Alcohol Consumption In Sweden Research Articles

Impact of the pandemic on leisure physical activity and alcohol consumption

BackgroundThe COVID-19 pandemic precipitated heightened morbidity and elevated mortality attributed to the SARS-CoV-2 infection. The pandemic also influenced health behaviors such as physical activity (PA) and alcohol consumption. The aim of this study was to examine changes in leisure PA and alcohol consumption in Sweden during the pandemic, and elucidate potential discrepancies in changes across demographic strata and socioeconomic status (SES).MethodsData were retrieved from two waves of the longitudinal cohort study Life conditions, Stress and Health (LSH) (n = 2,523). Two measures of change were used; longitudinal change relative to baseline (2012–2015) and reported change compared to before the pandemic. For these two change measures, differences between sex, age group and SES were analyzed using multinomial logistic regression.ResultsRegardless of the change measure, the proportion of individuals with diminished PA was notably higher among females compared to males. Furthermore, relative to baseline, females were less likely to have increased their PA, however according to the reported change they were more likely to have increased PA. Longitudinal change in PA compared to baseline followed a reversed age gradient, while, according to reported change, a decrease in PA during the pandemic was most prevalent in respondents 45 years of age at baseline (OR = 1.8, CI: 1.2–2.5) and respondents 50 years of age at baseline (OR = 1.7, CI: 1.2–2.4). High SES was associated with a greater variability in PA. Alcohol consumption was generally reduced during the pandemic. However, individuals aged 40 or 45 years at baseline were more likely than others to have initiated risky alcohol consumption.ConclusionsFemales exhibited a greater propensity to alter their PA levels during the pandemic, with the most profound decreases observed among individuals of working ages. Despite a general downturn in alcohol consumption, individuals aged 40 and 45 had a heightened likelihood of having initiated risky alcohol consumption compared to individuals in other age cohorts. In conclusion, societal restrictions during a pandemic render a dual impact on PA levels. While posing a risk for decreased PA among individuals in working ages, the restrictions also present a potential window of opportunity to increase PA, particularly among females.

Drinking and acquisition of unrecorded alcohol across educational groups in Sweden.

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. 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. 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. 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.

Has beverage composition of alcohol consumption in Sweden changed over time? An age-period-cohort analysis.

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. 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. 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. 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.

Climate impact of alcohol consumption in Sweden

Knowledge about the environmental impact of alcohol is limited and as an effect alcohol is often excluded from environmental studies of diets or included in incomplete ways. This paper describes the climate impact of beer, wine and liquor by using life cycle assessment. The climate impact is quantified per litre of specific alcoholic beverages and per total amount of alcohol consumed based on self-reported data of 50 000 individuals from 2009 within two population-based cohorts in Sweden. The results show that alcoholic beverages generate greenhouse gas (GHG) emissions in the range of 0.73–2.38 kg carbon dioxide equivalents (CO2e) per litre. Alcohol consumption in the population studied generates on average 52 kg CO2e per person and year. Within the 10% of the population with the highest intake of alcohol GHG emissions are up to 202 kg CO2e per person and year. Consumption of wine is responsible for the largest share of GHG emissions from alcoholic beverages (61%) followed by beer (33%), while liquor and strong wine account for a smaller share (6%). Alcohol consumption among men generates 90% higher GHG emissions than among women. Alcohol consumption and in consequence alcohol-related emissions are decreasing with increasing age of men and women. Our results indicate that alcohol consumption in Swedish men and women is responsible for an average of 3% of total diet-related GHG emissions and in sub-populations with the highest consumption up to 6–11%. Limiting alcohol could be an effective option to reduce the climate impact of diets, especially among men.

Czynniki kształtujące szwedzki rynek alkoholowy w warunkach zmian monopolu państwowego

IntroductionThe social costs of alcohol consumption in Sweden are still a challenge for alcohol policy. The privileges of the alcohol monopoly ‘Systembolaget’ established in 1950s of twentienth century have been gradually stepped back since Sweden's access to the EU. The author's aim is to verify the thesis of the complementary character of instruments for affecting the alcohol market (i.e. the regulatory and allocation policy) under conditions of the internal and external pressures on the Swedish monopoly. MethodThe methodology involves a critical study of recent literature works and legal documents as well as an analysis of statistical data. ResultsWhile effectively restricting the physical availability of alcohol, the monopoly succeeded also in shaping social attitudes to alcohol consumption. Regulations of excise duty rates and social campaigns made it possible for ‘Systembolaget’ to promote moderate alcohol consumption and effectively encourage the use of wine instead of other alcohol types. DiscussionThe undertaken analysis opens the way to a discussion on the possible effects of demonopolisation. Along with concerns regarding age limits controls in a free market model, an important argument against the abolition of ‘Systembolaget’ is its potential in meeting consumer expectations and shaping public opinion. ConclusionsThe thesis of the complementary character of alcohol policy instruments can be verified positively. Liberal tendencies in EU regulations make the allocative policy, with support of regulatory policy, a natural way to stabilise the monopoly's market share. Its publicity campaigns can be a lesson for countries with more liberal alcohol policies, including Poland.

Barriers to treatment for alcohol dependence: a qualitative study

Approximately half of all people with high alcohol consumption in Sweden fulfill criteria for either harmful consumption or dependence. Among the alcohol-dependent, the majority have dependence with low severity. They are also reluctant to seek treatment. This qualitative study, with data from seven focus group discussions and 14 individual interviews, aims to describe and explain how representations of alcohol consumption, dependence, and treatment create barriers to treatment. Thirty-two adults from the general population fulfilling DSM-IV criteria for alcohol dependence participated. Most of the participants agreed that they were heavy drinkers but did not perceive themselves as alcohol dependent. Having alcohol problems, as well as realizing the need for and entering treatment, was associated with shame and stigma, producing a strong barrier to treatment. The participants’ knowledge about treatment was limited and somewhat faulty, as they thought that treatment mainly involves medication with disulfiram, lifelong abstinence, and inpatient care at rehabilitation clinics. As these treatments are socially restrictive and stigmatizing, this understanding created a barrier to treatment. While treatment for alcohol problems in primary care was seen as less stigmatizing, the expertise among general practitioners in this field was questioned. Results indicate that, to lower the threshold for treatment seeking, treatment services need to better match the needs and wishes of the potential service users as well as take stigmatization into account. Primary care practices and general practitioners need to market their ability to treat people with drinking problems. The clinical understanding of alcohol dependence needs to be expanded to include mild to moderate dependence, conditions which can be managed in primary care.

Is Youth Violence Temporally Related to Alcohol? A Time-Series Analysis of Binge Drinking, Youth Violence and Total Alcohol Consumption in Sweden

The purpose of this study is to investigate the temporal association between violence and binge drinking among Swedish youth. Two time periods are analysed, the first one representing the full observation period 1971-2009 and the second one representing a confined period 1971-2000. Furthermore, the association between population drinking and binge drinking among youths is also investigated with regards to the two time periods. ARIMA modelling was applied in order to estimate these associations. Based on the confined time period (1971-2000), analyses revealed that four out of six estimates (two where borderline) of the association between binge drinking and violence (self-reported as well as convictions for assaults) were positive and statistically significant. However, most estimates became non-significant when the full study period (1971-2009) was analysed. The analyses of the relationship between total consumption and youth binge drinking revealed that binge drinking among military conscripts and boys was affected by changes in total consumption during the shorter confined study period. These associations became non-significant when the full study period was included in the models. (a) there was a positive relationship between violence and binge drinking among Swedish youth at the aggregated level, but mainly with regards to the shorter study period, (b) changes in per capita alcohol consumption were associated with binge drinking among young men and this was more evident for the shorter study period and (c) there was empirical evidence for the idea that these associations became weaker or non-existent after the year 2000.

Implementing brief interventions in health care: lessons learned from the Swedish Risk Drinking Project.

The Risk Drinking Project was a national implementation endeavour in Sweden, carried out from 2004 to 2010, based on a government initiative to give alcohol issues a more prominent place in routine primary, child, maternity and occupational health care. The article describes and analyses the project. Critical factors that were important for the results are identified. The magnitude of the project contributed to its reach and impact in terms of providers’ awareness of the project goals and key messages. The timing of the project was appropriate. The increase in alcohol consumption in Sweden and diminished opportunities for primary prevention strategies since entry to the European Union in 1995 have led to increased expectations for health care providers to become more actively involved in alcohol prevention. This awareness provided favourable conditions for this project. A multifaceted approach was used in the project. Most educational courses were held in workshops and seminars to encourage learning-by-doing. Motivational interviewing was an integral aspect. The concept of risk drinking was promoted in all the activities. Subprojects were tailored to the specific conditions of each respective setting, building on the skills the providers already had to modify existing work practices. Nurses were afforded a key role in the project.

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

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. 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). 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. 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.

Change and Stability?

Over the past two decades, alcohol consumption in Sweden has grown by 20 per cent as a result of an increasing consumption of wine and strong beer. The rise is driven by a combination of factors such as the higher physical availability and lower real prices of alcohol, which suggests that alcohol has become much more affordable. In addition, the possibilities to bring back cheaper alcohol from other EU countries have been greatly extended during the Swedish EU membership. No definite patterns were found with respect to certain social and demographic changes during the study period. Despite the significant increase in consumption, indicators of alcohol-related harms did not show consistently increasing trends. It is not evident why the increasing availability should have such different effects on various population sub-groups, and there are obviously other relevant factors at play. Widespread political concern at the implications of the rising availability of alcohol has led Sweden to spend more per capita than any other European country on alcohol policy and prevention initiatives. It will be a continuous challenge for policy makers to find measures that limit the harms caused by alcohol in the Swedish society.

Alcohol Consumption in Southern Sweden after Major Decreases in Danish Spirits Taxes and Increases in Swedish Travellers’ Quotas

Background: In 2003, Denmark lowered its tax on spirits, and in 2004, Sweden increased its traveller import quotas. Aim: The aim of the study was to determine whether these two changes increased self-reported alcohol consumption in southern Sweden, which is located near Denmark. Method: Data were collected through telephone interviews with the general population between 2003 and 2006. Individuals aged 16–80 years were interviewed. Some lived in southern Sweden, others in the northern region, which was assumed to be unaffected by the policy changes and was thus used as a control site. Analyses were performed for the total population as well as by sex, age, socio-economic group and consumption pattern. Results: The expected results were not found: alcohol consumption in southern Sweden had not changed. The few statistically significant changes found in southern Sweden indicated decreases. In the north, however, consumption seemed to have increased. Conclusion: In addition to the two policy changes mentioned above, other changes seem to have affected alcohol consumption in Sweden. It is possible, however, that the policy changes have affected population groups not reached by the survey, and thus other types of data need to be analysed before drawing any far-reaching conclusions.

Institutional trust and alcohol consumption in Sweden: The Swedish National Public Health Survey 2006

BackgroundTrust as a measure of social capital has been documented to be associated with health. Mediating factors for this association are not well investigated. Harmful alcohol consumption is believed to be one of the mediating factors. We hypothesized that low social capital defined as low institutional trust is associated with harmful alcohol consumption.MethodsData from the 2006 Swedish National Survey of Public Health were used for analyses. The total study population comprised a randomly selected representative sample of 26.305 men and 30.584 women aged 16–84 years. Harmful alcohol consumption was measured using a short version the Alcohol Use Disorders Identification Test (AUDIT), developed and recommended by the World Health Organisation. Low institutional trust was defined based on trust in ten main welfare institutions in Sweden.ResultsIndependent of age, country of birth and socioeconomic circumstances, low institutional trust was associated with increased likelihood of harmful alcohol consumption (OR (men) = 1.52, 95% CI 1.34–1.70) and (OR (women) = 1.50, 95% CI 1.35–1.66). This association was marginally altered after adjustment for interpersonal trust.ConclusionFindings of the present study show that lack of trust in institutions is associated with increased likelihood of harmful alcohol consumption. We hope that findings in the present study will inspire similar studies in other contexts and contribute to more knowledge on the association between institutional trust and lifestyle patterns. This evidence may contribute to policies and strategies related to alcohol consumption.

The societal cost of alcohol consumption: an estimation of the economic and human cost including health effects in Sweden, 2002

This article estimates the societal cost of alcohol consumption in Sweden in 2002, as well as the effects on health and quality of life. The estimation includes direct costs, indirect costs and intangible costs. Relevant cost-of-illness methods are applied using the human capital method and prevalence-based estimates, as suggested in existing international guidelines, allowing cautious comparison with prior studies. The results show that the net cost (i.e. including protective effects of alcohol consumption) is 20.3 billion Swedish kronor (SEK) and the gross cost (counting only detrimental effects) is 29.4 billion (0.9 and 1.3% of GDP). Alcohol consumption is estimated to cause a net loss of 121,800 QALYs. The results are within the range found in prior studies, although at the low end. A large number of sensitivity analyses are performed, indicating a sensitivity range of 50%.

Who drinks more in Sweden? A study on consumption trends among men and women and in various age groups during 1990–2002

This study examines trends in alcohol consumption in Sweden from 1990 to 2002, with the emphasis on the period after 1995 with Sweden as a member of the European Union (EU). The specific aim of the study is to study gender-specific and age-specific trends in self-reported consumption by means of five general population surveys conducted between 1990 and 2002. Trends in the proportion of high consumers were also studied. Alcohol sales and estimates of unrecorded consumption indicate that Swedish per capita alcohol consumption (per person aged 15 or older) rose by approximately 27 per cent, from 7.8 litres of pure alcohol in 1990 to 9.9 litres in 2002. Approximately 90 per cent of this increase has occurred since 1996. Analyses of self-reported consumption from survey data confirm this trend with more than a 30 per cent increase for both genders (aged 16–75 years) since 1996. Among women, this is mainly due to increased wine consumption, and among men to augmented consumption of wine as well as beer. Furthermore, the proportion of high consumers has increased – and more so than the per capita consumption. The study also shows that changes in consumption during the period of 1990 to 2002 differ for the various gender-and age-specific groups. Among women, for in-stance, the increase since 1996 has been strongest for the oldest women (50–75 years of age), and since 1998 statistically significant only among this group. The weakest, and thus not statistically significant, increase has occurred among women between the ages of 30 and 49. It is important to track the changes not only among men and women and various age groups, but also in the different sub-groups of the population, since changes in per capita consumption are strongly related to changes in different alcohol-related problems. Other groups of importance are e.g. various social classes (including the long-term unemployed and people on long-term disability benefits), regions, family units and, not least, different drinking groups, including high consumers. Improved knowledge of how consumption changes in different socio-demo-graphic groups will also improve our understanding of the causes and mechanisms behind changes in alcohol consumption in society.

Social class, drinking and alcohol-related mortality.

The main purpose of this study is to investigate the magnitude of class differences in the distribution of alcohol consumption in Sweden, and to assess whether this is compatible with the observed pattern in class-specific mortality. The emphasis is put on analyses of survey data from 1990, but we also provide an overview of earlier published data. The findings suggest that, over the past 20-30 years, there has been an equalization, or even reversal, between social strata in the average consumption of alcohol, such that the consumption level for manual laborers is now at parity with, or possibly exceeds, the level for non-manual employees. This shift may also have been accompanied by a shift in the dispersion: the 1990 survey data indicate that the consumption distribution for the manual laborers is more skewed than that for the non-manual employees, while no such tendency was detected in the early data. Calculations demonstrated that this difference in dispersion may well account for the elevated rate of alcohol-related mortality among manual laborers. The results are finally discussed as a case of deviation from the general rule of collective change in consumption.

Alkoholkonsumtionens mörkertal i Sverige 1960–1994

The aim of the study was to estimate the trend in unregistered alcohol consumption in Sweden during the period 1960–1994. The estimation was based on the discrepancy between the observed trend in alcohol related harms (alcohol-related mortality, assault, homicide, and drunk driving) and the trend expected from registered alcohol sales. The impact of alcohol sales on these indicators were estimated by means of ARIMA-analyses, and then the error term series was calculated for each indicator, meaning the difference between the observed and the expected trends in harm rates. A factor analysis of the four error-term series yielded one single factor which was interpreted as the unregistered alcohol consumption. According to the outcome this would have increased linearly by about 80% during the study period. Some comparisons are made with other data; for example it is noted that the trend in travelling abroad reasonably matches the trend in estimated unregistered consumption.

Alcohol and narcotics. Epidemiology and pregnancy risks.

Among alcohol and narcotics, alcohol is most comprehensively documented as a teratogen. However, for all other narcotics, data are continuously accumulating, convincingly displaying the teratogenic effects. The proportions between "somatic" teratogenicity and "behavioral" teratogenicity vary between the different agents. Preventive work in prenatal clinics and among social workers, as well as objective mass media attention to the problem, seems to have lowered the incidence of severe fetal alcohol syndrome where the above-mentioned activities have been practiced. The female alcohol consumption in Sweden decreased from 1976 to 1985; thereafter, a slow continuous increase is underway again. In Sweden the number of recruits to narcotic abuse peaked in the 1970s and early 1980s. Thereafter, the number of recruits among females decreased, but abuse has continued among the members of the older age groups.

Underreporting of alcohol-related mortality from cirrhosis is declining in Sweden and Denmark.

Death rates for alcoholic cirrhosis ran parallel to alcohol consumption in Sweden and Denmark from 1961 to 1986, according to official statistics. Reported death rates for alcoholic cirrhosis and for non-alcoholic cirrhosis increased linearly from 1965 to 1976 in Sweden and from 1967 to 1973 in Denmark. This suggests that constant proportions of deaths from real alcoholic cirrhosis are misclassified in official statistics as due to non-alcoholic cirrhosis during these time periods. Assuming that the mortality from real non-alcoholic cirrhosis is constant (c), a statistical model for estimating both c and the misclassification rates for real alcoholic cirrhosis (p) is proposed. In the Sweden population and in Danish males c was about 5 deaths per 100,000 adults annually. The model was not applicable to Danish females because their mortality from non-alcoholic cirrhosis decreased. The misclassification rate p was about 55% in both Swedish and Danish males and 70% in Swedish females during the above time periods. Moreover, during the past decade p has decreased to 30% in Swedish and Danish males.