Lithuania’s Alcohol Model: Combat Excessive Rates of Alcoholism

By Noah Thelen

Alcohol use disorder, commonly referred to as alcoholism, is a serious disease that is classified as uncontrolled drinking.[1] According to the World Health Organization (WHO), statistics on alcoholism are a concern globally, with roughly three million deaths each year attributed to the disease.[2] As of 2021, alcoholism is the seventh leading cause of death worldwide.[3] Lithuania has recognized increasing rate of alcohol consumption and has undergone studies to prevent growing tragedies.[4]

The Organisation for Economic Cooperation and Development (OECD) is a network for countries to share their eco-social problems and help find collaborative methods to reach a solution.[5] The OECD was founded in 1961 as a further development and expansion to the already existing Organisation for European Economic Cooperation.[6] With this expansion in 1961, it allowed countries like the United States and Canada to be involved to present their eco-social problems and help find solutions — something other countries had been doing for nearly fifteen years earlier.[7]

Throughout the history of alcohol use in societies, there have been many examples of regulations of alcohol production, distribution, and consumption.[8] Many of these historical examples only centered around combating alcohol within a country’s borders; thus, a global framework is a much newer concept.[9] In 2010, WHO agreed to create a Global Strategy to reduce the harmful use of excessive alcohol consumption.[10] With this Global Strategy, WHO received guidance from member countries, but it was ultimately up to each continental region to set a ground floor minimum for implementing the Global Strategy.[11]

Europe created the European Action Plan to Reduce the Harmful Use of Alcohol.[12] This plan built upon previous European plans and created five main objectives to follow: (1) raise awareness of the magnitude and nature of the health, social, and economic burdens of excessive alcohol consumption; (2) foster increase government commitment to addressing those burdens; (3) strengthen and disseminate information on the scale and detriments of alcohol-related harm along with effective interventions; (4) increase technical support to member states; and (5) strengthen partnerships among countries to share studies, findings, and resources.[13] Additionally, WHO recommended an increase excise tax on alcoholic beverages, an enactment of restrictions on exposure to alcohol advertisement, and restrict the physical availability of retailed alcohol sales.[14] As previously mentioned, these are all recommendations — and ground floor recommendations. Countries can set any regulations that are more stringent than WHO recommended to achieve their desired results.

If more countries follow the “best-buy model” promoted by WHO, then excessive alcohol consumption may decrease if implemented properly. Courtesy Wikipedia.

The final important piece of this WHO report was the creation of nine voluntary targets, including at least a ten percent reduction in the harmful use of alcohol by 2025.[15] The inclusion of the alcohol target and indicators in the global monitoring framework, as well as the risk factors associated with excessive alcohol consumption, will increase the demand for high-quality global data. This will be used to implement further modifications to plans recommended by WHO.[16]

The WHO has identified policies called the “Best-buy policies” that it believes are affordable, feasible, and cost effective strategies (in addition to the nine voluntary targets above).[17] The WHO recommend increasing excise tax on alcoholic beverages, enacting and enforcing bans on comprehensive restrictions on exposure to alcohol advertisements, and restrictions on the availability of alcohol.[18]  

In the early 2000’s, Lithuania was among the WHO Member States that had the highest per capital alcohol consumption levels.[19] Lithuania’s rate was 15.1 liters of alcohol per capita, and the rest of Europe was 11.2 liters of alcohol per capita.[20] Lithuania created the first action package spanning from 2008 to 2009, and fully implemented the package in 2014.[21] Lithuania has been hailed as the model country for implementing the “best-buy strategies” in a short period of time; thus saving numerous lives.[22]

For example, Lithuania increased its alcohol excise tax by twenty-eight percent on absolute ethyl alcohol and 111 percent on beer and wine between 2016 and 2017.[23] Additionally, retrial hours on Monday through Saturday were cut by two hours to 10:00 A.M. to 8:00 P.M.[24] On Sunday, alcohol sales are only allowed from 10:00 A.M. to 3:00 P.M.[25] Furthermore, Lithuania elected to raise the minimum drinking age from eighteen years old to twenty years old in 2018.[26]

Lithuania also has some of the strictest alcohol advertising laws in Europe.[27] The Republic of Lithuania Law on Alcohol was enacted on January 1, 2018 and provided a comprehensive ban on alcohol advertising, including through digital and social media.[28] This  provision completely banned alcohol advertising alcohol through radio, television, print, and specialized advertising brochures.[29] Despite the heavy backlash from companies, Lithuania has maintained the ban because alcohol advertising is a casual risk factor for earlier alcohol initiation and higher alcohol consumption.[30] Without the ban, the alcohol industry could re-gain broad access to younger consumers who are still in the critical development stage of their brain.[31]

Lithuania has been able to track the progress of their bans and have listened to their citizens regarding future revisions. There has been a growth in public support for these alcohol laws. A survey in 2019 stated that fifty-one percent of citizens have a positive opinion about the existing alcohol policy regulations, sixty-seven percent back the law raising the legal age to 20, and sixty-two percent support the total ban on alcohol advertisements.[32] The development of the alcohol control policy in Lithuania highlights the complexity policy makers face when confronting large-scale economic and public health concerns.

If more countries follow the “best-buy model” promoted by WHO, then excessive alcohol consumption may decrease if implemented properly. Lithuania has provided a model policy for countries to follow to properly implement low cost and highly effective alcohol policies that save numerous lives from addiction.

[1] See Peter Szczepanski, Alcoholism by Country Statistics, Abbeycare Foundation (Dec. 9, 2021), https://www.abbeycarefoundation.com/alcohol/alcoholism-by-country-statistics/.

[2] See id.

[3] See id.

[4] See Preventing Harmful Alcohol Use, Org. for Econ. Co-operation and Dev. (May 19, 2021), https://www.oecd.org/italy/Preventing-Harmful-Alcohol-Use-Key-Findings-ITALY.pdf.

[5] See OECD Countries 2023, World Population Rev., https://worldpopulationreview.com/country-rankings/oecd-countries.

[6] See id.

[7] See id.

[8] See Global Status Report on Alcohol and Health, 2018 Report, WHO (2018).

[9] See id.

[10] See id. at 25.

[11] See id. at 26.

[12] See id.

[13] See id.

[14] See id.

[15] See id. at 30 (Figure 2.1).

[16] See id.

[17] See Reducing Harm to Alcohol: Success Stories from 3 Countries, World Health Org. (Apr. 15, 2021), https://www.who.int/europe/news/item/15-04-2021-reducing-harm-due-to-alcohol-success-stories-from-3-countries.

[18] See id.

[19] See id.

[20] Global Status Report on Alcohol and Health, 2018 Report, supra note 8 at 274.

[21] See Understanding Lithuania’s Alcohol Policy Success, Movendi (Sept. 30, 2021), https://movendi.ngo/news/2021/09/30/understanding-lithuanias-alcohol-policy-success/.

[22] See id.

[23] Lukas Galkus, The Comprehensive Alcohol Advertising Ban in Lithuaia: A Case Study of Social Media, 19(19) Int’l J. Env’t Res. Pub. Health 12398, 12398 (2020), https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9566760/pdf/ijerph-19-12398.pdf.

[24] Id. at 2.

[25] Id.

[26] Laura Mišˇcikiene et. al, Review of the ˙ Lithuanian Alcohol Control Legislation in 1990–2020, 17(10) Int’l J. Env’t Res. Pub. Health 3454, 3454 (2020).

[27] World Health Organization Regional Office for Europe. Digital Marketing of Alcohol: Challenges and Policy Options for Better Health in the WHO European Region, WHO: Geneva, Switzerland (2021).

[28] Id.

[29] Ruling of the Constitutional Court of the Republic of Lithuania, Republic of Lithuania (Feb. 13, 1997), https://www.e-tar.lt/portal/lt/legalAct/TAR.3287CDEB8021.

[30] Paul Anderson et. al, Impact of Alcohol Advertising and Media Exposure on Adolescent Alcohol Use: A Systematic Review of Longitudinal Studies, 44(3) Alcohol Alcohol. 229, 229-43 (2009).

[31] See id.

[32] Understanding Lithuania’s Alcohol Policy Success, supra note 20. 2018 Results: Forty-eight percent had a positive opinion about the existing alcohol policy regulations, fifty-three percent backed the law raising the legal age, and fifty-seven percent supported the total advertisement ban.