Since the early 1990s, Lithuania has experienced an increasing level of alcohol consumption and a heavy burden of alcohol-related harm, which is associated with the development of alcohol policies. The aim of this analysis was to provide a chronology of change of Lithuanian alcohol control legislation and to present several other detailed examples of the political processes. The data were collected using document reviews. During the last three decades, the Lithuanian alcohol control policies have undergone several cycles of stricter control and liberalizations. Some of the limitations of the study are the exceptional focus on the public health perspective and the inclusion of policies targeting the population as a whole. The strength of the study is in providing a detailed background for future policy effectiveness studies. Some of the recent periods when a series of ‘best buy’ interventions were implemented during a short period are of particular importance, constituting a natural experiment, whose effects need to be studied in more detail in the future.

Issues: The last Soviet anti‐alcohol campaign of 1985 resulted in considerably reduced alcohol consumption and saved thousands of lives. But once the campaign's policies were abandoned and the Soviet alcohol monopoly broken up, a steep rise in mortality was observed in many of the newly formed successor countries, although some kept their monopolies. Almost 30 years after the campaign's end, the region faces diverse challenges in relation to alcohol.Approach: The present narrative review sheds light on recent drinking trends and alcohol policy developments in the 15 Former Soviet Union (FSU) countries, highlighting the most important setbacks, achievements and best practices. Vignettes of alcohol control policies in Belarus, Estonia, Kazakhstan, Lithuania and Uzbekistan are presented to illustrate the recent developments.Key Findings: Over the past decade, drinking levels have declined in almost all FSU countries, paralleled by the introduction of various alcohol‐control measures. The so‐called three ‘best buys’ put forward by the World Health Organization to reduce alcohol‐attributable burden (taxation and other measures to increase price, restrictions on alcohol availability and marketing) are relatively well implemented across the countries.Implications: In recent years, evidence‐based alcohol policies have been actively implemented as a response to the enormous alcohol‐attributable burden in many of the countries, although there is big variance across and within different jurisdictions.Conclusion: Strong declines in alcohol consumption were observed in the 15 FSU countries, which have introduced various alcohol control measures in recent years, resulting in a reduction of alcohol consumption in the World Health Organization European region overall.

Aims: To study the impact of alcohol control policy measures (i.e. increases in taxation, restrictions on availability, including minimum purchasing age regulations, legislation on drink driving and advertisement bans) on alcohol‐related traffic harm in Lithuania between January 2004 and February 2019.Design: Analyses of trend data on the proportion of alcohol‐related collisions and crashes, injury and mortality, adjusting for secular trends, seasonality, periods of alcohol control measure implementation and economic development. Generalized additive mixed models were used. Multiple sensitivity analyses were conducted.Setting: Lithuania.Cases: Monthly number of alcohol‐related cases of traffic collisions and crashes, injuries and deaths.Interventions and comparators: Periods of time during which new alcohol control measures were implemented and/or augmented compared to periods when they were not.Measurements: Monthly data for 2004 to 2019 from routine statistics of the Lithuanian Road Police Service.Findings: All indicators decreased consistently and significantly after the implementation of alcohol control measures, including increased taxation, reduction of availability and a ban on advertisement, starting in 2014. On average, each implemented policy measure permanently reduced the proportion of alcohol‐attributable crashes by 0.55% [95% confidence interval (CI) = 0.21–0.90%; P = 0.002], the proportion of alcohol‐attributable injuries by 0.60% (95% CI = 0.24–0.97%; P = 0.001) and the proportion of alcohol‐attributable deaths by 0.13% (95% CI = 0.10–0.15%; P < 0.001).Conclusions: Alcohol control policy measures, including measures to reduce overall level of alcohol consumption, were associated with a marked decrease in alcohol‐related traffic harm.