Change search
Link to record
Permanent link

Direct link
Publications (10 of 75) Show all publications
Raninen, J., Karlsson, P., Callinan, S. & Norström, T. (2024). Different measures of alcohol use as predictors of DSM-5 alcohol use disorder among adolescents – A cohort study from Sweden. Drug And Alcohol Dependence, Article ID 111265.
Open this publication in new window or tab >>Different measures of alcohol use as predictors of DSM-5 alcohol use disorder among adolescents – A cohort study from Sweden
2024 (English)In: Drug And Alcohol Dependence, ISSN 0376-8716, E-ISSN 1879-0046, article id 111265Article in journal (Refereed) Published
Abstract [en]

Background and aims

This study addresses a significant gap in existing research by investigating the longitudinal relationship between various measures of alcohol use and the development of alcohol use disorders (AUDs) in a cohort of Swedish adolescents.

Methods

A prospective longitudinal survey was conducted on 3,999 adolescents in Sweden who were in 9th grade in 2017 and were followed up in 2019. Baseline assessments included lifetime alcohol use, recent use (past 30 days), risky drinking (AUDIT-C), and heavy episodic drinking (HED). Follow-up assessments comprised eleven items measuring DSM-5 AUD criteria. The study explores prospective associations between these diverse alcohol use measures and the occurrence of AUD, while also calculating population attributable fractions (PAF).

Findings

The proportion of drinkers who met the criteria for AUD at follow-up was 31.8%. All baseline measures of alcohol use exhibited associations with subsequent AUD. Notably, the HED group demonstrated the highest prevalence of AUD at 51.4% (p<.001). However, when calculating PAFs, any lifetime alcohol use emerged as the most substantial contributor, accounting for 10.8% of all subsequent AUD cases.

Conclusions

This study underscores that alcohol use during mid-adolescence heightens the risk of developing AUD in late adolescence. Among the various measures, heavy episodic drinking presents the highest risk for later AUD. From a public health perspective, preventing any alcohol use emerges as the most effective strategy to mitigate the population-level burden of AUD.

Keywords
Alcohol, adolescent, survey, DSM-5, longitudinal
National Category
Social Work
Research subject
Social Work
Identifiers
urn:nbn:se:su:diva-227494 (URN)10.1016/j.drugalcdep.2024.111265 (DOI)001208143200001 ()38492254 (PubMedID)2-s2.0-85188007304 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2024-03-15 Created: 2024-03-15 Last updated: 2024-05-07Bibliographically approved
Gripe, I., Pape, H. & Norström, T. (2023). Associations Between Cannabis Use and Mental Distress in Young People: A Longitudinal Study. Journal of Adolescent Health
Open this publication in new window or tab >>Associations Between Cannabis Use and Mental Distress in Young People: A Longitudinal Study
2023 (English)In: Journal of Adolescent Health, ISSN 1054-139X, E-ISSN 1879-1972Article in journal (Refereed) Published
Abstract [en]

Purpose

Despite a large number of studies on the relation between cannabis use and mental distress in adolescence, results are inconclusive regarding the nature of this association. The aim of the present study is to expand this body of research by analyzing the within-person association between changes in cannabis use and changes in mental distress among young people.

Methods

We used longitudinal data from a national sample of young people in Norway. The cohort was assessed in 1992 (T1), 1994 (T2), 1999 (T3), and 2005 (T4). The cumulative response rate was 60%. Respondents who participated in all four waves, aged 11–18 years at T1 (N = 1,988) were analyzed. Within-person association between changes in cannabis use and changes in mental distress in terms of symptoms of depression, anxiety, suicidal ideation, and deliberate self-harm were estimated by applying fixed-effects modeling.

Results

For males, an increase in cannabis use from no use to more than 10 times/year was significantly associated with increased risk for anxiety (relative risk [RR]: 1.72, p = .009), depressed mood (RR: 1.49, p < .001), and suicidal ideation (RR: 3.43, p = .012). For females, the corresponding increase in cannabis use yielded an increased risk for anxiety (RR: 1.38, p = .023) and suicidal ideation (RR: 2.47, p = .002).

Discussion

Increased cannabis use during adolescence and young adulthood seem to increase the risk for symptoms of mental distress. Although the associations appear to be more pronounced among males, it was only for depression that there was a statistically significant gender difference in the association.

National Category
Social Sciences
Identifiers
urn:nbn:se:su:diva-224490 (URN)10.1016/j.jadohealth.2023.10.003 (DOI)001171543000001 ()38069929 (PubMedID)2-s2.0-85179466901 (Scopus ID)
Funder
The Research Council of Norway, 288083The Research Council of Norway, 301010Forte, Swedish Research Council for Health, Working Life and Welfare, 2017-01662
Available from: 2023-12-14 Created: 2023-12-14 Last updated: 2024-03-26
Norström, T. & Landberg, J. (2023). The association between population drinking and ischemic heart disease mortality in educational groups. Alcohol and Alcoholism, Article ID agad033.
Open this publication in new window or tab >>The association between population drinking and ischemic heart disease mortality in educational groups
2023 (English)In: Alcohol and Alcoholism, ISSN 0735-0414, E-ISSN 1464-3502, article id agad033Article in journal (Refereed) Published
Abstract [en]

A large number of observational studies have found a J-shaped relationship between alcohol intake and ischemic heart disease (IHD) risk. However, some studies suggest that the alleged cardio-protective effect may be an artifact in the way that the elevated risk for abstainers is due to self-selection on risk factors for IHD. The aim of this paper is to estimate the association between alcohol and IHD-mortality on the basis of aggregate time-series data, where the problem with selection effects is not present. In addition, we will analyze SES-specific mortality to investigate whether there is any socio-economic gradient in the relationship at issue. SES was measured by educational level. We used IHD-mortality in three educational groups as outcome. Per capita alcohol consumption was proxied by Systembolaget’s alcohol sales (litres of alcohol 100% per capita 15+). Swedish quarterly data on mortality and alcohol consumption spanned the period 1991Q1–2020Q4. We applied SARIMA time-series analysis. Survey data were used to construct an indicator of heavy SES-specific episodic drinking. The estimated association between per capita consumption and IHD-mortality was positive and statistically significant in the two groups with primary and secondary education, but not in the group with postsecondary education. The association was significantly stronger the lower the educational group. Although the associations were generally stronger for males than for females, these differences were not statistically significant (P > 0.05). Our findings suggest that the detrimental impact of per capita consumption on IHD-mortality was stronger the lower the educational group.

Keywords
alcohol, heart disease mortality, time-series, Sweden, education
National Category
Sociology (excluding Social Work, Social Psychology and Social Anthropology)
Identifiers
urn:nbn:se:su:diva-217325 (URN)10.1093/alcalc/agad033 (DOI)000990840400001 ()
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2017-01769
Available from: 2023-05-18 Created: 2023-05-23 Last updated: 2023-06-20Bibliographically approved
Sherk, A., Stockwell, T., Sorge, J., Churchill, S., Angus, C., Chikritzhs, T., . . . Simpura, J. (2023). The public-private decision for alcohol retail systems: Examining the economic, health, and social impacts of alternative systems in Finland. Nordic Studies on Alcohol and Drugs, 40(3), 218-232
Open this publication in new window or tab >>The public-private decision for alcohol retail systems: Examining the economic, health, and social impacts of alternative systems in Finland
Show others...
2023 (English)In: Nordic Studies on Alcohol and Drugs, ISSN 1455-0725, E-ISSN 1458-6126, Vol. 40, no 3, p. 218-232Article in journal (Refereed) Published
Abstract [en]

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.

Keywords
alcohol-caused harms, alcohol policy, alcohol retail systems, alcohol use, modelling study
National Category
Sociology (excluding Social Work, Social Psychology and Social Anthropology)
Identifiers
urn:nbn:se:su:diva-215593 (URN)10.1177/14550725231160335 (DOI)000950368000001 ()2-s2.0-85150965974 (Scopus ID)
Available from: 2023-03-20 Created: 2023-03-20 Last updated: 2023-06-12Bibliographically approved
Norström, T., Landberg, J. & Trolldal, B. (2022). Drinking and acquisition of unrecorded alcohol across educational groups in Sweden. Drug and Alcohol Review, 41(1), 160-170
Open this publication in new window or tab >>Drinking and acquisition of unrecorded alcohol across educational groups in Sweden
2022 (English)In: Drug and Alcohol Review, ISSN 0959-5236, E-ISSN 1465-3362, Vol. 41, no 1, p. 160-170Article in journal (Refereed) Published
Abstract [en]

Introduction: It is estimated that 18.5% of total alcohol consumption in Sweden in 2018 was unrecorded. However, little is known about the socio-economic profile of consumers of unrecorded alcohol. The aim of this study was to elucidate this issue by analysing data from a unique Swedish national repeated cross-sectional alcohol use survey.

Methods: Individual-level information on alcohol consumption and socio-economic status (SES) for the years 2013–2018 was retrieved from the Monitoring Project; a nationally representative monthly alcohol use survey. The analytical sample comprised 64 375 respondents aged 25–74 years. SES was measured by educational level. We used three educational groups: (i) low (<10 years); (ii) intermediate (10–12 years); and (iii) high (13+ years). We included indicators of the following sources of unrecorded alcohol consumption: travellers' import, smuggled alcohol, home production, internet and illicit home-distilling. We estimated adjusted SES-specific means of the various forms of unrecorded consumption. The means were adjusted for the effects of age, sex and region.

Results: There were no significant educational differences in the total of unrecorded alcohol consumption; the same holds true for home-production and internet. However, with respect to smuggled and home-distilling, a statistically significant educational gradient was observed with the lowest educational group scoring approximately four times higher than the highest.

Discussion and Conclusions: Our findings suggest that there are no differences across educational groups in the consumption of unrecorded alcohol as a whole. However, consumption of smuggled alcohol and illicitly distilled spirits is elevated in the low educational group.

Keywords
unrecorded alcohol, Sweden, education, socio-economic status
National Category
Sociology
Identifiers
urn:nbn:se:su:diva-193676 (URN)10.1111/dar.13304 (DOI)
Funder
Swedish Research Council, 2017-01769Forte, Swedish Research Council for Health, Working Life and Welfare, 2017-01769
Available from: 2021-06-04 Created: 2021-06-04 Last updated: 2022-02-25Bibliographically approved
Dadgar, I. & Norström, T. (2022). Is there a link between all-cause mortality and economic fluctuations?. Scandinavian Journal of Public Health, 50(1), 6-15
Open this publication in new window or tab >>Is there a link between all-cause mortality and economic fluctuations?
2022 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 50, no 1, p. 6-15Article in journal (Refereed) Published
Abstract [en]

Background: All-cause mortality is a global indicator of the overall health of the population, and its relation to the macro economy is thus of vital interest. The main aim was to estimate the short-term and the long-term impact of macroeconomic change on all-cause mortality. Variations in the unemployment rate were used as indicator of temporary fluctuations in the economy. Methods: We used time-series data for 21 OECD countries spanning the period 1960–2018. We used four outcomes: total mortality (0+), infant mortality (<1), mortality in the age-group 20–64, and old-age mortality (65+). Data on GDP/capita were obtained from the Maddison Project. Unemployment data (% unemployed in the work force) were sourced from Eurostat. We applied error correction modelling to estimate the short-term and the long-term impact of macroeconomic change on all-cause mortality. Results: We found that increases in unemployment were statistically significantly associated with decreases in all mortality outcomes except old-age mortality. Increases in GDP were associated with significant lowering long-term effects on mortality. Conclusions: Our findings, based on data from predominantly affluent countries, suggest that an increase in unemployment leads to a decrease in all-cause mortality. However, economic growth, as indicated by increased GDP, has a long-term protective health impact as indexed by lowered mortality.

Keywords
all-cause mortality, GDP, unemployment, Great Recession, error correction model
National Category
Sociology
Identifiers
urn:nbn:se:su:diva-198159 (URN)10.1177/14034948211049979 (DOI)000710264800001 ()
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2013-0376Swedish Research Council, 421-2012-5503
Available from: 2021-10-29 Created: 2021-10-29 Last updated: 2022-04-05Bibliographically approved
Landberg, J., Trolldal, B. & Norström, T. (2021). Is the theory of collectivity of drinking cultures valid across educational groups?. Drug and Alcohol Review, 40(3), 472-480
Open this publication in new window or tab >>Is the theory of collectivity of drinking cultures valid across educational groups?
2021 (English)In: Drug and Alcohol Review, ISSN 0959-5236, E-ISSN 1465-3362, Vol. 40, no 3, p. 472-480Article in journal (Refereed) Published
Abstract [en]

Introduction 

To explore whether Skog's theory of collectivity of drinking cultures is valid across groups with different socioeconomic position (SEP).

Methods

Individual‐level information on alcohol consumption and SEP for the years 2004–2014 were retrieved from the Monitoring Project; a nationally representative monthly alcohol use survey. The analytical sample consisted of 162 369 respondents aged 25–79 years. SEP was measured by education level. Alcohol use was measured by yearly volume of consumption and frequency of heavy episodic drinking (HED). Respondents were divided into six SEP‐groups based on their education level and sex. Mean yearly volume consumption and prevalence of monthly HED was calculated for each group and graphically plotted against the overall mean volume of consumption.

Results

The yearly changes in overall mean consumption during the study period reflected a collective shift in drinking across groups with basic, intermediate and high education. There were also indications that changes in overall mean consumption reflected collective shifts in the prevalence of HED across the SEP‐groups. Moreover, while the magnitude of the associations for both average volume and HED differed somewhat in strength across the SEP‐groups, they were clearly in the same, positive, direction.

Discussion and Conclusions

Our findings add support for including a socioeconomic dimension to Skog's theory of collectivity of drinking cultures. Future studies should replicate our analyses on cases and periods with more tangible changes in the price and availability of alcohol.

Keywords
average volume of alcohol consumption, heavy episodic drinking, socioeconomic position, collectivity, Sweden
National Category
Sociology
Identifiers
urn:nbn:se:su:diva-188766 (URN)10.1111/dar.13232 (DOI)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2021-01-12 Created: 2021-01-12 Last updated: 2022-02-25Bibliographically approved
Nilsson, T., Norström, T., Andréasson, S., Guldbrandsson, K., Allebeck, P. & Leifman, H. (2020). Effects of local alcohol prevention initiatives in Swedish municipalities, 2006–2014. Substance Use & Misuse, 55(6), 1008-1020
Open this publication in new window or tab >>Effects of local alcohol prevention initiatives in Swedish municipalities, 2006–2014
Show others...
2020 (English)In: Substance Use & Misuse, ISSN 1082-6084, E-ISSN 1532-2491, Vol. 55, no 6, p. 1008-1020Article in journal (Refereed) Published
Abstract [en]

Background: Several components of the Swedish alcohol policy, e.g., pricing and availability, weakened when Sweden joined the EU in 1995. To counteract the possible negative effects of this, emphasis was placed on the local level as an important arena of alcohol prevention. Thus, considerable efforts were made to strengthen alcohol prevention in Swedish municipalities. Objectives: The aim of this study was to examine whether local alcohol prevention reduced consumption and alcohol-related harm in Swedish municipalities. Methods: Alcohol prevention was monitored using a composite measure called the Alcohol Prevention Magnitude Measure (APMM), with subcategories of staff and budget, inspections and licenses, policy, activities, and cooperation. APMM and its categories were analysed in relation to alcohol consumption and harm over time, 2006–2014. A fixed effects model was used with 63% (N¼182, consumption) and 71% (N¼207, harm) of 290 Swedish municipalities, respectively, included in the analyses. Results: The main results suggest that when APMM increases with 1 percent, the alcohol-related mortality decreases with 0.26 percent, controlled for changes in population size, median income, unemployment, and post-secondary education. In light of this result, the estimated effect of APMM on alcohol consumption (sales) is small (0.02 percent decrease); possible explanations for this are discussed in the article. Conclusion:The overall results indicate that local alcohol prevention initiatives in Sweden have reduced some forms of alcohol-related harm, not least alcohol-related mortality, during the period 2006–2014. Further studies are needed to assess the generalizability of the present study.

Keywords
Alcohol, composite, measure, index, prevention, policy, municipality
National Category
Sociology (excluding Social Work, Social Psychology and Social Anthropology)
Identifiers
urn:nbn:se:su:diva-179070 (URN)10.1080/10826084.2020.1720246 (DOI)000513081200001 ()
Available from: 2020-02-17 Created: 2020-02-17 Last updated: 2022-02-26Bibliographically approved
Dadgar, I. & Norström, T. (2020). Is there a link between cardiovascular mortality and economic fluctuations?. Scandinavian Journal of Public Health, 48(7), 770-780
Open this publication in new window or tab >>Is there a link between cardiovascular mortality and economic fluctuations?
2020 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 48, no 7, p. 770-780Article in journal (Refereed) Published
Abstract [en]

Background: Unemployment might affect several risk factors of cardiovascular disease (CVD), which is the leading cause of death globally. The characterisation of the relation between these two phenomena is thus of great significance from a public-health perspective. The main aim of this study was to estimate the association between the unemployment rate and mortality from CVD and from coronary heart disease (CHD). Additional aims were (a) to assess whether the associations are modified by the degree of unemployment protection; (b) to determine the impact of GDP on heart-disease mortality; and (c) to assess the impact of the Great Recession in this context. Methods: We used time-series data for 32 countries spanning the period 1960–2015. We applied two alternative modelling strategies: (a) error correction modelling, provided that the data were co-integrated; and (b) first-difference modelling in the absence of co-integration. Separate models were estimated for each of five welfare state regimes with different levels of unemployment protection. We also performed country-specific ARIMA-analyses. Results: Because the data did not prove to be co-integrated, we applied first-difference modelling. The estimated effect of unemployment and GDP on CVD as well as CHD was statistically insignificant across age and sex groups and across the various welfare state regimes. An interaction term capturing the possible excess effect of unemployment during the Great Recession was also statistically insignificant. Conclusions: Our findings, based on data from predominantly affluent countries, suggest that heart-disease mortality does not respond to economic fluctuations.

Keywords
Heart-disease mortality, unemployment, GDP, Great Recession, time series
National Category
Economics
Research subject
Economics
Identifiers
urn:nbn:se:su:diva-178430 (URN)10.1177/1403494819890699 (DOI)000507024000001 ()
Available from: 2020-01-28 Created: 2020-01-28 Last updated: 2022-03-25Bibliographically approved
Norström, T. & Ramstedt, M. (2020). The Link Between Alcohol Sales and Alcohol-Related Harm in Finland, 1995-2016. Journal of Studies on Alcohol and Drugs, 81(5), 641-646
Open this publication in new window or tab >>The Link Between Alcohol Sales and Alcohol-Related Harm in Finland, 1995-2016
2020 (English)In: Journal of Studies on Alcohol and Drugs, ISSN 1937-1888, E-ISSN 1938-4114, Vol. 81, no 5, p. 641-646Article in journal (Refereed) Published
Abstract [sv]

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.

National Category
Sociology
Identifiers
urn:nbn:se:su:diva-185950 (URN)10.15288/jsad.2020.81.641 (DOI)000600600000015 ()
Available from: 2020-10-19 Created: 2020-10-19 Last updated: 2022-02-25Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-5746-7723

Search in DiVA

Show all publications