Nordic countries have a long history of alcohol consumption, complex challenges with heavy episodic drinking practices, and a reputation of implementing some of the strongest regulations to reduce alcohol-related harms.
Today, alcohol drinking levels in the Nordic countries, including Denmark, Finland, Iceland, Norway and Sweden, are among the lowest in the European Union. Unsurprisingly, alcohol is treated in many of these countries as no ordinary commodity and is strictly regulated.
WHO highlights some of the key elements of success:
- bans or restrictions on the marketing of alcohol
- taxation and pricing policies
- limiting alcohol availability.
Retail monopoly systems
One of the main ideas behind the Nordic approach is a vision that considering harms to health associated with alcohol consumption outweighs potential economic profits and revenues that might come from the sale of alcoholic beverages. That’s why limiting the negative effects that alcohol causes to society is at the centre of Nordic alcohol control measures.
Retail monopoly systems are a Nordic approach to bring this vision into practice and limit the harms of alcohol – not only to drinkers but also to those around them. All Nordic countries, excluding Denmark but including Greenland and the Faroe Islands (self-governing entities within the state of Denmark), have chosen to create and uphold such retail monopoly systems, which are government-owned and control when, where and at what price alcohol is sold.
The purpose of monopoly systems is to limit the various negative effects of alcohol on the population and society by reducing the number of outlets where alcohol is sold and enforcing other regulatory measures, such as restricting trading hours and sales promotions. Each Nordic country has its own national alcohol policy framework and retail monopolies are an essential part of it.
Compared to other alcohol trade systems, Nordic retail monopolies have proven to be an effective tool to limit the physical availability of alcohol and have been recognized as a best practice in international research and rating systems, such as the global ‘Alcohol: No Ordinary Commodity’ collaborative effort by an international group of addiction scientists.
Protecting young – protecting all
Taxation is another powerful measure that many Nordic countries use, not only to increase government revenue but also as a health measure. Even moderate increases in alcohol excise taxation in the Nordic countries have resulted in considerable health gains, as well as state revenues that can be used to invest in health care.
Taxation has also had an important role in protecting young people from the harmful effects of alcohol in the Nordics. High taxes on alcohol have been proven to reduce alcohol consumption and harm for all of society, including heavy drinkers and adolescents. There is also evidence of the benefit of taxation in delaying when young people start drinking.
Concerns over the negative effects of advertising on young people was also a core reason for countries like Norway to enforce stricter bans and restrictions on alcohol marketing.
“A comprehensive ban on alcohol marketing, enforced at the national and local level, is a best practice for reducing alcohol sales and consumption,” said Ingeborg Rossow from the Norwegian Institute of Public Health and one of the authors of the ‘Alcohol: No Ordinary Commodity’ collaborative review. “In Norway, a complete ban on marketing, introduced as early as 1975, and adding to other alcohol control measures, has had an immediate and lasting effect in reducing alcohol sales and consumption. What started with a concern for the health of young people has had a positive effect for the whole population.”
Collaboration with Nordic countries
The Nordic approach combines comprehensive alcohol control measures with effective awareness raising campaigns to promote safer societies in the countries, with reduced harm due to alcohol. “The Nordic countries have a strong history since the early or mid- twentieth century of countering their earlier history of heavy alcohol consumption and high rates of harm by direct state control of the alcohol market and marketing, in considerable part by alcohol being sold through state monopoly stores,” said Robin Room, an Australian researcher who has studied the effects of such systems, and who is also a co-author of ‘Alcohol: No Ordinary Commodity’.
Room continued, “This approach was to some extent weakened when Finland and Sweden joined the European Union and by pressures from private interests in this neoliberal age. But the Nordic alcohol monopoly systems, like those in Canadian provinces and U.S. states, have retained a system of control, which has been shown to serve the interest of public health and welfare, reducing the societal harms from alcohol.”
Given the leading role of these countries in the European alcohol policy agenda, WHO/Europe is exploring possibilities for strengthening collaboration with the Nordic countries to document and disseminate best practices in reducing alcohol-related harm.
“Many of the Nordic countries are doing well in communicating the risks associated with alcohol – a toxic and dependence-producing substance that is responsible for over 200 diseases and health conditions, including cancer,” said Dr Carina Ferreira-Borges, WHO/Europe Regional Adviser for Alcohol, Illicit Drugs and Prison Health. “With a growing understanding of this, we can create environments where the healthier choice of drinking less is easy and not stigmatized. Nordic countries and their government-owned retail monopolies are a very comprehensive example of how alcohol can be treated as no ordinary commodity.”
