Rice Peter
Steering Group Chair, Scottish Health Action on Alcohol Problems, Royal College of Physicians of Edinburgh, 12 Queen Street, Edinburgh, UK.
Alcohol Alcohol. 2019 Mar 1;54(2):123-127. doi: 10.1093/alcalc/agz013.
This paper briefly reviews the history of alcohol policy development in Europe leading to the current consensus in the health field on strategic priorities. There is a review of recent policy developments in selected European countries, both EU and non-EU members.
Narrative review of published journal articles, publications from WHO, and other health organisations and government publications.
The implementation of the WHO policy priorities has been variable across Europe. At EU level, there has been a recent pattern of trade considerations taking priority over health and a disinvestment in alcohol research and advocacy. Among EU member states new implementation of WHO strategies have been limited to a few smaller countries and regions. In Russia, there have been considerable falls in mortality following the introduction of controls on price, availability and marketing.
The implementation of WHO strategy at national level in Europe is highly dependent on the local political circumstances. Where there is concern about alcohol harm and political will, the WHO strategic priorities have been highly influential.In order to build public and political support for prevention, alcohol policy advocates should ensure that there is good data on trends within age, gender, and income groups and develops policies to respond to these trends. The concept of proportionate universalism, where interventions are understood to have a broad population effect but the effect is greater on the groups most in need, may be more useful than the traditional alcohol policy field conceptualisations of whole population and targeted measures.
本文简要回顾了欧洲酒精政策的发展历程,这一历程促成了目前健康领域在战略重点上的共识。本文还审视了部分欧洲国家(包括欧盟成员国和非欧盟成员国)近期的政策发展情况。
对已发表的期刊文章、世界卫生组织及其他卫生组织的出版物以及政府出版物进行叙述性综述。
世界卫生组织的政策重点在欧洲各地的实施情况各不相同。在欧盟层面,近期出现了贸易考量优先于健康、减少对酒精研究和宣传投入的趋势。在欧盟成员国中,世界卫生组织战略的新实施仅限于少数几个较小的国家和地区。在俄罗斯,对价格、供应和营销实施管控后,死亡率大幅下降。
世界卫生组织战略在欧洲国家层面的实施高度依赖当地政治环境。在存在对酒精危害的担忧和政治意愿的地方,世界卫生组织的战略重点具有很大影响力。为了建立公众和政治对预防工作的支持,酒精政策倡导者应确保掌握有关年龄、性别和收入群体趋势的良好数据,并制定应对这些趋势的政策。相称普遍主义的概念,即干预措施被认为对广大人群有影响,但对最需要的群体影响更大,可能比传统酒精政策领域对全体人群和针对性措施的概念化更有用。