Alcohol - STAP：乙醇- STAP.doc

Local action plan for the town of Piteti2008 20101.The state of affairs regarding alcohol consumption1.1 National policyAt the national level, the problematics relating to alcohol was directed at several components, such as: public order, advertising, protection of minors. The national legislation is not clearly defined as regards alcohol. On the other hand, there are not, at the national level, researches and campaigns for awareness of the public opinion in this respect. In the Law no. 148 of the 26th of July 2000 on advertising, there are three articles forbidding the advertising for alcoholic beverages in areas intended exclusively for minors. The Decision no. 187 of the 3rd of April 2006 with regard to the Code regulating the contents of the audio-visual, in Section 2: Advertising of alcoholic beverages, refers to programs during which the advertising of spirits is forbidden, as well as the fact that “Commercials relating to alcohol in which children appear are forbidden.” The Law no. 61 of the 27th of September 1991, republished in the year 2000, on punishing acts of violation against norms of social cohabitation, public order and public peace refers to sanctions relating to serving alcoholic beverages, inside public houses, to consumers who are obviously under the influence of drink, as well as to minors. The Law no. 265 of the 16th of June 2004, amending the Law no. 61/1991 on punishing acts of violation against norms of social cohabitation, public order and public peace, mentions the fact that, in public places, consumption of alcoholic beverages by persons under 18 years old is strictly forbidden. The Penal Code of the 28th of June 2004 (the Law no. 301/2004) defines the term of intoxication and its consequences on the facts having legal responsibility, as well as the sanctions concerning the non observance of the fiscal system of alcohol. The Emergency Ordinance no. 195 of the 12th of December 2002 on public road traffic republished, strictly forbids to a person who has consumed alcoholic beverages to drive on public roads. The Norms of the 26th of May 2006 concerning the enforcement of the provisions of the title XI - Funding of some health costs of the Law no. 95/2006 on healthcare reform regulate the amounts instituted for fighting against excessive consumption of alcoholic beverages which are directed to funding some health costs, being included in the “vice tax”, and which are increased on a yearly basis. Continuation of the campaign “protect your children against harmful drinking” at the level of the town of Piteti, with the possibility of extending such project in the other towns of the country, as a model for good practice. Improvement of the legislation concerning alcohol marketing to young persons, as well as granting licences for alcohol and food. Among others, such modification concerns the following elements:o Stricter regulations concerning selling alcoholic beverages to young persons under 18 years old.o Extension of the mayors authority concerning the Law on licences for alcohol and food. Apart from the existing interventions, such as imposing some sanctions or fines for non-observance of the legislation and withdrawal of the licences, we suggest, for the future, the possibility of withdrawing the licences for limited periods of time. o Controls intensification in discos and places for entertainment for young persons, aiming to selling and consuming alcohol. Stricter monitoring of enforcement of the legal age for selling alcoholic beverages to young persons. The suggestion is to authorize the mayor to appoint supervisors at the municipality level and (for example) to include the police in the supervising local action. Taking steps against sweet mixtures drinks.? Increasing, at the local level, of the taxes for using alcoholic beverages.1.2 Policy at the level of the municipality of PitetiAlcohol moderating policy has to be aimed at concrete actions relating to awareness of the public opinion by actions which could provide a general view of the existing policy and activities in Piteti. Alcohol consumption by young people a primary concern within the local health policy and youth policy.The authorities at the local level have participated, within the DRAIN project developed in the town of Piteti, in reaching the goals relating the local policies for counteracting the excessive use of alcohol. According to a research concerning alcohol consumption among young persons in the town of Piteti, developed in 2008 by the University of Piteti and the University of Twente, Netherlands, 88% of the young persons attending a type of school and being 12-17 years old, are drinking alcohol now, or drank alcohol in the past. Therefore, one of the primary concerns of the DRAIN project was based especially on alcohol consumption by young persons. The aim is the following: “by correct identification of the problematics relating to alcohol consumption, to suggest measures of intervention aiming at decreasing of the number of young persons consuming alcohol. Alcohol prevention is also an important issue in Pitetis youth policy. Regulations and compliancesArt. 21 of the Law no. 61/1991 provides that “serving consumers with alcoholic beverages, inside or outside public houses when, according to the law, they are closed, or serving alcoholic beverages is forbidden, or after the working program, set under the operating permit.;Art. 24 of the Law no. 61/1991 provides that serving with alcoholic beverages, within public houses, consumers who are clearly under the influence of alcohol, as well as minors is forbidden.” To take into account the legal provisions, but also those referring to selling and marketing alcoholic beverages in certain areas situated near the education, health, religious institutions, as well as the provisions of Art. 24 of the Law no. 218/2002. The territorial police units shall cooperate with the local councils, and, as the case may be, with the mayors, in order to fulfil the written decisions and orders of such councils and mayors, issued within the limits of their competences in the field of public order. Another important issue is represented by intensification of taking the legal steps for enforcement of the legislation. The partners in charge shall join their efforts in order to reduce the excessive consumption of alcohol by young persons and to ensure that the hospitality industry units shall try to prevent persons under 18 years old from consuming alcohol in their units. This may be carried out by: staff training, non enforcing promotions and offers, as well as cooperating with warning campaigns and prevention projects. Signalling and prevention at the local levelAt the national level, there is no campaign aimed at alcohol, similar to those aimed at tobacco and drugs. Most of the times, the use of alcohol is treated in a tangential way, as another risk factor, together with tobacco and drugs. Not to mention campaigns for informing parents. Sports clubs, discos or clubsThere arent any agreements with sports clubs regarding alcohol, neither campaigns developed in discos. Support and prevention by schoolsThe DRAIN project has developed several campaigns and actions in the high schools in Piteti by involving pupils, teachers and parents. They aimed at paying a special attention to prevention by organization of education, information, training. Unfortunately, the component relating to counselling within schools, to support from a psychological point of view and to healthcare of young persons after alcohol intoxication or after accidents and injuries in connection with alcohol consumption have not been materialized in a project. In fact, the Romanian legislation itself is not very clear in this respect.2.4Results of the local data collection and of observationsIn May 2008 the University of Piteti and the University of Twente, from the Netherlands, cooperated in a scientific study where a questionnaire was administered at Piteti high schools. 50 class rooms at 17 high schools, a total of 1,300 students, were surveyed, resulting in a data base of 1,026 useful questionnaires (which classes?). This representative sample of Piteti youth has uncovered some interesting facts about the alcohol drinking behaviour of Piteti youth. The results of this study are summarized below. Only 12 percent of Piteti youth (from 14 to 19 years of age) does not drink alcohol, this means that 88 percent of youth drinks alcohol now or drank in the past. There are more boys than girls drinking, 93 percent of Piteti boys drink alcohol and 85 percent of girls. Almost 50 percent of boys start drinking before the age of 13. Fortunately this is much lower for girls, 22 percent of girls start drinking before the age of 13.Wine, beer and homebrewed alcohol are the preferred drinks for Piteti youth. Boys drink mostly beer and girls mostly wine. Even though these drinks have a different alcohol percentage, the package container used determines that the amount of pure alcohol is the same. One can of beer contains the same amount of alcohol as one (smaller) can of wine, which means that beer is just as damaging for the health of the boys as wine is for the girls. Beer is not like food in general, it is a dangerous substance for the physical and mental health of youth.Although Piteti students drink alcohol regularly and sometimes they drink a lot of alcohol at once, they do report that they do not get drunk often. This does not mean that they are not affected by alcohol though. Students have gotten into accidents, problems with their parents and friends, and have received bad grades at school due to alcohol consumption. This has also made them feel physically sick, a clear sign of drinking too much alcohol.Only 28 percent of the students indicated that they did not drink at all in the past 30 days, 20 percent drank once, which means that more than 50 percent are regular drinkers. Again this pattern is more serious for boys than it is for girls. 70 percent of the boys in Piteti are regular drinkers. Most students drink on the weekends, but 20 percent of the boys and 12 percent of the girls also drink on weekdays. This is a very serious indicator for alcohol problems, now or in the future. Piteti youth can buy their alcohol virtually everywhere they like. The shop, disco and bar owners are not allowed to sell alcohol to anyone under the age of 18, but in reality they do not ask for the age of the student nor do they ask to see their identification card, students state in the questionnaire. To verify these statements; in the weekend of 17 and 18 October a scientific researcher carried out a research where under aged students attempted to buy alcohol and recorded their experiences. In 100 percent of more than 50 attempts the students where successful, also when they visited bars and shops that were close to schools. This shows once and for all that the sellers of alcohol do not obey the law and that they are selling alcohol to the children of Piteti, damaging their health and their school grades.Youth under the age of 18 can buy alcohol anywhere they like in Piteti. This presumption has been proven by a scientific mystery shopping research carried out in October 2008. Some students visited 58 alcohol sales points in Piteti and were successful in their attempt to buy alcohol in all 58 locations. According to Romanian law it is forbidden to sell alcohol to youth under the age of 18. The START project, a local alcohol prevention project aiming to reduce underage drinking, has initiated the research. The research has been carried out by scientists of the University of Twente in the Netherlands and the University of Piteti.The mystery shoppers visited 50 supermarkets and food stores and 8 bars. In all 58 alcohol purchase attempts youth were successful in buying alcohol, and they were never refused to buy alcohol (which, according to the law should have happened). The mystery shoppers were carefully selected and trained for their job and they followed a standard protocol in their purchase attempts. They were to enter the store or bar and select an alcohol drink. If they were asked about their age by the salesperson, they would say that they were 18 years old (instead of 17), just as youth would normally lie about their age. During all 58 purchase attempts the students were asked their age only once and they were sold alcohol anyway. After purchasing the alcohol the youth did not drink it, but would leave the alcohol at the table or hand it over to the researchersThe coordinator of the START project, Mrs. Nina Sima, initiated the research, because a survey amongst Piteti school youth in May 2008 showed shocking numbers of alcohol use amongst the school youth aged 14 and up. Only 12 percent of Piteti youth (from 14 to 19 years of age) does not drink alcohol. This means that 88 percent of youth drink alcohol now or in the past. There are more boys than girls drinking, 93 percent of Piteti boys drink alcohol and 85 percent of girls. Almost 50 percent of boys start drinking before the age of 13. Fortunately this is much lower for girls, 22 percent of girls start drinking before the age of 13.Only 28 percent of the students indicated that they did not drink at all in the past 30 days, 20 percent drank once, which means that more than 50 percent are regular drinkers. Again this pattern is more serious for boys than it is for girls. 70 percent of the boys in Piteti are regular drinkers. Most students drink on the weekends, but 20 percent of the boys and 12 percent of the girls also drink on weekdays. This is a very serious indicator for alcohol problems, now or in the future.Four 17 year old high school students were part of this mystery shopping research. These students visited 58 alcohol sales points in Piteti, pretending to be ordinary customers who buy beer, but, in the meanwhile, observing the behaviour of the sales personnel. Mystery shopping research is a common tool to evaluate service quality of stores and medical care. Undercover research can also be used to investigate retailers compliance with alcohol legislation. This is done in the USA, UK and the Netherlands for over ten years, with good and reliable results. Piteti is the first city in Romania that uses the mystery shopping research to establish the compliance rate with the law that states that alcohol can not be sold to minors.The most effective method to reduce alcohol use by youth, is to reduce the availability of alcohol. Romanian law states that it is forbidden to sell alcohol to youth under 18, in order to protect the health of youth. The researchers have advised the coordinator of the START project to make the compliance of the age limit for sale of alcohol to youth one of the main pillars of the local alcohol prevention project. Alcohol sales persons should receive a training to learn to detect if youth are underage and how to refuse service to these buyers. The compliance with the age limit should be checked periodically by representatives of the city council and licensing bodies, who should apply sanctions to the alcohol sales points who structurally break the law 3. VisionIn this chapter the vision behind the project will be explained further. First, the definition of alcohol prevention is described. This definition is the basis for the vision underpinning this plan. After this, an operationalized model is presented that visualizes the integrated approach of the issues surrounding alcohol use. According to this model, effective alcohol prevention consists of three pillars: regulation, compliance and public support. These three pillars will be explained one at a time and a number of effective interventions within these pillars are mentioned.3.1 Alcohol preventionAlcohol consumption is deeply rooted in Piteti society. Drinking alcohol is often positively associated with fun and communicating easier with other people. Yet, alcohol is not a normal consumer product because the use of alcohol comes with risks. The physical availability and social acceptation of alcohol in society create an environment in which many people view alcohol as a normal consumer product and view not using alcohol as socially undesirable. The drawbacks of alcohol consumption are increasingly becoming visible. An example of this is the media attention in recent years for coma-drinking among young people.Alcohol prevention is a broad concept and three types of it may be distinguished. First, there is universal prevention that is aimed at the population at large. This type of prevention has as its goal to prevent problems and is aimed at target groups that do not, or not yet, exhibit any harmful alcohol consumption. Second, selective prevention exists, that is targeted at a sub-group of the population that has an above average chance of developing mental, or physical problems. Finally, indicated prevention is distinguished, aimed at people with problematic alcohol use that is not yet diagnosed as alcohol abuse or addiction, but is harmful. To prevent problematic alcohol use by young people in the future, it is necessary to reduce the availability of alcohol. Our focus is therefore on universal prevention. Besides this, interventions aimed at selective, or indicated prevention can be supportive towards reaching the set goals.3.2 Influencing the surroundings of young peopleAlcohol consumption is not only a personal choice, but is also determined by the surroundings of the person drinking alcohol. Alcohol related problems arise, not because young people with an elevated risk cant moderate their drinking, but are the result of the interactio