Презентация на Александър Хинц - Harm Reduction and Prevention Policies For Tobacco and Alcohol in

Harm Reduction and Prevention Policies for Tobacco and Alcohol in Germany

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Prevention Policies and Instruments How to regulate ‘sin goods’?

Primary Prevention

Price

Supply

§ Aims to prevent the development of diseases.

Favorable factors include a healthy diet, sporting activities or good stress management.1

Harm Reduction

Demand

§ Defined as reducing the harms of harmful behaviour to individuals and society.2

Quantity

Secondary Prevention § Aimed at the early detection of diseases. Diseases are to be detected at the earliest possible stage so that early therapy can be initiated.1

Tertiary Prevention § Aims to mitigate the consequences of illness, to prevent a relapse in the case of illnesses that have already developed, and to prevent the worsening of the illness.1

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Prevention toolbox Supply § Advertisement ban at points of sale § Packaging § Event sponsoring § Internet sales ban § CRM interference

Demand § Excise taxation § Public awareness programs § Minimum prices § Import duties § Warning labels Next

Source: 1) Bundesministerium für Gesundheit (2022): Prävention. 2) Levesque, R. J. R. (2018). Harm Reduction. In: Levesque R. J. R. (eds), Encyclopedia of Adolescence, 1716-1718.

Regulation Milestones: Tobacco Tobacco regulation has been characterized by a continuous tax increase 2000-2004

2005-2009

Tabaksteuergesetz (2002-2005): Yearly, unannounced and unplanned increase of tax

2010-2014

Tabaksteuergesetz (2009): Concretization of the tax, including tax calculation

Unfocused, irregular employment of taxation as a regulatory measure

2015-2019

Tabaksteuergesetz (2011): Definition/outlining of tobacco tax increases until 2016

2020-present

Tabaksteuermodernisierungsgesetz (2022): Taxation of heat-not-burn products and ecigarette liquids Expansion of tax to include novel products. No preferential treatment of risk-reduced products

Alignment of taxation to be more target-oriented and predictable

Yearly tobacco tax revenue in bn EUR

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16,0 15,0

14,27

14,09

14,0

14,92

14,41

14,25 13,37

Total growth 28.8%

13,0 12,0

14,73

14,34

CAGR 1.21%

11,44

11,0

01 0 2

02 0 2

03 0 2

04 0 2

05 0 2

06 0 2

07 0 2

08 0 2

09 0 2

10 0 2

11 0 2

12 0 2

13 0 2

14 0 2

15 0 2

16 0 2

Source: Statistisches Bundesamt (2022): Statistik über das Steueraufkommen. Steuereinnahmen: Deutschland, Jahre, Steuerarten vor der Steuerverteilung.

17 0 2

18 0 2

19 0 2

20 0 2

21 0 2

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Regulation Milestones: Alcohol The unlocked potential of excise taxation as prevention instrument 1950-2003

2003-present

Regulatory focus on high percentage alcoholic beverage avoidance

Regulatory focus on prevention regarding initiation and risky consumption patterns

Action Plan Drugs and Addiction (2003): Supporting an alcohol-free lifestyle, promoting the responsible use of alcohol and reducing the proportion of the population with risky alcohol use

National Strategy on Drug and Addiction Policy (2012): Reducing the incidence of binge drinking among children and adolescents, protecting children and young people from alcohol advertising and focusing on risk groups in the adult population

Yearly alcohol tax revenue in bn EUR 3,6 3,5 3,4 3,3 3,2 3,1 3,0 2,9 2,8

3,47

3,42

3,37

3,31

3,30

3,09

02 0 2

03 0 2

04 0 2

05 0 2

06 0 2

07 0 2

CAGR -0.68%

08 0 2

09 0 2

3,13 3,01

10 0 2

11 0 2

12 0 2

13 0 2

14 0 2

15 0 2

16 0 2

17 0 2

18 0 2

19 0 2

20 0 2

21 0 2

Source: Statistisches Bundesamt (2022): Statistik über das Steueraufkommen. Steuereinnahmen: Deutschland, Jahre, Steuerarten vor der Steuerverteilung. Statista (2022): Steuereinnahmen aus der Biersteuer in Deutschland von 2008 bis 2021. BMF (2022): Kassenmäßige Steuereinnahmen nach Steuerarten in den Kalenderjahren 2006 - 2009. BMF (2022): Kassenmäßige Steuereinnahmen nach Steuerarten in den Kalenderjahren 2002 - 2005. BMF (2022): Kassenmäßige Steuereinnahmen nach Steuerarten in den Kalenderjahren 1998 - 2001.

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3,22

3,18

Total growth -13.3%

00 0 2

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High Level: Alcohol Low-alcoholic beverages are responsible for the bulk of the alcohol intake in Germany

Alcohol, recorded per capita (15+) consumption (in litres of pure alcohol)

§ Relative stable alcoholic intake in Germany since 2000 (-15.7%)

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§ Per capita consumption of spirits decreased by 19% and beer by 20.8%

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§ Only per capita consumption of vine stagnated (-1.6%)

6 4 2 0

00 20

02 20

04 06 20 20 All types

08 20 Spirits

10 20

12 20 Wine

14 20 Beer

16 20

18 20

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§ The bulk of the German alcohol intake follows from lowalcoholic beverages, which are less taxed and less regulated Next

Source: WHO (2022): Data. GHO. Themes. Topics. Indicator Group. Alcohol, Levels of Consumption. Alcohol, recorded per capita (15+) consumption (in litres of pure alcohol).

Deep Dive: Alcohol Different subgroup-specific affections between men and women

Prevalence (2018) of hazardous drinking among 18–64-year-olds (male) in % 20 18 16 14 12 10 8 6 4 2 0

Men Ø 12.4%

14,6 11,9

18-24

18,3

25-29

14,3

10

10,6

30-39

40-49

50-59

60-64

Hazardous On average, 12.4% of males engage in drinking: hazardous drinking with the highest shares for Ø > 24g pure the subgroups 18-24 (14.6%) and 60-64 (18.3%) alcohol per day

Prevalence (2018) of hazardous drinking among 18–64-year-olds (female) in % 20 18 16 14 12 10 8 6 4 2 0

18,6 15,6

Women Ø 12.8%

12,6

12,5

12 6

8,9

18-24

25-29

30-39

40-49

50-59

60-64

Hazardous On average, 12.8% of women engage in drinking: hazardous drinking with the highest shares for Ø > 12g pure the subgroups 18-24 (18.6%) and 25-29 (15.6%) alcohol per day Next

Source: Seitz et al. (2019): IFT Institut für Therapieforschung. Kurzbericht Epidemiologischer Suchtsurvey 2018 (ESA (2018)). Tabellenband: Alkoholkonsum, episodisches Rauschtrinken und Hinweise auf Alkoholabhängigkeit und –missbrauch nach Geschlecht und Alter im Jahr 2018.

High Level: Tobacco Sharp smoking prevalence decline in Germany since 2000

Non-age-standardized estimates of current tobacco use and cigarette smoking in % 35

30

25

20

15 2000

2005 2010 2015 Estimate of current tobacco use prevalence Estimate of current cigarette smoking prevalence

2018

§ Sharp decline of the German smoking prevalence rate since 2000 (-40%) § In parallel, the current tobacco use prevalence rate also declined to the same degree § There are no data-driven forecasts that substantiate the concern that novel tobacco products could initiate a trend reversal

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Source: WHO (2022): By category. Tobacco control. Monitor. Non-age-standardized estimates of current tobacco use, tobacco smoking and cigarette smoking. Data by country.

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Deep Dive: Tobacco Different subgroup-specific affections between men and women

Frequency and amount (2018) of smoking among 18–64-year-olds (male) in % 100 90 80 70 60 50 40 30 20 10 0

Frequency and amount (2018) of smoking among 18–64-year-olds (female) in % 100 90 80 70 60 50 40 30 20 10 0

18-24

25-29 30-39 X > 20 11 < X < 19

40-49 X < 10

50-59 not daily

60-64

Smoking intensity (>beyond 20) is higher in older age groups, highest level is shown for 40-49 years of age. Results of regulatory & fiscal measures differ between subgroups.

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18-24

25-29 30-39 X > 20 11 < X < 19

40-49 X < 10

50-59 not daily

60-64

Smoking intensity (>beyond 20 ) is higher in older age groups, highest level is shown for 60-64 years of age. Results of regulatory & fiscal measures differ between subgroups.

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Source: Seitz, N.-N., John, L., Atzendorf, J., Rauschert, C. & Kraus, L. (2019). Kurzbericht Epidemiologischer Suchtsurvey 2018. Tabellenband: Tabakkonsum und Hinweise auf Konsumabhängigkeit nach Geschlecht und Alter im Jahr 2018. München: IFT Institut für Therapieforschung.

Tobacco & Alcohol: Asymmetries Policy inconsistencies and regulatory loopholes

Policy Target

Regulation

Modest drinking

Stop smoking

Substance-regulation

Product-regulation

Awareness raising

Smoke-free society

Concentration-based

Volume-based 9

Indicators

Per capita consumption Continuous

Alternatives

Prevalence Binary

No close substitutes

Close substitutes

Binary

No harm reduction

Vaper, Heater etc.

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