The Green Paper on Alcohol Policy has been Estonia’s strategy document for addressing alcohol-related harms since 2013. Its objectives include: reducing alcohol consumption and curbing harmful drinking patterns; preventing underage drinking; minimizing alcohol-related crime, social problems and health damage; and developing treatment and rehabilitation services for alcohol dependence.This technical report evaluates the public health impact of the Green Paper and associated policies, providing evidence-based insights for future alcohol control efforts in Estonia. The evaluation analyses alcohol consumption and related harms in Estonia from 2000 to 2023, focusing on periods before and after the implementation ofthe Green Paper’s recommendations.Following the Green Paper’s adoption (2013–2019), adult per capita alcohol consumption in Estonia decreased notably. Key indicators, such as age-standardized all-cause mortality and life expectancy at birth, demonstrated positive trends until the onset of the coronavirus disease pandemic. Evaluation of specific indicators revealedmixed outcomes: while there was a notable reduction in alcohol consumption and intoxication among minors, the target of reducing the annual population alcohol consumption to under 8 L per capita was not achieved. Although policy implementation coincided with decreases in alcohol-attributable injuries and mortality rates,it is challenging to attribute these improvements solely to the Green Paper.
Authors
- Citation
- World Health Organization. Regional Office for Europe . (2024). Evaluation of the Estonian Green Paper on Alcohol Policy. World Health Organization. Regional Office for Europe. https://iris.who.int/handle/10665/377091 . License: CC BY-NC-SA 3.0 IGO
- ISBN
- 9789289061124 (PDF)
- Published in
- Switzerland
- Rights
- CC BY-NC-SA 3.0 IGO
- Rights Holder
- World Health Organization
- Rights URI
- https://creativecommons.org/licenses/by-nc-sa/3.0/igo
Table of Contents
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- Acknowledgements 5
- Abbreviations 6
- Executive summary 7
- 1.Context and aims of the study 10
- 1.1. Brief overview of the development of Estonian alcohol control policy 11
- 1.2. Alcohol consumption and the burden of mortality and disease in Estonia 11
- 1.2.1. Trends in age-standardized alcohol-attributable disease burden between 2010 and 2019 11
- 1.2.2. Alcohol-attributable disease and mortality burden in 2019 12
- 1.3. Alcohol consumption patterns and alcohol consumption as a public health problem in Estonia 14
- 1.4. Aim and scope of the study 17
- 1.5. Analytical approach, data and methods 19
- 2. Results 21
- 2.1. Impacts on the level of alcohol consumption 22
- 2.1.1. APC 22
- 2.1.2. Indicators of alcohol consumption by minors 24
- 2.2. Impacts on alcohol availability 26
- 2.3. Impacts on mortality and life expectancy 28
- 2.3.1. All-cause mortality and life expectancy 28
- 2.3.2. Alcohol-attributable injuries and fatalities following injury: measuring a formal indicator of the Green Paper 29
- 2.4. Alcohol-attributable morbidity, treatment and costs in Estonia 30
- 2.5. Social harm associated with alcohol use 32
- 2.5.1 Traffic indicators 32
- 2.5.2 Crime indicators 34
- 2.6. Statistical evaluation of single policy measures in Estonia: taxation 35
- 2.6.1. Level of alcohol consumption 35
- 2.6.2. Mortality indicators 35
- 2.6.3. Changes in excise taxes for alcohol and cross-border trade 36
- 2.6.4. Tax revenues 36
- 2.7. Public perception of and expert opinion on alcohol control policies and the impact of the Green Paper 37
- 2.7.1. Public perception 37
- 2.7.2. Experts’ perspectives 38
- 3. Policy considerations 40
- Annexes 43
- Annex 1. Supplementary figures and tables 44
- Annex 2. Mapping the Green Paper’s proposed measures to the WHO Global Strategy to reduce harmful alcohol use 50
- Annex 3. Alcohol policy expert survey: methodology and key findings 55
- References 61
