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1.
  • Agardh, Emilie E., et al. (author)
  • Alcohol-attributed disease burden in four Nordic countries between 2000 and 2017 : Are the gender gaps narrowing? A comparison using the Global Burden of Disease, Injury and Risk Factor 2017 study
  • 2021
  • In: Drug and Alcohol Review. - : Wiley. - 0959-5236 .- 1465-3362. ; 40:3, s. 431-442
  • Journal article (peer-reviewed)abstract
    • Introduction and Aims. The gender difference in alcohol use seems to have narrowed in the Nordic countries, but it is not clear to what extent this may have affected differences in levels of harm. We compared gender differences in all-cause and cause-specific alcohol-attributed disease burden, as measured by disability-adjusted life-years (DALY), in four Nordic countries in 2000-2017, to find out if gender gaps in DALYs had narrowed. Design and Methods. Alcohol-attributed disease burden by DALYs per 100 000 population with 95% uncertainty intervals were extracted from the Global Burden of Disease database. Results. In 2017, all-cause DALYs in males varied between 2531 in Finland and 976 in Norway, and in females between 620 in Denmark and 270 in Norway. Finland had the largest gender differences and Norway the smallest, closely followed by Sweden. During 2000-2017, absolute gender differences in all-cause DALYs declined by 31% in Denmark, 26% in Finland, 19% in Sweden and 18% in Norway. In Finland, this was driven by a larger relative decline in males than females; in Norway, it was due to increased burden in females. In Denmark, the burden in females declined slightly more than in males, in relative terms, while in Sweden the relative decline was similar in males and females. Discussion and Conclusions. The gender gaps in harm narrowed to a different extent in the Nordic countries, with the differences driven by different conditions. Findings are informative about how inequality, policy and sociocultural differences affect levels of harm by gender.
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2.
  • Andersson, Filip, et al. (author)
  • Prevalence of cannabis use among young adults in Sweden comparing randomized response technique with a traditional survey
  • 2023
  • In: Addiction. - 0965-2140 .- 1360-0443. ; 118:9, s. 1801-1810
  • Journal article (peer-reviewed)abstract
    • Background and Aims: The prevalence of cannabis use based on self-reports is likely to be underestimated in population surveys, especially in contexts where its use is a criminal offence. Indirect survey methods ask sensitive questions ensuring that answers cannot be identified with an individual respondent, therefore potentially resulting in more reliable estimates. We aimed to measure whether the indirect survey method ‘randomized response technique’ (RRT) increased response rate and/or increased disclosure of cannabis use among young adults compared with a traditional survey.Design: We conducted two parallel nation-wide surveys during the spring and the summer of 2021. The first survey was a traditional questionnaire-based one (focusing on substance use and gambling). The second survey applied an indirect survey method known as ‘the cross-wise model’ to questions related to cannabis use. The two surveys employed identical procedures (e.g. invitations, reminders and wording of the questions)Setting and Participants: The participants were young adults (aged 18–29 years) living in Sweden. The traditional survey had 1200 respondents (56.9% women) and the indirect survey had 2951 respondents (53.6% women).Measurements: In both surveys, cannabis use was assessed according to three time-frames: life-time use; use during the past year; and use during the past 30 days.Findings: The estimated prevalence of cannabis use was two- to threefold higher on all measures when estimated using the indirect survey method compared with the traditional survey: use during life-time (43.2 versus 27.3%); during the past year (19.2 versus 10.4%); and during the past 30 days (13.2 versus 3.7%). The discrepancy was larger among males and individuals with an education shorter than 10 years, who were unemployed, and who were born in non-European countries.Conclusions: Indirect survey methods may provide more accurate estimates than traditional surveys on prevalence of self-reported cannabis use.
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3.
  • Fugelstad, Anna, et al. (author)
  • Drug-related deaths : Statistics based on death certificates miss one-third of cases
  • 2020
  • In: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 48:1, s. 29-37
  • Journal article (peer-reviewed)abstract
    • AIMS: Statistics on drug-related deaths (DRD) provide crucial information on the drug situation. The European Monitoring Centre for Drug and Drug Addiction (EMCDDA) has published a specification for extracting DRD from national mortality registers to be used in international comparisons. However, surprisingly little is known of the accuracy of DRD statistics derived from national mortality registers. This study assesses the accuracy of Swedish data derived from national mortality registers by comparing it with other sources of data.METHODS: We compared five Swedish datasets. Three were derived from national mortality registers, two according to a Swedish specification and one according to the EMCDDA specification. A fourth dataset was based on toxicological analyses. We used a fifth dataset, an inventory of DRD in Stockholm, to assess the completeness and coverage of the Swedish datasets.RESULTS: All datasets were extracted from high-quality registers, but still did not capture all DRD, and both the numbers and demographic characteristics varied considerably. However, the time trends were consistent between the selections. In international comparisons, data completeness and investigation procedures may impact even more on stated numbers.CONCLUSIONS: Basing international comparisons on numbers or rates of DRDs gives misleading results, but comparing trends is still meaningful.
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4.
  • Fugelstad, Anna, et al. (author)
  • Oxycodone-related deaths in Sweden 2006-2018
  • 2022
  • In: Drug And Alcohol Dependence. - : Elsevier BV. - 0376-8716 .- 1879-0046. ; 234
  • Journal article (peer-reviewed)abstract
    • Aim: To identify and characterize oxycodone related deaths in Sweden from 2006 to 2018 and to compare them to other opioid-related deaths.Methods: To assess the factors contributing to the deaths, we used multinomial logistic regression to compare oxycodone-related deaths extracted from all forensic autopsy examinations and toxicology cases in the age groups 15-34 (reference group), 35-54 and 55-74 with regard to sex, presence of benzodiazepines and alcohol at the time of death, prescription of oxycodone, benzodiazepines and antidepressants, previous substance use related (SUD) treatment, and manner of death. The oxycodone related deaths were compared with deaths with presence of other opioids.Result: We identified 575 oxycodone-related deaths, and the rate increased during the study period from 0.10 to 1.12 per 100,000 in parallel with an increase of oxycodone prescriptions from 3.17 to 30.33 per 1000. Oxycodone-related deaths amounted to 10.0% of all opioid-related deaths. The deaths occurred mainly in older patients previously being prescribed oxycodone. Benzodiazepines were present at the time of death in 403 (70%) and alcohol in 259 (45%). Prescriptions of any opioid for pain (61%), oxycodone (50%), benzodiazepines (67%) and antidepressants (55%) were common. Only 15% had received treatment for SUD during the last year.Conclusion: Oxycodone-related deaths increased in Sweden between 2006 and 2018 in parallel to an increase in oxycodone prescriptions. The increase occurred mainly in older patients being prescribed oxycodone for pain. There might be specific interventions needed to avoid oxycodone-related deaths compared to other opioidrelated deaths associated with illicit opioid use.
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5.
  • Gripe, Isabella, et al. (author)
  • Are the well‐off youth in Sweden more likely to use cannabis?
  • 2021
  • In: Drug and Alcohol Review. - : Wiley. - 0959-5236 .- 1465-3362. ; 40:1, s. 126-134
  • Journal article (peer-reviewed)abstract
    • Introduction and Aims. Results from previous research are inconsistent regarding the association between socioeconomic status (SES) and cannabis use among adolescents. Since there are risks associated with cannabis use, a social gradient in cannabis use may contribute to reproducing socioeconomic differences in life opportunities. The aim of this study was to assess the association between childhood SES and cannabis use among youth in Sweden. Design and Methods. We used repeated cross‐sectional data from three waves (2014–2016) of the Swedish national school survey among 11th graders. The analysis encompassed 9497 individuals in 668 school classes. Childhood SES was measured through parents' highest education, as reported by the students. Cannabis use was measured in terms of lifetime use and frequency of use. Data were analysed using multi‐level mixed‐effects Poisson regression. Results. Adolescents with at least 1 parent with university/college education had 17% (incidence rate ratio 1.17, confidence interval 1.05, 1.30) higher risk of lifetime use of cannabis compared with those whose parents had no university/college education, adjusting for sex, SES of the school environment, academic orientation, truancy, risk assessment and parental permissiveness. Among life‐time users of cannabis, risk for frequent cannabis use was 28% (incidence rate ratio 0.72, confidence interval 0.53, 0.97) lower for those with at least 1 parent with university or college education. Discussion and Conclusions. Childhood SES, in terms of parental education, was associated with cannabis use among Swedish adolescents. Adolescents from families with lower SES were less likely to ever try cannabis, but at higher risk for frequent use.
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6.
  • Kraus, Ludwig, 1955-, et al. (author)
  • Does the decline in Swedish adolescent drinking persist into early adulthood?
  • 2024
  • In: Addiction. - 0965-2140 .- 1360-0443. ; 119:2, s. 259-267
  • Journal article (peer-reviewed)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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7.
  • Landberg, Jonas, 1974-, et al. (author)
  • Distribution of sickness absence risk across different levels and patterns of drinking : findings from the Stockholm Public Health Cohort
  • 2021
  • In: Nordic Studies on Alcohol and Drugs. - : SAGE Publications. - 1455-0725 .- 1458-6126. ; 38:3, s. 305-318
  • Journal article (peer-reviewed)abstract
    • Aim: This study estimated (i) the risk function between different indicators of alcohol use and long-term sickness absence, adjusting for possible confounding factors, (ii) whether the risk function between average volume of consumption and sickness absence is modified by heavy episodic drinking (HED), and (iii) to what extent the risk for sickness absence among abstainers is due to health selection bias. Data and methods: The study was based on data from the Stockholm Public Health Cohort 2006, with an analytical sample of 16,477 respondents aged 18–64 years. The outcome included register-based long-term (> 14 days) sickness absence. Negative binominal regression was used to estimate the association between sickness absence and average weekly volume of consumption, frequency of HED, and both in interaction. Results: Abstainers, chronic heavy drinkers and respondents with the highest frequency of HED had approximately two-fold higher rates of sickness absence relative to the reference groups, i.e., moderate drinkers and those with HED one to 6 times per year. Adjustment for confounding factors did not materially affect the shape of the risk function. After exclusion of abstainers with alcohol-related problems, or poor health, the estimates for abstainers became non-significant. Moderate drinkers with HED did not have significantly higher rates of sickness absence than moderate drinkers without HED. Conclusions: Our results suggest a significant association between alcohol use and sickness absence. There were indications that the U-shaped risk function may largely be due to health selection bias among abstainers. We found no indication of effect modification of HED on moderate drinking.
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8.
  • Landberg, Jonas, et al. (author)
  • The Contribution of Alcohol Use, Other Lifestyle Factors and Working Conditions to Socioeconomic Differences in Sickness Absence
  • 2020
  • In: European Addiction Research. - : S. Karger AG. - 1022-6877 .- 1421-9891. ; 26:1, s. 40-51
  • Journal article (peer-reviewed)abstract
    • Introduction: This study investigates how alcohol use contributes to the social gradient in sickness absence. Other factors assessed include lifestyle factors (smoking, physical activity and body mass index), physical and psychosocial working conditions. Methods: The study used baseline data from the Stockholm public health cohort 2006, with an analytical sample of 17,008 respondents aged 25-64 years. Outcome variables included self-reported short-term (<14 days) and register-based long-term (>14 days) sickness absence. Socioeconomic position (SEP) was measured by occupational class. Alcohol use was measured by average weekly volume and frequency of heavy episodic drinking. Negative binominal regression was used to estimate sex-specific SEP differences in sickness absence, before and after adjusting for alcohol use and the additional explanatory factors. Results: Adjusting for alcohol use attenuated the SEP differences in long-term sickness absence by 20% for men and 14% for women. Alcohol use explained a smaller proportion of the differences in short-term sickness absence. Alcohol use in combination with other lifestyle factors attenuated the SEP differences (20-35%) for both outcomes. Physical working conditions explained more than half of the gradient in long-term sickness absence, whereas psychosocial conditions had greater impact on short-term sickness absence among men. Discussion/Conclusion: Alcohol use explains a substantial proportion of the SEP disparities in long-term sickness absence among men. The effect is smaller among women and for short-term sickness absence. Our findings support the notion that physical working conditions constitute the key explanatory variable for SEP differences in long-term sickness absence, but add that psychosocial working conditions have greater impact on the gradient in short-term sickness absence among men.
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9.
  • Norström, Thor, et al. (author)
  • The impact of the COVID-19 pandemic on mortality in Sweden—Did it differ across socioeconomic groups?
  • 2024
  • In: European Journal of Epidemiology. - 0393-2990 .- 1573-7284.
  • Journal article (peer-reviewed)abstract
    • The characterization of the socioeconomic profle of COVID-19 mortality is limited. Likewise, the mapping of potential indirect adverse outcomes of the pandemic, such as suicide and alcohol abuse, along socioeconomic lines is still meagre. The main aim of this paper is to (i) depict SES-diferences in COVID-19 mortality, and (ii) to assess the impact of the COVID-19 pandemic on suicide and alcohol mortality across socioeconomic groups. We used Swedish monthly data spanning the period January 2016–December 2021. We chose education as indicator of socioeconomic status (SES). The following causes of deaths were included in the analysis: COVID-19, all-cause mortality excluding COVID-19, suicide and a composite index of alcohol-specifc deaths. SARIMA-modelling was used to assess the impact of the pandemic on suicide and alcohol-specifc mortality. Two alternative measures of the pandemic were used: (1) a dummy that was coded 1 during the pandemic (March 2020 and onwards), and 0 otherwise, and (2) the Oxford COVID-19 Government Response Tracker’s Stringency Index. There was a marked SES-gradient in COVID-19 mortality in the working-age population (25–64) which was larger than for other causes of death. A SES-gradient was also found in the old-age population, but this gradient did not difer from the gradient for other causes of death. The outcome from the SARIMA time-series analyses suggested that the pandemic did not have any impact on suicide or alcohol-specifc mortality in any of the educational and gender groups.
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10.
  • Norström, Thor, et al. (author)
  • The Link Between Alcohol Sales and Alcohol-Related Harm in Finland, 1995-2016
  • 2020
  • In: Journal of Studies on Alcohol and Drugs. - : Alcohol Research Documentation, Inc.. - 1937-1888 .- 1938-4114. ; 81:5, s. 641-646
  • Journal article (peer-reviewed)abstract
    • Objective:A key assumption in Finnish alcohol policy is that the officially registered alcohol consumption (i.e., alcohol sales) is closely related to alcohol-related harm. During the last two decades, a sizable part of total alcohol consumption, however, comprises unrecorded consumption, which may potentially make alcohol sales less powerful as a predictor of alcohol-related harm. This article thus aims to estimate the relationship between alcohol sales and alcohol-related harm on the basis of more recent Finnish time-series data.Method:Data on alcohol sales (liters of 100% alcohol/capita age 15 years and older) were obtained from the National Institute for Health and Welfare in Finland. As indicators of harm, we used police-reported assaults and three forms of mortality: alcohol-specific mortality, accidents, and suicide. Quarterly data on mortality and alcohol sales spanned the period 1995–2016, and data on police-reported offenses covered the period 1990–2016. Data were analyzed by SARIMA (Seasonal Autoregressive Integrated Moving Average) modeling.Results:A positive and significant association between alcohol sales and all harm indicators was found. A 1-L increase in alcohol sales per capita was associated with a 20% increase in alcohol-specific mortality, a 12% increase in assaults, and a 5%–6% increase in accidents and suicide. These estimates are in line with earlier findings estimated on data for the period when unrecorded alcohol consumption was less common in Finland.Conclusions:The results provide support for a continued strong relationship between alcohol sales and alcohol-related harm in Finland. Policy measures aimed at lowering alcohol sales were supported from these results.
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11.
  • Ramstedt, Mats, et al. (author)
  • Are changes in parenting related to the decline in youth drinking? : Evidence from a comparison of Sweden and Denmark
  • 2022
  • In: Nordic Studies on Alcohol and Drugs. - : Sage Publications. - 1455-0725 .- 1458-6126. ; 39:2, s. 124-133
  • Journal article (peer-reviewed)abstract
    • Introduction: The aim of this study was to replicate earlier studies suggesting that changes in parenting have contributed to the recent decline in youth drinking by comparing parenting in a country experiencing a sharp decline in youth drinking (Sweden) with a country with only a small decline (Denmark). Data and analysis: Data stem from self-reported information from 15-16-year-old children in the Swedish and Danish subsamples of ESPAD. Youth drinking was measured by prevalence and frequency of drinking over the past year. Parenting was measured in terms of the extent the child reported that: (1) parents' attitudes towards offspring drinking are restrictive, (2) parents set up general rules for what their children are allowed to do, and (3) parents have high level of knowledge about where and with whom their children spend time. The association between these indicators of parenting and youth drinking was first estimated with logistic regressions. Second, changes in parenting between 1999 and 2015 were compared between Denmark and Sweden across the study period. Results: Restrictive parental attitudes were associated with a lower likelihood of past-year drinking and frequent drinking in both Sweden and Denmark. This attitude was more common in Sweden, where it also became more prevalent between 2003 and 2015 in contrast to in Denmark. The association between strict parental rule-setting and youth drinking was weak in both countries. A high parental knowledge of the child's whereabouts was linked to a lower likelihood of past-year drinking in Sweden and a lower frequency of drinking in both countries. Parental knowledge of offspring's whereabouts did not develop differently in Sweden and Denmark, with a high and stable proportion in both countries. Conclusion: More restrictive parental attitudes towards youth drinking may have contributed to the decline in youth drinking, whereas the importance of general parental rule-setting and parental knowledge of offspring's whereabouts was not supported.
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12.
  • Ramstedt, Mats, 1965-, et al. (author)
  • Children with problem-drinking parents in a Swedish national sample: is the risk of harm related to the severity of parental problem drinking?
  • 2023
  • In: European journal of public health. - : Oxford University Press (OUP). - 1464-360X .- 1101-1262. ; 33:2, s. 312-316
  • Journal article (peer-reviewed)abstract
    • BackgroundThe aim of this paper is to examine the link between severity in exposure to parental problem drinking in a Swedish national population sample of children aged 15–16 years. Specifically, we assessed whether the risk of poor health, poor relationships and a problematic school situation increase with severity in exposure to parental problem drinking.MethodsNational population survey from 2017 with a representative sample of 5 576 adolescents born in 2001. Logistic regression models were used to estimate odds ratios (ORs) with 95% confidence intervals (95% CIs). A short version of The Children of Alcoholics Screening Test, CAST-6, was used to identify children with problem-drinking parents. Health status, social relations and school situation were assessed by well-established measures.ResultsThe risk of having poor health, poor school performance and poor social relations increased with severity of parental problem drinking. The risk was lowest among children least severely affected (Crude models ranged from OR: 1.2, 95% CI 1.0–1.4 to OR: 2.2, 95% CI 1.8–2.6) and highest among children most severely affected (Crude models ranges from OR: 1.7, 95% CI 1.3–2.1 to OR: 6.6, 95% CI 5.1–8.6). The risk became lower when adjusting for gender and socioeconomic position but were still higher compared to children without problem-drinking parents.ConclusionsAppropriate screening and intervention programs are necessary for children with problem-drinking parents especially when exposure is severe but also at mild forms of exposure.
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13.
  • Ramstedt, Mats, et al. (author)
  • Children with problem drinking parents in Sweden : Prevalence and risk of adverse consequences in a national cohort born in 2001
  • 2022
  • In: Drug and Alcohol Review. - : John Wiley & Sons. - 0959-5236 .- 1465-3362. ; 41:3, s. 625-632
  • Journal article (peer-reviewed)abstract
    • INTRODUCTION: To estimate the prevalence of children with problem drinking parents in Sweden and the extent to which they have an elevated risk of poor health, social relationships and school situation in comparison with other children.METHODS: Survey with a nationally representative sample of Swedish youth aged 15-16 years (n = 5576) was conducted in 2017. A short version of The Children of Alcoholics Screening Test (CAST-6) was used to identify children with problem drinking parents. Health status, social relations and school situation were measured by well-established measures. Overall prevalences for girls and boys were presented as well as relative risks (RR) of harm for children with problem drinking parents compared with other children.RESULTS: A total of 13.1% of the sample had at least one problem drinking parent during adolescence according to CAST-6-a higher proportion of girls (15.4%) than boys (10.8%). This group had an elevated risk of poor general health as well psychosomatic problems compared with other children (RR 1.2-1.9). They were also more likely to use medication for depression, sleeping difficulties and anxiety (RR 2.2-2.6). Their social relations were also worse especially with their father (RR 3.1) and they had more problems at school (RR 2.6).DISCUSSION AND CONCLUSIONS: The risk of problems related to parental drinking goes beyond the most severe cases where parents have been in treatment for their alcohol problem. This is important knowledge since the majority of problem drinkers never seek treatment and the major part of parental problem drinking is found in population samples.
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14.
  • Raninen, Jonas, et al. (author)
  • 17 Is the New 15 : Changing Alcohol Consumption among Swedish Youth
  • 2022
  • In: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 19:3
  • Journal article (peer-reviewed)abstract
    • To examine and compare trends in drinking prevalence in nationally representative samples of Swedish 9th and 11th grade students between 2000 and 2018. A further aim is to compare drinking behaviours in the two age groups during years with similar drinking prevalence. Data were drawn from annual surveys of a nationally representative sample of students in year 9 (15–16 years old) and year 11 (17–18 years old). The data covered 19 years for year 9 and 16 years for year 11. Two reference years where the prevalence of drinking was similar were extracted for further comparison, 2018 for year 11 (n = 4878) and 2005 for year 9 (n = 5423). The reference years were compared with regard to the volume of drinking, heavy episodic drinking, having had an accident and quarrelling while drunk. The prevalence of drinking declined in both age groups during the study period. The rate of decline was somewhat higher among year 9 students. In 2018, the prevalence of drinking was the same for year 11 students as it was for year 9 students in 2005. The volume of drinking was lower among year 11 students in 2018 than year 9 students in 2005. No differences were observed for heavy episodic drinking. The decline in drinking has caused a displacement of consumption so that today’s 17–18-year-olds have a similar drinking behaviour to what 15–16-year-olds had in 2005.
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15.
  • Raninen, Jonas, et al. (author)
  • Mind the gap! Gender differences in alcohol consumption among Swedish ninth graders 1989–2021
  • 2024
  • In: Drug and Alcohol Review. - 0959-5236 .- 1465-3362. ; 43:3, s. 596-603
  • Journal article (peer-reviewed)abstract
    • Introduction: To examine gender differences in drinking habits among Swedish ninth graders over the period 1989–2021.Methods: Annual school surveys with nationally representative samples of ninth-grade students in Sweden covering the period 1989–2021, total sample of 180,538 students. Drinking habits were measured with self-reports of frequency and quantity of use and frequency of heavy episodic drinking. Differences between genders were compared annually and differences were tested using logistic and ordinary least square regression models with cluster robust standard errors.Results: Small gender differences in the prevalence of alcohol use during the first part of the study period were followed by an increasing gap over the past decade with girls being more likely to drink alcohol than boys. Boys consumed larger amounts of alcohol than girls during the first three decades of the studied period but no gender differences were found in later years. Binge drinking was more prevalent among boys during 1989 to 2000 but no systematic gender difference was found during the past 15 years.Discussion and Conclusions: There used to be clear gender differences in drinking habits among ninth graders in Sweden with boys drinking more than girls. This gap has narrowed over the past three decades and among contemporary adolescents, no gender differences are found neither in binge drinking nor volume of drinking and the prevalence of drinking is even higher among girls.
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16.
  • Raninen, Jonas, et al. (author)
  • To drink or not to drink : A study of the association between rates of non-drinkers and per drinker mean alcohol consumption in the Swedish general population
  • 2022
  • In: Drug and Alcohol Review. - : John Wiley & Sons. - 0959-5236 .- 1465-3362. ; 41:6, s. 1475-1483
  • Journal article (peer-reviewed)abstract
    • INTRODUCTION: Understanding how the mean consumption per drinker and rates of non-drinking interplay to form overall per capita alcohol consumption is imperative for our understanding of population drinking. The aim of the present study is to examine the association between rates of non-drinkers and per drinker mean alcohol consumption in the Swedish adult population and for different percentiles of drinkers.METHODS: Data came from a monthly telephone survey of drinking habits in the Swedish adult population between 2002 and 2013. Alcohol consumption and non-drinking during the last 30 days were measured by beverage-specific quantity-frequency questions. Regression models estimated the association between the rate of non-drinkers and per drinker volume on annual data. Auto-regressive integrated moving average time-series models estimated the association on monthly data.RESULTS: A significant (P < 0.01) negative association (-0.849) was found between the rate of non-drinkers and per drinker mean volume on annual data. A unit increase in non-drinking was associated with a decline of 0.85 cl of pure alcohol among drinkers. This finding was mirrored across all percentiles of consumption. The semi-log models found that a 1% unit increase in the rate of non-drinkers was followed by a 2% reduction in per drinker mean consumption. Auto-regressive integrated moving average time-series models verified these results.DISCUSSION AND CONCLUSIONS: There is a significant association between the proportion of non-drinkers and the amount of drinking among drinkers. The theory of collectivity of drinking cultures should also include the non-drinking part of the population.
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17.
  • Sherk, Adam, et al. (author)
  • The public-private decision for alcohol retail systems : Examining the economic, health, and social impacts of alternative systems in Finland
  • 2023
  • In: Nordic Studies on Alcohol and Drugs. - : SAGE Publications. - 1455-0725 .- 1458-6126. ; 40:3, s. 218-232
  • Journal article (peer-reviewed)abstract
    • Background: Organising alcohol retail systems with more or less public ownership has implications for health and the economy. The aim of the present study was to estimate the economic, health, and social impacts of alcohol use in Finland in 2018 (baseline), and in two alternative scenarios in which current partial public ownership of alcohol retail sales is either increased or fully privatised.Methods: Baseline alcohol-attributable harms and costs were estimated across five categories of death, disability, and criminal justice. Two alternate alcohol retail systems were defined as privately owned stores selling: (1) only low strength alcoholic beverages (public ownership scenario, similar to Sweden); or (2) all beverages (private ownership scenario). Policy analyses were conducted to estimate changes in alcohol use per capita. Health and economic impacts were modelled using administrative data and epidemiological modelling.Results: In Finland in 2018, alcohol use was estimated to be responsible for €1.51 billion (95% Uncertainty Estimates: €1.43 billion, €1.58 billion) in social cost, 3,846 deaths, and 270,652 criminal justice events. In the public ownership scenario, it was estimated that alcohol use would decline by 15.8% (11.8%, 19.7%) and social cost by €384.3 million (€189.5 million, €559.2 million). Full privatisation was associated with an increase in alcohol use of 9.0% (6.2%, 11.8%) and an increase in social cost of €289.7 million (€140.8 million, €439.5 million).Conclusion: The outcome from applying a novel analytical approach suggests that more public ownership of the alcohol retail system may lead to significant decreases in alcohol-caused death, disability, crime, and social costs. Conversely, full privatisation of the ownership model would lead to increased harm and costs.
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18.
  • Sundin, Erica, et al. (author)
  • Country-Level Heavy Episodic Drinking and Individual-Level Experiences of Harm from Others' Drinking-Related Aggression in 19 European Countries
  • 2022
  • In: European Addiction Research. - : S. Karger AG. - 1022-6877 .- 1421-9891. ; 28:2, s. 134-142
  • Journal article (peer-reviewed)abstract
    • Introduction: There is limited knowledge about how individual experiences of harm from others’ drinking are influenced by heavy episodic drinking (HED) at the country level. The present study aimed to assess (1) the association between the country-level prevalence of HED and the risk of experiencing harm from others’ drinking-related aggression and (2) if HED at the country level modifies the association between consumption of alcohol per capita (APC) and such harm. Methods: Outcome data from 32,576 participants from 19 European countries stem from the RARHA SEAS study. Self-reported harm from others’ drinking included having been verbally abused, harmed physically, or having serious arguments. Data on country-level drinking patterns were derived from the World Health Organization. Associations between country-level prevalence of monthly HED and experiences of aggression (at least 1 of 3 studied harms) were derived through multilevel models – adjusted for country-level age structure and by including the respondent’s own HED patterns as a mediator. Results: A 1% increase in the prevalence of monthly HED was associated with 5% higher odds (odds ratio [OR] 1.05) of experiencing others’ alcohol-related aggression among men, and 6% (OR 1.06) among women. The results suggest that the association between APC and harm was stronger in countries with high prevalences of HED, but the modifying effect could not be confirmed. Discussion/Conclusion: Harm from others’ drinking-related aggression depends not only on individual factors but is also influenced by the drinking patterns of the population. However, the country-level prevalence of HED only explains a small part of the variance of this type of harm.
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19.
  • Thern, Emelie, et al. (author)
  • Long-term effects of youth unemployment on alcoholrelated morbidity
  • 2020
  • In: Addiction. - : Wiley. - 0965-2140 .- 1360-0443. ; 115:3, s. 418-425
  • Journal article (peer-reviewed)abstract
    • AimTo test if exposure to unemployment in young adulthood is associated with an increased risk of later alcohol‐related morbidity.DesignA nation‐wide register‐linked longitudinal population‐based study.SettingSweden.ParticipantsA total of 16 490 individuals born between 1967 and 1978, who had participated in the Labour Force Survey between the ages of 16–24 years during 1990–95.MeasurementInformation on the outcome of alcohol‐related morbidity was obtained from the National Hospital Discharge Register. The Swedish index of alcohol‐related in‐patient care was used to define the outcome. Information on sex, age and country of birth, as well as parents’ level of education, socio‐economic status and alcohol‐related health problems, were also obtained. Average follow‐up time was 22 years. Cox regression analysis was used to obtain hazard ratios (HR) with 95% confidence intervals (CI).FindingsCompared with full‐time students, individuals who experienced short‐ and long‐term unemployment spells at a young age were at an increased risk of later alcohol‐related morbidity; < 3 months (HR = 2.04, 95% CI = 1.35–3.09), 3–6 months (HR = 2.20, 95% CI = 1.29–3.75) and > 6 months (HR = 1.99, 95% CI = 1.06–3.71) of unemployment, after adjusting for several important individual and family level covariates.ConclusionIn Sweden, a nation‐wide register‐based study with a 22‐year follow‐up suggests that being unemployed in young adulthood is associated with an increased risk of alcohol‐related morbidity later in life.
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20.
  • Thern, Emelie, et al. (author)
  • The associations between unemployment at a young age and binge drinking and alcohol-related problems
  • 2020
  • In: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 30:2, s. 368-373
  • Journal article (peer-reviewed)abstract
    • Background: Youth unemployment remains at a high stable level in many countries making it a public health problem of importance. The aim was to examine the short-term effect of unemployment at a young age (aged 17-29 years) on self-reported binge drinking and alcohol-related problems. Methods: We used data from a cross-sectional national study that took place in 2013, with a follow-up in 2014. A sample of young adults aged 17-29 years (n = 1188, response rate of 46.3%) that completed both surveys served as the study sample in the current study. The same self-reported questionnaire, consisting of questions regarding their alcohol habits and sociodemographic information, was used on both occasions. Information on the outcomes of binge drinking and alcohol-related harm were obtained from the 2014 survey. From the 2013 survey, information on individual and family level covariates were collected. Odds ratios (ORs) with 95% confidence intervals (CIs) with employed individuals as the reference group were estimated by logistic regression analysis. Results: At baseline, results indicate that employed individuals reported the greatest prevalence of weekly binge drinking. In the fully adjusted models, unemployment appeared to be associated with an increased risk of alcohol-related problems (OR 1.37, 95% CI 0.77-2.45); however, this was not the case for weekly binge drinking (OR 0. 94, 95% CI 0.45-1.96). Conclusion: Unemployment at a young age may be a risk factor for later alcohol-related problems. Thus, targeting youth unemployment could be one element in an effective health policy aimed at reducing rates of alcohol use disorders.
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21.
  • Trolldal, Björn, et al. (author)
  • Changes in the Price of Alcohol and Effect on Youth Drinking and in Different Socio-Economic Groups
  • 2021
  • In: Alcohol and Alcoholism. - : Oxford University Press (OUP). - 0735-0414 .- 1464-3502. ; 56:4, s. 475-481
  • Journal article (peer-reviewed)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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