Foreword to the NordAN Helsinki Conference

Four years ago, in 2015, when NordAN was having its conference last time in Helsinki, the General Assembly adopted a resolution reminding that “the monopoly system is an important corner-stone of Iceland’s effective alcohol policy.” The reason for that was that the Parliament of Iceland was considering a bill proposing the abolition of a public monopoly on sales of alcohol and authorising the right to sell alcohol at all retail outlets. Since then, multiple attempts have been made to reach that goal. In total five times, a bill of this kind has been submitted for parliamentary consideration in Iceland.

On 1 January 2018, the maximum strength of alcoholic beverages sold in retail stores was raised to 5.5% alcohol by volume, and the requirement for production by fermentation was removed. This means that grocery shops, kiosks and petrol stations can also sell strong beers and ciders and long drink beverages produced by adding strong alcoholic beverages. That change lifted the 4.7-per cent limit that has been in force since the 1960s.

In Sweden, primarily the Center Party has repeatedly pushed for small-scale alcohol sales directly on farms, and similar discussion is going on in other Nordic countries as well. Earlier this summer Sweden decided that the state-run Systembolaget chain is now able to deliver alcohol home to customers across the entire country.

Something seems to be changing, and that’s why we have decided to title our conference in Helsinki this year “Alcohol and other drugs in a changing society“.

Conference speakers have all something serious to say about the situation, in the Nordic countries, but also on a broader perspective. EU Health Commissioner Vytenis Andriukaitis from Lithuania will be replaced in coming weeks by Stella Kyriakides from Cyprus. As a doctor himself, Commissioner Andriukaitis, clearly understands the problems alcohol causes. “Drink driving, violence, the suffering of children in families with alcohol problems, costs to health and social systems and reduced productivity – this is what alcohol misuse inflicts on our society,” he said in 2015. “I am very concerned about this, as a person, as a medical doctor, as a commissioner. We need to do better; we need to do more; and we need to work together to succeed.”

Former Director of the Finnish Institute for Health and Welfare and former MP in Finland, dr Pekka Puska, was on the frontlines when the latest liberalisation of the Finnish alcohol policy took place. In January 2018 he stated who was winning from it all. “The decision was, of course, distressing because it was made on the terms of influential people and money and at the expense of public health, families and children.”

But not all societal changes have been negative. Both, Commissioner Andriukaitis and former health minister of Estonia, Jevgeni Ossinovski are, coming from Baltic countries, which have experienced significant developments concerning alcohol regulations. Minister Ossinovski was leading this work in Estonia by getting the job done and also attracting loads of powerful enemies and criticism on himself. “I understand alcohol producers are standing up for their interests, but I believe their financial interests do not outweigh the health of the Estonian people,” Ossinovski said in 2015 when introducing the new set of policy measures. He then added: “A sector which makes a profit from killing the Estonian people must also understand this.”

Professor Tim Stockwell from Canada is one of the global leaders in alcohol research, and he has studied the Nordic situation as well. Last year he was leading a group of scientists estimating the public health impact of disbanding a government alcohol monopoly in Sweden. The clear conclusion of the study was: “If Swedes wish to have an alcohol monopoly as an efficient tool to reduce harms, it is also important to not erode it through seemingly minor exceptions, e.g. allowing alcohol sales via the Internet or permitting the sale of alcohol at farms, something currently being proposed.”

As it is pretty clear already, the main danger in Nordic countries is facing the traditional retail monopoly systems. Finnish Alko’s managing director Leena Laitinen came to that office only a few months before the 2018 Alcohol Act change. She insists that their mission is still the same: “We don’t want to increase sales. Instead of quantities, we focus on quality. We do responsible work.”

Rather new in Swedish Systembolaget is also Anna Raninen, who is responsible for Alcohol Research and known to many as the former communication director at The Swedish Council for Information on Alcohol and Other Drugs (CAN). These are people who understand the value of traditional Nordic alcohol policies.

Another area where we see troubling changes is, of course, the drugs policy, more precisely the cannabis legalisation. Stig Erik Sørheim, the president of EURAD, a European network for prevention, treatment and recovery, visited North-America, where cannabis is legalised in different countries and states. “We still don’t know the full consequences of cannabis legalisation, but instead of waiting for the evidence, several other states and countries have rushed to legalise – perhaps most significantly, Canada. Luxembourg and New Zealand have also put legalisation on the agenda. Critics say that the world blindly followed the US into a global war on drugs. Are we now blindly following them into legalisation?” Sørheim is raising the question.

Cannabis issue will also continue in the conference’s “speed-dating session” where Karin Rantala from EHYT is talking about cannabis interventions for young cannabis users. Leena Harake from KSAN will address future challenges concerning pregnant women, mental health issues and the needs of women in addiction. Mariann Skar, Secretary General of Eurocare will update us on an ongoing battle over alcohol labelling issue in EU. Emi Maeda from EHYT will introduce us to the KUPLA “Students reforming substance use culture” project. Raivis Ievins has led the initiative gathering over 10 000 signatures for raising the age limit in Latvia, and he will be there to talk about it.

International progress influences what happens on the national level, but the same works the other way around as well. Maybe even more so. Dr Carina Ferreira-Borges from WHO Europe, Moscow office is pushing for European countries to work together: “When alcohol is one of the biggest killers of our young people, we cannot afford to be complacent. This is a product that is repeatedly marketed and made available to youth despite evidence that alcohol consumption has a detrimental effect on brain development and physical health. This is the next generation of leaders, and we must protect them.” Eurocare President Tiziana Codenotti said already in 2012 asking for a new alcohol strategy (that we are still waiting for) that “despite all the progress achieved over last years, our work to tackle alcohol-related harm and raise it on the political agenda is by no means finished. Europe is still the heaviest drinking region in the world and harm caused by alcohol to the individual and society at large is too high.” One of the countries where the progress has taken place is Scotland. “In 2009, the Scottish Government recognised that Scotland needed to change its relationship with alcohol, introducing a nationwide strategy, with 41 components, including Minimum Unit Pricing (MUP), which was eventually implemented after six years of legal challenges in 2018. However, there is no cause for complacency. Drawing on my own and others’ research, I will suggest that some of our most socially and economically disadvantaged young people remain at risk of serious harm from alcohol,” says Dr Eric Carlin, Director of Scottish Health Action on Alcohol Problems (SHAAP).

Several institutions work for the betterment of alcohol policy in our region. The Northern Dimension Partnership in Public Health and Social Well-being (NDPHS) and Nordic Welfare Centre (NWC) are one of those. Dr. Ülla-Karin Nurm, Director of the NDPHS Secretariat reminded earlier this month the delegates of the 69th session of the WHO European regional committee: “The importance of a comprehensive alcohol policy on the international level cannot be underestimated, since many aspects of alcohol policy cross the borders. There is a need for a vigorous progress in Europe with the alcohol policy, as the regional action plan is coming to an end.”

Nina Rehn-Mendoza Director of Public Health, and Nadja Frederiksen, Senior Adviser from Nordic Welfare Centre will introduce various projects and focus points that the NWC has at the moment, including alcohol and other substances during pregnancy – in a Nordic perspective.

One of the significant drivers behind changes in our society is the alcohol industry. That influence has been studied by professor Heikki Hiilamo who concluded that “that the involvement of the alcohol industry in political decision-making following Finland’s EU membership has given the industry legitimacy and new opportunities to influence alcohol policy while limiting policies to protect the public from alcohol-related harms.”

During the last months, NordAN has worked to figure out if the youth political organisations in Nordic countries are in line with their major parties when it comes to alcohol policies. In other words, our interest is to find if these societal changes are coming from young people are not. At the Helsinki Conference, we will make the first conclusions and discuss it all with representatives from our member organisations.

Change is normal. Our societies need change. But what drives it? Why we change to the right and not to the left? Or the other way around. How does the changing attitudes on the grass-root level, change the way our politicians make their decisions? Looking at the tremors in our countries, what can we expect? And what could we do to influence it all?

Come and join our speakers and us in Helsinki. Raise additional questions, suggest solutions, add your input! See you in the current capital of the European Union!