Joel Volkov's opinion piece "Conflict of values in three acts" includes a series of misleading claims about alcohol advertising restrictions and the effects of healthcare policy, and accuses me of incomprehensible things. As minister of health, it is my duty to protect public health, but also to explain decisions taken and inform the public about a knowledge-based approach.

Who to trust when it comes to healthcare policy?

We have based healthcare policy on the recommendations of independent experts and scientists in Estonia. Their main goal is to protect [public] health, instead of personal gain or political point-scoring. Our advisers include doctors, researchers and other health specialists whose recommendations are based on scientific evidence.

But it is true that we should also trust the Estonian people. A 2022 study by the National Institute for Health Development (TAI) suggests that 74 percent of people in Estonia support banning all alcohol advertising in online channels. An annual study of the Estonian Institute of Economic Research also tells us that most people support broader alcohol advertising restrictions. Therefore, whose interests does alcohol advertising serve? Because the people do not want to see it.

In a situation where it is claimed that my decisions are biased or based on unprofessional advice, I really proceed from the comprehensive social support and the recommendations of independent experts.

Do advertising restrictions yield economic benefit or loss?

Data from TAI suggests that alcohol-related conditions cost the state over €50 million annually – money that could be used to shorten waiting times in medicine. The social and economic costs of alcohol consumption have been estimated at over €1 billion. For example, 40 percent of people with reduced capacity for work are grappling with behavioral and psychological problems in which alcohol addiction plays a major role.

Restricting alcohol advertising is not just a healthcare measure, but an investment in the future and economic sustainability of our people. Alcohol ad restrictions help limit consumption, especially among young people and other vulnerable groups, which in turn helps decrease alcohol-related losses.

Claims according to which alcohol ad restrictions harm the economy or limit free speech ignore the fact that protecting public health is a crucial public task. We need to strike a balance between economic interests and public health, considering the long-term effect alcohol overconsumption has on people's well-being and the national economy.

The alcohol advertising revenue of a few companies and the effect of increased consumption on GDP pale in comparison to the damage done by incapacity for work due to addiction, sickness and premature deaths. While a few companies might see a boost to their turnover for a couple of years, in the long run, we will be shedding labor, a resource we are already short on, which is holding back economic growth.

Restricting alcohol advertising is not just moral and healthy, it is an economically rational decision helping to keep down public costs and improve general well-being in the long run.

Does advertising have an effect?

Evidence shows that even though patterns of consumption and cultural factors may differ, alcohol ads have a steady effect on consumption. Estonia is no exception, and we have no reason to believe our residents somehow react differently to alcohol ads.

Studies have shown that advertising raises awareness on alcohol products, affects attitudes and increases the likelihood of people, especially young people, taking up drinking earlier in life and drinking more. These finds are based on extensive epidemiological and sociopsychological studies on the effects of advertising in different cultures and societies.

Research also shows that it is possible to reduce alcohol consumption and related damages by restricting advertising, especially among young people and other vulnerable groups.

We do not need repeated studies to prove the obvious; that limiting advertising helps protect especially vulnerable target groups from the harmful effects of alcohol.

But are advertising restrictions working?

Estonia's experience shows that alcohol consumption among minors has been falling since restrictions were introduced. Studies also show that ad restrictions affect attitudes toward alcohol consumption by promoting healthier behavior and reducing the cultural normalization of alcohol.

For example, it has been established that people are more cautious and knowledgeable about drinking in countries where advertising is subject to strict limitations or is banned altogether.

Alcohol ad restrictions do not limit anyone's personal freedoms nor do they stop people from consuming alcohol. Ad restrictions are important and effective when it comes to protecting public health, especially among young people and vulnerable groups, and help make alcohol less attractive in the eyes of young people. We need to remember that the effect of restrictions manifests in the medium to long term in the form of shaping attitudes in society.

It is erroneous to claim that alcohol consumption has grown by 30 percent since restrictions were introduced. First, consumption is still declining among young people as a group sensitive to advertising. Secondly, while the amount of alcohol consumed per adult resident has, unfortunately, grown, this happened during a period when the excise duty on alcohol was slashed, while the number of shops that sell alcohol has grown by 50 percent.

Why is self-regulation not enough?

The experiment of self-regulation cannot start with alcohol policy. Self-regulation is valuable but needs to be practiced first, and efforts should start in areas where the price of failure is not comparable to alcohol damage.

It seems that self-regulation is proving insufficient when it comes to protecting public interest and limiting the negative effect of alcohol ads on vulnerable groups, especially youths and kids.

As concerns the presentation by the U.K. regulator (ASA), Shahriar Coupal clearly said that alcohol advertising boosts consumption. It remains unclear what Joel Volkov considers successful self-regulation in the U.K. in a situation where it is used as an unfortunate example of the latter.

Experience also tells us that self-regulation largely depends on goodwill in the industry and might be sensitive to conflicts of interest where economic considerations might get in the way of public health goals. Such conflicts of interest could lead to inefficient advertising restrictions or their uneven execution, leaving vulnerable groups unprotected.

Why attack ministers on a personal level?

In December 2016, I was reading a paper, sitting in the kitchen of the Praxis Center for Policy Studies, and wondering why someone would attack a minister personally. The minister in question was then Health Minister Jevgeni Ossinovski who was planning to introduce alcohol advertisement restrictions. The very restrictions the Economy Ministry's "modernization" of the Advertising Act is now proposing we lift and replace with self-regulation, which I do not endorse and Joel Volkov does.

According to Volkov, ministers are simpleminded, incompetent, ignorant when it comes to advertising and indifferent when it concerns the economy. Also that competent advertisers and the alcohol lobby are being overshadowed. I have no doubt that Volkov is competent in his field, a respected manager with a storied career who has for years fought for the free availability of alcohol and relevant ads. A contribution that should not be overshadowed indeed.

I hereby propose to the press publishing Joel Volkov's photograph next to every news story about alcohol-related deaths. Why just cover burnt houses, totaled vehicles and kitchens that double as crime scenes if we can add a photograph recognizing years of hard work.

In summary, advertising restrictions do not limit anyone's freedoms, but they help reduce risks for young people and addicts. Restrictions are rooted in proof, and cannot just be replaced with self-regulation, and reducing alcohol-related losses in society is necessary for long-term economic growth.

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