| 1. |
- Brännström, Lars, et al.
(författare)
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Spatial spillover effects of a community action programme targeting on-licensed premises on violent assaults : evidence from a natural experiment
- 2016
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Ingår i: Journal of Epidemiology and Community Health. - : BMJ. - 0143-005X .- 1470-2738. ; 70:3, s. 226-230
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Tidskriftsartikel (refereegranskat)abstract
- Background Spatial dependencies may influence the success of community action strategies to prevent and reduce harmful alcohol use. This study examined the effectiveness of a multicomponent Responsible Beverage Service (RBS) programme targeting on-licensed premises on police-recorded assaults in Swedish municipalities. It was expected that the implementation of the programme within any given municipality had an indirect effect by reducing violent assaults in adjacent municipalities.Methods This study was a natural experiment exploiting the temporal and spatial variation in the implementation of the RBS programme to predict change in the rate of violent assaults in all Swedish municipalities during 1996–2009 (n=288; T=14; N=4 032). Yearly police-recorded violent assaults per 100 000 inhabitants aged 15 and above committed on weekend nights were used as a dependent variable. Programme fidelity was identified by means of survey data. A semilogarithmic fixed-effects spatial panel regression model was used to estimate the direct, indirect and total effects of the programme.Results The direct, indirect and total effects were −1.8% (95% CI −4.4% to 0.8%), −5.8% (95% CI −11.5% to −0.1%) and −7.6% (95% CI −13.2% to −2.2%), respectively. Averaged over time and across all municipalities, implementing one additional programme component in all municipalities will thus reduce violent assaults in one typical municipality by nearly 8%.Conclusions The indirect effect of the programme was three times larger than its direct effect. Failing to account for such local spillover effects can result in a considerable underestimation of the programme's total impact and may lead to erroneous policy recommendations.
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| 2. |
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| 3. |
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| 4. |
- Kraus, Ludwig, 1955-, et al.
(författare)
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Does the decline in Swedish adolescent drinking persist into early adulthood?
- 2024
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Ingår i: Addiction. - 0965-2140 .- 1360-0443. ; 119:2, s. 259-267
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims: Sweden has experienced a substantial decrease in adolescent drinking over the past decades. Whether the reduction persists into early adulthood remains unclear. Using survey data, the present study aimed to determine whether reductions in indicators of alcohol use observed among adolescents remain in early adulthood and whether changes in alcohol intake are consistent among light/moderate and heavy drinkers.Design: Data from the Swedish monthly Alcohol Monitoring Survey (2001–20) were used to construct five 5-year birth cohorts (1978–82, 1983–87, 1988–92, 1993–97 and 1998–2002).Setting: Sweden.Participants: A total of n = 52 847 respondents (48% females) aged 16 and 30 years were included in this study.Measurements: For both males and females, temporal changes in the prevalence of any drinking, the prevalence of heavy episodic drinking (HED) and total alcohol intake in the past 30 days in centilitres were analysed.Findings: The prevalence of any drinking in more recent cohorts remained low until young people came into their early (females) and mid- (males) 20s. Male cohorts differed in the prevalence of HED across age, with the later cohorts showing lower odds than earlier cohorts (odds ratios between 0.54 and 0.66). Among females, no systematic differences between cohorts across age could be observed. Later male birth cohorts in light/moderate drinkers had lower alcohol intake than earlier cohorts (correlation coefficients between −0.09 and −0.54). No statistically significant cohort effects were found for male heavy drinkers. Although differences in alcohol intake among females diminished as age increased, the cohorts did not differ systematically in their level of alcohol intake.Conclusions: In Sweden, the reduced uptake of drinking in adolescents appears to fade as people move into adulthood. Observed reductions in alcohol intake among light and moderate drinkers appear to persist into adulthood. More recent male cohorts show a lower prevalence rate of heavy episodic drinking.
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| 5. |
- Kraus, Ludwig, et al.
(författare)
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Has beverage composition of alcohol consumption in Sweden changed over time? An age-period-cohort analysis
- 2022
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Ingår i: Drug and Alcohol Review. - : Wiley. - 0959-5236 .- 1465-3362. ; 41:1, s. 153-166
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Tidskriftsartikel (refereegranskat)abstract
- Introduction. In recent years, beverage composition of total alcohol consumption has changed substantially in Sweden. As beverage choice is strongly associated with drinking practices, our paper aims to analyse trends in beverage composition of alcohol consumption by age, period and cohort. Methods. Age-period-cohort (APC) analysis was conducted using monthly data from the Swedish Alcohol Monitoring Survey (2003-2018). The sample consisted of n = 260 633 respondents aged 16-80 years. APC analysis was conducted on drinkers only (n = 193 954; 96 211 males, 97 743 females). Beverage composition was defined as the beverage-specific proportion of total intake in litre ethanol. Fractional multinomial logit regression was applied to estimate the independent effects of age, period and cohort on trends in beverage composition. Results. Regression models revealed statistically significant effects of age on all beverages except for medium-strength beer and spirits in males. Controlling for age and cohort, decreasing trends were found over time for medium-strength beer and spirits. The proportion of regular beer increased statistically significantly in males and the proportion of wine in females, whereas the trends for the opposite sex remained stable in each case. Predictions for cohorts showed statistically significant decreasing trends for medium-strength beer in males, lower proportions for regular beer and higher proportions for spirits in the youngest cohorts. Discussion and Conclusions. The increasing proportion of wine drinking, which is associated with less risky drinking practices, may decrease alcohol-related morbidity and mortality. Increasing proportions of spirits in the youngest cohorts raises concerns of a possible revival in spirits consumption among the youngest.
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| 6. |
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| 7. |
- Landberg, Jonas, et al.
(författare)
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Is the theory of collectivity of drinking cultures valid across educational groups?
- 2021
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Ingår i: Drug and Alcohol Review. - : Wiley. - 0959-5236 .- 1465-3362. ; 40:3, s. 472-480
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Tidskriftsartikel (refereegranskat)abstract
- Introduction To explore whether Skog's theory of collectivity of drinking cultures is valid across groups with different socioeconomic position (SEP).MethodsIndividual‐level information on alcohol consumption and SEP for the years 2004–2014 were retrieved from the Monitoring Project; a nationally representative monthly alcohol use survey. The analytical sample consisted of 162 369 respondents aged 25–79 years. SEP was measured by education level. Alcohol use was measured by yearly volume of consumption and frequency of heavy episodic drinking (HED). Respondents were divided into six SEP‐groups based on their education level and sex. Mean yearly volume consumption and prevalence of monthly HED was calculated for each group and graphically plotted against the overall mean volume of consumption.ResultsThe yearly changes in overall mean consumption during the study period reflected a collective shift in drinking across groups with basic, intermediate and high education. There were also indications that changes in overall mean consumption reflected collective shifts in the prevalence of HED across the SEP‐groups. Moreover, while the magnitude of the associations for both average volume and HED differed somewhat in strength across the SEP‐groups, they were clearly in the same, positive, direction.Discussion and ConclusionsOur findings add support for including a socioeconomic dimension to Skog's theory of collectivity of drinking cultures. Future studies should replicate our analyses on cases and periods with more tangible changes in the price and availability of alcohol.
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| 8. |
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| 9. |
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| 10. |
- Loy, Johanna K., et al.
(författare)
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Changes in Alcoholic Beverage Choice and Risky Drinking among Adolescents in Europe 1999-2019
- 2021
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:20
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Tidskriftsartikel (refereegranskat)abstract
- This paper explores trends in beverage preference in adolescents, identifies related regional differences, and examines cluster differences in key drinking measures. Data were obtained from the European School Survey Project on Alcohol and Other Drugs (ESPAD), covering 24 European countries between 1999 and 2019. Trends in the distribution of alcoholic beverages on the participants’ most recent drinking occasion were analysed by sex and country using fractional multinomial logit regression. Clusters of countries based on trends and predicted beverage proportions were compared regarding the prevalence of drinkers, mean alcohol volume and prevalence of heavy drinking. Four distinct clusters each among girls and boys emerged. Among girls, there was not one type of beverage that was preferred across clusters, but the proportion of cider/alcopops strongly increased over time in most clusters. Among boys, the proportion of beer decreased, but was dominant across time in all clusters. Only northern European countries formed a geographically defined region with the highest prevalence of heavy drinking and average alcohol volume in both genders. Adolescent beverage preferences are associated with mean alcohol volume and heavy drinking at a country-level. Future approaches to drinking cultures need to take subpopulations such as adolescents into account.
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| 11. |
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| 12. |
- Norström, Thor, et al.
(författare)
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Concluding policy implications
- 2002
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Ingår i: Alcohol in Postwar Europe. - Stockholm : National Institute of Public Health [Folkhälsoinstitutet] :Almqvist & Wiksell International. - 9122019928 ; , s. 220-225
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 13. |
- Norström, Thor, et al.
(författare)
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Conclusions
- 2002
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Ingår i: Alcohol in Postwar Europe. - Stockholm : National Institute of Public Health and Almqvist & Wiksell International. - 9122019928 ; , s. 185-194
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 14. |
- Norström, Thor, et al.
(författare)
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Drinking and acquisition of unrecorded alcohol across educational groups in Sweden
- 2022
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Ingår i: Drug and Alcohol Review. - : Wiley. - 0959-5236 .- 1465-3362. ; 41:1, s. 160-170
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: It is estimated that 18.5% of total alcohol consumption in Sweden in 2018 was unrecorded. However, little is known about the socio-economic profile of consumers of unrecorded alcohol. The aim of this study was to elucidate this issue by analysing data from a unique Swedish national repeated cross-sectional alcohol use survey.Methods: Individual-level information on alcohol consumption and socio-economic status (SES) for the years 2013–2018 was retrieved from the Monitoring Project; a nationally representative monthly alcohol use survey. The analytical sample comprised 64 375 respondents aged 25–74 years. SES was measured by educational level. We used three educational groups: (i) low (<10 years); (ii) intermediate (10–12 years); and (iii) high (13+ years). We included indicators of the following sources of unrecorded alcohol consumption: travellers' import, smuggled alcohol, home production, internet and illicit home-distilling. We estimated adjusted SES-specific means of the various forms of unrecorded consumption. The means were adjusted for the effects of age, sex and region.Results: There were no significant educational differences in the total of unrecorded alcohol consumption; the same holds true for home-production and internet. However, with respect to smuggled and home-distilling, a statistically significant educational gradient was observed with the lowest educational group scoring approximately four times higher than the highest.Discussion and Conclusions: Our findings suggest that there are no differences across educational groups in the consumption of unrecorded alcohol as a whole. However, consumption of smuggled alcohol and illicitly distilled spirits is elevated in the low educational group.
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| 15. |
- Norström, Thor, 1948-, et al.
(författare)
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Was the STAD-program really that successful?
- 2013
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Ingår i: Nordic Studies on Alcohol and Drugs. - : SAGE Publications. - 1455-0725 .- 1458-6126. ; 30:3, s. 171-178
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Tidskriftsartikel (refereegranskat)abstract
- AIM - A community intervention programme STAD was launched in Stockholm in January 1998, which included training in responsible beverage service and stricter enforcement of existing alcohol laws. An evaluation suggested that during the first 33 months of the programme, the level of police-recorded violence dropped by a striking 29%. We propose to probe the robustness of this estimate, which is often cited as evidence of the effectiveness of these kinds of intervention. In this paper, we reanalyse the underlying data by applying alternative model specifications. DATA AND METHODS - We reanalysed the original data on police-recorded violence from January 1994 to September 2000 by autoregressive integrated moving average (ARIMA) modelling. We estimated models based on raw data and seasonally differenced data; we also varied the definition of control area and applied the statistical technique of difference-in-differences modelling. RESULTS - The estimated intervention effects from these model specifications were all strongly significant statistically, ranging between 21% and 32%. CONCLUSION - Estimates based on a variety of model specifications were generally somewhat lower than those previously reported. However, the new estimates were all strongly statistically significant and fairly uniform with regard to effect size, which suggests that the findings of a substantial impact of the STAD programme are indeed quite robust.
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| 16. |
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| 17. |
- Trolldal, Björn, et al.
(författare)
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Alcohol price elasticities in control and license states in the US, 1982-1999
- 2005
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Ingår i: Addiction. - 0965-2140 .- 1360-0443. ; 100:8, s. 1158-1165
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Tidskriftsartikel (refereegranskat)abstract
- AIM:The demand for alcohol has been demonstrated repeatedly to be sensitive to price changes. However, estimated price elasticities vary by study region and over time. One explanation for these variations might be that different countries or parts of countries have had different alcohol control systems. The hypothesis addressed in this study was that a regulated market leads to higher transaction costs associated with purchasing alcohol, which in turn increases the full price of the beverages (the nominal cash price plus transaction costs). As a result, the cash price of alcohol represents a smaller part of the full price in a highly regulated market. Assuming that customers respond primarily to changes in full price, the demand for alcohol should be less sensitive to changes in cash price where regulation is stricter. This study examined whether variations in price elasticities were a function of the different regulatory systems in control and license states in the United States during the period 1982-99.DATA AND METHODS:Time-series cross-sectional analyses (in 50 states over 18 years) were conducted. Elasticities were estimated using a multiplicative model based upon first-differences of time-series within states. Disposable income and other socio-demographic variables were used as control variables. All data were obtained from archival sources.FINDINGS:The demand for spirits and beer were significantly more sensitive to price changes in license states than in control states. The estimated price elasticity for wine sales was also somewhat larger in license states, but not significantly so.CONCLUSION:The lower price elasticities for spirits and beer in the control states support the hypothesis that customers respond primarily to changes in the full price of alcohol.
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| 18. |
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| 19. |
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| 20. |
- Trolldal, Björn
(författare)
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An investigation of the effect of privatization of retail sales of alcohol on consumption and traffic accidents in Alberta, Canada
- 2005
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Ingår i: Addiction. - : John Wiley & Sons, Inc.. - 0965-2140 .- 1360-0443. ; 100:5, s. 662-671
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Tidskriftsartikel (refereegranskat)abstract
- Aims Privatization of the retail sale of alcohol in Alberta took place primarily between the end of the 1980s and the beginning of the 1990s. The aim of this study was to evaluate the effects of this privatization on alcohol sales and on the incidence of fatal motor vehicle traffic accidents in the province. Data and method Interrupted time-series analysis (ARIMA) with a quasi-experimental control area design was used, and all series were differenced to remove long-term trends. Canada, with the exception of Alberta, was the control area. The effects of privatization were measured by means of created privatization variables. In the analyses of the effects of privatization on alcohol sales, the inhabitants’ disposable income and alcohol prices were used as control variables. The study period was 1950–2000. When effects on the number of fatal motor vehicle traffic accidents were analysed the number of road motor vehicle registrations was used as a control variable, and the study period was 1950–98. Findings Privatization had a significant permanent effect on the sale of spirits, but the effect was not large enough to affect total sales. The effect on wine and beer sales was not significant. There was no significant effect on the number of fatal motor vehicle traffic accidents. Conclusion The fact that sales on the wholesale level continued to be monopolized, along with the fact that alcohol sales were never allowed in ordinary grocery stores, may explain the lack of any larger effects of privatization on alcohol sales in Alberta.
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| 21. |
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| 22. |
- Trolldal, Björn, 1961-
(författare)
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Availability and Salels of Alcohol : Experiences from Canada and the U.S.
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis consists of four papers, all of which focus on the effects of changes in the availability of alcoholic beverages on alcohol sales. The second paper also examines the effects of changes in the availability of alcohol on the incidence of fatal traffic crashes. The aim of the first paper was to evaluate the effects of the privatization of the retail sale of certain wines in Quebec in 1978, when grocery stores were allowed to sell domestically produced wine along with wine imported and bottled by the Liquor Board in Quebec. This right was extended in 1983 to cover imported wines bottled by privately owned manufacturers as well, and in 1984 larger grocery store chains were also allowed to sell such wine. Interrupted time-series analysis (ARIMA) with a quasi-experimental control area design was used in the study, and the study period was 1950-2000. Possible effects of the policy changes on alcohol sales were measured by means of intervention variables. Contrary to earlier studies regarding these policy changes, the results presented in this paper showed a significant and permanent effect of the policy change on wine sales in 1978. Wine sales increased by 10 percent, but the effect was not so large as to affect total sales. In 1983-1984 no immediate significant increase in wine sales was found. The retail sale of spirits, wine and beer was privatized in Alberta primarily between the end of the 1980s and the beginning of the 1990s. The effects of this privatization on alcohol sales and on the incidence of fatal traffic crashes were analyzed in the second paper. The design of the study was similar to that described in paper 1. According to the results of the study, privatization had a significant permanent effect on the sale of spirits, which increased by 12 percent. The effect was not large enough to affect total sales, however, and there was no significant effect on the number of fatal traffic crashes. The fact that sales continued to be monopolized on the wholesale level, along with the fact that alcohol sales were never permitted in grocery stores, may explain why the effects of privatization were not greater. The research questions addressed in the third paper were to what extent changes in economic and physical availability (i.e. the number of outlets) affected alcohol sales in four Canadian provinces (Alberta, British Columbia, Ontario and Quebec), and to what extent the possible effects varied among these provinces. ARIMA time-series analyses were used in this study, and the main study period was 1951-2000. Changes in economic availability in general, and in price in particular, had larger effects on sales than changes in the number of outlets. Among the beverages analyzed, the demand for spirits was most sensitive to changes in availability. There were some disparities among the provinces regarding the effect of price changes on sales, but not regarding the effects of changes in income or in the number of outlets. The demand for alcohol has repeatedly been shown to be sensitive to price changes, but the estimates vary by study region and over time. One explanation for these variations might be that different jurisdictions have had different alcohol control systems. The hypothesis addressed in the fourth paper was that a regulated market leads to higher transaction costs associated with purchases of alcohol, which in turn increases the full price of alcohol (i.e. the nominal cash price plus transaction costs). As a result, the cash price of alcohol represents a smaller part of the full price in a highly regulated market. Assuming that customers respond primarily to changes in the full price, the demand for alcohol should be less sensitive to changes in cash price in jurisdictions where regulation is stricter. In this study, the question examined was whether variations in price elasticities were a function of the different regulatory systems in control and license states in the U.S. during the period 1982-1999. (The control states had more heavily regulated alcohol markets than the license states.) Time-series cross-sectional analyses were conducted. The results showed that the demand for spirits and beer was significantly more sensitive to price changes in license states than in control states, which supports the hypothesis that customers respond primarily to changes in the full price of alcohol. The results presented in this thesis suggest that the relationship between changes in availability and alcohol sales is a complex one and that effects of changes in a specific kind of availability on sales and alcohol-related problems have to be seen in the context of other alcohol policy measures. For example, the effects of privatization in the two Canadian provinces were unexpectedly small, especially in Alberta. These results might be explained by the fact that the total alcohol market continued to be rather heavily regulated, especially on the wholesale distribution level. In addition, the results regarding price elasticities in the U.S. showed that the demand for alcohol was less sensitive to ordinary price changes in jurisdictions where alcohol sales were more restricted and where transaction costs were correspondingly greater.
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| 23. |
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| 24. |
- Trolldal, Björn, et al.
(författare)
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Changes in the Price of Alcohol and Effect on Youth Drinking and in Different Socio-Economic Groups
- 2021
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Ingår i: Alcohol and Alcoholism. - : Oxford University Press (OUP). - 0735-0414 .- 1464-3502. ; 56:4, s. 475-481
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Many studies have shown that changes in alcohol prices have a significant effect on total sales. However, few studies have focused on youth, particularly in different socioeconomic groups. This study examined the effect of changes in the price of alcohol on consumption levels and binge drinking among 15 to 16 year old students in Sweden, both overall, among boys and girls, as well as within different socioeconomic groups.Methods: Data on consumption were retrieved from a representative survey of students aged 15-16, conducted annually between 1989 and 2017. Time series analysis employed an autoregressive integrated moving average model (ARIMA). Two types of price data were used: the official price at the retail stores, and the mean price of the ten cheapest beverages in each category. The mean aggregate annual income per Swedish household was included as a control variable.The variable used to measure the socioeconomic status was the proportion of the ninth-grade students at each school, who had at least one parent with an education higher than upper secondary school.Results: The students' alcohol consumption levels and binge drinking were not significantly affected by price changes during the study period; this was true both for the group as a whole, and among subgroups of boys or girls or of different socioeconomic status. Results were similar regardless of which type of price data variable was used in the analyses.Conclusion: Neither average nor minimum price of alcohol had a significant impact on the development of youth drinking in Sweden during the study period.
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| 25. |
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| 26. |
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| 27. |
- Trolldal, Björn, et al.
(författare)
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Effects of a Multi-component Responsible Beverage Service Program on Violent Assaults in Sweden
- 2013
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Ingår i: Addiction. - : Wiley. - 0965-2140 .- 1360-0443. ; 108:1, s. 89-96
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Tidskriftsartikel (refereegranskat)abstract
- Aim: A multi-component Responsible Beverage Service (RBS) programme has been disseminated in Swedish municipalities. The aim of the programme is to reduce violence associated with consumption of alcohol at on-licensed premises. This study aimed to analyse the effect of the programme on police-recorded assaults after the dissemination of the programme in Swedish municipalities, 19962009.Design: This study is a natural experiment that uses variation in the level of implementation of the RBS programme to predict change in the rate of police-recorded assaults. Setting Swedish municipalities. Participants The municipalities included in the study initiated the RBS programme no later than 2008. On-licensed premises open during the evenings must exist. Of 290 municipalities, 237 fulfilled these requirements.Measurement: Programme fidelity was studied by means of several surveys. Yearly data on police-recorded assaults, per 100?000 inhabitants aged 15 and above, committed on weekend nights, were used as dependent variable. A fixed-effects panel data regression model was used to examine the effect of the programme.Findings: Each extension of the programme, by one component, was associated with a significant 3.1% reduction in assaults. However, this effect was seen mainly in smaller municipalities. Of the different components of the programme, the presence of a community coalition steering group had a significant effect on assaults. No significant effect was found regarding RBS training or supervision of on-licensed premises.Conclusion: Multi-component Responsible Beverage Service programmes can have a significant effect on police-recorded assaults even when implemented on a large scale in many communities.
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| 29. |
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