Fighting alcohol harm: The EU’s strategy under review

Binge drinking alcohol.JPG

Europeans have the highest per-capita consumption of alcohol, and drinking causes nearly 1-in-10 cases of ill health and premature death. The European Commission’s informal alcohol strategy, launched in 2006, is set for a detailed evaluation in 2013, with the policy objective of reducing the health and social harm caused by excessive alcohol consumption.

An average adult (aged 15+ years) in the EU consumes 12.5 litres of pure alcohol or nearly three drinks a day, the World Health Organization (WHO) stated in its 2012 report Alcohol in the European Union - Consumption, harm and policy approaches.

This is more than double the world average.

Harmful and hazardous alcohol consumption is the third largest risk factor for ill health in the EU, responsible for 195,000 deaths each year and accounting for 12% of male and 2% of female premature mortality, according to the EU's first progress report on the Implementation of the EU Alcohol Strategy, published in 2009.

The estimated economic cost to the EU is around €125 billion, the report says.

EU data indicates that alcohol consumption has remained broadly stable for most member states between 2002 and 2006, for example in Mediterranean countries such as France, Italy and Spain.

However, there was a steep increase in eight countries, led by Estonia (+40%), Latvia (+33%) and Poland (+25%). In contrast, the level of recorded alcohol consumption dropped by some 9% in Luxembourg and Malta during that period, the report notes.

The EU's 2006 alcohol strategy

The EU’s Alcohol Strategy, launched in 2006, is designed to help national governments and other stakeholders coordinate their action to reduce alcohol related harm in the EU.

However, the strategy does not impose concrete legislation on member states at this stage, relying instead on policy coordination and exchanges of best practices between countries. To do this, the strategy introduced an alcohol and health forum, launched in 2007, where member organisations - public and private - are invited to debate, compare approaches and take action to tackle alcohol related harm (>> Read the Commission's summary report on commitments made by the forum).

Harmful and hazardous alcohol consumption has a major impact on public health and also generates costs related to health care, health insurance, law enforcement and public order, and workplaces.

Harmful alcohol consumption also has a negative impact on labour and productivity. Therefore, the EU wants to foster workplace-based initiatives. Stakeholders such as business organisations and trade unions have a particular responsibility in this regard.

Five priorities

The Commission strategy identifies the following five priority themes, which it considers relevant in all member states:

  • Protect young people, children and the unborn child;
  • Reduce injuries and death from alcohol-related road accidents;
  • Prevent alcohol-related harm among adults and reduce the negative impact on the workplace;
  • Inform, educate and raise awareness on the impact of harmful and hazardous alcohol consumption, and on appropriate consumption patterns;
  • Develop and maintain a common evidence base at EU level.

These priorities are reflected in three working groups established under the EU alcohol and health forum on the following topics: youth-related aspects, marketing and science.

Most member states now have a written alcohol policy in place. There is a continuous trend towards an age limit of 18 years for selling and serving alcohol, and towards lowered Blood Alcohol Concentration limits for drivers of motorised vehicles. 

Strategy update

The strategy is now up for review, and will draw on early conclusions from the first progress report, published in September 2009.

In the updated strategy, the European Commission is expected to avoid any direct discussion over tax or pricing, which will remain a national prerogative.

However, the EU Executive will come under pressure to give clear guidance on how member states can impose pricing measures, especially since they are likely to be challenged under EU competition law.

Young people and binge drinking

There is an increasing trend of binge drinking among young people in many parts of the EU, but especially in Northern Europe and the United Kingdom.

This is exacerbated by the availability of alcoholic beverages to underage consumers. According to the European Commission, there is therefore a need to consider further actions to curb underage drinking and harmful drinking patterns among young people.

Young people are particularly at risk from the short-term effects of drunkenness, including accidents and violence. Alcohol-related deaths account for around 10% of all deaths among young women and 25% for men aged 15-29, according to the Commission's first progress report on the EU's alcohol strategy, published in September 2009.

The proportion of youth and young adults with harmful consumption patterns in the EU has increased in many member states over the last 10 years. This can contribute to long-term adverse health effects and increase the risk of social harm, the Commission says.

Young people are also often unfairly depicted as the perpetrators of alcohol problems rather than the victims. In the EU's first strategy report, alcohol is estimated to be a causal factor in 16% of cases of child abuse and neglect.

Avoiding harm to others: Pregnancy and road deaths

Drinkers risk not only their own health, but also the health of others, policymakers argue.

This can start even before birth as exposure to alcohol during pregnancy can impair brain development of the fetus, result in low birth weight and is also associated with intellectual deficits that become apparent later in childhood.

As high-risk consumption is increasing among young women and as alcohol consumption impacts the foetus, the EU wants to raise awareness on this issue.

But there are many other ways harm to other people’s health can be attributed to alcohol consumption.

In its 2012 alcohol report for the European Union, the World Health Organization analysed the number of deaths which can be attributed to harm caused to others by alcohol consumption. In 2004, the figure for men of all ages was 5,564 deaths; for women, 2,146 deaths.

Transport injuries are the first cause of harm caused to others, with violence being a distant second cause.

Southern Europe experiences the greatest proportion of alcohol-attributable harm to others. However, in central-eastern and eastern Europe, calculations indicate that there is a higher number of motor vehicle accidents where the drunk driver harms only him or herself.

About 25% of the accidents in the EU are linked to alcohol consumption, according to the WHO. At least 10,000 people are killed in alcohol-related road accidents every year, notes the Commission in its 2009 report.

Those aged 18-24 are particularly in danger of having an accident, according to the EU's 2006 strategy. Some 35% to 45% of fatalities of this age group are due to traffic accidents and traffic accidents are the most common cause of death for young people. For drink-driving accidents, two-thirds of the people involved were between 15-34 years, and 96% were male.

Industry self-regulation: The responsible marketing pact

Faced the threat of regulatory action by policymakers, leading producers from the beer, wine and spirits sectors reacted with a pledge to reduce the visibility of alcohol advertising and minimise their appeal to minors.

Europe’s eight largest alcohol manufacturers agreed to work with the World Federation of Advertisers (WFA), the European Commission and national associations to protect the young and vulnerable from targeted advertising.

The so-called Responsible Marketing Pact, launched in April 2012, will create common EU-wide guidelines designed to prevent minors from seeing alcohol ‘viral’ adverts on social media, and prohibit the creation of ads which seek to allure young people.

The signatories include AB InBev, Bacardi, Brown-Forman, Carlsberg, Diageo, Heineken, Pernod Ricard and SAB Miller, which together represent a majority of European alcohol advertising spending.

"The Responsible Marketing Pact breaks new ground because it is the first time major companies from the beer, wine and spirits sectors have come together to seek unified responsibility standards for all alcohol beverage marketing communications,” said Stephan Loerke, managing director at the World Federation of Advertising. The initiative, he added, marked a turning point in the industry's commitment to responsible marketing.

Under the pact, standards for age controls will be established along with a common standard that ads may only be placed in media where at least 70% of the audience is expected to be above the legal purchase age.

After agreeing on the standards, implementation and compliance will be monitored by the audit firm Accenture and national self-regulatory organisations. Sanctions for violations include public naming and shaming, and referral to national regulatory authorities in cases of repeat offences.

>> Read: Alcohol industry unites in advert abuse clampdown

Advertising and marketing – especially through social media – are areas the Commission is expected to consider explicitly in its strategy update.

Indeed, advertising standards in relation to alcohol vary considerably across the EU.

In France there is a blanket ban on alcohol advertising, with limited and strict exceptions. Manufacturers there are banned from associating themselves with sporting events such as the Olympic Games.

But the UK has taken a different view and allowed Heineken to be one of the principal sponsors of the London 2012 Olympics. Scandinavian countries also prohibit television and magazine advertising, whilst in other EU countries advertising remains possible though tightly controlled.

Meanwhile, the alcohol industry's marketing practices – including the sponsorship of major sporting or cultural events – continues to raise concerns for the Commission, which has threatened to legislate if the sector fails to self-regulate.

Health groups such as the European Centre for Monitoring Alcohol Marketing (EUCAM) have criticised the pact for hardly being new, similar voluntary rules have already been implemented in the beer sector for example. "Key points in this new marketing pact have already proven to be ineffective," EUCAM said.

Minimum pricing: A rising trend

But binge drinking among young people is probably the top concerns for policymakers, particularly in the UK, where Scotland was the first to introduce a minimum price on alcohol to discourage excessive drinking. England and Wales were due to follow soon, with proposals to introduce minimum pricing too. Similar proposals have also been tabled in France.

>> Read: Scotland first to introduce minimum price on alcohol and England, Wales target binge drinking with minimum pricing

On pricing, the regulatory landscape in Europe is currently mixed.

In the EU, member states must apply tax rated for different categories of alcoholic drinks. However, there is nothing in EU rules prohibiting countries from setting minimum prices for alcohol, as long as these prices are compatible with EU rules, such as no discrimination between imported goods and domestic goods, and no restriction on the free movement of goods.

Industry-backed advisors have warned that rising alcohol taxes and minimum pricing strategies will boost the amount of “unrecorded alcohol” consumed in Europe, increasing bootlegging and health risks.

In 2005, 22% of total adult consumption in Europe was unrecorded, according to the last global estimates of unrecorded alcohol produced by the WHO in 2005.

The Scottish experiment

Meanwhile, reactions to the Scottish minimum pricing law were heated.

The Scottish Parliament overwhelmingly passed a bill in May 2012 that introduced a 0.50£ (0.63€) minimum price for a unit of alcohol, the first legally-binding minimum price within the EU. This means that from April 2013, cut-price alcohol beverages will be outlawed in Scotland.

The bill is expected to improve the region’s health and crime levels by reducing binge drinking.

But the European Spirits Organisation (CEPS) and the Comité Européen des Entreprises Vins – representing Europe’s liqueur and wine producers respectively – attached themselves to an action in the Court of Session launched by the Scotch Whisky Association to challenge the Scottish government.

They argue that minimum pricing represents an illegal barrier to trade, will discriminate between companies in the market and fail to address harmful drinking.

The group added that a minimum price is illegal under EU and global competition laws and would also ruin the Scottish whisky industry's efforts to counter price controls and high tariffs in overseas markets.

>> Read: Whisky makers expected to challenge minimum pricing rules


Organisations fighting alcohol abuse are generally sceptical about the effectiveness of industry self-commitments.

“I am not happy with self-regulation alone as a stand alone measure [in relation to alcohol advertising],” said Marienn Skar, the secretary-general of Eurocare the alcohol policy alliance. “The problem is that there is no evidence that it has any effects.”

Consumer groups defending traditional beer culture also have their reservations about the initiative. “We think advertising is often used by larger brewers as market domination we are against mass advertising so blanket banning is not we believe the way to go,” said Ian Loe, of the secretariat of the European Beer Consumers Union (EBCU).

Loe explained: “Norway, for example, bans alcohol and beer [advertisements] even outside bars. But you can promote low-and non-alcoholic beer. So the larger brewers can still advertise. We are against mass advertising but we would like to see an open beer market and not one dominated by two brands to the exclusion of all else. We think it’s unfair competition.”

Alcohol producers, for their part, emphasised the industry's unity in addressing common challenges.

“Alcohol beverage producers take seriously the expectations from our consumers and society at large that our marketing communications must respect the highest standards. We are joining forces with our partners to show that meeting and exceeding these expectations continues to be our priority,” said Jean-François van Boxmeer, chief executive of Heineken.

“As business leaders we have a responsibility to lead by example, and this is a unique case of industry pooling its collective resources and experiences to build common alcohol marketing standards that will stand the test of time,” said Andrew Morgan, President of Diageo Europe, which owns brands like J&B whisky, Smirnoff vodka and Guinness beer.

“By setting self-regulatory standards that go significantly further than the law, and verifying that these are complied with, we will make a tangible difference to the governance of beverage alcohol marketing. This is an excellent example of the contribution of voluntary action to the objectives of the European Strategy on reducing alcohol-related harm,” said Christian Barré, chief executive of Domecq Bodegas, Pernod Ricard.


During Spring 2012, a wide public debate took place in Britain over the issue of minimum pricing rules.

“Binge drinking isn't some fringe issue, it accounts for half of all alcohol consumed in this country. The crime and violence it causes drains resources in our hospitals, generates mayhem on our streets and spreads fear in our communities,” according to UK Prime Minister David Cameron.

He added: “We're consulting on the actual price, but if it is 40p that could mean 50,000 fewer crimes each year and 900 fewer alcohol related deaths per year by the end of the decade.”

“The government needs to make sure it does not just create a cash windfall for the supermarkets, instead of lowering prices of other goods or supporting better prevention and treatment of alcohol abuse to cut crime further and save lives,” said the shadow UK Home Secretary, the Labour Party’s Yvette Cooper.

“I think one has to be quite sceptical,” said Gavin Partington, interim chief executive of the Wine and Spirit Trade Association. “Only a few months ago you have got two ministers saying they understand it to be probably illegal, and suddenly now they are advocating it - I don't think the legal position has changed any.”

“Irresponsible drinking has cultural causes and retailers have been hugely engaged in information and education to change attitudes to drinking,” according to Andrew Opie, of the British Retail Consortium. “It's a myth to suggest that supermarkets are the problem or that a pub is somehow a safer drinking environment. Effectively, a minimum price is a tax on responsible drinkers,” Opie added.

“Health care workers who struggle every day to cope with the impact of our nation's unhealthy drinking will welcome tough new policies in areas such as price and licensing that are based on evidence and should bring about real benefits,” said Eric Appleby, of Alcohol Concern.

“Europe’s brewers are opposed to further punitive tax hikes that harm the brewing sector, kill off further jobs and thereby damage Europe’s growth prospects. Beer consumption in the EU already declined by 8% in the two years following the start of the economic crisis, whilst 260,000 jobs were lost, primarily in the bars, pubs and cafés that depend on beer,” according to Pierre-Oliver Bergeron, secretary-general of the Brewers of Europe, the trade confederation of European brewers associations and breweries.

“As to whether tax and price increases are an effective way of addressing alcohol-related harm, we can only draw people’s attention to the fact that the highest prices and taxes are to be found in Scandinavia and the British Isles, the countries that interestingly also have the highest levels of binge drinking in Europe,” Bergeron concluded.

“Price plays an important part in consumption levels. And minimum pricing is a very equitable way to curb binge drinking and alcohol related harm as it will primarily affect young people and heavy drinkers,” said Monika Kosi?ska, secretary-general of health NGO the European Public Health Alliance (EPHA).


In May 2012, the Scottish parliament overwhelmingly passed a bill introducing a minimum price for a unit of alcohol.

"There is a pressing need for a wide range of measures to tackle excessive alcohol consumption. A minimum pricing scheme supported by a number of other measures, such as restrictions on the volume of adverts promoting alcohol, will help turn back our increasingly damaging patterns of consumption. The European Commission is to propose a new European Alcohol Strategy. We look forward to strong proposals that will ensure a level playing field across EU countries," concluded Kosi?ska.

“It [minimum pricing] will help Scotland achieve a ‘cultural shift’ in its unhealthy attitudes to alcohol,” said Nicola Sturgeon from the Scottish health secretary in the summer 2012. "This policy will save lives – it’s as simple as that."

“European law is clear - minimum pricing is an illegal barrier to trade. We fully agree alcohol misuse must be tackled, but other more effective measures can be used, without creating barriers to trade,” said Paul Skehan, director-general of the European Spirits Organisation.

“Whilst supporting the overall objective of reducing alcohol-related harm, The Brewers of Europe is of the opinion that the Scottish [minimum pricing] measure is an ill-conceived and mis-targeted measure that will artificially distort competition and discriminate against imported products,” said Pierre-Olivier Bergeron, secretary-general of the Brewers of Europe.

The European Spirits Organisation (CEPS) and the Comité Européen des Entreprises Vins – representing Europe’s liqueur and wine producers respectively – attached themselves to an action in the Scottish Court of Sessions launched by the Scotch Whisky Association to challenge the Scottish government.

They argue that minimum pricing represents an illegal barrier to trade, will discriminate between companies in the market and fail to address harmful drinking.

The group added that a minimum price is illegal under EU and global competition laws and would also ruin the Scottish whisky industry's efforts to counter price controls and high tariffs in overseas markets.

  • Oct. 2006: The first EU Alcohol Strategy adopted.
  • Sept. 2009: EU Commission releases first progress report on the implementation of the EU Alcohol Strategy.
  • April 2012: Leading producers from the beer, wine and spirits sectors launch their first joint initiative in advertising self-regulation designed to combat abuses across social media.
  • May 2012: The Scottish parliament overwhelmingly passed a bill introducing a 0.50£ (0.63€) minimum price for a unit of alcohol, the first legally-binding minimum price within the EU.
  • 2013: European Commission to review the EU's alcohol strategy.
  • April 2013: Cut-price alcohol beverages will be outlawed in Scotland.
  • By June 2013: World Federation of Advertisers to present a first progress report on implementation and compliance with the agreed common standards. A final report is due by February 2015.

European Commission

World Health Organization

Business & Industry


  • European Alcohol Policy Alliance (Eurocare): Website
  • Active (Sobriety, Friendship and Peace): Website
  • Alcohol Policy Youth Network (APYN): Website
  • European Public Health Alliance (EPHA): Website
  • European Association for the Study of the Liver (EASL): Website
  • Youth Forum: Website
  • European Kidney Health Alliance (EKHA): Website
  • European Centre for Monitoring Alcohol Marketing (EUCAM): Website
  • European school survey project on alcohol and other drugs (ESPAD): Website
  • European Beer Consumers Union: Website

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