Introduction and Aims. Over the recent decades, Lithuania has reported very high alcohol-related harm and mortality indicators when compared to other countries. This, among other reasons, led to an adoption of comprehensive evidence-based alcohol control policy measures back in 2007 and 2016. The aim of this study is to examine alcohol-related male mortality in the context of changing alcohol control policies over the period 2000-2017. Design and Methods. The life table decomposition method was applied to estimate to what extent the age groups and causes of death are responsible for changes in male life expectancy in the period 2000-2017. Furthermore, a time series intervention model was used to study the impact of alcohol control measures on alcohol-related mortality. A seasonal autoregressive integrated moving average model was fitted. Results. Male life expectancy increased by 6.23 years in the period 2007-2017, mainly due to a decrease in mortality from external causes of death (2.12 years), cardiovascular diseases (1.84 years) and alcohol-related disorders (0.86 years). Reduced male mortality in the 30-64 years age group also contributed to a large increase in male life expectancy during the same period. Discussion and Conclusions. The greatest positive effect of reduced alcohol-related mortality to male life expectancy was observed during the period 2007-2009. It overlaps with the start of implementation of the comprehensive alcohol control measures. However, further research on the impact of different alcohol policy interventions on various outcomes is needed.

Over the three last decades, Lithuania has reported some of the highest male suicide rates in the world. This paper relies on longitudinal census-linked data for Lithuania covering the entire male population aged 30-64 years during the 2011-2017 period. The study uses multilevel modelling to examine the importance of the selected individual-and area-level contextual characteristics. One of the key findings is the persistence of a suicide disadvantage among males living in rural areas. This disadvantage could not be explained by major sociodemographic characteristics and remained statistically significant for those individuals who migrated to urban areas. Unlike some other studies, we found that socioeconomic area-level characteristics retained their significance after controlling for the major individual-level characteristics. This evidence highlights the potential for policies aimed at improving area-level conditions.

BackgroundAlthough excessive alcohol-related mortality in the post-Soviet countries remains the major public health threat, determinants of this phenomenon are still poorly understood.AimsWe assess simultaneously individual- and area-level factors associated with an elevated risk of alcohol-related mortality among Lithuanian males aged 30–64.MethodsOur analysis is based on a census-linked dataset containing information on individual- and area-level characteristics and death events which occurred between March 1st, 2011 and December 31st, 2013. We limit the analysis to a few causes of death which are directly linked to excessive alcohol consumption: accidental poisonings by alcohol (X45) and liver cirrhosis (K70 and K74). Multilevel Poisson regression models with random intercepts are applied to estimate mortality rate ratios (MRR).ResultsThe selected individual-level characteristics are important predictors of alcohol-related mortality, whereas area-level variables show much less pronounced or insignificant effects. Compared to married men, never married (MRR = 1.9, CI:1.6–2.2), divorced (MRR = 2.6, CI:2.3–2.9), and widowed (MRR = 2.4, CI: 1.8–3.1) men are disadvantaged groups. Men who have the lowest level of educational attainment have the highest mortality risk (MRR = 1.7 CI:1.4–2.1). Being unemployed is associated with a five-fold risk of alcohol-related death (MRR = 5.1, CI: 4.4–5.9), even after adjusting for all other individual variables. Lithuanian males have an advantage over Russian (MRR = 1.3, CI:1.1–1.6) and Polish (MRR = 1.8, CI: 1.5–2.2) males. After adjusting for all individual characteristics, only two out of seven area-level variables—i.e., the share of ethnic minorities in the population and the election turnout—have statistically significant direct associations. These variables contribute to a higher risk of alcohol-related mortality at the individual level.ConclusionsThe huge and increasing socio-economic disparities in alcohol-related mortality indicate that recently implemented anti-alcohol measures in Lithuania should be reinforced by specific measures targeting the most disadvantaged population groups and geographical areas.

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Aims: From 1 January 2018, the number of retail hours for the sale of alcohol was reduced from 14 to 5 hours on Sundays and from 14 to 10 hours on the other days of the week in Lithuania. The significant reduction of hours for the sale of alcohol on Sundays may have affected the distribution of alcohol-attributable deaths during the week. This study aimed to examine the change in the weekly pattern of alcohol-attributable male mortality before and after imposing limits on the hours when alcohol can be sold. Methods: Age-standardised male death rates by days of the week were calculated for four groups according to cause of death: alcohol poisoning (X45), all external causes of death (V01–Y98), diseases of the circulatory system (I00–I99) and all other causes of death. We compared age-standardised death rates for two periods: before (2015–2017) and after (2018–2019) the intervention. Mortality and population data were obtained from the Lithuanian Institute of Hygiene and Human Mortality Database. Results: We found that during 2018–2019, earlier observed peak in age-standardised death rates for external causes of death on Sunday diminished, and this day no longer differed from the weekly average. The same tendency was also observed for the Monday excess mortality due to circulatory diseases. Conclusions: The reduction of the hours when alcohol can be sold from the beginning of 2018 was associated with a change in a weekly pattern of alcohol-attributable male mortality. However, more studies are needed to examine the causes of the change in mortality pattern.