Alcohol Prevention in the Netherlands: firststeps to evidence based prevention

Wim van Dalen – National Foundation for Alcohol Prevention; wvandalen@stap.nl

‘To introduce my country

• The Netherlands

• 17 million inhabitants

The stereotypes of our country to attract visitors

•

• cheeze

flowers

Wooden shoos

Wooden shoos

Alcohol in the Netherlands

• 8,1 liter pure alcohol per capita• Beer most popular, but is

slowly decreasing• Wine consumption is ‘always’

slowly increasing• Premixers and other sweet

drinks (up to 14,9 %): a riskychallenge for kids

• The so-called beer-home-tap is promotedenormously

Source: ESPAD 2003 NL: 25%

≥10 times drinking in the last months (15/16 years)

Binge drinking last month (3 times or more)

Starting age of weekly drinking

0%

20%

40%

60%

80%

100%

9jr 10jr 11jr 12jr 13jr 14jr 15jr 16jr 17jr

jongens meisjes

One of the biggest threats: drinking figures of young girls

. Lifetime Girls

0

20

40

60

80

100

1988 1992 1996 1999 2003

121314151617-18

Alcohol in the Netherlands

• Dutch young people (12-18) drink most frequently compared to allEuropean youth (25% drinks al least every three days a week).

• 50% of the boys of 15 drinks more than 5 glasses at a weekend night; 20% more than 10 glasses.

• 10 % of the whole population drinks above ‘safe’ norms and have concrete problems (17% man, 4% women)

• There are 360.000 alcohol addicts and 450.000 problem drinkers

• Costs of alcohol for society: 2.58 billion euro dollar(KPMG, 2001)

Alcohol and young people

• Very tolerant attitude of parents

• Buying alcohol is very easy

• Still too much focus oneducation

Parents are tolerant…

• 40% of the Dutch parents accept drinking their kids of 12-13 onparties where they are alone with friends

• 65 % accept this for 14-15 year old kids

(Van den Eijnden, 2006).

Key problem…big exposure to alcohol

• Alcohol is cheap

• Alcopops are easy to get

• Marketing is attractive

Many youngsters create their own drinking places

shifts in policy …..

• More focus on municipal/regional alcohol policy

• More focus on enforcement

• More focus on parents

• Concrete success: tv and radio ban before 9 p.m

What do we need…..

• A reframing of the concept of prevention

• a stronger ‘prevention management’ of the local authorities

• more input of and cooperation with enforcement people

• more input from volunteers, parents, citizens..

• more research on local level

Project Eindhoven region (720.000 inh.)21 municipalities

Back ground: a lot of media coverage on alcohol problems

• Accidents in nightly discotrain between Eindhoven and surrounding villages

• Increased alcohol consumption among youth in the region

• Increasing number of (illegal) private drinking places

Alcohol consumers (in %)Regional figures

13

31

56

7787 90

0102030405060708090

%

12 13 14 15 16 17Age

The prevention model

Creating public support

EnforcementPolicy and legislation

Prevention

Consequences• Drunk driving• Drug overdose• Alcohol poisoning• Alcohol-involved

injuries and death• Violence• Crime involvement• Alcohol dependency

Alcohol Consumption

DEMAND

Retail (or Illegal)Availability of

Alcohol

• Restricting sales of alcohol to minors• Alcohol vending machine bans• Alcohol-free parks and public spaces

Enforcement and Regulation• Tax increase on alcohol products• Community police enforcement

priority• Curfews and family rules

Overall Community Supply of Alcohol

convenience and availability of Alcohol

SocialAvailability of

Alcohol

social accessretail sales

SUPPLYSUPPLYAlcohol

Availability

perceived threat of enforcement

exposureNews,

Entertainment and Product Marketing (Mass media, TV,

advertising)

community acceptability

or disapproval

Personal, Family, & Community

Attributes• Individual/Peer Domain• Family Domain• Community Domain

School Environments and

Programs

enforcement support of community values

community pressurefor enforcement

involvement

System approach

Community Norms:

Acceptability of Alcohol

Consumption

Don’t go for fast success : step by step model

Problem Political support Awareness

Public support

Political decision(2)

Plan/ Goals/ succes

criteria

Political decision(1)

ImplementationSteering group etc

Financies

Clear measurable project goals

• No alcohol use below 16

• No drunkenness in public

Who got involved?

• Healthcare • Police• Alcohol law enforcers (VWA)• Civil servants• Region of Eindhoven (SRE)

• Not involved yet: sellers of alcohol

Essential contributing factors for the start of this project

• The personal involvement of some policy makers • The financial support from the province• The media exposure from the regional press• Focus not primarily on education• The mutual will to start a long term project

1. Creating public support

• Strategic and creative use of the media

• Involvement of parents

• Warning posters in outlets

• Organization of special events related to alcohol

2. Policy and legislation

• Evaluation of the municipal alcohol policies

• Design of a more effective alcohol policy plan on:

– Cabins– Bar opening hours– Alcohol use in public places– Licensing system

• Design of a alcohol free zones plan

3. Enforcement

Development of a specific alcohol enforcement policy:

• the drinking age of 16 year

• being drunk in public

• drinking & driving

• drinking in public places

We also test new enforcement strategies

Research agenda

• Epidemiological research

• Compliance research (mystery shoppers)

• Parental attitude study

• Process evaluation

Compliance researchN=224

• Sport clubs (n=60): 100%• Bar/disco (n=83): 95.2%• Supermarket (n=81): 91.4%

Potential critical factors for the future

• The results from the compliance checks• A possible one sided focus on parental education• Financial problems• Enforcers with a lack of capacity• Domino effect when municipalities refuse/quit cooperation• Lack of support for continuation after 4 years

Thank you

• Ir. W.E. (Wim) van Dalen• Manager STAP• www.stap.nl• wvandalen@stap.nl

• Barcelona, April 2008