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Addiction problems / addiction prevention
Addiction problems: shared responsibility instead of just personal responsibility
One in four people in Switzerland still smokes, one in five drinks too much or too often alcohol, and 3% of the population have consumed cannabis in the last month. In the general population, consumer behavior has not changed significantly. The situation is different with young people: here opposing developments are emerging. With the Addiction Panorama 2016, Addiction Switzerland publishes for the second time analyzes in the areas of alcohol, tobacco, illegal drugs, gambling and, now, on internet consumption. With more than 11,000 deaths each year and 10 billion francs in follow-up costs, addiction problems challenge the whole of society. Not only the individual, but also the state and the economy bear responsibility - a point of view that cannot be taken for granted, as a look at developments in addiction policy shows.
Tobacco as a problem continues to be high: no further decline in the smoking rate. It was still not possible to achieve a decrease in the smoking rate. The tobacco-related problem load has even increased somewhat, with 9,500 deaths per year, which has lagged behind the increase in the number of women smokers in recent decades. While the quota of smokers is stagnating, the market is changing: fewer conventional cigarettes are being bought, but more people are turning to hand-rolled cigarettes, water pipes and e-cigarettes, although the latter have so far mostly been a trial consumption.
Alcohol: constant problem burden with unequal distribution of consumption
With 8.1 liters of pure alcohol, there is still a slight decrease in annual per capita consumption. In particular, the daily glass of wine is less part of everyday life for Mr and Mrs Swiss. However, total consumption is still very unevenly distributed: a good 11% of the adult population drink half of all alcohol, which is reflected in an unchanged high level of problems: Furthermore, a person dies every 5 to 6 hours as a result of alcohol consumption. It is estimated that around 250,000 people have an alcohol dependency and a further half a million have the alcohol problem of close relatives; there are also around 100,000 children from families exposed to alcohol.
Illegal drugs: continued widespread use of cannabis and new regulatory models under scrutiny
Cannabis remains by far the most widely used illegal substance. It is most widespread in the 15- to 34-year-old age group, with one in 14 people consuming. The discussion about the possible advantages and disadvantages of cannabis regulation is at the center of the drug policy discussions - now against the background of initial experiences with new regulatory models in four American states and in Uruguay.
Money game: Uncertain development due to planned market expansion
A good 1% of the population plays in a problematic or pathological way. A significant part of the revenue for the operator and the state comes from their wallets. The new gaming law now wants to open up the profitable market on the Internet as well. Without adequate measures to protect gamblers, the legislature risks increasing problems with gambling.
Opposing developments among the young
Less alcohol, tobacco and cannabis up to the age of 15, increasing among older adolescents
A noticeable development can be seen among boys with regard to alcohol and tobacco: The latest student survey shows that today's 15-year-olds are more cautious in dealing with alcohol than they used to be, while among the 15- to 19-year-olds have been binge drinking 2011 increases. A similar phenomenon with tobacco: Among the 11 to 15 year olds, the proportion of smokers has been falling since 2002, among the 15 to 19 year olds there are signs that they are increasingly resorting to the smoldering stalk. There was also a decline in cannabis use among 15-year-olds - albeit less pronounced - while the trend among 15- to 19-year-olds is stable or rising slightly. Interestingly, at least in France and the USA, similar developments are emerging.
Open questions, uncertain developments
It remains to be seen whether the development among younger adolescents is related to a changed parenting behavior, greater health awareness, successes in addiction prevention and youth protection, or to a changed behavior of adolescents going out. According to new studies, there are certain signs of a "domesticization" of the younger generation, so that they come into less or later contact with addictive substances. It is unclear what influence the greater use of media will have. It is true that younger and younger age groups have access to the virtual world: over half of 6 to 13 year olds have their own smartphone and 12 to 19 year olds spend an average of two hours per day during the week and three or more hours per day in their free time Day on the weekend and during the holidays on the Internet. At the same time, the latest youth surveys suggest that employment in the virtual world has not led to a decline in “real” activities and friendships.
Addiction as a challenge for society as a whole
To focus exclusively on young people, which is all too popular in politics, does not go far enough. Firstly, the adolescents orientate themselves towards the adult world and secondly, the substance-related problematic branch is mainly due to the consumption behavior of the adults. That is why addiction prevention and policy must be understood as a task for society as a whole, for which all actors - the consumers, the state and the economy are responsible.
Personal responsibility is important, but not all are equal
The parliamentary initiative “Komatrinkers should pay for stays in hospitals and sobering cells themselves”, which fortunately was written off by the National Council at the end of last year, was symptomatic of the zeitgeist of today's health policy. In addition to the break with the principle of solidarity, it was argued once again with the young people in the role of those who caused the problem, although less than 10% of the people hospitalized for alcohol intoxication are young people. Proponents spoke a lot about personal responsibility, an argument that is increasingly enjoying popularity not only in industry-related, but also in health policy circles, while the responsibility of society and politics is neglected despite increasing deregulation of the market Growing up in Switzerland in a family with addiction problems are up to six times more likely to become addicts themselves. They don't have a choice of whether or not to face addiction problems. Rather, society must create the conditions so that children can grow up to be healthy, responsible citizens. However, politicians often block health-promoting investments with the argument of personal responsibility. Demanding this from others without taking responsibility for minors or groups at risk is not justifiable.
Personal freedom is not the same as market freedom!
The argument that regulatory measures restrict personal responsibility and personal freedom falls short: it is not about prohibiting substance use or stigmatizing users. Framework conditions that promote health-literate action and not consumption are important. The more than 10,000 deaths and 10 billion francs in follow-up costs make it clear that even legal addictive substances are not ordinary consumer goods. Current surveys show that a ban on tobacco advertising or measures against ridiculous prices for alcohol are supported by the majority of the population . For most of them, these measures would hardly be noticeable, but they would protect young people and those with problematic consumption. In addition, it seems contradictory to many that young people should be convinced of the risks of smoking and at the same time tobacco advertising in typical youth places such as festivals or on social media promises freedom and coolness. The new Tobacco Products Act, which will be discussed this year, offers an opportunity to resolve these contradictions. In regulating the gaming market, too, Parliament is given the opportunity to bring the interests of health policy into balance with those of the economy by reintegrating the originally intended strengthening of player protection Looking for new ways of dealing with cannabis, especially at the level of the cantons and cities. It is important not to consider the different developments in the legal and illegal addiction area in isolation from one another: Experience with deregulations in the alcohol and tobacco product market teaches us that a market-oriented cannabis model as it is currently implemented in the USA is of little use in the interests of addiction prevention can. Just as little in the sense of a coherent addiction policy is it if a product like tobacco, which kills a person every hour, can still be promoted with advertising, while the consumption of illegal drugs is already a crime. It remains to be hoped that addiction policy will be less ideological and more based on factual analyzes of previous experiences.
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