FINLAND: Alcohol-related deaths and liver disease increased after the 2018 alcohol law reform

02.12.2022 - The reform of the Alcohol Act that came into force in 2018 had a negative impact on the health of Finns and on alcohol consumption among young people.

In 2019 and 2020, around 160 more people died from alcohol-related diseases and intoxications per year than before the law change in 2017. In 2020, a total of around 1,700 people died from these causes.

The data comes from a recent THL report commissioned by the Ministry of Social Affairs and Health to assess the impact of the overall reform of the Alcohol Act on alcohol availability, consumption and harm.

In particular, there was an increase in alcohol-related liver disease deaths in men. The number of such cases climbed by 12% between 2017 and 2019, and by 22% by 2020. The number of alcohol-related liver disease deaths treated in healthcare also increased.

The Alcohol Act that entered into force in 2018, among other things, raised the maximum alcohol content of beverages sold in grocery stores from 4.7% to 5.5% and allowed the sale of mixed drinks diluted with spirits in grocery stores.

"After the reform of the law, the increase in alcohol mortality outpaced the increase in alcohol consumption at the population level. This suggests that heavy drinkers have increased their alcohol consumption more than other consumers," says Pia Mäkelä, Research Professor at THL.

Sales of strong beers and mixed drinks increased significantly - overall consumption grew slightly The reform of the Alcohol Act increased retail sales of strong beers of 4.8% to 5.5% by over 600% and retail sales of mixed drinks of the same strength by over 500% between 2017 and 2019.

By contrast, consumption of other alcoholic beverages sold in grocery stores, especially medium beer, declined.

In 2018, total alcohol consumption was 10.1 litres of 100% alcohol per capita aged 15 and over, up only slightly by 0.1 litres compared to the previous year. Total alcohol consumption includes both statistical consumption of alcohol, i.e. retail and on-licence sales, and unrecorded consumption, i.e. travellers' imports and online sales.

However, when the independent effect of the alcohol law is separated from the simultaneous effects of other factors using a statistical time series model, the alcohol law reform probably increased the recorded consumption of alcohol by about 3% compared to the level of consumption that would have occurred in the absence of the law reform.

"Alcohol taxes were increased by 10% in 2018. Normally, tax increases reduce alcohol consumption, but this was not the case in 2018. Consumption increased slightly despite the tax increases," says Mäkelä.

From 2019 onwards, overall alcohol consumption decreased again, partly due to the increases in alcohol taxes and the COVID-19 epidemic. Looking at the longer term, overall consumption in Finland has generally decreased since 2007.

Prices were higher than expected

The impact of the Alcohol Act on alcohol consumption was reduced by price competition remaining smaller than expected.

After removing the impact of the tax increase on alcohol prices, strong beer prices were around 8% lower than before. These beverages were almost entirely shifted to grocery stores. Price competition for strong beer is significantly less than for medium beer: for the cheapest products, the duty-free price of strong beer is about three times that of medium beer.

For the most popular long drink, there was no price difference between Alko's stores and grocery stores in 2022.

Sobering up of minors stalled According to school health surveys, the sobering trend among under-age young people stalled between 2017 and 2019. Although the sobering trend among young people seems to have resumed positively from 2019 onwards, there are indications that the downward trend in binge drinking has stopped for some young people.

Based on the European School Student Survey on Youth Substance Use (ESPAD), Finnish girls aged 15-16 have even increased their consumption of alcohol and the number of doses drunk at one time. This is probably explained by the fact that girls' consumption of mixed drinks increased.

"The high price of mixed drinks and strong beer has possibly restrained the purchases of young people and people with low incomes to some extent. Despite the high price, the consumption of mixed drinks increased especially among underage girls after these drinks could be bought in local stores," says Kirsimarja Raitasalo, special researcher at THL.

Increasing the availability of alcohol would again increase harm

In relation to the entire alcohol sales system, the reform of the alcohol law in 2018 was quite small: 3.2 percent of Alko's sales were opened to private competition.

A more extensive dismantling of Alko's exclusivity system could clearly increase the adverse effects. "Limiting the number of points of sale and removing the goal of sales promotion from the alcohol market is a key means of preventing alcohol harm and promoting the well-being, health and safety of the population. This is where the exclusive system of retail alcohol sales plays a key role," says THL CEO Markku Tervahauta.

Source: THL