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Article Excerpt
On many occasions throughout the 20th century, medical professionals and religous clergy have worked together with the local Slovenian government, as well as the federal Yugoslavian government, to implement measures that would curtail alcohol consumption among Slovenians. These measures included wine legislation, traffic safety education, and a ban on advertising alcoholic beverages, all with the goal to reduce harm caused by alcohol misuse. The first measure implemented in the 21st century, and the topic of this article, was created with the similar goal of reducing alcohol-related harm by limiting availability of alcohol products, especially among young people. Zakon o omejevanju porabe alkohola (ZOPA) (Act Restricting the Use of Alcohol) was approved by the Slovenian National Assembly (the lower house of the parliament of the Republic of Slovenia) on January 28, 2003. This Act is an example of international collaboration between local government, public health professionals, law enforcement, the economic sector, public media, the World Health Organization, and the European community. This article first contextualizes this law by discussing earlier legal measures aimed at reducing alcohol-related harm in Slovenia, then describes the arguments of supporters and opponents of the policy leading up to its enactment, and finally briefly examines the enforcement and effectiveness of the policy in reducing alcohol-related harm.
Background
Slovenia is a small central European country with an historically high rate of alcohol consumption. With over 200 square kilometers of vineyards in three Slovenian wine growing regions, Slovenia is a supplier of top quality specialty wines. Meals in the country are often accompanied by a generous serving of Slovenian wine, the favorite national spirit (called "rakija" or "zganje), or the Slovenian beers "Lasko" and "Union."
The winemaking tradition in the Slovenian region dates back to at least the 1st century A.D., as Slovenia's geographical location provides an ideal climate for viticulture (Alkalaj, 1996). Podravje, Posavje and Primorje are the three wine growing regions of Slovenia. They are located in different parts of the country and as such have different microclimates, soil compositions, and viticultural traditions that contribute to the wide range of wines available (Preseren, 2003).
In addition to wine's ties to the culture, Slovenia's historical connections with the Austro-Hungarian Empire contribute to a tradition of beer brewing and heavy beer drinking in the country. With two different beer breweries in the small nation, one located in the town of Lasko and the other in Ljubljana, Slovenes do not have to look hard for their beer of choice. The Lasko brewery was established in 1825, while the Union brewery dates to 1864.
Aside from wine and beer, spirits are also commonly consumed in Slovenia. Rakija (or zganje) is the most common type of spirit in Slovenian houses, and it is often offered as a sign of hospitality. It is made of fermented fruit juices from apples, pears, plums, and sometimes grapes. Like in other South Slavic countries, rakija, and alcohol in general, is an important part of the culture and is often associated with many cultural rituals and festivals (Cebasek-Travnik, 2007). During funerals, for example, the family of the deceased person is obliged to offer zganje to every visitor (Lozar-Podlogar, n.d.).
Living in a small country that produces each of the three main forms of alcoholic beverages influences the degree to which alcohol consumption is socially accepted. Assessing the state of alcohol drinking and alcohol culture in Slovenia, where expansion of wine consumption as well as of other alcoholic beverages is a sort of national pride, scholars have noted that many factors influence social acceptability of alcohol consumption. Some of these factors include a social atmosphere in Slovenia where traditionally: 1. Alcoholic beverages were more accessible to youth relative to non-alcoholic beverages (especially fruit juices) since the former cost less; 2. Alcohol was sold in hospitality establishments from the time the establishments open (in some instances this is in early morning hours); 3. Prohibiting the sale of alcohol beverages to minors, intoxicated persons and drivers of motor vehicles was rarely practiced; 4. It was not uncommon for alcohol to be consumed at work; 5. Unrestricted private production and distillation of alcohol was often beyond the reach of sanitary and taxation control (see Nolimal & Premik, 1994).
The Slovenian population's low level of awareness of alcohol-related harm continues to contribute to the positive cultural beliefs associated with drinking alcoholic beverages (Cebasek-Travnik, 2007). Therefore, it is not surprising that any effort to educate the public of alcohol-related harms may be unwelcome and that attempts to legislate alcohol policy will be protested and, if passed, possibly ignored.
This is the atmosphere that Dr. Zdenka Cebasek-Travnik encountered when she took on the responsibilities of becoming a national leader for the European Alcohol Action Plan (EAAP) in 1994. Through the EAAP, the World Health Organization (WHO) helped 43 Member States, which had agreed to participate, to create programs aimed at preventing the health risks and negative social consequences resulting from alcohol use (EUROCARE, n.d.). Committed to the possibility of alcohol-related harm prevention, Dr. Cebasek-Travnik followed the proposed WHO strategies and worked to bring the issue of alcohol-related harm to the forefront of national discourse in Slovenia. The effort led to a law passed by the Slovenian government in 2003 in an attempt to limit the use of alcohol and reduce alcohol-related harm.
Historical struggle with alcohol consumption
In an effort to reduce the increasingly visible health and social consequences resulting from alcohol use, large temperance movements spread across many parts of Europe in the late 19th and early 20th centuries (Anderson & Baumberg, 2006). The temperance movement was quite strong in the land of the South Slavs and in the Republics of Serbia, Croatia, and Slovenia until at least the early 1930s (Bennett, 1992). The temperance movement in Yugoslavia was led by medical professionals who were concerned with public health and who relied mainly on primary prevention measures, such as restrictions on alcohol availability, and on educational programs designed to inspire abstinence or moderation in drinking. Most of these professionals were not interested in outright legal prohibition because they recognized not only the futility of such an effort but also the important role that alcohol played in the economy (Bennett, 1992).
The first treatment for alcoholics in Slovenia was proposed in 1834 by Dr. Franz Wilhelm Lippich (Cebasek-Travnik, 2007). Dr. Lippich was of Slovene origin and worked as "the doctor for the poor" in Ljubljana for over 11 years. He believed that alcoholism is a disease, the difficult treatment of which requires establishing institutions and health care center (Cebasek-Travnik & Slavec, 2006). He was also among the few of his contemporaries who used a scientific approach to examine the state of public health (Cebasek-Travnik & Slavec, 2006). While Dr. Lippich was not in favor of prohibition of alcoholic beverages, he did suggest a need to decrease alcohol production by one-third (Cebasek-Travnik & Slavec, 2006) in order to reduce some of the harmful effects resulting from alcohol use. In 1904, Roman Catholic clergy provided the initial organizational momentum for the Slovenian temperance movement, and the first organization against alcohol consumption, "Society for Sobriety," was founded in the country (Bennett, 1992). The first Slovenian wine legislation came into force in 1905 (Cebasek-Travnik, 2007).
After World War II, Slovenia experienced rapid growth in the number of motorized vehicles, and this so-called "motorization outburst" gave rise to an epidemic of road accidents, some of which were alcohol-related (Eksler, Heinrich, Gyurmati. Hollo. Bensa, Bolko & Krivec, 2005). In 1965 the Road Safety Department initiated the First Fundamental Road Safety Act, mandating traffic safety education and focusing mainly on educating school children (Eksler, et al., 2005). In 1990, Slovenian police began extensive blood alcohol testing of motor vehicle drivers, which still represents one of the most important measures for assuring traffic safety in Slovenia (Eksler, et al., 2005). The Road Safety Act of 1998 contained even more restrictive provisions for road users and required a 0.0% blood alcohol concentration for drivers of public transport, drivers transporting goods or people, professional drivers, and driving instructors (Eksler, et al., 2005; Sesok, 2004). Shortly after the new Road Safety Act was implemented, morbidity and mortality from traffic accidents significantly decreased (Eksler, et al., 2005; Mujkic & Rovan, 2003). In 1998, for example, there were 310 road traffic fatalities, representing a 13% reduction from the prior year (Mujkic & Rovan, 2003). Similarly,...
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