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1.
  • Källmén, Håkan, et al. (författare)
  • The psychometric properties of the AUDIT : a survey from a random sample of elderly Swedish adults
  • 2014
  • Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 14, s. 672-
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Increasing alcohol consumption and related harms have been reported among the elderly population of Europe. Consequently, it is important to monitor patterns of alcohol use, and to use a valid and reliable tool when screening for risky consumption in this age group. The aim was to evaluate the internal consistency reliability and construct validity of the Alcohol Use Disorders Identification Test (AUDIT) in elderly Swedish adults, and to compare the results with the general Swedish population. Another aim was to calculate the level of alcohol consumption (AUDIT-C) to be used for comparison in future studies. Methods: The questionnaire was sent to 1459 Swedish adults aged 79-80 years with a response rate of 73.3%. Internal consistency reliability, were assessed using Cronbach alpha, and confirmatory factor analysis assessed construct validity of the Alcohol Use Disorders Identification Test (AUDIT) in elderly population as compared to a Swedish general population sample. Results: The results showed that AUDIT was more reliable and valid among the Swedish general population sample than among the elderly and that Item 1 and 4 in AUDIT was less reliable and valid among the elderly. Conclusions: While the AUDIT showed acceptable psychometric properties in the general population sample, it's performance was of less quality among the elderly respondents. Further psychometric assessments of the AUDIT in elderly populations are required before it is implemented more widely.
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2.
  • Engdahl, Barbro, et al. (författare)
  • Is the population level link between drinking and harm similar for women and men? : a time series analysis with focus on gender-specific drinking and alcohol-related hospitalizations in Sweden
  • 2011
  • Ingår i: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 21:4, s. 432-437
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: A question that has not been addressed in the literature is whether the population level association between alcohol and harm differs between men and women. The main aim of this article is to fill this gap by analysing recently collected time series data of male and female self-reported drinking in relation to gender-specific harm indicators in Sweden. Methods: Male and female per capita and risk consumption was estimated on the basis of self-reported data from monthly alcohol surveys for the period 2002-07. Overall per capita consumption including recorded sales and estimates of unrecorded consumption were also collected for the same period. Alcohol-related hospitalizations were used as indicators of alcohol-related harm. Data were aggregated into quarterly observations and analysed by means of time series analyses (ARIMA-modelling). Results: Overall per capita consumption was significantly related to both male and female alcohol-related hospitalizations. Male per capita consumption and risk consumption were also significantly related to alcohol-related hospitalizations among men. Female per capita consumption and risk consumption had also a positive association with alcohol-related hospitalizations but statistical significance was only reached for alcohol poisonings where the association was even stronger than for men. Conclusions: Changes in alcohol consumption in Sweden was associated with changes in male and female alcohol-related hospitalizations also in analyses based on gender-specific consumption measures. There was no clear evidence that the population level association between alcohol and harm differed between men and women.
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3.
  • Gustafsson, Nina-Katri, 1976- (författare)
  • Bridging the world : Alcohol Policy in Transition and Diverging Alcohol Patterns in Sweden
  • 2010
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The present dissertation aims at analysing the effects of recent alcohol policy changes. The traditional strict policy in Sweden had focused on high pricing and limited availability to control levels of alcohol consumed and thus alcohol-related harms. However, increased travellers’ allowances meant larger availability of cheaper alcohol when importing from Denmark and Germany, which are the countries from which Swedes obtain most of their private imports; the tax decrease in Denmark further decreased the price. As the economic literature links demand to price of a commodity and the early (smaller) quota changes had resulted in higher consumption in southern Sweden, it was expected that these latest changes would mean higher consumption and more alcohol-related problems in this area in particular. Some groups were additionally expected to be more affected than others.The present compilation thesis comprises four related articles and an introductory chapter that ties them together. Article I focuses on private imports in relation to quota changes 2002 – 2004 and relate this to purchase at the alcohol monopoly stores. Self-reported consumption and alcohol-related problems are studied in Article II and IV. In Article III, register data on alcohol-related harms, i.e. hospitalizations and police-recorded crimes, are analysed.The results of the dissertation were puzzling, since there was no large increase in consumption or alcohol-related problems in the south, but increases in the north during the period. However, private imports and cases of hospitalization due to alcohol poisoning were found to have increased in the south. Thus, the results imply that these policy changes had an effect on private imports, but that this effect was not large enough to increase total consumption as well. Additionally, increased alcohol poisoning cases implied that there had been an impact among high consumers. The increases found in consumption and problems in the north may instead have other explanations.
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4.
  • Gustafsson, Nina-Katri J., et al. (författare)
  • Changes in alcohol-related harm in Sweden after increasing alcohol import quotas and a Danish tax decrease-an interrupted time-series analysis for 2000-2007
  • 2011
  • Ingår i: International Journal of Epidemiology. - : Oxford University Press (OUP). - 0300-5771 .- 1464-3685. ; 40:2, s. 432-440
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Denmark decreased its tax on spirits by 45% on 1 October 2003. Shortly thereafter, on 1 January 2004, Sweden increased its import quotas of privately imported alcohol, allowing travellers to bring in much larger amounts of alcohol from other European Union countries. Although these changes were assumed to increase alcohol-related harm in Sweden, particularly among people living close to Denmark, analyses based on survey data collected before and after these changes have not supported this assumption. The present article tests whether alcohol-related harm in southern Sweden was affected by these changes by analysing other indicators of alcohol-related harm, e. g. harm recorded in different kinds of registers. Methods Interrupted time-series analysis was performed with monthly data on cases of hospitalization due to acute alcohol poisoning, number of reported violent assaults and drunk driving for the years 2000-07 in southern Sweden using the northern parts of Sweden as a control and additionally controlling for two earlier major changes in quotas. Results The findings were not consistent with respect to whether alcohol-related harm increased in southern Sweden after the decrease in Danish spirits tax and the increase in Swedish alcohol import quotas. On the one hand, an increase in acute alcohol poisonings was found, particularly in the 50-69 years age group, on the other hand, no increase was found in violent assaults and drunk driving. Conclusions The present results raise important questions about the association between changes in availability and alcohol-related harms. More research using other methodological approaches and data is needed to obtain a comprehensive picture of what actually happened in southern Sweden.
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5.
  • Landberg, Jonas, 1974- (författare)
  • Alcohol-Related Problems in Eastern Europe : A Comparative Perspective
  • 2010
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • This thesis investigates the association between alcohol consumption and alcohol-related harm in Eastern Europe. The main aim was to estimate to what extent changes in per capita alcohol consumption have an impact on different forms of alcohol-related mortality, and to put the results in an international comparative perspective. The thesis includes four papers; the first two papers use aggregate time-series analysis to assess how changes in per capita consumption affect rates in suicide mortality and fatal non-intentional injuries in several Eastern European countries, respectively. The third paper applies the same methodological approach to analyse the population-level relationship between alcohol and homicide in Russia and the U.S.. The fourth paper employs survey data to assess how the risk of experiencing alcohol-related problems in relation to volume of consumption in the Baltic countries compares to Sweden and Italy. The results of the first three papers suggests: (i) that changes in per capita consumption are significantly related to changes in mortality rates of suicide, non-intentional injuries and homicide in the countries under study; (ii) that the relationship is stronger for men than for women, and (iii) that the relationship tends to be stronger in the countries with more detrimental drinking patterns, e.g. Russia. The results of the fourth paper suggest that the risk of experiencing alcohol-related problems in relation to level of drinking in the Baltic countries is similar to the corresponding risk in Sweden, but considerably stronger than in Italy. In conclusion, the findings support the significance of a public health approach to alcohol-related problems in Eastern Europe, i.e., policy measures directed towards total alcohol consumption. In addition, strategies aimed at reducing the occurrence of binge drinking seem to have great potential for reducing alcohol-related harm and mortality in Eastern European countries.
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6.
  • Leimar, Per, et al. (författare)
  • Public opinion and alcohol policy in Sweden, 1990-2012
  • 2013
  • Ingår i: Nordic Studies on Alcohol and Drugs. - : SAGE Publications. - 1455-0725 .- 1458-6126. ; 30:6 2013, s. 473-490
  • Tidskriftsartikel (refereegranskat)abstract
    • We analyse the association between public opinions and political decisions on alcohol policy in Sweden during the last decades. Methods Reviews of existing Swedish surveys on public opinion and recent data on the opinion of decision-makers. Results Restrictive alcohol policy measures have much support in Sweden and this support has increased in the last decade. The opinions of the public and their elected representatives correspond fairly well but the relation between these opinions and policy decisions are not always straightforward. Conclusions There is little support for the idea that public opinion has been a major influence on alcohol policy formation in the period of 1990–2012.
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7.
  • Norström, Thor, 1948-, et al. (författare)
  • Potential Consequences of Replacing a Retail Alcohol Monopoly with a Private License System : Results from Sweden
  • 2010
  • Ingår i: Addiction. - : Wiley. - 0965-2140 .- 1360-0443. ; 105:12, s. 2113-2119
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim  To examine the potential effects of replacing the Swedish alcohol retail system with a private licensing system on alcohol consumption and alcohol-related harm. Design  Two possible scenarios were analysed: (1) replacing the current alcohol retail monopoly with private licensed stores that specialize in alcohol sales or (2) making all alcohol available in grocery stores. We utilized a multiplicative model that projected effects of changes in a set of key factors including hours of sale, retail prices, promotion and advertising and outlet density. Next, we estimated the effect of the projected consumption increase on a set of harm indicators. Values for the model parameters were obtained from the research literature. Measurements  Measures of alcohol-related harm included explicitly alcohol-related mortality, accident mortality, suicide, homicide, assaults, drinking driving and sickness absence. Findings  According to the projections, scenario 1 yields a consumption increase of 17% (1.4 litres/capita), which in turn would cause an additional 770 deaths, 8500 assaults, 2700 drinking driving offences and 4.5 million sick days per year. The corresponding figures for scenario 2 are a consumption increase of 37.4% (3.1 litres/capita) leading to an additional annual toll of 2000 deaths, 20 000 assaults, 6600 drinking driving offences and 11.1 million days of sick leave. Conclusions  Projections based on the research literature suggest that privatization of the Swedish alcohol retail market would significantly increase alcohol consumption and alcohol-related harm.
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8.
  • Piontek, Daniela, et al. (författare)
  • Individual and country-level effects of cannabis-related perceptions on cannabis use : A multilevel study among adolescents in 32 European countries
  • 2013
  • Ingår i: Journal of Adolescent Health. - : Elsevier BV. - 1054-139X .- 1879-1972. ; 52:4, s. 473-479
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose. The present paper investigated individual and aggregated effects of cannabis-related perceptions and other cannabis-related indicators on 12-months cannabis use prevalence and frequency among 15-16 year olds using multilevel analysis across 32 European countries.Methods. Data on cannabis use, perceptions of availability, risks and friends’ use as well as socio-demographic characteristics were taken from the 2007 European School Survey Project on Alcohol and Other Drugs (ESPAD). On country-level, aggregated measures of the perceptions were used. Moreover, data on cannabis price and 12-months cannabis use prevalence in the total population were taken from the World Drug Report. The analytical sample comprised n = 86,107 students (82.5 % of the overall 2007 international database).Results. Strong and persistent individual-level effects were identified for perceived availability, perceived harm and the number of cannabis using friends. The effects on cannabis use prevalence and frequency were more pronounced than country-level effects. On country-level, aggregated perceived peer consumption and population prevalence were significant predictors, while price was found not related to both outcome variables. The association between perceived friends’ use and cannabis use was moderated by aggregated perceived availability.Conclusions. Proximal influences related to the immediate social situation seem to be more strongly associated with cannabis use than distal influences related to social contexts emphasizing the importance of personal attitudes and perceptions in substance use behaviour. Prevention programs may focus on informing adolescents about the potential risks of cannabis and on correcting misperceptions of social norms. Policy measures may target on reducing visibility of drug use.
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  • Ramstedt, Mats (författare)
  • How much alcohol do you buy? : A comparison of self-reported alcohol purchases with actual sales
  • 2010
  • Ingår i: Addiction. - : Wiley. - 0965-2140 .- 1360-0443. ; 105:4, s. 649-654
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Unrecorded alcohol has increased in the Nordic countries during recent years, above all in terms of cross-border trade. This implies that trends and levels of per capita consumption would look different without estimates of this source of alcohol, estimates that in Sweden and other countries are made through surveys. Aim The overall aim is to analyse the validity of Swedish survey estimates of alcohol bought in the cross-border trade and possibly to develop weights that can be applied to such estimates. Data and method The analysis consists of comparing self-reported purchases of spirits, wine, cider/alcopops and beer at retail monopoly (Systembolaget) during 2008 (n = 18 000) with actual sales during the same period overall and monthly. Findings Of the recorded amount of purchases at Systembolaget, 87% was reported in the survey, compared with the 40-60% usually found for self-reported consumption. Significant differences across beverages were revealed, showing a lower coverage rate for beer and spirits and a higher coverage rate for wine and cider. Changes in purchases of all beverages were captured fairly well, at least changes taking place from one month to another. Conclusions Self-reported alcohol purchases achieve a higher coverage rate than found typically in studies based on self-reported use of alcohol. If adjustments are to be made to correct for underreporting in self-reported data on alcohol purchases, different weights should be applied to different beverages. Furthermore, at least major changes in how much alcohol is purchased in the population can be monitored using well-designed population surveys.
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14.
  • Ramstedt, Mats (författare)
  • Population drinking and homicide in Australia : A time series analysis of the period 1950-2003
  • 2011
  • Ingår i: Drug and Alcohol Review. - : Wiley. - 0959-5236 .- 1465-3362. ; 30:5, s. 466-472
  • Tidskriftsartikel (refereegranskat)abstract
    • Background. Despite a significant amount of research on alcohol and homicide in Australia, as yet there has been no study of the association at the aggregate level to reveal where Australia fits in with respect to the cultural differences found in the international research of this association. Aims. To analyse the temporal association between population drinking and homicide in Australia and to put the results in an international comparative perspective. Method. Using Autoregressive Integrated Moving Average (ARIMA) time series analysis, overall and gender-specific homicide rates from 1950 to 2003 were analysed in relation to alcohol consumption overall as well as to different beverages. Findings. A one-litre increase in per capita consumption was followed by an 8% increase in overall and male homicide rates and a 6% increase in female homicide rates. The effect was mainly driven by beer consumption. In a comparative perspective, the importance of population drinking was similar to what has been found inWestern Europe. Conclusions. Australia belongs to the group of countries where lowering population drinking is likely to be associated with lower homicide rates and reducing beer consumption seems to be the most efficient way to achieve this. [Ramstedt M. Population drinking and homicide in Australia: A time series analysis of the period 1950-2003.
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15.
  • Ramstedt, Mats, et al. (författare)
  • Reducing youth violence related to student parties : Findings from a community intervention project in Stockholm
  • 2013
  • Ingår i: Drug and Alcohol Review. - : Wiley. - 0959-5236 .- 1465-3362. ; 32:6, s. 561-565
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundDuring the spring of 2007, the police reported a marked increase in violence and binge drinking related to high school student graduation parties on weekday nights at restaurants in Stockholm city. This spurred a multi-component community intervention project to reduce these problems. AimsThis study aims to evaluate the impact of the intervention on youth-related violence on weekday nights in 2008-2010. Design and MethodThe outcome measure entailed the number of violence-related emergency room visits on weekday nights (10:00 pm-6:00 am) by adolescents aged 18-20 years. The study period was 1 April-31 May, which is when most student graduation parties took place. The data covered the years 2005-2010, with three data points before the intervention, and three after the intervention was introduced. Because the intervention was expected to apply to weekdays only, the control series involved a corresponding indicator pertaining to weekend nights (10:00 pm-6:00 am). The intervention effect was assessed by means of difference-in-differences estimation. ResultsThe estimated intervention effect according to the difference-in-differences estimation models was a statistically significant 23% reduction of violence among young people. Discussion and ConclusionThis type of intervention is a promising measure of preventing youth violence and deserves to be continued. Such continuation would also provide additional data required for a more conclusive assessment.[Ramstedt M, Leifman H, Muller D, Sundin E, Norstrom T. Reducing youth violence related to student parties: Findings from a community intervention project in Stockholm. Drug Alcohol Rev 2013;32:561-565]
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18.
  • Room, Robin, et al. (författare)
  • What happened to alcohol consumption and problems in the Nordic countries when alcohol taxes were decreased and borders opened?
  • 2013
  • Ingår i: The international journal of alcohol and drug research. - : International Journal of Alcohol and Drug Research. - 1925-7066. ; 2:1, s. 77-87
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims: The study tests the effects of reduction in alcohol taxation and increased travellers’ allowances on alcohol consumption and related harm in Denmark, Finland and southern Sweden. In late 2003 and early 2004, taxes on alcoholic beverages were reduced in Denmark and Finland, and the abolition of quantitative quotas on alcohol import for personal use from other European Union countries made cheaper alcohol more available in Denmark, Finland and Sweden. Methods: Analyses of routine statistical register data, and summarizing results from longitudinal and repeated cross-sectional population surveys and other previous analyses, with northern Sweden as a control site for secular trends.Results: Contrary to expectations, alcohol consumption – as based on register data – increased only in Finland and not in Denmark and southern Sweden, and self-reported survey data did not show an increase in any site. In Finland, alcohol-attributable harms in register data increased, especially in people with low socio-economic status. Few such effects were found in Denmark and southern Sweden. Neither did results for self-reported alcohol-attributable problems show any general increases in the three sites. These results remained after controlling for regression to the mean and modelling of drop-outs.Conclusions: Harms measured in register data did tend to increase in the short term with the policy change, particularly in Finland, where the tax changes were broader. But reducing price and increasing availability does not always increase alcohol consumption and harm. Effects are dampened in affluent societies, and other factors may intervene. The results for Finland also suggest some limits for general population surveys in testing for relatively small policy effects.
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19.
  • Stenius, Kerstin, et al. (författare)
  • Addiction research centres and the nurturing of creativity : Centre for Social Research on Alcohol and Drugs (SoRAD), Stockholm University, Sweden
  • 2010
  • Ingår i: Addiction. - : Wiley. - 0965-2140 .- 1360-0443. ; 105:3, s. 402-407
  • Tidskriftsartikel (refereegranskat)abstract
    • The Centre for Social Research on Alcohol and Drugs (SoRAD) was established as a national research centre and department within the Faculty of Social Science at Stockholm University in 1997, following a Government Report and with the aim to strengthen social alcohol and drug research. Initially, core funding came from the Swedish Council for Working Life and Social Research and from the Ministry of Health and Social Affairs for several long-term projects. Today, SoRAD, with 25 senior and junior researchers, has core funding from the university but most of its funding comes from external national and international grants. Research is organized under three themes: consumption, problems and norms, alcohol and drug policy and societal reactions, treatment and recovery processes. SoRADs scientific approach, multi-disciplinarity, a mix of qualitative and quantitative methods and international comparisons was established by the centre's first leader, Robin Room. Regular internal seminars are held and young researchers are encouraged to attend scientific meetings and take part in collaborative projects. SoRAD researchers produce government-funded monthly statistics on alcohol consumption and purchase, and take part in various national government committees, but SoRADs research has no clear political or bureaucratic constraints. One of the future challenges for SoRAD will be the proposed system for university grants allocation, where applied social science will have difficulties competing with basic biomedical research if decisions are based on publication and citation measures.
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20.
  • Wennberg, Peter, 1973-, et al. (författare)
  • The effects of missing data when surveying alcohol habits
  • 2011
  • Ingår i: Nordisk Alkohol- og narkotikatidsskrift (NAT). - Helsinki : Nordisk Ministerråd. - 1455-0725 .- 1458-6126. ; 28:1, s. 43-50
  • Tidskriftsartikel (refereegranskat)abstract
    • This study aimed at describing the effects of missing data when surveying alcohol consumption using a Random Digit Dialling procedure. Methods Data was part of the Monitor project including repeated monthly data on the alcohol habits in the general Swedish population. Non-respondents during four months were followed up a year later and asked to do a shortened telephone interview and were compared to a concurrent sample of respondents (n=2552 versus n=6005). Further, using a second approach, the monthly levels of non-response was related to the level of measured alcohol use in a time series analysis (n=67500). Results The results indicated no differences in the level of reported alcohol or tobacco use with except for a slightly higher proportion of alcohol abstainers in the sample of initial non-response. The time series showed no pattern of co-variation between the obtained non-response levels and the assessed levels of alcohol or tobacco use. Conclusions On the basis of the results it was meaningful to make a distinction between “soft” non-respondents (responding after extensive contacting effort) and “hard” non-respondents (not responding albeit extensive effort) and the results suggest that inclusion of the “soft” non-respondents does not by necessity lead to higher levels of assessed alcohol use.
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