getting financial support to run their activities. She also pointed out that issues related to the different ways/possibilities of implementation of national strategies, can be one of the topics for the future meetings of the ASA EG, and also an issue to be brought to the attention of the Politicians.

Prof.Eugenia Koshkina (Russia), clarified that the function of the Center is based on Co-financing principle and that Regions are covering 50% of running costs, which is also a good signal for the sustainability of those activities.

Russia is also a part of ESPAD research, but it covers only Moscow. Some results from the latest ESPAD survey were unexpected, like the decrease in use of Substance. In the meantime the use of inhalers is back to the level of 90s, and usage of ecstasy is on the level of 2,4% of surveyed population.

In the field of legislation, Russian Federation has introduced the increase in the minimum purchase age up to 21 years, and it also put limitations on Alco pops and Energetic drinks.

Mr.Bernt Bull (Chair) informed that currently there are 3 main topics within the field of Alcohol and Substance abuse, which are actively discussed in Norway. The first is preparation of comprehensive report to parliament on alcohol and drug use, including doping for non sport functions. One of the themes being discussed is usage of Heroin as a part of the treatment of addicts.). One of the challenges to be tackled by this report is to find out the ways of involvement other sectors, in addition to the Health, in the implementation of proposed activities. Another challenges to make health services more interested with the preventive work,.

Second issue is debates on EU regulations on TV advertisement,particularly related to the directive on audiovisual media services form 2010 which took over for the old TV-directive. Norway has decided to take on the directive, but will keep its ban on advertising aiming particularly at the Norwegian market.

The third issue relates to a matter of principles to be discussed by the EFTA court this spring. I concerns whether the Icelandic Wine monopoly can refuse a caffeinated alcohol drink to be sold through their shops

Ms.Gelena Kriveliene (Lithuania) informed the meetings participants that unfortunately the law with the aim of total banning of Alcohol advertisement was not presented to the Parliament, as it was agreed before. Electronic cigarettes are more and more coming to the Lithuania market, and with its heavy advertisement, it becomes difficult to deal with this problem. The new law was also passed, prohibiting the sale of Alcohol in the Kiosks. One of the problems facing by Lithuanian Health authorities is how to define the level of drunkenness, in order to deny client to buy an alcohol.

Mr.Bernt Bull (Chair) remarked that this is more the responsibility issue, which mostly lay on the shoulders of Alcohol provider/seller. In addition, visible intoxication from alcohol can always used be to deny selling of alcohol.

Ms.Karin Nilsson-Kelly (Sweden) mentioned that Sweden has special training courses for the restaurant staff, to decrease the violence in the restaurants and also how to recognize the intoxication. For some period the results of “Mystery shop” studies were used also for these purposes, but now this study is stopped due to some legal restrictions.

Mr.Janusz Sieroslawski (Poland) mentioned that Poland also has special regulations and rules prohibiting sale of alcohol to the drunken people.

Ms.Karin Nilsson-Kelly (Sweden) updated the ASA EG members on the current development in Sweden. The study on alcohol marketing is still under discussion. One of the main aims of the proposed study is to investigate the role of digital media in the Alcohol marketing and its impact. New organization for treatment and care of addicted people is created, with the long term objective of improved collaboration on the local level. Special campaign has been developed to assist the children from the families with Alcohol Problems. One of the target groups of his campaign is pregnant women. Total consumption of alcohol in Sweden went down by 10%, with women of age 45 and above drinking more. So, now special strategies will be developed for the elderly people.

Mr. Mārcis Trapencieris (Latvia) briefed on current development in Latvia. Country was also involved in 2 big studies, ESPAD and SMART. Now there is a plan to implement new study under the FINBALT initiative, and currently questionnaire for this study is under the discussions. Latvia has adopted 2 strategies, one on Public Health (covering 2012-2017) and Drug prevention Strategy for the period of 2013-2017. The alcohol plan for 2012-2014 is now submitted to the Cabinet of Ministers. This document is seen more as a strategy defined document, so no money are allocated for specific actions. It is planned that from 2013, Latvia will ban Alcohol from the gas stations and from 2014 Alcohol could be sold only in specialized places. Discussions are on-going on revision of Alcohol taxation in order to adjust it to the current Economical crisis and inflation rates.

The Meeting took note of the presented information

4.  Development of joint report with WHO EURO

In accordance with the agreement from the previous meetings of ASA EG and EUSBSR Technical assistance support for the ASA Expert Group, the National Research Centre on Addiction of Russian Federation was tasked to develop a joint report with WHO, using the data from who survey on Alcohol policy in EU-countries and Russia.

Mr.Bernt Bull (Chair) suggested to give prioritity to 2-3 topics from the Survey questionnaire, as a main elementof the ASA EG report. He also suggested avoiding questions with quantitative measurement, as many times data collected in different countries is incomparable.

Prof.Eugenia Kohskina (Russia) remarked that it would be interesting to concentrate the efforts in analyzing issues related to Alcohol Policy implementation, regulations and health sector responses.

Mr. Mārcis Trapencieris (Latvia) recommended trying and comparing data from EU countries with Russia, which can bring added value to the work implemented by WHO.

Mr.Janusz Sieroslawski (Poland) suggested going through the new WHO report and seeing what kind of information is missing, in order to add that from the NDPHS side.

The ASA EG decided that based on WHO questionnaire, the National Research Center on Addictions, Russian Federation, will select up to 20 questions within the 3 suggested topics till the April 15th. Those questions will be distributed among the ASA EG members and WHO, for revision and approval by May 1st. The Partner Countries will then submit answers to these questions, which together with the data from Russia will be analyzed and compiled in the report from the ASA EG.

5.  Discussion of proposal to establish sub –group for development of possible Policy recommendation for the PAC meeting in 2013

Mr.Bernt Bull (Chair) proposed to create a small working group within the ASA EG, in order to develop suggestions for the possible policy advises for the NDPHS partner countries, by end of 2013. The main objective of this group will be to raise the issues and problems which are common for the Partner countries, in the field of Harmful use of Alcohol and invite Policy makers to discuss those issues and make decision. Final aim will be to come up with the document for the Politicians to be discussed at the PAC meeting in 2013.

Mr.Bernt Bull (Chair) suggested including young researchers to this group, who can make a literature review and collect information on the selected topics, which will be chosen by the ASA EG, in order to analyze info and develop policy recommendations. He suggested to include Ms.Mariliis Tael, from Estonia, who had developed the ASA EG Thematic report on Alcohol Policies.

Prof.Eugenia Koshkina (Russia) agreed with this suggestion and has nominated Mr. Konstantin Vishinski, to the sub working group.

Mr.Janusz Sieroslawski (Poland) expressed willingness to participate in the work of sub group. Mr.Bernt Bull,Ms.Triinu Taht and Dr.Zaza Tsereteli had also joined this group.

It was decided that ASA EG will seek funds to organize the work and meetings of the sub-group on Policy development. In the meantime the ASA EG members will continue discussions in order to select possible topics for the development of Policy recommendations in the selected fields.