Good practice principles low rik drinking EU RARHA

A quarter of a century of alcohol campaigns in Denmark
Kit Broholm a
In Denmark, yearly alcohol campaigns have been carried out by health authorities since 1990. The
campaigns have highlighted various aspects of alcohol related harm and disseminated information
on drinking guidelines to various target groups. In 2010, the focus of the drinking guidelines was
shifted from high risk to low risk. The national campaigns have served as an umbrella for activities
at local level and, together with concrete guidance for municipal action, have been the backbone
of a national health promotion strategy.
Alcohol consumption has fallen in Denmark from 12,2 litres pure alcohol per capita (age 15+) in 1996 to
9,3 litres in 2015 – a 23% reduction in less than 20 years [ 1 ]. Consumption is decreasing among both
men and women and in all age groups, in particular among young men aged 16-24 years. The only
exception is well-educated persons aged 65 years or more whose alcohol consumption shows an
upward trend.[ 2 ]
To explain this development it is necessary to look at Danish alcohol policy in terms of both control
measures and health promotion initiatives. Denmark has a tradition of liberal alcohol policy, with excise
duty and licensing of on-premise sale of alcoholic beverages as the main regulatory instruments. The
trend has been toward further liberalization: restrictions on alcohol advertising have been lifted, the
availability of alcohol has increased including through internet retailing, and excise duties have been
lowered.
As a consequence of the liberal policy, alcohol consumption among young people became a cause
for concern in the 1990s. The first ESPAD survey report in 1995 showed vividly that young people in
Denmark were drinking more than their European counterparts.[ 3 ] In 1998 a mimimum age of 15 years
was introduced for retail purchasing of alcoholic beverages. In 2004 the age limit was raised to 16 years,
and in 2011 to 18 years for beverages containing 16,5% alcohol or more. (For on-premise serving of
alcoholic beverages the age limit has been 18 years since 1924.) In parallel with raising the age limit,
schools were recommended to agree on a school policy on alcohol and on common rules with parents
of pupils in the 5th to 9th grade. School-based work was supported through national campaigns and
materials.
The combination of measures has made an effect. Among boys, the share of those who had tried
alcohol fell from 74% in 1998 to 49% in 2002 for 11 year olds, from 86% to 76% for 13 year olds, and
from 95% to 92% for 15 year olds. The trend has been steadily falling. In 2014, the figures were 21% for
11 year olds, 36% for 13 year olds and 77% for 15 year olds.[ 4 ]
Regarding the population at large, health promotion has been the main strategy to reduce alcohol
related harm, combining support for the development of municipal alcohol policy and action with
nation-wide information campaigns including drinking guidelines.
Health promotion in municipalities
In order to strengthen municipalities’ capacity and structures for health promotion, the Danish Health
Authority has produced guidance materials on 11 different themes on which action should be stepped
up, including alcohol, tobacco, physical exercise, diet and mental health. Each health promotion
package lays out facts on the risk factor, presents evidence of effective interventions and describes
good practice. Evidence-informed recommendations for municipal health promotion are presented
regarding structural interventions, health promotion services, information and education and early
detection. The recommended actions are indicated as basic level, suggested by current best evidence,
and as developmental, that is, requiring a higher level of proactivity and new competencies. The aim is
to assist municipal decision-makers and health planners in setting priorities, planning and organizing
local health promotion and disease prevention.[ 5 ]
a
The Danish Health Authority
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Good practice principles for low risk drinking guidelines