Kiểm soát rượu bia ở việt nam hiện nay nhìn từ góc độ thực tiễn và chính sách

Sir kien-Nhan dinh xd hgi hgc s6 (143), 201355 KIEM SOAT RLTOU BIA CJ VIET NAM HIEN NAY NHIN TU* GOC DO THT/C TIEN VA CHINH SACH Dji^NG NGUYEN ANH* NGHlfeM THI T H U Y " Tom tdt: Bai viet ddnh gid thuc trgng su dung vd kiem sodt rugu bia tren the giai \d a Viet Nam hi^n Mice sdn xudt va tieu thu rugu bia d nu&c ta gia tdng mgnh theo thai gian, phdn ndo cho thdy nhimg kho khan vd hgn che kiem sodt logi hdng hoa dgc bi^t ndy Co nhieu bi$n phdp kiem sodt rugu bia nhung bien phdp quan trgng va hieu qua nhdt Id ban hdnh vd thuc hien cdc chinh sdch, phdp ludt nhdm hgn chi nguon san xudt vd nhu cdu tieu thu rugu bia Kinh nghiem qudc te vd cdc nuac khu vice cho thdy vi^c ban hdnh cdc quy dinh phdp lugt la phuang thuc tot nhdt de kiem sodt tinh trgng Igm dung rugu bia vd nhung h$ li/iy xd hdi a Vi$t Nam Tdc gid bdi viet kien nghj vi^c nhanh chong hodn thien vd thong qua Du thdo Lugt Kiem sodt rugu bia Tit khda: kiem soat va tieu th\i rugru bia, luat kiem soat rui^u bia, Viet Nam Nhdn bai:10/8/2018 Gia phdn bi^n: 17/8/2018 Duy?tddng: 08/9/2018 Dan nhap Rugu bia da tra uong quen thuoc kh6ng chi cr Viet Nam ma nhieu nuac tren the gioi Nghien cuu cua To chiic Y te The gioi (WHO, 2004) cho thay sir dung nrgu bia la mot hanh vi kha bien, gin lien vai nhieu quoc gia tren the gioi, d6 CO Vi$t Nam Tuy nhien, tu nam 1984, To chiic Y t^ the giai cung dong thai chi ring ruau bia, dac bi$t la rugu co tac dpng den sue khoe the chat, tam ly ciia cd nhSn, gia dinh va cgng dong Rugu bia la mgt 10 nguyen nhan gay hi vong hang dau tren The gicri (WHO, 2014), voi 50% ca tii vong xa gan, 30% ca tu vong ung thu thuc quan, dgng kinh va giet nguoi, 20% ca tii vong tai nan giao thong Rugu bia la nguySn nhan true tiep cua can benh ung thu va tren 30 b?nh doi voi ngucri (loan thSn kinh nrgu, viem da than kinh, b?nh ly ca tim; viem da day ) va \k nguyen nhan hang dau gSy gdnh nSng b?nh tat cac nuac dang phat trien hi?n Rugu bia co quan h? true tiep voi tai nan giao thong, bao l\rc xa hgi, hiep dam, khong lam chti va kiem soat dugc hanh vi, (WHO, 2014; Booth va cgng su, 2011) C) cdc nudc tren the gidi, rugu la chat gay nghi?n bien voi ty le cao han ty le sii dung ma tiiy dan cu (Simpura va Karlsson, 2001) Rugu la nguyen nhan hoac co Viin Hdn lam Khoa hgc xd hgi Vi4t Nam, " Vien Xd hgi hoc Vien Hdn Idm Khoa hgc xa hgi VietNam 56 Kiim sodt ruau bia a Viet Nam hien lien quan dSn 84% trucmg hap tii vong, 70% vu tu sat, 90% vu au da, chiSm 70% cac vu toi pham bao luc, va 60% vu tai nan oto (Rebach, 1992) Liy vi du tai Phap, hang nam co 40-50 nghin nguoi tCi vong nguyen nhan lien quan den uong rugu bia, trieu nguoi gap kho khan sire khoe vi rugu bia, din dSn chi phi 1cm ve y te va xa hoi Rugu bia la mgt nhiing nguyen nhan gay nhOng nguy hai cho silc khoe nguoi dan tren toan cSu Da CO nhiSu cong trinh nghien ciiu chi ring rugu bia co lien quan den hon 60 loai benh tat khac cho nguoi (Room, 1996; Room va cgng su, 2005) Di doi voi su phat triSn kinh tS-xa hgi, nganh san xuat rugu bia va uong co nuoc ta ciing dang phat triSn nhanh chong Viet Nam dugc coi la mgt so rat it qu6c gia tren toan ciu co miic san xuit va tieu thu rugu bia Of miic cao va hau nhu khong giam nhOng nam qua (WHO, 2011) Dac biet, rugu bia co lien quan vai cac truong hgp tai nan giao thong vgi thiet hai kinh ik tai nan giao thong lien quan toi rugu bia rat Ion Rugu bia co lien quan vol 36,2% cac truong hgp tai nan giao thong cr nam gioi va 0,7% cac truang hgp a ntr giai Thiet hai kinh te tai nan giao thong lien quan tai rugu bia uoc tinh gin I ty la My vao 2010 (WHO, 2014) Rugu bia la nguyen nhan chii yeu nhat, dan den 30% cac vu gay roi trat tu xa hgi va 33,7% cac vu bao luc gia dinh o Viet Nam Dieu tra quoc gia ve bao luc gia dinh (T6ng cue Thdng ke, 2010) cho thiy tre em Viet Nam cung dang la nan nhan viec lam dung rugu bia ciia nguoi Ion nhu: bi xuc pham, nhue ma, mang chiri (11,1%), bi bo doi hay thieu sir cham soc bao ve ciia nguoi Ion (6,5%.), phai chimg kien bao luc nghiem trgng gia dinh (6,1%)), va ban than bi danh dap gay dau don ve the xac (3,8%) Do nhiing tac dgng tieu cue ciia rugu bia doi vai sire khoe cua nguoi nen cang CO nhieu quoc gia quan tam va dua cac chinh sach nham kiem soat rugu, bia tren nhieu phuang dien nhu san xuat, kinh doanh va sir dung Nhi^u nuac da co nhiing quy djnh nham kiem soat rugu bia de tranh nhiing tac hai rugu mang lai Viec san xuat va tieu thu rugu bia noi tren dat cau hoi la lam the nao de kiem soat rugu bia? Thuc trang sir dung rugu bia, tac hai ciia viec sir dung rugu bia va viec quan ly rugu bia a tren the giai va nuac ta hien nhu the nao? Cac nuac tren th^ giai da co nhirng kinh nghiem gi viec kiem soat lam dung rugu bia? Nhiing ggi ma gi co th^ tham khao dugc cho Viet Nam? Cau tra lgi khong sin co va cang kho co thS la cau tra loi dung n^u nhu khong dua tren cac ket qua nghien cim khoa hgc Bai viSt la ka qua cua nhiem vu nghien cim Bao cao xa hgi thutmg nien 2018 Vien Xa hgi hgc la co quan chu tri thuc hien voi tieu ii: Sic dung vii kietn soai ruau bia: Kinit nghiem thi gi&i vit thuc liin Viet Nam viit sti dung tu lieu tir cac cong trinh nghien ciru hien co vh san xuit, tieu thu va kijm soat bia, d6ng thoi co sir dung mgt sfi 56 lieu khao sat nam 2017 cita nhiem vii tren nhom nghien cim thuc hien Thyc trang sii- dung ruwu bia 6' Viet Nam Sti dung rugu bia la mgt hanh vi rat ph6 biSn, gin liSn vai dac trung dan tgc ciia nhieu nuoc tren the gioi, co Viet Nam Sir dung rugu bia dugc xem nhu la mot hanh vi van hoa d&i song xa hgi nuoc ta M6i djp le hgi, dam dinh, lien hoan ciia Dgng Nguyen Anh, Nghiem Thi Thuy 57 nguai Viet luon gdn lien vol bia rugu (Truang Xuan Trucmg, 2015) Kit qua ciia nhilu nghien ciiu truoc day cho h\k, ty le sii dung rugu bia cua nguai dan Viet Nam la cao Bao cao toan cdu ve su dung rugu bia va siic khoe (WHO, 2014) cho thdy lugng rugu bia tieu thu binh quan ddu nguai ciia ngirofi Viet Nam giai doan 2003-2005 trung binh la 3,8 lit nguyen chat/nguai/ nam, dSn giai doan 2008-2010, lugng rugu bia/ddu nguoi tdng len gdp doi la 6,6 lit con/ngudi/nam Cung theo bdo cdo ndy, rieng doi vai nam giai, miic tieu thu trung binh la 27,4 lit nguyen chat/ngudi/nam, cao hon nhieu so vai cdc nuac khu vuc Nghien ciiu ciia Vien Chien luge va Chinh sdch Y te da 1dm ro miic sir dung rugu trung binh cua ngudi Viet Nam khd cao vd gia tang nhanh, binh quan 6,4 dan vi nrgu/ngdy vd 26,1 dem vi rugu/tudn; vugt khd xa nguooig an todn theo quy dinh (Vien Chien luge vd Chinh sach Y te, 2015) K^t qua khdo sdt nam 2017 ciia nhom d^ tdi nghien ciiu cho thdy lugng rugu bia sir dung cua ngudi Viet Nam bien a miic cao vc; xap xi 1/3 so ngudi mdu khdo sat (N=1634) su dung tren 60 gram rugu nguyen chat (quy doi) mgt ldn uong - la miic nguy co cao theo tieu "chudn quy dinh cua To chiic Y te The gidi (Hinh 1) Hinh Lirgng riroii bia su dung/llin cua agirdi dSa mSu khao sat, 2017 (N=1634) Nguon: Khdo sdt cua de tdi, 2017 Ket qud '"Danh gia lac dgng cua viec ban hdnh Ludt phdng chong lam dung rugu bia" Vien Xa hgi hgc thuc hien tai tinh thdnh nam 2015 cho thay 2/3 s6 ngudi tu 18 ddn 29 tudi mau khao sdt da tung su dung rugu bia Trong s6 nay, 12,3% su dung thuang xuyen hdng vd tap trung chinh vdo nhom tuoi cho thdy tudi ngudi sir dung rugu bia d nuoc ta dang cd xu hudng tre hda vdi ty le nam chiem 78% va nu chiem 36% (Vien Xa hpi hgc, 2015) Truac dd nam, ket qua Dieu tra qudc gia Vi nien vd Thanh nien Viet Nam vdng hai (SAVY2) da cho thdy khoang 60% nam vi nien va nien mdu da timg sir dung rugu bia (Bg Ngi vu vd UNFPA, 2015; Nguyin Thanh Liem vd cgng su, 2010) Xu huang sii dung rugu bia giai tre Id mdt van de nan gidi can dugc quan tam gidi quyet K^t qua khdo sat cua nhom nghien ciiu (2017) dugc trinh bdy Hinh 2A va 23 cho thdy ddc diem xa hgi ciia ngudi sir dung rugu bia Nhin chung nam gidi, ngudi da ket hdn, song tai nong thdn cd ty le sir dung rugu bia cao hem han so vdi ty le d nhdm nu 58 Kiim sodt rugu bia a Vi^t Nam hijn ngudi chua kit hon, sdng tai thi Tuang t\r, nhdm lao dOng lam thu6 vd t^ lam viec c6 ty le udng rugu bia cao hem nhilu so vdi nhom tiidt nghi?p Nhdm ddn khong theo ton giao nao cung cd ty le tieu dimg rugu bia cao hem so vcri nhom c6 tdn gido (Ph^t gido, Cong gido va cdc ton giao khdc) Hinh 2A Dac di^m ngiroi su- dung ruflii bia mliu khao sdt (N= 1634) 100 90 80 70 • 60 • % 50 40 30 20 10 89,0 85,0 •• •• • •• 70,5 ••• -•• • 1 11 29,5 15,0 4,6 6,4 Ly hdn Chira kk hon K^t bon TJianhttli Nir Nong th6n Nam Ngudn • Khdo sdt cda de tdi, 2017 Hinh 2B S a c dilm ngirM sir dyng rirmi bia man khao sat (N=1634) Urn thue Tii lam viec Tbat nghiep i^ac Khong TG Ph^t giao Cong giao Ton giao Ididc Ngudn.Khao sdt cua de tdi, 2017 Rieng san lugng bia nam 2016 cita Vift Nam la 3.800 ty lit, nhu vSy tinh trung binh moi nguM Viet Nam u6ng 42 lit bia nam 2016, tang khoang Ut so voi nam 2015 truoc d6 Viiri siic tieu thy nhanh va nhiju, nganh san xuit rucm bia nuoc dat myc tieu d6n nam 2025 se san xuat tren t^- lit bia va 440 trieu lit niou c6ng nghiSp mSi nam (Bo Cong thuong, 2017) Co thS noi, luong nrou bia tieu thu o Viet Nam gia tang nhanh theo thoi gian, vdi nhu cau tieu dimg khdng bi gioi hjn Mirc dp tieu thu vaau bia tang til 2,8 ty lit bia nam 2012 len tren ty lit nam 2016, binh quan moi nguoi dan tieu thy 42 lit Dgng Nguyen Anh, Nghiim Thj Thuy 59 bia/nam Cdc tinh deu cd kS hoach phdt triln nhd mdy bia cung nhu sdn xudt bia dia phucmg cho rieng minh Den ndm 2012, cd 78 nhd mdy ddng ky san xuat 10 trieu lit bia/nam (Hi$p hgi rugu bia vd nudc gidi khdt, 2014) Theo T6 chiic Y t€ th^ gicri, chi phi cho tieu thu bia cua Viet Nam khoang 3,4 ty USD/ndm, gdn 3% so thu ngan sdch cua cd nuac, khien Viet Nam trd qudc gia cd siic tieu th\i rugu bia cao nhdt Ddng Nam A, diing thir 10 chau A va diing thii 29 todn thS gidi (WHO, 2016) Co nhieu yhx to ly giai cho viec sir dung rugu bia a nuac ta, dd chii yeu la viec tiep can nrgu bia a nudc ta qud de ddng cho mgi ddi tugng, cimg vdi gid nrgu bia qud re nguon cung nuac va nhap khau deu ddi dao, de tiep can Ben canh nhung loai rugu bia dang dugc sdn xudt nuoc thi d nudc ta cdn mdt lugng Ion rugu bia nhdp ngoai theo ca duong chinh thiic va nh|tp lau, kho cd thi kilm sodt Cd thi thdy bia rugu nhdp khau va sdn xudt nudc dugc bay bdn cong khai va tran ngap trSn thi trudng hien nay, khdng chi d cdc phd Idm md khdp cac tinh thanh, dia phuong, thdm chi d cd ndng thdn vimg sdu, vimg xa Cdc vu ngO dgc sir dung phdi rugu gid, rugu pha che tit cdn cong nghiep da khien nhilu ngu6i mdt mang Nhilu vu budn bdn trdi phep, kinh doanh rugu lau cung dugc ca quan chiic ndng tich cue phanh phui nhung chua dii siic ran de lgi nhu^n qua ldn Theo bdo cao Bg Cong thuang (2014), Vi?t Nam chi binh qudn tiSu thu bia hem ty USD/ndm (khoang 1,8% GDP) tucmg duang vcri 3% thu ngdn sdch cd nu6c va cao g^p lan mirc ddng gdp ngdn sdch cua nganh sdn xudt rugu bia, nudc gidi khat hang ndm (800 trieu USD/nam) Nhung so tren cho thay sdn lugng rugu bia a Vi?t Nam cang gia tang, vdi xu huong nam sau ludn tang vd cao hem nam trudc Theo xu hudng dd, lugng rugu bia tieu th\i toan qudc se tdng gap nhieu lan nhung ndm tdi Khdng the khdng de c$p khdi lugng rugu thii cong ngucri dan sdn xuat, vdi khoang vcri 32 trieu lit de kinh doanh dugc cap phep va 300 tri?u lit trdi ndi ngodi thj trudng hien khong dugc qudn ly Vdi su phdt triSn nhanh chong nhu tren, ngdnh cong nghiep bia rugu nudc ta quy hoach da ddt muc tieu den ndm 2025 se san xudt ty lit bia va 440 trieu lit rugu cdng nghiep moi ndm (Bg Cong thuemg, 2009) Dong thai vai lugng rugu, bia dugc sdn xudt a nuac thi a Viet Nam cdn mgt lugng ldn rugu bia dugc nhap khau ve theo cd dudng chinh thiic vd nhdp idu rat khd kiem sodt Rugu bia id mgt ba nguyen nhdn hang dau lam gia tdng ty le tai nan giao thdng tai Viet Nam ddi vai nam giai dg tudi 15-49 (Institute of Health Metrics and Evaluation, 2013; Bg Cdng an, 2014) Sd vy tai nan giao thdng ngudi tham gia giao thdng cd sii dung rugu bia dang ngdy cdng gia tdng vd tro thdnh mgt vdn dl biic xiic cua nhieu dia phucmg hien Trong s6 18.412 nan nhan tai nan giao thdng nhap vien thi 36% nguai di xe mdy cd ndng dg cdn mdu cao han miic cho ph^p, 66,8% ngucri ldi xe d td co nong dg cdn mdu cao han miic cho phep (WHO, 2014) Theo sd li€u thong ke gan ddy, trung binh moi ndm Viet Nam cd 12.000 ngudi chit vi tai nan giao thong, dd 4.800 truong hgp cd lien quan din rugu bia (Bd Cdng an, 2014) 60 Kiim sodt ruyu bia cr Viet Nam hien Sit dung ruou bia co the gay ganh nang kinh te doi voi cd nhdn, gia dinh va t o ^ xa hoi lien quan din cac phi ton v6 chSm s6c sire kh6e, giam ho^c mit nang suat lao dong va giai quylt cac hau qua xa hOi khdc Theo bao cao cua To chiic Y te The gidi (WHO, 2014), trung binh moi nam co khodng 3,3 tri^u ca hi vong sii dvmg raiTu/bia {chiSm 5,9% cac tnrcmg hop tir vong) Bao cao cua Vi$n Chiln luge va Chinh sdch Y te (2005) uoc tinh co tdi 4,4% nguM dtn Viet Nam phai gdnh chiu benh t jt hau qua cua ru(?u bia Ru(?u bia ldy di mot ngudn tai chinh rdt quan nguoi ngheo, gia dinh, ca cgng ddng noi nguoi sinh s6ng va la nguyen nhan lam khien cho tinh trang ngheo d6i thSm trim Ngoai tdc dong tieu cue vl site khoe, tinh mang thi mqa bia c6 tdc dpng tieu cue din xa hoi Theo s6 lieu cua co quan chile ndng, khoang 30% so vu gay rli trat tu xa hpi va 33,7% cdc vy bao luc gia dinh co nguyen nhan xuat phdt tir viec sii dyng rupu bia (T6ng cyc Thing kd, 2010) Tre em Viet Nam ciing dang la nan nhan cdc vu viec lam dung rupu bia cua nguoi ldn nhu bi xiic pham, nhye ma, mang chiri (11,1%), bi bd mac, thieu su cham sdc bdo ve cua ngudi ldn (6,5%), phai chiing kien bgo hanh nghiem trpng gia dinh (6,1%), bi ddnh ddp gdy dau ddn ve the xdc (3,8%) (xem WHO, 2014) Sir dyng ruou bia cdn la tdc nhdn gdy bao luc, nhdt la bao lire gia dinh, tdi pham, mat an ninh trat ty M^c dii udng cd dupc ban va sir dyng hpp phdp d nhieu nuoc chau Au, nhung lupng tieu thy rupu bia, dd udng va van hda udng rupu bia khac gitta cdc nudc (Simpura va Karlsson, 2001; World Drink Trends, 2002; Hibell va cdng sy, 2000) Tji Ai-len va Na Uy - hai nudc Bdc Au cd hau Ijnh vdi thdi quen thich sir dyng rupu mauih, lupng tieu thy trung binh mdi nSm khodng lit rupu/nguW ndm, mpt s6 nuoc thudc chau lyc nhu Phdp va Bd Dao Nha, Sec, Diic vd Ai Len 1^ san xuit va sii dyng nhilu rupu vang vdi miic tieu thu trung binh khoang 11 lit rupu/nguoi/nam (World Drink Trends, 2002; Osterberg va Karlsson, 2002; Hope, 2014) Theo To ehiic Y tl Thi gidi, ngudi su dung rupu bia cua m0t sd nude tren thi gidi cang cd xu hudng tre hda, va vi$c tiSu thu rupu bia nhdm ddi tupng gia tang cd tin suit va miic dg (WHO, 2011) Kiim soat rygii bia tren the gidi va Vi|t Nam 3.1 Kinh ngkifm th\rc tiin tren thi gi&i Tnrdc thyc trang tieu dimg rupu bia cung vdi nhiing tdc ddng tieu cue cho xa hdi, nhieu qudc gia tren thi gidi da cd nhitag bi$n phdp nhdm kilm sodt rupu bia vd nhiing tdc h?i md rupu bia mang 1^ cho nguoi Cd nhilu bi?n phap kilm sodt nrpu bia nhung bidn phdp quan trpng vd cd tac ddng manh la ban hanh cac chinh sdch, phdp luat nhdm him chi sdn xuit vd tieu thy rupu bia Ben c?nh nhimg dao lu?it, quy dinh chinh sdch thi cdn cd quy dinh khdng chinh thiic cd anh hudng din kilm sodt rupu bia nhu chuin muc xa hdi, phong tyc tjp quan, truyin thdng van hda, tuyen truyin nang cao nhan thirc, va tham chi rupu dupc qudn ly bdi mpt sd dinh ehl khdng chinh thiic lam cho viec kilm soat rupu bia de dang hon (Osterberg vd Karlsson, 2002) Cd thi kl din nhitag chinh sach phap luat cua mdt sd quoc gia tren thi gidi nhu sau Dgng Nguyen Anh, Nghiem Thj Thuy Hoa Ky da ban hdnh Dao ludt kilm sodt nrgu bia tir rdt sam Ngay 17/7/1984, Qudc hgi Hoa Ky da ban hanh Dao luat Qudc gia quy dinh tudi tdi thilu dugc phep sii dung rugu bia Du ludt bdt budc chinh quyin tdt cd cdc tiiu bang phai ndng tudi dugc phep udng bia din 18-19 tudi hodc 20-21 tudi Vl quy dinh tudi dugc mua nrgu, tir nam 1988 tdt cd 50 bang vd Thu Washington DC thuc hi?n quy dinh ngudi mua rugu phdi tir 21 tudi trd 16n (New York Times, 1996^ Hdu hit cdc tieu bang deu cho ngudi dudi 21 tudi dugc udng rugu mdt sd trudng hgp ddc biet nhu su kien tdn gido, sinh hoat van hda dia phucmg, ky nghi ll d gia dinh Ve viec sdn xudt rugu bia, cac tieu bang deu cd chinh sdch chat che vai nhung quy dinh nghiem cdm sdn xuat tai nha cdc loai bia, rugu vang mat ong, rugu tdo, rugu vang va han che cdc dd udng cd cdn khdc Dao ludt ve kinh doanh vd cimg cap rugu bia ciia New Zealand ndm 2012 quy dinh cdm ban rugu bia cho vi thdnh nien, vd dp dung mdt sd hinh phat nghiem khdc cho cac ldi xe sir dung rugu bia, va nghiem cam qudng cdo rugu bia dudi mgi hinh thiic Vdo ndm 1988, Chinh phu Uc ban hanh dao ludt kiem soat rugu bia vdi nhihig quy dinh nhu khdng bdn rugu bia cho thieu nien vd vi thdnh nien Cac ddi tugng deu cd mdt ma sd cd nhan hg den cdc cdu lac bg hoac khu vui choi gidi tri Neu vi pham thi nguai bdn cd thi bi phat tir $200-$2.000 Uc Cdc ca sd bdn rugu bia Uc deu phai cd giay ph^p, quy dinh noi ndo dugc phep udng rugu bia Tdt cd mgi ngudi deu khdng dugc udng rugu bia tai cdc ncri cdng cdng nhu ngodi dudng phd, trdn tdu xe, cdng vien, bai bien, hay khdng gian cdng cdng (Western Australia Police Force, 1988) Tai Phap, ludt kiem sodt rugu bia va thudc la dugc ban hdnh ddng thdi tir ndm 1991, ludt ndy quy dinh: tdt ca dd udng cd cdn tren 1,2% deu dugc xem nhu rugu vd nghiem cdm qudng cdo rugu vdi muc dich nham vdo ngudi tre tudi Khdng dugc qudng cdo rugu tren tivi va rap chieu phim ducri mgi hinh thiic Cdc cdng ty sdn xudt vd kinh doanh rugu khdng dugc phep tdi trg cho cdc su kien van hda vd the thao, va rugu bia chi dugc qudng cdo tren cdc dn phdm ddnh cho ngucri lan hoac tren bang ddn thdng bao (vdi nhung dilu ki|n rat nghiem ngat), va mgt sd su kien ddc biet nhu hdi chg rugu, hay bdo tang vl rugu Phap cdn tien hdnh nhirng chien djch toan qudc van dgng nguoi dan han chi sit dung nrgu, danh thue cao rugu mgnh va sii dung dgi ngu nhdn vien cong tdc xa hdi dl hd trg, giai quyet hdu qua cho nhung ngudi chiu dnh hudng cua rugu bia hogc la nan nhan ciia rugu bia (Craplet, 2014) Ci chdu A, Sri Lanka Id nuac co nhung quy dinh nghiem tiic ve sir dung rugu bia vd dd udng cd cdn Luiit cua Sri Lanka ban hdnh ndm 2006 quy dinh cdm ban rugu cho nguoi dudi 21 tuoi; cdm ban nrgu bang mdy ban hdng tu ddng; cdm qudng cdo rugu tren mgi phuang tien truyin thdng dai chiing (NATA, 2006) Nhd vdy, qudc gia Nam A da tilt kiem dugc rdt nhilu chi phi xd hdi va ngan chdn dugc thdi quen sir dung nrgu vd tinh trang nghien rugu nam gioi vd thieu nien Thdi Lan Id qudc gia tai khu vuc Ddng Nam A cd nhieu quy dinh lien quan den dd udng cd cdn vd mgt Uy ban qudc gia thgc hien gidm sat dgc lap Ludt Kiem soat udng cd cdn cua Thdi Lan ban hanh nam 2008 quy dinh nhd sdn xuat dd uong cd hodc nha nhdp khau thuc hien cung cap cdc nguyen lieu ddng goi, nhan va thdng diep cdnh bao 62 Kiim sodt ruau bia a Viet Nam hien cho tit cd cac loai dd udng cd cdn sdn xudt nudc va nhap Idiiu (Office of the Council of State, 2009) Bd luat dua cac quy dinh rat cu thi vl dia dilm cim ban rupu bia, thdi gian bdn quy dinh tir 11 gio trua din gid chilu va tir gid chilu din nua dem Luat quy dinh khdng dupc ban rupu bia cho ngudi dudi 20 tudi va ngudi dang say rupu; khdng sir dung may ban ruou bia tu dpng hay hang rong, qudn xa via he, khdng dupc giam gia dl khuyin mai rupu bia vd mdt sd chinh sdch idiac niia lien quan den kiem soat rupu bia Cd nhan, td chiic vi pham cd thi bi truy ciiu trdch nhiem hinh su va tham chi ngdi til Ben canh bp Ludt ndi tren, nhieu chinh sdch kiem sodt rupu bia dupc thuc hien tich cue nhitag nam qua tai Thdi Lan, gdp phin han ehl nhitag h$u qua cua lam dyng rupu bia vd dupc ddnh gid la cdng Cd nhilu bien phap kilm soat rupu bia nhung bien phdp quan trpng va cd tac dpng manh la ban hanh thuc hien cdc chinh sdch, phdp luat nhim ban che ngudn san xuat va nhu cdu tieu thu rupu bia Mdt sd qudc gia vdi quyet tdm chinh tri cao va h? thdng luat phdp da ban hanh va thuc Men cdng chinh sdch kiem sodt rupu bia Tuy nhien, khdng it cdc qudc gia that b^i bdi qud trpng lpi nhuan san xuat va kinh doanh rupu bia mang lai hon la bdo ve tinh mang ngudi Hon nira, song hanh vdi nhGng dao luat, quy dinh chinh sach thi cdn cd nhieu quy dinh ngoai lu^t cd dnh hudng den hi?u qud kiem soat rupu bia nhu phong tuc tap qudn, ldi sdng, mirc nhan thirc, lpi ich nhdm, thdm chi mot sd dinh che khdng chinh thiic can trd khien cho phdp ludt, chinh sdch khd cd thd phat huy dupc anh hudng de dang (Osterberg va Karlsson, 2002) 3.2 Kiem sodt rteffu bia d Viet Nam CJ Viet Nam, cac vdn ban chinh sdch lien quan din quan ly vd kilm sodt rupu bia da dupc ban hanh tir nhimg nam diu tien Nhd nudc Viet Nam ddi Sic lenh sd 57/1945 ciia Chinh phu lam thdi nudc Viet Nam Dan chit Cpng hda voi ndi dung cim triet dl viec san xudt, tang trii, tieu thu vd kl ca sit dung ruou Trong giai doan 1955-1975, Nha nudc quan ly chat che viec san xuat va kinh doanh ruou, cho nen da han ehl dupe tinh trang lam dyng rupu bia Tuy nhien, tir sau cd chinh sach ddi mdi vd nhit la giai doan 20 nam qua, nganh cdng nghiep sdn xuit rupu da phdt triln nhanh voi su tham gia cua nhilu phdn kinh te San xudt, kinh doanh va nhit la tieu thu rupu bia d Viet Nam khdng dupc han chi Ludt Kilm sodt rupu bia van chua dupc ban hanh hi?n cd kha nhieu Ludt, Nghi dinh Thong tu khac lien quan din rupu bia nhu: Ludt Quang cdo, Ludt Thui tieu thu dac biet, Luat Phdng chdng bao lyc gia dinh, Luat An toan giao thdng dudng bd, Cho den vin chua cd cac hudng dan cy the vl viee han ehl s6 lupng vd ddi tupng kinh doanh rupu bia; chua cd quy dinh vl cim quang cao, tilp thi; chua cd chinh sach kiem sodt sdn xudt va luu thdng rupu tu niu; chua cd chinh sdch truyin thdng van ddng nang cao nhdn thirc xa hdi phdng chdng lam dung rupu bia Viec tudn thu chinh sdch, phap luat cua ngudi sdn xuit, kinh doanh, ngudi sir dung rupu bia cdn rit thip, tham chi khdng gdp phdn ngan ch^, han chi lam dyng rupu bia xa hdi (Vien Xa hdi hoc, 2015) Dudi sy vail ddng ciia mdt sd doanh nghiep sdn xudt nrpu bia, nhilu quy djnh chinh sach nham kilm sodt rupu bia bi dilu chinh, sai lech muc tieu, thdm chi bi vd hieu Dgng Nguyen Anh, Nghiem Thi Thuy 63 hda Cdc doanh nghiep ndy dugc su hd trg, bdo ke, chdng lung cua mdt so quan chiic nen tim mgi cdch xin giam thui, va tham chi cdn tron thui vd tilp tuc ddy manh sdn xuat vd kinh doanh nrgu bia Ddy Id khd khan thdch thiic rdt khd vugt qua neu chi sir dyng bien phap hanh chinh hay keu ggi chung chung Khi dugc hdi vl su cdn thiet cd mgt bg ludt phdng, chdng tdc hai ciia lam dyng rugu bia, cd den 85,8% ngudi dan ddng tinh cho rdng vi?c ban hanh Ludt la can thiet (Vien Xd hdi hgc, 2015) Tuy nhien, nhung ddng thdi tren dien dan phdp ludt hien cho thdy viec ban hanh lu^t phdng, chdng tac hai rugu bia (chua phdi Id ki6m soat nrgu bia) da vdp phdi su phdn ling gay gat tir nhieu ben, dd chii yeu la cdc doanh nghiep sdn xudt rugu bia, Hiep hgi cdc doanh nghiep rugu bia, nuac gidi khdt dang tim mgi ly de phdn bdc, chdng lai viSc ban hdnh LuEit phong, chdng tdc hai rugu bia Thuc te da cho thdy, sdn xudt rugu bia cdng tdng trudmg thi gid tri siic khde vd cudc sdng cdng ddng cdng gidm siit, chi phi xa hdi cdng tdng vd hau qud cang khd ludng Rdt can cd mgt du ludt todn diSn cd du siic bao phu vd kiem sodt tdc hai cua nd den ddi sdng xa hdi, vdi cdc che tdi quy dinh ngudn san xuat cung cap rugu bia, cdc hoat dgng kinh doanh rugu bia vd gidm miic tieu thu rugu bia, tir dd gidm tdc hai ciia nrgu bia Du luat dd trudc het phdi vi siic khde cgng ddng, gidm gdnh nang benh tat, tit vong sir dung rugu bia gay Lgi ich xa hdi va nguai cdn dugc ddt len tren chii khdng phdi vi lgi ich cua mdt nhdm hay ciia mdt bd nganh nao Ket luan Muc va tin sudt sii dung rugu bia a Viet Nam Id cao so vcri qudc te, mirc tieu thu rugu bia van a miic cao vd mang lai nhieu he luy tieu cue cho siic khde ngudi sit dung cung nhu nhilu tdc dgng khac ddi vai cgng ddng xa hdi Nhiing v\i ngg ddc udng phdi rugu gia, rugu pha che tir cdn cdng nghiep da khien nhieu ngucri mdt mang Nhieu vu budn bdn trdi phep, kinh doanh rugu lau cung dugc cac ca quan chiic nang phanh phui Tuy nhien, tinh hinh chung cho thay quyet tdm kiem sodt rugu bia d nudc ta chua di vdo thuc chat vd cdc hdnh dgng (nlu cd) nhdm cdi thien tinh hinh hien nhin chung ySu kem Khi doi sdng ngudi ddn dugc ndng cao, rugu bia ngdy cdng sdn cd thi cdc nhu cau sii dung vd miic sir dung rugu bia cung tdng len Trong do, cdc quy dinh chinh sach lien quan din kilm sodt rugu bia d Viet Nam tiep tuc bgc Id nhung han che, bat cap, ddi hdi phai dilu chinh kip thcri nhdm ddp ling yeu cau cang cao cua doi sdng kinh te-xa hdi ciia ddt nuac Mgt nhirng cdng cu qudn ly nhd nudc cd hi|u qua d Viet Nam Id cdc chi tdi hinh sir, hdnh chinh Ngi dung xu phat vi pham hanh chinh, xii ly hinh sir lien quan den rugu bia can dugc lam rd cdc ITnh v\rc va hanh vi lien quan nhu quang cdo, khuyen mai rugu, bia, sdn xudt, kinh doanh rugu, giao thdng vd trat ty an toan xa hdi, v.v Nhd nudc rat cdn ban hanh LuEtt Kidm sodt rugu bia de cd co sd phap ly vd dilu kien kinh doanh rugu bia, gidm miic sdn xudt, kinh doanh vd tieu thu rugu bia, ciing nhu han che linh trang san xudt vd sit dung nrgu bia khdng ddm bdo tieu chuan Diit khoat khdng vi chi tieu tang tnrdng hay lgi nhudn nganh sdn xudt, kinh doanh rugu bia mang lai ma chdn chir, thoai lui viec ban hdnh Luat Kiem sodt rugu bia Kinh nghi?m cua mgt sd nuoc 64 Kiim sodt rugu bia a Viet Nam hijn khu vuc nhu Thdi Lan, Sri Lanka da cho thdy day Id phuang thirc hieu qud nhdt de kilm sodt sdn xudt, kinh doanh va sii dung nrgu bia Tai lifu tham khao Booth, A., Meier P., Shapland J., Wong R., Paisley S 2011 Alcohol pricing and criminal harm, a rapid evidence assessment of the published research literature Sheffield University, School of Health and Related Research BQ C6ng thircmg 2017 Bdo cdo quy hogch phdt triin sdn xudt Bia - Rugu vd Nttac gidi khdt a Vi4t Nam din ndm 2030, tdm nhin din 2040 Bo Cong thucmg, H i Npi Bo C6ng thuong 2014 Bdo cdo nghien ciru linh hinh sdn xudt vd sir dung ruau bia a Vi^t Nam 89 Cong thuang, Ha Noi BO Cong thucmg 2009 Bdo cdo ddnh gid phuc vu xdy dipig quy hogch phdt trien ngdnh Bia - Rugv - Nudc gidl khdt Vi?t Nam din ndm 2015, tdm nhin din ndm 2025 Bp Cong thucmg, HA N0i BQ Noi vy va UNFPA 2015 Bdo cdo Qudc gia ve niin Viit Nam Quy DSn s6 Lifin Hgp qu6c, Hi Noi Bo C6ng an 2014 Ba nguyen nhdn hdng ddu gdy tai ngn giao thdng Id chgy qud toe dg, ldn ldn vd su dung ruau, bia tham gia giao thong Cyc Canh sat Giao thong, Ha Npi Craplet, Micheal.2006 Alcohol Policy in France: Between Traditions and Paradoxes, Paris Hibell, B, Anderson, B, Bjamanson, T v^ cpng su 2004 The European School Survey Project on Alcohol and Other Drugs report The Swedish Council for Information of Alcohol and Other Drugs, Stochholm Hi?p hpi Bia-Rupu-Nudc giai khat Vi^t Nam 2014 Bdo cdo di dn ddnh gid tdc dgng kinh te-xd hgi cUa ngdnh bia tgi Vi^f Nam nam 2014 Hope, Ann 2014 Alcohol's Harm to others in Ireland, Department of Public Health and Primary Care, Trinity College, Dublin Institute of Health Metrics and Evaluation (http://vizhub.healthdata.org/gbd-compare) 2013 Global burden of diseases study N ATA (National Authority on Tobacco and Alcohol) 2016 Sn Lanka National Policy on Alcohol Act No 1770-27, NATA, Sri Lanka New York Times 1996 Ban hdnh Lugt quy d/nh vi tudi tdi thiiu dw?c siJt dvng Wi7(https://w^w.nytimes.com/1996/07/03/us/louisiana-court-upholds-drinking-age.html) nrgu Nguyen Thanh Liem v i cic tic gia 2010 Sii dyng mga bia vk thu6c l i IhiSu nien Vift Nam Kit qud phdn tich Dieu tra Qudc gia vi Vf thdnh nien vd Thanh nien Vi?t Nam 2003 & 2009 (SAVY) Bao cSo chuyen de Office ofthe Council of State 2009 Alcohol Beverage Act of Thailand No 1770-15 Government Gazette, Vol 125, Part 33, dated Februray 13, 2008 Osterberg E, Karlsson T, eds 2002 Alcohol policies in EU Member States and Norway A collection of country reports Helsinki, STAKES Rebach, H 1992 Alcohol and Drug Use among American Minorities P 23-57 In Trimble, J.E, Boiek, C Niemcryk, S.J., Eds Ethnic and Muticultural Drug Use: Perpective on Current Research Binghamton NY The Haworth Press Room, R 1996 Gender Roles and interactions in Drinking and Drug Use Journal ofSubtance 227-39 Room, R va c^ng sir 2005 Alcohol and Public Health Lancet 365, 519-30 AbuseS, Dgng Nguyen Anh Nghiem Thj Thiiy 65 Simpura J, Karlsson T 2001 Trends in drinking patterns in fifteen European countries, 1950 to 2000 A collection of country reports Helsinki, STAKES Tdng cue Th6ng ke 2010 DiSu tra qu6c gia va bao lire gia dinh 2010, Hi Npi T6 chiic Y ti Thfigiori 2011 Bdo cdo todn cdu vi thuc trang sir dung rugv, bia vd sue khoe nam 2011 To chiic Y t6 The gioi Truong Xuan Tnr£mg 2015 Vdn hoa su dung rugu bia a Vi4t Nam Bio cio dl tii nghiSn ciiu cap Bp, Vi^n xahoi hpc Hi Npi Uy ban vl Cic vin dl xS hpi ciia Qu6c hpi 2015 Ky ylu Hpi thao Vdn di him sodt rugu bia tgi VietNam, thing 11/2015 Vi?n Chien luoc va Chinh sich Y te 2015 Bdo cdo tinh hinh Igm dung rugu bia& Vi4t Nam Bp Y te Ha Npi Vien Xa h^i hpc 2015 Bdo cdo ddnh gid tdc dong cua viec ban hdnh Lugt phong chong Igm di^ng rugu bia Vi?n Xa h6i hpc Hi Npi WHO 2014 Global status report on alcohol and health 2014 Geneva World Health Organization, Geneva WHO 2005 Public health problems caused by harmfiil use of alcohol Report by the Secretariat of fift eighth World Health Assembly A58/18 Provisional agenda item 13-14 World Health Organization Geneva WHO 2004, Global Status Report: Alcohol Policy, Department of Mental Health and Substance Abus World Health Organisation, Geneva Western Australia Police Force 1988 TVieZ./q'aor Co«rro/.4c( The Government of Australia, Canberra World Drink Trends 2002 Produclschap voor Gedistilleerde Dranken and World Advertising Research Centre Ltd, Henley-on-Luton, United Kingdom  ... Viet Nam u6ng 42 lit bia nam 2016, tang khoang Ut so voi nam 2015 truoc d6 Viiri siic tieu thy nhanh va nhiju, nganh san xuit rucm bia nuoc dat myc tieu d6n nam 2025 se san xuat tren t^- lit bia. .. lit bia nam 2012 len tren ty lit nam 2016, binh quan moi nguoi dan tieu thy 42 lit Dgng Nguyen Anh, Nghiim Thj Thuy 59 bia/ nam Cdc tinh deu cd kS hoach phdt triln nhd mdy bia cung nhu sdn xudt bia. .. ndm (800 trieu USD /nam) Nhung so tren cho thay sdn lugng rugu bia a Vi?t Nam cang gia tang, vdi xu huong nam sau ludn tang vd cao hem nam trudc Theo xu hudng dd, lugng rugu bia tieu thi toan