Given the global nature of the alcohol industry, there is a need for international regulation to limit the influence of vested interests on national lawmaking.

Smoking causes a considerable mortality burden in Lithuania, killing nine times more males than females. Therefore reduction of smoking prevalence is an urgent public health need, which calls for implementation of effective and comprehensive tobacco control measures consistent with the World Health Organization Framework Convention on Tobacco Control Articles and Protocols and The Tobacco Products Directive.

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Introduction: The estimates of the economic burden of smoking provide the basis for a comprehensive assessment of the overall economic impact and evidence for potential public health policy intervention by the government. The aim of this paper is to estimate the smoking-attributable direct healthcare expenditure covered by the Compulsory Health Insurance Fund (CHIF) in Lithuania in 2013. Methods: A prevalence-based and disease-specific annual cost approach was applied to 25 smoking-related diseases or disease categories. Our analysis included only direct government healthcare expenditure (reimbursed by CHIF), including: smoking-attributable outpatient and inpatient care services, medical rehabilitation, reimbursable and publicly procured pharmaceuticals and medical aids, the emergency medical aid (ambulance) service, nursing, and expensive tests and procedures. The smoking-attributable expenditure on the above-mentioned healthcare services was calculated by multiplying the total annual expenditure by the corresponding smoking attributable fractions (SAFs). Results: The total smoking-attributable government expenditure amounted to €37.4 million in 2013. This represented 3% of the total CHIF budget in 2013. Smoking-attributable expenditure on inpatient care and medical rehabilitation services was two times higher for male smokers, than for female smokers. Conclusions: Smoking imposes a significant preventable financial cost within the budget of the Lithuanian healthcare system. A quantitative estimation of smoking related healthcare costs could provide an incentive for the development of smoking cessation services, with additional attention towards male smokers, as well as an important focus on smoking prevention among children and youths.

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AUDIT test is a traditional methodology to diagnose harmful use of alcohol. The study summarizes the AUDIT test results from the public survey data which was performed in 2007.Methods. The representative sample of Lithuanian adult (15-74 years old) population has been surveyed in October-December 2007. In total 3302 respondents filled in the questionnaire. The level of harmful use of alcohol was estimated with the AUDIT test. The respondents were also asked to provide additional demographic information as well as information about their expenditure on alcoholic beverages.Results. The harmful use of alcohol was observed in 1/5 of 15-74 years old Lithuanians. The highest prevalence of harmful use of alcohol was among 35-44 years old males, and 25-34 years old females. It was around three times more common among males then among females. The lower education, unemployment, living in rural areas, and living alone were the factors more closely associated with the higher prevalence of problematic alcohol use. Problematic alcohol users spend in average 4 times more money to purchase alcoholic beverages. According to the study results alcohol related problems are associated with significant proportion of Lithuanian population. Special concern must be attributed to a fact that the problematic use of alcohol is high among the people in youngest age groups.

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