Work

Alcohol Policy Gaps Across Europe: Findings from a Scoping Review in the Horizon Europe 4PCAN Project

Year: 2025

Type: article

Abstract: Background Alcohol led to 741,000 cancer cases globally in 2020. In Europe, Eastern countries face a higher alcohol-attributable cancer burden than Western ones. As part of the Horizon Europe project: Personalized CANcer Primary Prevention research through Citizen Participation and digitally enabled social innovation (4PCAN), we mapped alcohol control policies across 31 countries and assessed their policy strength to support cancer prevention. Methods We conducted a scoping review following PRISMA guidelines across 27 EU and 4 additional countries (Moldova, Ukraine, North Macedonia, Montenegro). Using the PCC framework, we searched PubMed, Scopus, official and grey literature (2008-2023). Policies were categorized according to WHO-recommended domains. Strictness was scored through a modified BtG scale, a weighted system covering production, distribution, marketing, control, and taxation, with final scores expressed as a percentage of maximum points. Results We identified 346 alcohol-related laws. Licensing requirements (124, 35.8%) prevailed, followed by taxation (40, 11.6%), drink-driving (34, 9.8%), advertising restrictions (34, 9.8%), and age limits (29, 8.4%). Health warnings (22, 6.4%), public drinking (10, 2.9%), retail sales regulations (9, 2.6%), and sales promotions (7, 2.0%) were less frequent. Top performers for policy strictness were Sweden (82.5%), Finland (80%), and Ireland (77.5%), demonstrating comprehensive alcohol control frameworks. Conversely, Bulgaria, Croatia, Czech Republic, North Macedonia, and Malta (each 25%) had major gaps, especially in pricing and marketing. Conclusions Alcohol control policies across Europe vary widely, with critical gaps in pricing measures and health warnings. Despite proven effectiveness, strategies like minimum pricing and consumer labels remain underused. Strengthening and harmonizing alcohol policies could support cancer prevention goals, reduce alcohol-related harms, and decrease health inequalities across the region. Key messages • Alcohol policy strength varies across Europe, Nordic countries lead, while Eastern nations lag, risking higher cancer burdens due to policy gaps in pricing and marketing. • Despite strong evidence, most European countries underuse life-saving alcohol controls like minimum pricing and health warnings, leaving cancer prevention on the table.

Source: European Journal of Public Health

DOI: 10.1093/eurpub/ckaf161.1142