Communication from the Commission to the Council, the European Parliament, the European Economic and Social Committee and the Committee of the Regions an EU strategy to support Member States in reducing alcohol related harm {SEC(2006) 1358} {SEC(2006) 1360} {SEC(2006) 1411}
Date: 2006-10-24
Institutions: European Commission
Subjects: EU policy, alcoholism, consumer protection, public awareness campaign, public health, transport accident, young person

COMMISSION OF THE EUROPEAN COMMUNITIES 

Brussels, 24.10.2006 
COM(2006) 625 final 

COMMUNICATION FROM THE COMMISSION TO THE COUNCIL, THE 
EUROPEAN PARLIAMENT, THE EUROPEAN ECONOMIC AND SOCIAL 
COMMITTEE AND THE COMMITTEE OF THE REGIONS 

An EU strategy to support Member States in reducing alcohol related harm 

{SEC(2006) 1358} 
{SEC(2006) 1360} 
{SEC(2006) 1411} 

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TABLE OF CONTENTS 

1. 

2. 

3. 

4. 

5. 

Introduction .................................................................................................................. 4 

Mandate for action ....................................................................................................... 4 

Case for action ............................................................................................................. 6 

The consultation and impact assessment process ........................................................ 7 

Five priority themes and relevant good practives ........................................................ 8 

5.1. 

Protect young people, children and the unborn child................................................... 8 

5.1.1.  Rationale for action ...................................................................................................... 8 

5.1.2.  Good practice ............................................................................................................... 9 

5.2. 

Reduce injuries and deaths from alcohol-related road traffic accidents ...................... 9 

5.2.1.  Rationale for action ...................................................................................................... 9 

5.2.2.  Good practice ............................................................................................................... 9 

5.3. 

Prevent alcohol-related harm among adults and reduce the negative impact  
on the workplace ........................................................................................................ 10 

5.3.1.  Rationale for action .................................................................................................... 10 

5.3.2.  Good practice ............................................................................................................. 10 

5.4. 

Inform, educate and raise awareness on the impact of harmful and  
hazardous alcohol consumption, and on appropriate consumption patterns.............. 11 

5.4.1.  Rationale for action .................................................................................................... 11 

5.4.2.  Good practice ............................................................................................................. 11 

5.5. 

Develop, support and maintain a common evidence base ......................................... 11 

5.5.1.  Rationale for action .................................................................................................... 12 

5.5.2.  What is needed ........................................................................................................... 12 

6. 

6.1. 

6.2. 

Three levels of actions ............................................................................................... 12 

Action by the European Commission ........................................................................ 12 

Subsidiarity: Mapping of actions implemented by Member States ........................... 14 

6.2.1.  National action ........................................................................................................... 14 

6.2.2.  Local action................................................................................................................ 15 

6.3. 

Coordination of actions at EU level ........................................................................... 16 

6.3.1.  Alcohol and Health Forum......................................................................................... 16 

6.3.2.  Drink-driving ............................................................................................................. 16 

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6.3.3.  Commercial communication ...................................................................................... 16 

7. 

Conclusions ................................................................................................................ 17 

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1. 

INTRODUCTION 

This  Communication  addresses  the  adverse  health  effects  related  to  harmful  and  hazardous 
alcohol consumption1, as well as the related social and economic consequences, and answers 
to Council requests for the Commission to follow-up, assess and monitor developments and 
the measures taken in this field and to report back on the need for further actions. It focuses 
on  preventing  and  cutting  back  heavy  and  extreme  drinking  patterns,  as  well  as  under-age 
drinking, and some of their most harmful consequences such as alcohol-related road accidents 
and  Foetal  Alcohol  Syndrome.  The  Communication  therefore  is  not  a  reflection  on  alcohol 
use as such, but on misuse and its harmful consequences. The Communication recognises that 
there  are  different  cultural  habits  related  to  alcohol  consumption  in  the  various  Member 
States. There is no intention to substitute Community action to national policies, which have 
already been put in place in most of the Member States and relate to national competences in 
accordance with the principle of subsidiarity and Article 152 of the EC Treaty. In particular, 
the  Commission  does  not  intend  as  a  consequence  of  this  Communication  to  propose  the 
development of harmonised legislation in the field of the prevention of alcohol-related harm. 

The  Communication  aims  at  mapping  actions  which  have  already  been  put  in  place  by  the 
Commission  and  Member  States,  and  identifies  on  the  one  hand  good  practices  which  have 
led  to  positive  results,  and  on  the  other  hand,  areas  of  socio-economic  importance  and 
Community relevance where further progress could be made. 

The Communication also explains how the Commission can further support and complement 
national  public  health  policies  implemented  by  Member  States  in  cooperation  with 
stakeholders2, taking into account that drinking patterns and cultures vary across the EU. This 
commitment  from  the  Commission  to  further  pursue  and  develop  actions  under  its 
competences together with a list of good practices which have been implemented in different 
Member States, and the establishment of an Alcohol and Health Forum which will help their 
dissemination,  will  constitute  the  backbone  of  a  comprehensive  strategy  to  reduce  alcohol- 
related harm in Europe. 

2. 

MANDATE FOR ACTION  

The  European  Union  has  competence  and  responsibility  to  address  public  health  problems 
such as harmful and hazardous alcohol use by complementing national actions in this field, as 
stated in Article 152 of the EC Treaty.  

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2 

Hazardous alcohol consumption has been defined as a level of consumption or pattern of drinking that 
is likely to result in harm should present drinking habits persist (Babor, T., Campbell, R., Room, R. & 
Saunders,  J.,  (1994)  Lexicon  of  Alcohol  and  Drug  Terms,  World  Health  Organization,  Geneva); 
however,  there  is  no  standardised  agreement  on  the  level  of  alcohol  consumption  that  should  be 
regarded  as  hazardous  drinking.  Harmful  drinking  is  defined  as  ‘a  pattern  of  drinking  that  causes 
damage  to  health,  either physical  (such  as liver  cirrhosis)  or  mental  (such  as depression secondary  to 
alcohol  consumption)’  (The  ICD-10  Classification  of  Mental  and  Behavioural  Disorders:  Clinical 
Descriptions and Diagnostic Guidelines. Geneva: World Health Organisation 1992). 
These include actors as varied as health and consumer NGOs, self-help groups, producers and retailers 
of  alcoholic  beverages,  the  hospitality  sector,  schools,  employers  and  trade  unions,  the  advertising 
industry, the media… 

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The European Court of Justice has repeatedly confirmed that combating alcohol-related harm 
is an important and valid public health goal3. 

In 2001 the Council adopted a Recommendation on the drinking of alcohol by young people, 
in particular children and adolescents4, which invites the Commission to follow-up, assess and 
monitor  developments  and  the  measures  taken,  and  to  report  back  on  the  need  for  further 
actions5. 

In  its  Conclusions  of  5  June  2001  the  Council  invited  the  Commission  to  put  forward 
proposals for a comprehensive Community strategy aimed at reducing alcohol-related harm to 
complement national policies. The Council Conclusions on Alcohol and young people of June 
2004 reiterated this invitation6. 

Most  Member  States  have  taken  actions  to  reduce  alcohol-related  harm,  and  many  of  them 
have  extensive  policies  in  this  field.  Despite  the  implementation  of  health  policies  at  both 
Community  and national  level,  the  level of harm, especially among young people, on roads 
and at workplaces is still unacceptably high in all Member States. Moreover, studies carried 
out at national and EU level7 show that in some cases, where there is a cross border element, 
better  coordination  at,  and  synergies  established  with,  the  EU  level  might  be  needed. 
Examples include cross-border sales promotion of alcohol which could attract young drinkers, 
or  cross-border  TV  advertising  of  alcoholic  beverages  which  could  conflict  with  national 
restrictions.  

This  tends  to  show  that  some  problems  are  shared  by  all  Member  States  (i.e.  underage 
drinking  or  alcohol-related  road  accidents),  that  the  policies  which  have  been  led  to  tackle 
them have not been fully successful since the problems either remain or in certain cases have 
worsened,  and  that  some  issues  are  of  Community  relevance  because  of  a  cross-border 
element. This highlights the need for further actions and cooperation at EU and national level. 
This  Communication  sets  out  a  European  Union  approach  to  support  and  underpin  a 
coordinated strategy to reduce alcohol-related harm, which will rely on commitments from the 
Commission to further pursue and develop actions under its competences and dissemination 
of good practices which have been implemented in different Member States. 

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Franzen case (C-189/95), Heinonen case (C-394/97), Gourmet case (C-405/98), Catalonia (C-190 and 
C-179/90), Loi Evin (C-262/02 and C-429/02). 
Council Recommendation 2001/458/EC (OJ L 161, 16.6.2001, p. 38); 
http://eur-lex.europa.eu/pri/en/oj/dat/2001/l_161/l_16120010616en00380041.pdf 
Full report published at http://ec.europa.eu/comm/health 
Council  Conclusions  of  5  June  2001  on  a  Community  strategy  to  reduce  alcohol-related  harm  (OJ  C 
175, 20.6.2001, p. 1); 
http://eur-lex.europa.eu/pri/en/oj/dat/2001/c_175/c_17520010620en00010002.pdf; 
Council Conclusions on Alcohol and Young people of 1-2 June 2004 
(http://ue.eu.int/ueDocs/cms_Data/docs/pressData/en/lsa/80729.pdf). 
e.g.: What are the most effective and cost-effective interventions in alcohol?, WHO Regional Office for 
Europe’s  Health  Evidence  Network  (HEN)  2004;  Alcohol  Policy  and  the  Public  Good,  Griffith 
Edwards  1994,  Cochrane  Library;  EconLit  and  the  Alcohol  and  Alcohol  Problems  Science  Database 
(ETOH), National Institute on Alcohol Abuse and Alcoholism (NIAA). 

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EU  action  to  reduce  alcohol-related  harm  will  support  the  implementation  of  other  relevant 
policy  objectives  already  agreed  at  EU  level,  e.g.  on  Road  Safety8,  Health  and  Safety  at 
work9, and the Convention on the Rights of the Child10. 

3. 

CASE FOR ACTION 

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,  and  thus  has  a  negative  impact  on  economic  development  and  on  society  as  a 
whole.  Harmful  and  hazardous  alcohol  consumption  is  a  key  health  determinant  and  one  of 
the main causes of premature death and avoidable disease. It is a net cause of 7.4 %11 of all 
ill-health  and  early  death  in  the  EU,  and  has  a  negative  impact  on  labour  and  productivity. 
Policies aimed at the prevention and treatment of harmful and hazardous consumption as well 
as appropriate information on responsible patterns of consumption have important benefits for 
individuals  and  families,  but  also  address  social  costs  and  the  labour  market,  and  will 
contribute  to  fostering  competitiveness  in  line  with  the  Lisbon  objectives,  and  with  the 
objective of more Healthy Life Years for all. Workplace-based initiatives should therefore be 
fostered.  The  relevant  stakeholders  (business  organisations,  trade  unions)  have  a  particular 
responsibility in this regard. 

Young people in the EU are particularly at risk, as over 10% of female mortality and around 
25% of male mortality in the 15–29 age group is related to hazardous alcohol consumption12. 
The harmful and hazardous consumption of alcohol has effects not only on those who drink, 
but  also  on  others  and  on  society.  Harmful  effects  of  alcohol  tend  to  be  greater  in  less 
advantaged social groups, and therefore contribute to inequalities in health.  

While average alcohol consumption has been decreasing in the EU, the proportion of youth 
and  young  adults  with  harmful  and  hazardous  consumption  patterns  has  increased  in  many 
Member  States  over  the  last  ten  years13.  Drinking  patterns  in  many  parts  of  the  EU,  and 
particularly the reported increasing trends in under-age “binge-drinking”14 and high frequency 
under-age drinking in many European countries15, may have long-term adverse health effects 
and increase the risk of social harm. 

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Commission Recommendation 2004/345/EC of 6 April 2004 on enforcement in the field of road safety 
(OJ  L  111,  17.4.2004);  Commission  Recommendation  2001/116/EC  of  17  January  2001  on  the 
maximum  permitted  blood  alcohol  content  (BAC)  for  drivers  of  motorised  vehicles  (OJ  L  43, 
14.2.2001); Communication of the Commission (OJ C 48, 14.2.2004). 
Community strategy on health and safety at work 2002-2006 -  COM(2002) 118. 
UN Resolution 44/25 of 20 November 1989. 
The  WHO’s  Global  Burden  of  Disease  Study  (Rehm  et  al  2003a  and  b,  Rehm  et  al  2004  and  Rehm 
2005). 
Alcohol  in  Europe  -  A  public  health  perspective,  P  Anderson  and  B  Baumberg,  Institute  of  Alcohol 
Studies, UK 2006 - http://ec.europa.eu/health-eu/news_alcoholineurope_en.htm (based on The WHO’s 
Global Burden of Disease Study, Rehm et al 2003a and b, Rehm et al 2004 and Rehm 2005). 
Increasing trends are mostly reported among young adults (above legal drinking ages). Binge-drinking 
among under aged drinkers has levelled out in EU-15 but increased in EU-10. 
“Binge-drinking”  is  normally  considered  to  be  the  drinking  over  5  units  of  alcohol  on  one  single 
occasion. 
The  ESPAD  Report  2003,  Alcohol  and  Other  Drug  Use  Among  Students  in  35  European  Countries, 
Björn Hibell et al, Stockholm 2004 http://www.espad.org/reports.asp. 

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Traffic  accidents  related  to  alcohol  consumption  are  also  a  major  cause  for  concern.  About 
one  accident  in  four  can  be  linked  to  alcohol  consumption,  and  at  least  10 000  people  are 
killed in alcohol-related road accidents in the EU each year. The EU has the goal of halving 
the  number  of  people  killed  on  European  roads  from  50 000  in  the  year  2000  to  25 000  by 
201016, and efforts to curb drink-driving can make a substantial contribution to achieving this 
objective. 

Exposure  to  alcohol  during  pregnancy  can  impair  brain  development  of  the  foetus  and  is 
associated  with  intellectual  deficits  that  become  apparent  later  in  childhood17.  As  high-risk 
consumption  is  increasing  among  young  women  in  most  Member  States  and  as  alcohol 
consumption  impacts  on  the  foetus  already  at  the  start  of  the  pregnancy,  awareness  raising 
interventions on this issue are of key importance. 

In order to address the above concerns, and based on the outcomes of the impact assessment 
process, the Commission has identified the following five priority themes, which are relevant 
in all Member States and for which Community action in complement to national policies and 
coordination of national actions has an added value:  

•  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  themes  cut  across  EU,  national  and  local  level,  and  call  for  multi-stakeholder  and 
multi-sector action. The present strategy therefore proposes to highlight what the Commission 
and Member States have already done, and further action or continuation of existing actions 
by the Commission. It also presents good practices implemented in Member States, and which 
could inspire similar actions and synergies at national level. 

4. 

THE CONSULTATION AND IMPACT ASSESSMENT PROCESS  

Since  2004  the  Commission  services  have  held  extensive  consultations  with  Member  State 
experts, 
the 

international  organisations,  researchers  and  stakeholders18.  In  addition, 

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COM(2001) 370: "European transport policy for 2010: time to decide". 
In France for example, more than 700 children were born with Foetal Alcohol Syndrome in 2001, and 
more than 60 000 persons are estimated to be living with this condition (data calculated by the INSERM 
-  “Expertise  collective”  in  September  2001  -  after  two  epidemiological  studies  made  in  the  North  of 
France and La Réunion. 
Including  Non-Governmental  Organisations  (health  and  consumer  NGOs,  self-help  groups…)  and 
organisations representing producers of alcoholic drinks. 

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Commission  has  participated  in  round  table  talks  organised  with  selected  key  stakeholders 
under the auspices of the European Policy Centre (EPC)19. 

Through  an  open  call  for  tender  the  Commission  contracted  an  expert  public  health  report 
from the Institute of Alcohol Studies20.  

To analyse the health, social, economic and environmental problems related to alcohol and the 
different policy options the Commission conducted an Impact Assessment21. 

Furthermore,  stakeholders  had  an  opportunity  to  comment  on  an  open  consultation  on  the 
labelling of food and drinks launched by the Commission22. 

5. 

FIVE PRIORITY THEMES AND RELEVANT GOOD PRACTIVES 

5.1. 

Protect young people, children and the unborn child 

Aims 

Aim 1: To curb under-age drinking, reduce hazardous and harmful drinking among 
young people, in cooperation with all stakeholders. 

Aim 2: To reduce the harm suffered by children in families with alcohol problems. 

Aim  3:  To  reduce  exposure  to  alcohol  during  pregnancy,  thereby  reducing  the 
number of children born with Foetal Alcohol Disorders. 

5.1.1.  Rationale for action 

Young people are often unfairly depicted as the perpetrators of alcohol problems rather than 
the  victims.  Alcohol  is  estimated  to  be  a  causal  factor  in  16%  of  cases  of  child  abuse  and 
neglect23. 

Harmful alcohol consumption among young people has been shown to have a negative impact 
not  only  on  health  and  social  wellbeing,  but  also  on  educational  attainment24.  There  is  an 
increasing  trend  of  “binge-drinking”  by  young  people  in  many  parts  of  the  EU.  This  is 
exacerbated  by  the  continued  availability  of  alcoholic  beverages  to  under-age  consumers. 
There is therefore a need to consider further actions to curb under-age drinking and harmful 
drinking patterns among youth. 

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The EPC report on the alcohol round table is published on www.theepc.be. 
Published  on  the  EU  Health  portal  and  web  site  alongside  a  report  on  the  peer  review  meeting, 
comments from the peer review panel, stakeholders’ views on alcohol policy and on the implementation 
of the Council Recommendation (http://ec.europa.eu/health-eu/news_alcoholineurope_en.htm). 
Furthermore, a more detailed economic analysis of the impact of alcohol on the economic development 
of  the  EU  has  been  conducted  as  part  of  the  impact  assessment  procedure  by  an  external  contractor: 
“RAND Report”, published on http://ec.europa.eu/comm/health 
The  background  paper  used 
for 
http://ec.europa.eu/food/food/labellingnutrition/betterregulation/index_en.htm. 
English et al. 1995, Single et al, 1999, Ridolfo and Stevenson 2001, taken from Alcohol in Europe – a 
public health perspective - http://ec.europa.eu/health-eu/news_alcoholineurope_en.htm 
RAND: An economic analysis of the impact of alcohol on the economic development in EU (Horlings, 
Scoggins 2006). 

available  on 

consultation 

Internet 

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Actors in the alcohol beverage chain have been actively engaged in most Member States in 
enforcement of national regulations, and have declared their willingness to become more pro-
active in enforcing regulatory and self-regulatory measures. 

Some Member States have increased taxes on products which they perceive to be particularly 
attractive to under age drinkers25.  

5.1.2.  Good practice 

Worrying  drinking  trends  among  young  people  can  be  effectively  addressed  through  public 
policy.  The  2001  Council  Recommendation  has  contributed  to  developing  such  policies. 
Examples  of  effective  measures  implemented  by  Member  States  are:  enforcement  of 
restrictions on sales, on availability and on marketing likely to influence young people, broad 
community-based  action  to  prevent  harm  and  risky  behaviour,  involving  teachers,  parents, 
stakeholders and young people themselves26, and supported by media messages and life-skills 
training programmes. The alcohol beverage industry and retailers can play an important role 
to ensure that alcohol is consumed responsibly.  

5.2. 

Reduce injuries and deaths from alcohol-related road traffic accidents27 

Aims 

Aim 4: To contribute to reducing alcohol-related road fatalities and injuries.  

5.2.1.  Rationale for action 

Approximately one accident in four can be linked to alcohol consumption, and at least 10 000 
people are killed in alcohol-related road accidents in the EU each year. Young people aged 18 
to  24  are  particularly  in  danger  of  having  an  accident.  35%  to  45%  of  fatalities  of  this  age 
group are due to traffic accidents. For young people, traffic accidents are the most common 
cause of death (47% according to several sources). For drink-driving accidents, two thirds of 
the people involved were between 15 and 34 years, and 96% were male. 

5.2.2.  Good practice 

Numerous studies have found that the risk of alcohol-related road traffic accidents increases 
with  the  blood  alcohol  concentration  (BAC)  of  the  driver.  All  Member  States  have  taken 
measures to introduce BAC limits. Studies tend to show that an enforced maximum limit of 
less  would  be  desirable28.  Effective  enforcement  of  drink-driving 
0.5  mg/ml  or 

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This  has  been  addressed  by  imposing  a  special  tax  or  compulsory  labelling  for  products  such  as 
“alcopops” (Denmark, France, Germany, Ireland and Luxembourg). 
The  Commission  has  involved  young  people  in  the  consultation  process  of  this  Communication,  in 
projects  co-financed  trough  the  Public  Health  Programme.  The  European  Youth  Forum  has  set  up  a 
working group to contribute to the ongoing work. 
Apart  from  road  traffic,  and  in  line  with  the  general  concerns  regarding  alcohol  at  the  workplace  as 
described in Section 5.3, there is obviously also a need to check alcohol consumption in other transport 
sectors, such as sea, rail and air transport. These are however not addressed specifically by the present 
Communication. 
A  review  of  112  studies  provided  strong  evidence  that  impairment  in  driving  skills  begins  with  a 
departure from a zero blood alcohol concentration level (Moskowitz and Fiorentino 2000). A study that 
compared the blood alcohol concentrations (BACs) of drivers in accidents with the BACs of drivers not 
involved in accidents found that male and female drivers at all ages who had BACs between 0.2 g/l and 
0.49 g/l had at least a three times greater risk of dying in a single vehicle crash. The risk increased to at 

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countermeasures could substantially reduce traffic deaths (by up to 25% in the case of men, 
and  up  to  10%  in  the  case  of  women),  injuries  and  disability.  Example  of  efficient  national 
policies rely  on  the introduction and enforcement of  frequent and systematic random breath 
testing,  supported  by  education  and  awareness  campaigns  involving  all  stakeholders.  A 
combination of strict enforcement and active awareness raising is a key to success. Young and 
novice  drivers  are  more  involved  in  alcohol-related  road  accidents.  Another  example  of 
efficient  policy  is  the  introduction  of  a  lower  or  zero  BAC  limit  for  these  drivers  and,  for 
safety reasons, also for public transport drivers as well as for drivers of commercial vehicles, 
in particular those transporting dangerous goods. 

5.3. 

Prevent alcohol-related harm among adults and reduce the negative impact on 
the workplace  

Aims 

Aim 5: To decrease alcohol-related chronic physical and mental disorders.  

Aim 6: To decrease the number of alcohol related deaths. 

Aim 7: To provide information to consumers to make informed choices. 

Aim 8: To contribute to the reduction of alcohol-related harm at the workplace, and 
promote workplace related actions. 

5.3.1.  Rationale for action 

Although  85%  of  adult  individuals  consume  alcohol  in  a  moderate  and  responsible  manner 
most  of  the  time,  harmful  and  hazardous  alcohol  consumption  is  one  of  the  main  causes  of 
premature  death  and  avoidable  disease  and  furthermore  has  a  negative  impact  on  working 
capacity29.  Alcohol-related  absenteeism  or  drinking  during  working  hours  have  a  negative 
impact on work performance, and therefore on competitiveness and productivity30. While 266 
million adults drink alcohol up to 20g (women) or 40g (men) per day, over 58 million adults 
(15%) consume above this level, with 20 million of these (6%) drinking at over 40g (women) 
or 60g per day (men). Looking at addiction rather than drinking levels, it is also estimated that 
23 million Europeans (5% of men, 1% of women) are dependent on alcohol in any one year. 

5.3.2.  Good practice 

Experience  gained  in  Member  States  tends  to  show  that  improved  enforcement  of  current 
regulations,  codes  and  standards,  is  essential  to  reduce  the  negative  impact  of  harmful  and 
hazardous  alcohol  consumption.  Licence  enforcement,  server  training,  community-  and 
workplace-based  interventions,  pricing  policy  (e.g.  reducing  “two-drinks-for-one”  offers), 
coordination  of  public  transport  and  closing  times,  advice  by  doctors  or  nurses  in  primary 

least 6 times with a BAC between 0.5 g/l and 0.79 g/l and to 11 times with a BAC between 0.8 g/l and 
0.99 g/l (Zador et al 2000) All studies confirm that the positive effect of new legislation to lower BAC 
limits  is  higher  if  it  is  followed by  public  discussions,  media  campaigns  and  enforcement  of  the  new 
laws. 
Alcohol  in  Europe  -  A  public  health  perspective,  P  Anderson  and  B  Baumberg,  Institute  of  Alcohol 
Studies, UK 2006 - http://ec.europa.eu/health-eu/news_alcoholineurope_en.htm 
RAND: An economic analysis of the impact of alcohol on the economic development in EU (Horlings, 
Scoggins 2006). 

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health care to people at risk, and treatment, are interventions that appear effective to prevent 
alcohol-related  harm  among  adults  and  reduce  the  negative  impact  on  the  workplace. 
Education,  information  activities  and  campaigns  promoting  moderate  consumption,  or 
addressing  drink-driving,  alcohol  during  pregnancy  and  under-age  drinking,  can  be  used  to 
mobilise public support for interventions.  

5.4. 

Inform,  educate  and  raise  awareness  on  the  impact  of  harmful  and  hazardous 
alcohol consumption, and on appropriate consumption patterns 

Aims 

Aim 9: To increase EU citizens’ awareness of the impact of harmful and hazardous 
alcohol  consumption  on  health,  especially  the  impact  of  alcohol  on  the  foetus,  on 
under-age drinkers, on working and on driving performance. 

5.4.1.  Rationale for action 

Citizens have the right to obtain relevant information on the health impact, and in particular 
on the risks and consequences related to harmful and hazardous consumption of alcohol, and 
to obtain more detailed information on added ingredients that may be harmful to the health of 
certain groups of consumers. Moderate alcohol consumption appears to offer some protection 
against  coronary  heart  disease  in  older  people  (45  and  above  depending  on  gender  and 
individual differences). 

5.4.2.  Good practice 

Lifestyle  choices  at  a  young  age  pre-determine  health  as  an  adult.  This  makes  children  and 
young people – as well as their parents – an important target group for health education and 
awareness  raising  interventions.  Broad  and  carefully  implemented  health  and  life-skills 
education  programmes,  beginning  in  early  childhood  and  ideally  continued  throughout 
adolescence,  can  raise  awareness  and  have  an  impact  on  risk  behaviour.  Such  interventions 
should address both risk factors such as alcohol and periods of risk, such as adolescence, and 
protective factors, i.e. changes in lifestyles and behaviours. 

Media  campaigns  –  such  as  the  Community-funded  “Euro-Bob”  campaign  aimed  at 
preventing  drink-driving  –  can  be  used  to  inform  and  raise  awareness  among  citizens  and 
support policy interventions. 

5.5. 

Develop, support and maintain a common evidence base  

Aims 

Aim  10:  To  obtain  comparable  information  on  alcohol  consumption,  especially  on 
young  people;  definitions  on  harmful  and  hazardous  consumption,  on  drinking 
patterns, on the social and health effects of alcohol; and information on the impact of 
alcohol  policy measures and of alcohol consumption  on productivity  and economic 
development. 

Aim  11:  To  evaluate  the  impact  of  initiatives  taken  on  the  basis  of  this 
Communication. 

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5.5.1.  Rationale for action 

Research  and  information  systems  are  crucial  for  the  development  and  implementation  of 
effective actions at EU, national and local level to be able to prevent harmful and hazardous 
consumption as well as to better assess the effects of moderate alcohol consumption. There is 
also  a  strong  need  for  common  definitions  of  binge-drinking,  harmful  and  hazardous 
consumption, in particular to follow trends in young peoples’ drinking habits. 

5.5.2.  What is needed 

In addition to the ongoing work on European Community Health Indicators, the Commission 
services have identified the need to develop a standardised definition for data on alcohol use 
and  alcohol-related  harm;  to  initiate  research  to  estimate  the  cost  and  benefits  of  policy 
options; to carry out regular and comparative European surveys; and to fill research gaps on 
alcohol-related  health  and  social  harm,  on  the  causes  of  harmful  and  hazardous  alcohol 
consumption,  and  on  its  role  in  widening  the  health  gap  between  socio-economic  groups. 
Furthermore, there is a need for assessing the differentiation of drinking patterns by country, 
age and gender. 

Moreover,  there  is  a  need  for  further  studies  to  evaluate  the  effectiveness  of  actions  and 
interventions, as proposed in this Communication. 

6. 

THREE LEVELS OF ACTIONS  

Member  States  have  the  main  responsibility  for  national  alcohol  policy.  In  addition,  the 
Community encourages cooperation and coordination between the Member States and lends 
support  to  their  action.  As  a  complement  to  these  national  initiatives,  the  Commission 
implements  policies  in  the  field  of  alcohol  related  harm,  in  particular  through  the  Public 
Health  Programme  and  the  Research  Framework  Programme.  There  are  thus  three  levels  of 
actions,  the  national  level,  the  coordination  of  national  policies  at  Community  level  and 
actions by the Commission on the basis of its prerogatives. In this context, the main role of 
the Commission is: (1) to inform and raise awareness on major public health concerns at EU 
and  Member  State  level,  and  to  cooperate  with  Member  States  in  addressing  these;  (2)  to 
initiate  action at EU level when this relates to its field of competence, in particular through 
sectoral  programs  and  (3)  to  support  and  help  coordinate  national  actions,  in  particular  by 
identifying and disseminating good practice across the EU.  

6.1. 

Action by the European Commission 

The Community role in public health is to complement Member State efforts, to add value to 
their  actions  and,  in  particular,  to  deal  with  issues  that  Member  States  cannot  effectively 
handle on their own. The Commission will in particular prioritise actions to: 

•  Support, through the Public Health Programme, projects that contribute towards reducing 
alcohol-related harm in the EU, especially the harm suffered by children and young people, 
and monitor and evaluate the effectiveness of interventions. (refers to aims 1-11 in Section 
5) 

•  Support, through the Public Health Programme and other existing structures, the creation 
of  a  system  for  flexible  but  standardised  definitions  for  alcohol  data,  the  conducting  of 

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repeated and comparative surveys on alcohol consumption, in particular via the European 
Health Interview Survey and complementary surveys (to be developed in the framework of 
the  European  Health  Survey  System  and  the  European  Statistical  System),  and  the 
development  of  health  indicators  to  monitor  and  assess  developments.  Comparable 
information on alcohol will be made available on the Europa web site linked to the Health 
Portal. (aims 9-11) 

•  Support  the  monitoring  of  young  people’s  drinking  habits,  and  of  the  harm  they  suffer, 
with a particular focus on the increased alcohol consumption among girls and the increase 
in “binge-drinking”. (aims 1, 3, 4, 6, 7, 9) 

•  Develop, in cooperation with Member States and stakeholders, strategies aimed at curbing 
under-age  drinking.  This  would  take  the  form  of  exchanges  of  good  practice  to  address 
issues  such  as  selling  and  serving,  irresponsible  marketing,  and  the  image  of  excessive 
alcohol use conveyed through the media and by role models, and could possibly be taken 
forward  within  the  Alcohol  and  Health  Forum  referred  to  in  Section  6.3.1.  and  in  the 
implementation of the European Youth Pact31. (aims 1, 2, 4, 5, 6, 7, 8) 

•  Support  Member  States  and  stakeholders  in  their  efforts  to  develop  information  and 
education  programmes  on  the  effect  of  harmful  drinking  and  on  responsible  patterns  of 
consumption. (aims 1- 9) 

•  Explore, in cooperation with Member States and business organisations, the possibility of 
developing  specific  information  and  education  campaigns  or  similar  initiatives  to  tackle 
alcohol-related  harm  at  the  workplace.  In  this context,  exchange  of  specific  best  practice 
should be pursued, possibly together with other Commission led initiatives such as those 
on e.g. Corporate Social Responsibility. (aims 1-9) 

•  Support  the  involvement  of  relevant  organisations  competent  in  the  field  of  workplace 
health,  e.g.  the  European  Agency  for  Safety  and  Health  at  Work  given  the  relevance  of 
some  of  its  initiatives  such  as  the  ‘The  Healthy  Workplace  Initiative’  which  aims  to 
provide  both  employers  and  employees  with  easy  access  to  information  about  how  to 
improve their business environment by becoming healthier and more productive. (aims 1-
9) 

•  Explore, in cooperation with Member States and stakeholders, the usefulness of developing 
efficient  common  approaches  throughout  the  Community  to  provide  adequate  consumer 
information.  Such  reflections  are  particularly  important  as  some  Member  States  are 
planning  to  introduce  warning  labels  (e.  g.  on  alcohol  and  pregnancy),  and  as  more 
generally there is an ongoing discussion about best practice in consumer education. (aims 
1, 3, 4, 6, 7, 9)  

•  To  report  on  the  implementation  of  measures  to  tackle  harmful  and  hazardous  alcohol 
consumption,  as  described  in  this  Communication,  based  also  on  the  information  from 

31 

In  its  Communication  on  “European  policies  concerning  youth:  Addressing  the  concerns  of  young 
people  in  Europe  –  implementing  the  European  Youth  Pact  and  promoting  active  citizenship”  of  30 
May 2005 the Commission confirms the importance of paying attention to the health of young people. 
One of the areas for action is the use of alcohol by young people.  

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Member States, and on the impact of the EU strategy set out in this Communication. (aim 
11) 

Moreover,  through  the  proposed  7th  Research  Framework  Programme  (2007-2013),  in 
particular under the Health Theme of the proposed Specific Programme "Co-operation", there 
will  be  opportunities  to  examine  how  research  at  the  European  level  brings  value  to  an  EU 
strategy  to  support  Member  States  to  reduce  alcohol  related  harm.  In  order  to  provide 
evidence  for  the  best  public  health  measures  and  to  guide  integrated  policy  making  for 
prevention of alcohol abuse, areas for research could include:  

•  work on young people’s drinking habits (trends, determinants);  

•  the link between harmful alcohol consumption/drinking patterns and related health, social 

and economic harm (refers to aims 1-10 in Section 5); 

•  other factors relating to impact on society (refers to aims 1-10 in Section 5).  

6.2. 

Subsidiarity: Mapping of actions implemented by Member States  

6.2.1.  National action 

Most  Member  States  have  put  in  place  legislation  and  policy  related  to  the  harmful  and 
hazardous  consumption  of  alcoholic  beverages.  Moreover,  in  2005  fifteen  Member  States 
reported  that they  had adopted national action plans, or  had coordinating  bodies for alcohol 
policy  in  place.  The  range  of  measures  implemented  by  Member  States  is  very  large  and 
includes issues such as education, consumer information, and enforcement of traffic controls 
or of selling licences for alcoholic beverage as well as setting the levels of alcohol taxation32. 

Specific measures adopted by Member States to reduce alcohol-related harm with a view to 
protecting public health are based on their particular cultural contexts. The mapping of certain 
actions  taken  within  the  framework  of  national  policies  can  facilitate  the  dissemination  of 
good practices. Every measure has to be considered on a case-by-case basis; in all cases, they 
should  be  evidence-based,  proportionate  and  implemented  on  a  non-discriminatory  basis. 
Examples of national measures currently implemented in Member States are the following: 

•  Action to improve consumer information, at point of sale or on products, on the impact of 
alcohol  abuse  on  health  and  work  performance.  As  part  of  consumer  information,  some 
Member  States  have  introduced,  or  are  considering  introducing  labelling  to  protect 
the  unborn  child.  Other  actions  aim  at  providing  easily 
pregnant  women  and 
understandable information on alcohol content and moderate drinking. (aims 1-9) 

•  Action to better enforce age limits for selling and serving alcohol. Such actions appear to 
be more efficient if they involve all stakeholders, parents, and young people. As alcohol is 
poorly metabolised at a young age, the re-examination of minimum age requirements for 
selling  and  serving  all  alcoholic  beverages,  in  particular  where  the  minimum  age  is 

32 

Minimum rates for excise duties are laid down in Council Directive 92/84/EEC of 19 October 1992 on 
the approximation of the rates of excise duty on alcohol and alcoholic beverages. Above these minima 
Member  States  are  free  to  set  their  national  rates  at  levels  they  consider  appropriate  and  which  may 
incorporate other policies such as health. 

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currently  below  18  years,  also  appears  to  be  considered  by  some  Member  States  as  an 
option. (aims 1, 4, 6, 7, 8) 

•  Interventions  and  educational  programmes  are  proven  to  increase  the  ability  of  young 
people,  and  their  parents,  to  tackle  alcohol  problems  and  risky  behaviour.  These 
interventions  could  target  both  risk  and  protective  factors,  with  the  aim  of  promoting 
effective behavioural change among children and adolescents, and could be carried out in 
schools and other appropriate settings. To increase efficiency, this should actively involve 
young people and all other relevant stakeholders. (aims 1, 2, 4, 6-9) 

•  Introduction  and  enforcement  of  rules  against  serving  alcohol  to  intoxicated  persons,  as 
well  as  effective  licensing  systems  for  the  sale  and  responsible  serving  of  alcoholic 
products, in accordance with their particular contexts and national legal order. (aims 1-7, 9) 

•  Introduction  of  a  zero  BAC  limit  for  young  or  inexperienced  drivers,  and  for  public 
transport drivers as well as drivers of commercial vehicles, in particular those transporting 
dangerous goods. (aims 4-6) 

•  Development of a framework to enable unrestricted (random) breath testing for all drivers, 
enforcement  of  drink-driving  countermeasures  and  application  of  dissuasive  sanctions 
against all who are found to be driving over the BAC limit, and in particular for repeated 
drink drivers. (aims 4-7, 9) 

•  Specific  actions  aimed  at  addressing  the  problems  posed  by  alcohol  consumption  at  and 

around the workplace. (aims 2-6) 

•  Allocation  of  the  necessary  resources  in  primary  health  care,  to  advice  and  treatment 
regarding hazardous and harmful alcohol consumption, to provide training for health care 
professionals and to prioritise alcohol prevention at workplaces, counselling for children in 
families with alcohol problems and education and awareness-raising actions to protect the 
unborn child. (aims 2-9) 

•  Establishment  of  publicly  funded  alcohol  research  and  monitoring  programmes.  (aims  7-

11) 

6.2.2.  Local action 

National  strategies  could  be  more  effective  if  they  are  supported  by  local  and  community 
based activities. Moreover, local multi-stakeholder action appears to be essential to underpin 
the strategy set out in this Communication. For example: 

•  Active  learning  methods  could  be  used  to  discourage  adolescents  to  start  experimenting 

with harmful alcohol consumption. (aims 1, 6, 7, 9) 

•  For  all  workplaces,  there  could  be  a  policy  to  prevent  alcohol-related  harm,  including 
information  and/or  education  campaigns,  and  to  provide  help  and  specialised  care  for 
employees with alcohol-related problems. (aims 5-9) 

•  Youth and civil society organisations should reflect on how they can contribute to reducing 

alcohol-related harm. (aims 1-9) 

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•  Local  communities  could  contribute  to  prevent  and  promote  strategies  to  protect  citizens 

from alcohol-related harm. (aims 1-9) 

6.3. 

Coordination of actions at EU level  

EU competence in health is not confined to specific public health actions. Where possible, the 
Commission  will  seek  to  improve  the  coherence  between  policies  that  have  an  impact  on 
alcohol-related harm. A number of mechanisms are currently in place to ensure that health is 
taken into consideration in other Community policy areas, in accordance with Article 152(1) 
of the EC Treaty.  

6.3.1.  Alcohol and Health Forum 

Using  the  EU  Platform  for  Action  on  Diet,  Physical  Activity  and  Health  as  a  model,  the 
Commission will set up an Alcohol and Health Forum by June 2007, which will put together 
experts  from  different  stakeholder  organisations  and  representatives  from  Member  States, 
other  EU  institutions  and  agencies.  The  overall  objective  of  this  Forum  will  be  to  support, 
provide  input  for  and  monitor  the  implementation  of  the  strategy  outlined  in  this 
Communication. The Alcohol and Health Forum could, when appropriate, set up sub-groups 
on special topics such as research, information and data collection, and education. (aims 1-11) 

6.3.2.  Drink-driving 

In order to better coordinate the activities to reduce alcohol-related road accidents, and with a 
particular  view  to  combating  drink-driving,  the  Commission  will  improve  coordination 
between drink-driving and road safety actions, including those supported by the Public Health 
Programme and the Action Plan on Road Safety. This will address in particular the issue of 
novice and young drivers. (aims 4, 6, 7) 

6.3.3.  Commercial communication 

Community  law  already  regulates  certain  aspects  of  commercial  communication,  and  some 
instruments are currently being reviewed and updated. In addition, there is increasing clarity 
regarding the kinds of self-regulatory best practices that will help create effective parameters 
of  behaviour  for  advertisers,  and  thus  align  advertising  practice  with  social  expectations33. 
The  Commission  services  will  work  with  stakeholders  to  create  sustained  momentum  for 
cooperation on responsible commercial communication and sales, including the presentation 
of a model of responsible consumption of alcohol. The main aim will be to support EU and 
national/local Government actions to prevent irresponsible marketing of alcoholic beverages, 
and to regularly examine trends in advertising and issues of concern relating to  advertising, 
for example on alcohol.  

33 

Television advertising for alcoholic beverages is regulated by the Television without Frontiers Directive 
(Council Directive 89/552/EEC of 3 October 1989 on the coordination of certain provisions laid down 
by  Law,  Regulation  or  Administrative  Action  in  Member  States  concerning  the  pursuit  of  television 
broadcasting  activities  -  OJ  L  298,  17.10.1989,  p.  23).  Directive  2005/29/EC  of  the  European 
Parliament  and  of  the  Council  of  11  May  2005  concerning  unfair  business-to-consumer  commercial 
practices addresses misleading and aggressive practices, and practices which use coercion as a means of 
selling  (OJ  L  149,  11.6.2005,  p.  22).  As  far  as  self-regulation  approaches  are  concerned,  the  multi-
stakeholder  and  multi-sector  Advertising  Round  Table  established  by  the  Commission  services  has 
identified some key elements for effective self-regulation, which are presented in the report available at: 
http://ec.europa.eu/consumers/overview/report_advertising_en.pdf.  

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One aim of this joint effort will be to reach an agreement with representatives from a range of 
sectors  (hospitality,  retail,  producers,  media/advertising)  on  a  code  of  commercial 
communication  implemented  at  national  and  EU  level.  Benchmarks  for  codes/strategies  at 
national level could be agreed. 

As part of this approach, the impact of self-regulatory codes on young people’s drinking and 
industry  compliance  with  such  codes  will  also  be  monitored.  Independent  parties  will  be 
invited  to  verify  the  performance  and  outcomes  of  self-regulatory  codes  against  the  agreed 
to  adjust  objectives 
benchmarks, 
accordingly. (aims 1-9) 

thus  allowing  Social  Responsibility  Organisations 

7. 

CONCLUSIONS 

With this Communication, the Commission, in response to the Council’s invitation in 2001, 
presents a comprehensive strategy to reduce alcohol-related harm in Europe until the end of 
2012, and explains what has already been done at national and Community level, what are the 
priority areas which deserve further action and how the Commission can further contribute to 
address this major public health concern. The Commission proposes that Member States and 
stakeholders should take this Communication as a basis to work forward, in particular within 
the framework of the Alcohol and Health Forum. 

The Commission considers that its main contribution to the strategy should be based on the 
existing approach of complementing national policies and strategies in this area and therefore, 
does  not  intend  to  implement  the  strategy  through  specific  new  legislative  proposals.  The 
Commission  will  report  regularly  on  the  implementation  of  measures  to  tackle  harmful  and 
hazardous alcohol consumption, as described in this Communication, as well as on the impact 
of the EU strategy set out in this Communication; this will be based on regular reporting from 
the Member States on the implementation of the relevant measures. 

Certain existing Member States actions are to be considered as examples of good practice and 
have  proven  their  effects.  In  respect  of  the  principles  of  subsidiarity  and  better  regulation, 
these  actions  need  to  be  strengthened  in  order  to  achieve  the  goal  of  this  strategy.  The 
Commission  will  contribute  through  its  role  of  complementing  Member  States  efforts,  by 
adding  value  to  their  actions  and  dealing  with  issues  that  Member  States  cannot  effectively 
handle on their own. 

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