Hungary's Neglected “Alcohol Problem”: Alcohol Drinking in a Heavy Consumer Country

Abstract

Hungary has always belonged to the group of nations characterized by high alcoholic beverage consumption and it is still one of the leading liver cirrhosis mortality countries in Europe and in the world. This research studies changes in selected contextual factors and control policy measures that are most strongly correlated with changes in alcohol consumption and selected related harms in Hungary between 1960 and 2008. The method to analyze the association between different variables was similar to that of the European AMPHORA project. The analysis, which has been done, highlights the central role of urbanization and population ageing in Hungary in affecting the increase of consumption of alcoholic beverages, especially beer. Alcohol control policy measures show little explanatory power to interpret consumption changes; having had no effect in curbing alcohol consumption and no, or little impact on alcohol consumption-related deaths. Study's limitations are noted.

Keywords :

• alcohol consumption
• alcohol consumption-related harms
• socio-demographic factors
• alcohol policy measures
• time series analysis
• Artificial Neural Network analysis

THE AUTHORS

Zsuzsanna Elekes, is PhD in economics and in sociology, DSc in sociology and demography, and Associate Professor at the Institute of Sociology and Social Policy, at the Corvinus University of Budapest. Since the mid 1980s, her research activities have focused on alcohol and drug use epidemiology. She has participated in several international projects conducted on alcohol and drug issues like: ESPAD (European School Survey Project on Alcohol and other Drugs) and GENACIS (Gender Culture Alcohol–International Study) program, in the SMART and AMPHORA projects. She teaches courses for graduate and PhD students of sociology and social policy on alcohol and drug epidemiology, social problems, and drug policy. She is a member of the Demographic Committee of the Hungarian Academy of Sciences, and she has been the member of different Hungarian advisory boards or expert groups. She has published several books and articles on alcohol and drug problems both in Hungarian and international journals.

Notes

1 Treatment can be briefly and usefully defined as a unique, planned, goal directed, temporally structured, multi-dimensional change process, of necessary quality, appropriateness, and conditions and resources (internal and external), which is bounded (culture, place, time, etc.), associated with a range of stakeholders with agendas, and can be categorized into professional-based, tradition-based, mutual-help-based (AA,NA, etc.), and self-help (“natural recovery”) models. There are no unique models or techniques used with substance users—of whatever types and heterogeneities—which are not also used with nonsubstance users. Whether or not a treatment technique is indicated or contra-indicated, and what are its selection underpinnings (theory-based, empirically-based, “principle of faith-based, tradition-based, etc.) continues to be a generic and key treatment issue. In the West, with the relatively new ideology of “harm reduction” and the even newer Quality of Life (QOL) and wellbeing treatment-driven models, there are now new sets of goals in addition to those derived from/associated with the older tradition of abstinence driven models. Conflict-resolution models may stimulate an additional option for intervention. Each ideological model has its own criteria for success as well as failure as well as iatrogenic (treatment caused)-related harms. Treatment is implemented under conditions of uncertainty in a range of environments; ambulatory as well as within institutions which can include controlled environments. Treatment includes a spectrum of clinician–caregiver–patient relationships representing various forms of decision-making traditions/models; (1). the hierarchical model in which the clinician-treatment agent makes the decision(s) and the recipient is compliant and relatively passive, (2) shared decision-making which facilitates the collaboration between clinician and patient(s) in which both are active, and (3) the “informed model” in which the patient makes the decision(s). Editor's note

2 The reader is referred to Hills's criteria for causation which were developed in order to help assist researchers and clinicians determine if risk factors were causes of a particular disease or outcomes or merely associated. (Hill, A. B. (1965). The environment and disease: associations or causation? Proceedings of the Royal Society of Medicine 58: 295–300.). Editor's note