Impact of the WHO "best buys" for alcohol policy on consumption and health in the Baltic countries and Poland 2000-2020.

Alcohol use is a major risk factor for burden of disease. This narrative review aims to document the effects of major alcohol control policies, in particular taxation increases and availability restrictions in the three Baltic countries (Estonia, Latvia, and Lithuania) between 2000 and 2020. These measures have been successful in curbing alcohol sales, in general without increasing consumption of alcoholic beverages from unrecorded sources; although for more recent changes this may have been partly due to the COVID-19 pandemic. Moreover, findings from time-series analyses suggest improved health, measured as reductions in all-cause and alcohol-attributable mortality, as well as narrowing absolute mortality inequalities between lower and higher educated groups. For most outcomes, there were sex differences observed, with alcohol control policies more strongly affecting males. In contrast to this successful path, alcohol control policies were mostly dismantled in the neighbouring country of Poland, resulting in a rising death toll due to liver cirrhosis and other alcohol-attributable deaths. The natural experiment in this region of high-income European countries with high consumption levels highlights the importance of effective alcohol control policies for improving population health.

Changes in attitudes toward alcohol control policies in Lithuania: findings from two representative surveys in 2015 and 2020.

Background: A set of evidence-based alcohol control policy measures was adopted in the period 2016-2020 in Lithuania. The present study fills a knowledge gap on how changes in alcohol control policy are associated with attitudes toward different alcohol policy measures.Objective: This study aims to explore whether support for key alcohol control policy measures in Lithuania declined following implementation of alcohol control measures.Methods: Data came from the Standard European Alcohol Survey. Two representative surveys with the same questionnaire, were conducted in Lithuania in 2015 (N = 1513, 51.7% female, response rate was 38.9%) and 2020 (N = 1015, 50.6% female, response rate was 38.0%). Multi-stage stratified probability sampling was applied. Surveys were carried out using computer-assisted face-to-face interviews, descriptive statistics and multiple logistic regression analyses was applied. We used a binomial logistic regression analysis and the Pearson chi-square test.Results: There was a significant decline in a proportion of respondents who agreed that the number of alcohol selling places should be kept low (OR: 0.84, p = .032), alcohol prices should be kept high (OR: 0.83, p = .027), and the police should be allowed to randomly check whether the driver is sober (OR: 0.65, p < .001). The proportion of respondents who agree that individuals are responsible enough with their drinking significantly declined (OR: 0.76, p = .003).Conclusion: Support for restrictions on alcohol-selling points, increase in alcohol price, and random alcohol testing of drivers declined following the adoption of new alcohol control policy measures. Our findings might be beneficial for policy-makers planning alcohol control policies and information campaigns.

Alcohol intoxication incidence differences at companies in Lithuania.

INTRODUCTION: Employee alcohol consumption is a major challenge to both the health of the employee and productivity of the company. Our study investigates the overall alcohol intoxication rates of employees at companies in Lithuania, alcohol intoxication incidence rates during the work week and associations between company variables and employee alcohol intoxication at work. METHODS: Data for our study were collected at 153 different companies in Lithuania during the year 2018. Overall 2 455 997 alcohol breath tests were analysed. Data were analysed using descriptive statistics and Poisson regression analysis. RESULTS: Descriptive statistics showed that the alcohol intoxication (blood alcohol concentration ≥ 0.01%) incidence rate was 0.31% (n = 7535). Average alcohol intoxication was 0.04%. Furthermore, higher alcohol intoxication incidence rates were found on Mondays and in the morning than at any other day or time. The results of Poisson regression analysis showed that the alcohol intoxication incidence rate ratios were highest among small companies, companies from the farming sector and companies from rural areas. DISCUSSION AND CONCLUSIONS: We found a relationship between company variables, testing time and incidence rates of alcohol intoxication. The increased alcohol intoxication at work throughout the weekend and on Monday is consistent with the alcohol consumption patterns in the Lithuanian population. Relatively low alcohol intoxication rate for the majority of the positively tested cases may indicate consumption of small amounts of alcohol just before starting work or excessive alcohol consumption the day before. Our findings could be an indicator of an underlying problem and have implications for alcohol prevention strategies.

Disclosure of alcohol-related harm: Children's experiences.

OBJECTIVES: (1) to learn to whom children disclose experiences of harm caused by their parents' or carers' substance abuse, (2) to show whether professionals enable children to disclose this harm, and (3) to highlight what kind of assistance they provide after disclosure of harm. METHODS: The study is based on in-depth semi-structured interviews with children living with alcohol-abusing caregivers in Lithuania. Twenty-three children, aged from 8 to 18 years, from social risk families participated in this study. RESULTS: Children suffer not only from the maltreatment itself, but also from the associative stigma of the caregivers' drinking. They prefer to disclose their troubles in informal settings because professionals often do not help children to disclose harm and may even ignore it. CONCLUSION: The analysis shows that when children reveal parental alcohol problems, there is no inquiry, follow-up, or management of the children's problems related to the caregivers' drinking. And yet, protective factors such as social support and positive experiences may enhance children's resilience in adverse conditions. Policy-makers should reduce barriers to disclosure and refocus their strategies from risk identification to identification of protective factors. Professionals need to develop an understanding about how they can support children to disclose harms related to the caregivers' drinking so that harms to children can be managed sensitively and well.

Alcohol-related child maltreatment: Reports to the Child Rights Protection Service in Kaunas municipality.

AIM: To increase understanding of alcohol-related child maltreatment on the basis of child protection cases in Lithuania. The study is based on a document content analysis of 203 case records of families at social risk. It identifies the prevalence of alcohol-related harm by analysing associations between types of drinkers and child maltreatment. It also maps the distribution of people who typically report this maltreatment. Both qualitative and quantitative analytical approaches are employed. RESULTS: Child neglect was the most prevalent type of child maltreatment and was usually reported together with other types of child maltreatment. Child maltreatment was typically mentioned in the context of a caregiver's heavy drinking. In 85.7% (174) of the cases, the family had at least one problem drinker. More than one problem drinker was detected in as many as a third of all cases. At least one form of child maltreatment was detected in families with a drinking mother in 60% of the cases (χ2 = 4.825, p < 0.05), with a drinking father in 36% of the cases (p > 0.05), and in 15% of the cases (p > 0.05) when there was a drinking partner in the family. The most common source of reporting by the authorities was the police (26.6%), and the most typical non-official source was the child's relatives (16.3%). CONCLUSIONS: Alcohol-related child maltreatment needs special attention if issues of child safety in Lithuania are to be disclosed, evaluated, and responded to. Further research on this topic is needed.

Risk factors of severity of abuse against older women in the home setting: A multinational European study.

This article examines the ecological risk factors of abuse against older women. Data from 2,880 older women were randomly collected in five European countries (Austria, Belgium, Finland, Lithuania, and Portugal) using a standardized questionnaire. Results indicate that overall 30.1 % older women had at least one experience of abuse in the past year. The findings demonstrate that a single emphasis on personal risk factors (e.g., health, coping) is important but too simple: Abuse is multifaceted and is embedded in environmental (e.g., loneliness, household income) as well as macrocultural contexts (e.g., old age dependency ratio).

Item non-response when measuring elder abuse: influence of methodological choices.

BACKGROUND: Efficient actions to fight elder abuse are highly dependent on reliable dimensions of the phenomenon. Accurate measures are nevertheless difficult to achieve owing to the sensitivity of the topic. Different research endeavours indicate varying prevalence rates, which are explained by different research designs and definitions used, but little is known about measurement errors such as item non-responses and how outcomes are affected by modes of administration. METHODS: A multi-national study was developed to measure domestic abuse against home-dwelling older women (aged >60 years) in Europe. The measurement instrument covered six forms of abuse, adapted from the Conflict Tactics Scale. 2880 individuals were interviewed by three different data collection methods (i.e. postal, face-to-face, telephone). RESULTS: Principal component analysis of missing values of 34 indicators of abuse showed various patterns of item non-response. Moreover, principal component analysis indicated several response patterns across different types of data collection. A binary logistic regression explained that item non-response and abuse prevalence is influenced by individual characteristics (social status, vulnerability), method effects such as content (sensitivity), the order of the questions (forms of abuse), by type of data collection and the presence of assistance in survey completion. CONCLUSION: The discussion revolves around how these findings could help improving measuring elder abuse. Advantages and disadvantages of the questionnaire and type of data collection methods are discussed in relation to three potential types of response errors: item positioning effect, acquiescence and social desirability.

European map of prevalence rates of elder abuse and its impact for future research.

This article aims to map existing prevalence research on abuse and neglect of older people and to provide a critical overview of existing methodologies, which have been adopted to survey the prevalence rates of abuse against elders. This article is part of the prevalence study of Abuse and Violence against Older Women (AVOW) study, which was conducted in five European countries (Austria, Belgium, Finland, Lithuania, and Portugal). The article provides an overview of the state of the art of prevalence data, survey designs and methods, instruments and results in Europe. Therefore, this draws on an extensive literature search and qualitative content analysis, which was conducted as an early part of the AVOW study. Results indicate that some EU countries have a rich history of prevalence research, whereas other countries have just begun to tackle this aspect of research on of elder abuse. One of the lacunae concerns reliable numbers on the prevalence rates of elder abuse. Research about where, when and how often elder abuse occurs, is inadequate and inconsistent. Data in some cases are based on professionals' reports rather than on information from older people themselves. Surveying elders about such a sensitive topic, however, implies the need for an adequate research instrument (questionnaire) and research design, and an adapted data collection method. In conclusion, substantial attention is paid to outlining possible guidelines for future research.