This document discusses strategies for reducing alcohol consumption in Italy. It describes how Italy has implemented the WHO European Alcohol Action Plan and the European Charter on Alcohol through its Frame Law on Alcohol from 2001. This law aims to protect people's rights from alcohol abuse and promote education, research, and support for organizations working to prevent alcohol problems. The document also outlines Italy's national health plan, monitoring system, and strategies to increase early identification of harmful drinkers and treatment of alcohol dependence through primary healthcare. It emphasizes the importance of continued public health efforts like education, training, and supporting a culture of lower alcohol consumption.

2. Osservatorio Nazionale Alcol - World Health Organization Collaborating Centre for
RESEARCH and HEALTH PROMOTION on ALCOHOL and ALCOHOL- RELATED HEALTH PROBLEMS
How can we make a successful story of
reducing alcohol consumption in Italy ?
Emanuele Scafato
Direttore, WHO Collaborating Centre for Research & Health Promotion on Alcohol and Alcohol-Relate
Direttore, Osservatorio Nazionale Alcol - CNESPS
Direttore, Salute della Popolazione e suoi Determinanti
Centro Nazionale Epidemiologia, Sorveglianza e Promozione della Salute- CNESPS
ISTITUTO SUPERIORE DI SANITA'
Presidente SIA, Società Italiana Alcologia
Vice Presidente EUFAS, European Federation Societies on Addictions
Board Advisor, APN Alchol Policy Network e INEBRIA
Rappresentante Gov. CNAPA, Committee on National Alcohol Policies and Actions

3. E M A N U E L E S C A F A T O 2 0 1 4
Country profile 2014 - ITALY

4. E M A N U E L E S C A F A T O 2 0 1 4
The European Alcohol Action plan
1992 - 1999

5. E M A N U E L E S C A F A T O 2 0 1 4
European Charter on Alcohol
Paris, december 1995
Alcohol? Less is better !

6. Istituto
Superiore
di Sanita’

7. E M A N U E L E S C A F A T O 2 0 1 4
ITALIA - 2001
FRAME LAW ON ALCOHOL 125/2001.

8. E M A N U E L E S C A F A T O 2 0 1 4
The Frame Law on Alcohol (nr 125/2001)
All over Europe, the 2001 n.
125 Italian law represented a
unique example of
implementation and full
endorsement of the WHO
European Alcohol Action Plan
and of the European Charter
on Alcohol main principles
reported in the Italian aims
at the art. 2 of the law as the
aims of the law.

9. E M A N U E L E S C A F A T O 2 0 1 4
The Frame Law on Alcohol (nr 125/2001)
Art. 2 – Aims This law:
 ensures all people’s rights, especially children and adolescents, to a
family, community and working life protected from the consequences
of alcoholic beverages abuse;
 fosters access to health and social treatment services for heavy
drinkers and their families;
 promotes information and education on the negative consequences
of alcohol consumption and abuse;
 promotes research and ensures adequate standards of training and
updating for professionals dealing with alcohol related problems;
 supports non profit non-governmental and voluntary organisations
which aim is to prevent or reduce alcohol-related problems.

10. E M A N U E L E S C A F A T O 2 0 1 4
CHARTER ENDORSEMENT IN ITALY
FROM PRINCIPLES TO RIGHTS

11. E M A N U E L E S C A F A T O 2 0 1 4
ITALY. Alcohol policy development

12. E M A N U E L E S C A F A T O 2 0 1 5
ALCOHOL : the framework for action in ITALY
NATIONAL HEALTH PLAN
LAWS and REGULATIONS
NATIONAL ALCOHOL AND HEALTH PLAN
NATIONAL COMMITTEE (Consulta Nazionale
Alcol)

13. E M A N U E L E S C A F A T O 2 0 1 5
The National Health Plan
A National Prevention Plan is agreed by the STATE-REGIONS Conference mostly leaving to
the regional autonomies the setting and the implementation of strategies and programs
that are ONLY oriented by the National Health Plan.
Promoting healthier lifestyles and habits (life
skills);
Tackling misleading risk-taking cultures;
Improving settings (family, schools, communities);
Strengthening health protection of the vulnerable
groups;
Decreasing “gradients” within and between groups
(inequalities in health) and reduce harm;
Ensuring a wider range of initiatives devoted at the
early detection of alcohol abuse.

14. E M A N U E L E S C A F A T O 2 0 1 5
Strategic areas of intervention
National Alcohol and Health Plan (PNAS)
1. Information and education
2. Drinking and driving
3. Alcohol and work
4. Treatment of harmful/hazardous alcohol consumption and
alcohol dependence
5. Production and distribution’s responsibility
6. Social network to face risk factors alcohol related
7. Strengthening NGOs, voluntary organizations, self-help and
mutual aid groups
8. Monitoring harm done by alcohol and strengthening alcohol
policy

15. E M A N U E L E S C A F A T O 2 0 1 5
To measure is the best way to
understand …
Monitoring and reporting is the
best way to support our and policy
makers understanding and actions
WHAT‘S BEST ?

16. Osservatorio Nazionale Alcol - World Health Organization Collaborating Centre for
RESEARCH and HEALTH PROMOTION on ALCOHOL and ALCOHOL- RELATED HEALTH PROBLEMS
ISTITUTO SUPERIORE DI SANITA’
OSSERVATORIO NAZIONA LE ALCOL _ CNESPS
Epidemiological Report
Alcohol MONITORING SYSTEM FLOW

17. E M A N U E L E S C A F A T O 2 0 1 5
ALCOHOL - ASSESSMENT & MONITORING
ISS-WHO CC FORMAL ROLES

18. Osservatorio Nazionale Alcol - World Health Organization Collaborating Centre for
RESEARCH and HEALTH PROMOTION on ALCOHOL and ALCOHOL- RELATED HEALTH PROBLEMS
http://www.epicentro.iss.it/alcol
INCREASING AWARENESS
ALCOHOL PREVENTION DAY 2001-2014

19. Osservatorio Nazionale Alcol - World Health Organization Collaborating Centre for
RESEARCH and HEALTH PROMOTION on ALCOHOL and ALCOHOL- RELATED HEALTH PROBLEMS
UPDATING NATIONAL RISK DEFINITION
The definition of hazardous drinkers (ISS criteria)
According to the Italian guidelines for a healthy diet
developed by INRAN hazardous drinkers are
subjects who fulfil one of the following criteria:
1 standard unit = 12 grams
1) women who consume more than 20 grams per day (1-2 glasses)
2) men who consume more than 40 grams of alcohol per day (2-3
glasses)
3) people aged 16-18, who consume more than 1 glass of any
alcoholic
beverage per day
4) people aged over 65 who consume more than 1 glass of any
alcoholic
beverage per day
FURTHERMORE
6) all individuals who consume on one occasion more than 6
glasses (binge drinking)

20. Osservatorio Nazionale Alcol - World Health Organization Collaborating Centre for
RESEARCH and HEALTH PROMOTION on ALCOHOL and ALCOHOL- RELATED HEALTH PROBLEMS
Osservatorio Nazionale Alcol - World Health Organization Collaborating Centre for
RESEARCH and HEALTH PROMOTION on ALCOHOL and ALCOHOL- RELATED HEALTH PROBLEMS
sono inoltre considerati comportamenti a rischio
Ø il Binge drinking, cioè il consumo in un’unica occasione di 6 o più UA
Ø il consumo di alcolici per le donne in gravidanza e in allattamento
Ø il consumo di qualsiasi bevanda alcolica per gli alcolisti in trattamento e gli ex alcolisti
EMANUELE SCAFATO 25/10/2012
Unità Alcoliche equivalenti (contenenti 12 g di alcol )
0-18 anni 18-20 & 65+ Donne Uomini
0 Unità 1 Unità 1 Unità 2 Unità
Tra 16 e
Low-risk drinking guidelines

21. E M A N U E L E S C A F A T O 2 0 1 5
INVERSE RELATIONSHIP BETWEEN Alcohol Dependency rates AND Per capita alcohol
consumption
EMANUELESCAFATO25/10/2012
LESSONS LEARNT: There is still room for supporting
decrease in per capita alcohol consumption
1996
1997
1998
1999
20002001
2002
2003
2004
2005
2006
2.0
3.0
4.0
5.0
6.0
7.0
8.0
9.0
10.0
11.0
12.0
7.80 8.00 8.20 8.40 8.60 8.80 9.00 9.20 9.40
TassoSTDutentitotalideiservizidietà10+(*10.000)
Consumo medio pro_capite (15+ anni)
r (coefficiente di pearson) = -0,933; p<0,001

22. Osservatorio Nazionale Alcol - World Health Organization Collaborating Centre for
RESEARCH and HEALTH PROMOTION on ALCOHOL and ALCOHOL- RELATED HEALTH PROBLEMS
Different needs for intervention at population level
having in mind that the decrease in alcohol consumption
is mainly achieved in moderate consumers and that a
hard target is stil represented by harmful consumers (as
an example males drinking more than 4 units per day)
PREVALENCE (%) of DAILY CONSUMERS by U.A. (1 UA= 12 gr)
MALES (age >11) YEARS 2003-2009
Uomini >11 anni
10,5 10,7 10,3 10,3 10,2 10,6
20,6 19,8 20,6 19,3 18,3 17,7
5,0 4,8 5,0 5,3 3,6 3,4
9,3 9,7 7,4 8,2 8,5 8,3
0,0
10,0
20,0
30,0
40,0
50,0
60,0
2003 2005 2006 2007 2008 2009
>4 UA
3 UA
2 UA
1 UA

23. E M A N U E L E S C A F A T O 2 0 1 5
Among 8 mln of
HEAVY DRINKERS
there are AT LEAST
- 400.000 male
HARMFUL drinkers
and more than
- 320.000 females
HARMFUL drinkers.
According to DSM V Harmful drinkers and Alcoholdependents are in need for TREATMENT AT
LEAST in order to STOP harm progression and to avoid further consequences .
THE GAP TO BE BRIDGED
TO PREVENT HARMFUL DRINKERS to become ALCOHOL DEPENDENTS

24. E M A N U E L E S C A F A T O 2 0 1 5
Figura. 2 Alcodipendenti in carico ai servizi per tipologia di accesso e consumatori dannosi di alcol - Anno
2012
THE GAP TO BE BRIDGED
HARMFUL DRINKERS vs ALCOHOL DEPENDENTS

25. E M A N U E L E S C A F A T O 2 0 1 5
Alcohol dependents
already in charge
by NHS services
NEW PATIENTS
20.623
OLD PATIENTS
49.147
HARMFUL
DRINKERS
Harmful drinkers
622.848
(M=403.651-F=219.197)
ALCOHOLDEPENDENTS
HARMFUL CONSUMERS AND ALCOHOL DEPENDENTS
DETECTION – EMERSION – INCLUSION

26. E M A N U E L E S C A F A T O 2 0 1 5
Lesson learnt : EIBI – IPIB implementation

27. Osservatorio Nazionale Alcol - World Health Organization Collaborating Centre for
RESEARCH and HEALTH PROMOTION on ALCOHOL and ALCOHOL- RELATED HEALTH PROBLEMS
EIBI-IPIB

28. E. SCAFATO, ISS CNAPA 22/10/2013 Luxemburg
http://www.amphoraproject.net/w2box/data/e-book/AMPHORA%20ebook.pdf

29. E M A N U E L E S C A F A T O 2 0 1 5
PHEPA- IPIB
TRAINING PROGRAM
Early Identification and Brief Intervention EIBI – (IPIB)

30. E M A N U E L E S C A F A T O 2 0 1 5
SCREENING AND BRIEF INTERVENTION as investment for health - ITALY

31. E M A N U E L E S C A F A T O 2 0 1 5
FUTURE ACTIONS
INFORMATION, EDUCATION, TRAINING, RULES…
INFORMATION
&
EDUCATION
promote life skills
support environments
provide protection
reduce harm
Information
by medical service
providers
Peer information
and partner
information
Sport’s, culture’s,
music’s
leaders
Health education by schools,
universities, etc.
Health education by parents,
grandparents and relatives
Community
leaders
Information by
pharmacists
The mass media:
- radio
- press
- television
GPs and social
councelling

32. E M A N U E L E S C A F A T O 2 0 1 5
THE NEED FOR ALCOHOL RESEARCH FUNDING…

33. E M A N U E L E S C A F A T O 2 0 1 5
CONCLUSIONS
Far to represent a goal already
achieved, the need for a reduction of the
risks related to alcohol use will continue
to represent a main aim in public health
supporting the need for a change toward
a more healthy drinking culture, re-
discovering and strengthening the
formal control of the society and
remarking to individuals that drinking is
perhaps one of their own responsibility.

34. Outcomes for the Third Millennium
INVESTING FOR HEALTH
• H. EDUCATION
• H. PREVENTION
• H. PROTECTION
• SOCIAL INFLUENCE
• FACILITATION
• ADVOCACY
EMPOWERMENT & PARTECIPATION
Rome ISS 1999

35. The need for RENEWING the challenge
for the FUTURE is STILL ...
INVESTING FOR HEALTH
SCAFATO, SEOUL 2015

36. E M A N U E L E S C A F A T O 2 0 1 5
Take Home Message
 To measure is the best way to understand. Monitoring and reporting is
the best way to support our and policy makers’ understanding and
actions.
 There is an inverse relationship between alcohol dependency and per
capital alcohol consumption. Harmful drinkers and alcohol
dependents are in need for treatment in order to stop harm
progression.
 Risk reduction and early detection of problems is a public health
concern and formal programs are needed in PHC.
 Increased awareness, education, training, changes in culture and
environment should be included as ongoing effort.
 Strengthening the formal control of the society is significant.
 Like in the case of Italy, the government plays a strong and important
role in reducing alcohol consumption.

37. E M A N U E L E S C A F A T O 2 0 1 5
THANK YOU FOR
YOUR ATTENTION
THANK YOU
emanuele.scafato@iss.it
www.epicentro.iss.it/alcol