Youth is a time of opening new doors, trying new
experiences, testing limits. For most of us, it is a tremendously rich
and exciting part of life. As Aristotle said: "The young are
permanently in a state resembling intoxication; for youth is sweet and
they are growing".
Unfortunately, real intoxication is also a factor
of youth. And far too often, it brings an abrupt end to it. Worldwide,
5% of all deaths of young people between the ages of 15 and 29 are
attributable to alcohol use.
In Europe, one in four deaths of men in the age
group 15 to 29 is related to alcohol. In parts of Eastern Europe, the
figure is as high as one in three. All in all, 55 000 young people in
this region died from causes related to alcohol use in 1999. That is a
shocking and tragic waste.
Globally, 140 million people are suffering from
alcohol dependence. Around the world, alcohol takes a heavy toll –
damaging public and private life with countless traffic fatalities and
injuries, home fires, drownings, suicides and violent crimes. But also
debt problems, ruined careers, divorces, birth defects, and children
with permanent emotional damage.
While some progress has been made in reducing
overall alcohol consumption in western parts of the European region,
the situation in the eastern part is worsening, and there are alarming
signs of deteriorating drinking habits among young people across the
Data from across the world suggests that a culture
of sporadic binge drinking among young people may now be increasing
also in developing countries. While overall rates of adult per capita
consumption are falling in many countries, young people are too often
drinking excessive quantities of alcohol to intoxication in single
The economic burden of excessive alcohol use is
also significant. The cost of under-age drinking in the United States
alone has been estimated by the US Department of Justice at nearly $53
billion in 1996.
Another study showed that the annual costs for
alcohol-related hospitalization in the state of New Mexico were USD 51
million while the annual alcohol taxes were only USD 35 million.
According to the latest UN Human Development
Report, alcohol-related vehicle crashes alone are estimated to cost
the Namibian economy at least one percent of gross domestic product
Alcohol use among young people is a serious
problem, but we know that we can considerably reduce the harm through
We have a wealth of experience from efforts to
limit consumption. We know, for example, that prohibition does not
work. The evidence we have indicates that we need a mix of policies.
It is clear that measures that reduce access to
alcohol are effective in reducing consumption. A minimum legal
drinking age, restrictions in number of hours per day or days per week
when alcohol can be bought, and policies on what kind of outlets are
licensed to sell alcohol, all have an effect on total alcohol
Evidence shows that drink-driving regulations
combined with campaigns to explain why these measures are necessary
are highly effective in reducing the deaths and injury from traffic
accidents. But such measures are only effective if they are strictly
Restrictions on advertising reduce consumption.
OECD countries with a ban on alcohol advertising had about 16% lower
alcohol consumption and 23% lower number of traffic fatalities than
countries with no advertising restrictions. For young people, five
extra minutes of alcohol advertising on television per day is
associated with an increase in daily alcohol intake of five grams,
according to recent research.
We know that, if done right, community action
programmes and information and counselling may contribute to creating
awareness about the danger of alcohol. A WHO organized study in ten
countries showed that simple counselling of people who were known to
drink heavily, but who were not alcohol dependent, had a significant
positive effect on both average alcohol consumption and intensity of
For youth we need positive alternatives: better
access to sports and recreation in and out of school.
Information activities have little or no effect,
however, unless they supplement policies which influence access and
use of alcohol such as taxes and age limits.
Alcohol is a serious problem. It is also a
All health policies must have popular support based
on an understanding of their importance. This is especially true of
alcohol policy. Alcohol is deeply embedded in the culture and social
activities of many societies. In these circumstances, a pro-health
policy on alcohol frequently faces strong opposition.
Public support should not be taken for granted but
has to be built systematically.
For example, people need to understand more fully
that it is not only their own health and happiness that can be harmed
by alcohol, but that other people’s drinking also may have direct
and indirect negative consequences for them. Examples are the victims
of drunken-driving or drunken assault. Or, in a broader sense, the
costs for every taxpayer of increased health care resources, and other
types of alcohol-related expenses.
We must develop an understanding that although
drinking is a personal act and an individual responsibility, it is
also behaviour shaped by our societies and something for which society
as a whole has a responsibility. It is thus counterproductive to
formulate health policy responses exclusively for the individual,
while neglecting the public health perspective.
Clearly, a national alcohol policy will need to be
rooted in national and local support. We need to pay more attention to
the evidence base on what mechanisms are needed to win that support.
This is especially important for the young.
The WHO European Charter on Alcohol that was
adopted in 1995 explicitly states that "all children and
adolescents have the right to grow up in an environment protected from
the negative consequences of alcohol consumption and to the extent
possible, from the promotion of alcoholic beverages".
Sadly, this is becoming increasingly difficult. Not
only are children growing up in an environment where they are
bombarded with positive images of alcohol, but our youth are a key
target of the marketing practices of the alcohol industry.
Over the past 10-15 years, we have seen that the
young have become an important target for marketing of alcoholic
products. When large marketing resources are directed towards
influencing youth behaviour, creating a balanced and healthy attitude
to alcohol becomes increasingly difficult.
When I was in medical school, my student colleagues
arranged a party where they served a dark beer which none of us girls
had ever seen before. Some of the boys had secretly mixed large
amounts of 96% medical alcohol into it, making it dangerously strong
for all of us who unsuspectingly drank it.
Luckily, feeling dizzy, I discovered their trick
early enough to still be standing on my feet. I was furious. Furious,
because somebody – even my fellow medical students who should know
better - could do such a thing. Furious that we were being manipulated
to get drunk against our will.
I can still clearly sense the fury I felt that
evening. And I get the same feeling of manipulation when I see some of
the marketing techniques that are being used to introduce alcohol to
very young people.
By mixing alcohol with fruit juices, energy drinks
and premixed "alcopops", and by using advertising that
focuses on youth lifestyle, sex, sports and fun, the large alcohol
manufacturers are trying to establish a habit of drinking alcohol at a
very young age. Look at most web sites for alcohol products – they
are clearly attempting to attract the young, with computer games,
competitions and offers of prizes and teenage fashion shows.
Go to night clubs and teenage discos and you will
often find dangerous marketing techniques. In Great Britain, young
people interviewed for a research project told how they were offered
deals that include "buy one, get one free" and even the
so-called "never ending vodka glass": buy one, get unlimited
Satellite television is now bringing commercials
for alcohol into every home, even here in Scandinavia, where alcohol
advertising has been banned for decades.
We need to strengthen our work to counter these
Action must be taken, by Member States, by
international organizations; by the alcohol industry; and by young
people themselves to counter the negative trends in their own
countries. We must also act to avert replicating or exceeding the
already high levels of alcohol-related harm in the industrialized
countries among young people in developing countries.
WHO will be an active and supportive partner in
Based on these concerns, I am calling for a
concerted review by international experts of this issue of marketing
and promotion of alcohol to young people. I would like to announce
that WHO will be hosting a meeting to move this issue forward, in
collaboration with the Government of Valencia in Spain later this
WHO will also be establishing a strategy advisory
committee on alcohol to address this serious public health problem.
Our job here over the next three days is to plan
future action, and in doing so, make a significant contribution to
improving global health.