Finland

Dr Eeva Ollila: As long as alcohol advertising is allowed, campaigns may be of limited effectiveness

More attention to the negative effects of alcohol in terms of increasing many chronic diseases, including cancer, should be paid, argues dr Eeva Ollila, Senior Medical Officer at the Cancer Society of Finland. 

Lauri BeekmannHow strongly would you rate alcohol as a cancer risk factor? Some are saying that, yes, alcohol is carcinogenic, but the risk is small. Should we start treating alcohol more like tobacco, thinking of policy measures?

Eeva Ollila: The scientific evidence on the carcinogenic nature of alcohol is clear. Used together with tobacco products, the effect is significantly stronger. 

Traditionally alcohol has in the Nordic countries been mostly looked from the social policy perspective, and measures to restrict access to alcohol were traditionally in the core of the Nordic approach. In that perspective, one could argue that the approach was similar to that of tobacco policies. This Nordic approach was very different from the traditional approach to alcohol policies of the EU, where it is looked more from the point of view of agricultural policies. 

Finland has liberalized its alcohol policy much more than, for example, Sweden. This has most likely been both because Finland’s other objectives in terms of agricultural policies have been stressed in its EU level policies, and because there have been domestic pressures to liberalize alcohol policies, at least partly due to close links with parts of the alcohol industry with important political actors. 

So the answer is yes, we should see policy measures as the core, even if the comparison to tobacco policies has some limitations, including but not limited to differences in the global legal framework. 

As in other countries, also Finland has a rather low awareness of alcohol and cancer link. According to the “Näin Suomi juo” report, only 37% agreed fully that alcohol causes cancer. Why do you think that is so low? 

Perhaps, the problems with alcoholism have been more central in public discussions than alcohol as a risk factor to chronic diseases. More attention to the negative effects of alcohol in terms of increasing many chronic diseases, including cancer, should be paid. 

What should be changed in raising that awareness?

In terms of citizens, one should share more information on the fact that alcohol increases the risk of cancer, as well as many other diseases. It is noteworthy that while the magnitude of the increase in risk correlates directly with the amount of alcohol used during lifetime, there is no safe amount of alcohol as regards cancer risk, even one daily portion increases the risk. As long as alcohol advertising, including product placement and other forms of indirect advertising, is allowed and continue well resourced, awareness-raising through, for example, campaigns may, however, be of limited effectiveness. 

As regards policy-makers, one should be able to communicate the overall effects of alcohol, including harmful effect to health (beyond the so-called statistically recorded alcohol diseases), social effects and effects on productivity and early retirement with their overall costs to the society. These costs could then be compared with the economic benefits of alcohol in society. 

On the other hand, would the increased awareness change much? People do know that smoking causes cancer, but still smoke?

Smoking has diminished tremendously over the last decades as a result of tobacco control policies, including restrictions in availability and in use, increasing price and information to the public. The attitudes and perception of tobacco products, especially cigarettes, have changed. With alcohol, there have been increases in availability, while the harmful effects of alcohol beyond alcohol dependency have not been seriously discussed.    

Finland aims to be a tobacco-free country by 2040. What would be a realistic goal with alcohol consumption?

Finland aims to be nicotine free by 2030 (tobacco-free by 2040 was the previous tobacco law). It is not a realistic goal for alcohol at the moment, as there is no political consensus on that, on the contrary, there are political forces in the opposite direction. 

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