Alcohol policy and alcohol-attributed disease burden in Finland and the Baltic countries 1995-2019

Abstract Introduction Alcohol remains a significant contributor to mortality and morbidity in Finland and the Baltic countries, particularly among men. This study aimed to assess alcohol policy restrictiveness in this region from 1995 to 2019 using a modified version of the Bridging the Gap (BtG-M) policy scale and examine its association with alcohol-related disease burden. Methods The study utilised national statutory laws to score policy restrictiveness (higher BtG-M scores mean stricter policies) and age-standardised rates of disability-adjusted life years (DALYs), years of life lost (YLLs), years lived with disability (YLDs) and deaths per 100,000 from the 2019 Global Burden of Disease Study (GBD). Spearman correlation tests and panel data regression models were applied to assess the association between policy scores and burden of disease. Results Finland maintained a high BtG-M score, while the Baltic countries experienced recent increases from initially lower scores. Alcohol-related disease burden showed an inverse association with policy changes in these countries. Strongest association was seen between the BtG-M score and DALY rates attributed to injuries. Premature mortality among men constituted the largest proportion of disease burden. Discussion and Conclusions Despite challenges in accessing and comparing policy data over time, we showed a strong association between alcohol policy and alcohol-related harm in Finland and the Baltic countries. This study is one of the first to use the BtG-M scale to monitor changes in alcohol policies over time and their relationship to alcohol-related harm using GBD methodology. The study highlights the effects of national alcohol policies on levels of alcohol-related harm. Key messages • This study stands out due to its longitudinal study design, which quantitatively compares the level of alcohol policy restrictiveness in Finland and the Baltic countries from 1995 to 2019. • Our study suggests that shifts towards more restrictive alcohol policies are linked to reduction in alcohol-related harm in Finland and the Baltic countries.