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  • 1. Ahacic, Kozma
    et al.
    Kennison, Robert F.
    Kåreholt, Ingemar
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Changes in sobriety in the Swedish population over three decades: age, period or cohort effects?2012In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 107, no 4, p. 748-755Article in journal (Refereed)
    Abstract [en]

    Aims  This study aimed to examine age, cohort and period trends in alcohol abstinence.

    Design  Two surveys, the Level of Living Survey collected in 1968, 1974, 1981, 1990 and 2000, and the Swedish Panel Study of the Oldest Old (SWEOLD) collected in 1992 and 2002, were studied with graphical depictions of cross-sectional and longitudinal data presented over time and over age. Cross-sectional 10-year age group differences, time-lag differences between waves and within-cohort differences between waves for 10-year birth cohorts were examined. Logistic regression models were applied to confirm the observed patterns.

    Setting  The samples were representative of the Swedish population.

    Participants  Participants ranged in age from 18 to 75 (n = 5000 per wave), and 77+ at later waves (n = 500).

    Measurements  Alcohol abstinence was determined by asking ‘Do you ever drink wine, beer, or spirits?’, where a ‘no’ response indicated abstinence.

    Findings  Decreases in abstinence rates were observed from 1968 to 2000/02. While cross-sectional analysis indicated increased abstinence with advancing age, the longitudinal analysis suggested otherwise. Inspection of cohort differences revealed little change within cohorts and large differences between cohorts; abstinence rates declined in later-born cohorts up to the 1940s birth cohorts; stability was observed in cohorts born since the 1940s. Logistic regression models indicated that neither age nor period were significant (P > 0.05) predictors of abstinence when cohort (P < 0.001) was included.

    Conclusion  Decreasing proportions of total alcohol abstainers in Sweden from 1968 to 2000 appear to be attributable primarily to decreases in successive cohorts rather than drinkers becoming abstainers.

  • 2.
    Almquist, Ylva B.
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Östberg, Viveca
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Social relationships and subsequent health-related behaviours: linkages between adolescent peer status and levels of adult smoking in a Stockholm cohort2012In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 108, no 3, p. 629-637Article in journal (Refereed)
    Abstract [en]

    Aims: Peer status reflects the extent to which an individual is accepted by the group. Some studies have reported that low peer status in adolescence is associated with a higher risk of smoking, while others found the reverse. No studies have investigated peer status influences on adult smoking. The aim of the study was therefore to examine the relationship between adolescents' peer status and the intensity of smoking in adulthood.

    Design: Prospective cohort study.

    Setting: Stockholm, Sweden.

    Participants: A subsample (n = 2329) of the cohort with information about adult smoking.

    Measurements: Peer status was assessed sociometrically at age 13 and information on smoking was gathered through a questionnaire at age 32. Relative risks (RR) for self-reported level of smoking were calculated using multinomial logistic regression. Several family-related and individual variables were included as control variables.

    Findings: Lower peer status in adolescence was associated with smoking of any intensity in adulthood. For example, the risk of heavy smoking was more than threefold (RR = 3.67) among individuals in the lowest status positions. The association with occasional smoking was abolished by controlling for factors related to adolescents' attitude to school and cognitive ability. For regular and heavy smoking the relationship was attenuated by controlling for these factors.

    Conclusions: Low peer status in adolescence appears to be a risk factor for smoking in adulthood. Part of this association may be explained by adolescents' feelings towards school and cognitive ability. However, being unpopular in adolescence remains a strong risk factor for regular and heavy smoking in adulthood.

  • 3. Andersson, Filip
    et al.
    Sundin, Erica
    Magnusson, Cecilia
    Ramstedt, Mats
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences. Karolinska Institutet, Sweden; The Swedish Council for Information on Alcohol and Other Drugs, Sweden.
    Galanti, Maria Rosaria
    Prevalence of cannabis use among young adults in Sweden comparing randomized response technique with a traditional survey2023In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 118, no 9, p. 1801-1810Article in journal (Refereed)
    Abstract [en]

    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.

  • 4. Babor, T.
    et al.
    Caetano, R.
    Casswell, S.
    Edwards, G.
    Giesbrecht, N.
    Graham, K.
    Grube, J.
    Hill, L.
    Holder, H.
    Homel, R.
    Livingston, M.
    Rehm, J.
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Rossow, I.
    Österberg, E.
    Alcohol: No Ordinary Commodity – a summary of the second edition2010In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 105, no 5, p. 769-779Article in journal (Refereed)
    Abstract [en]

    This article summarizes the contents of Alcohol: No Ordinary Commodity (2nd edn). The first part of the book describes why alcohol is not an ordinary commodity, and reviews epidemiological data that establish alcohol as a major contributor to the global burden of disease, disability and death in high-, middle- and low-income countries. This section also documents how international beer and spirits production has been consolidated recently by a small number of global corporations that are expanding their operations in Eastern Europe, Asia, Africa and Latin America. In the second part of the book, the scientific evidence for strategies and interventions that can prevent or minimize alcohol-related harm is reviewed critically in seven key areas: pricing and taxation, regulating the physical availability of alcohol, modifying the drinking context, drink-driving countermeasures, restrictions on marketing, education and persuasion strategies, and treatment and early intervention services. Finally, the book addresses the policy-making process at the local, national and international levels and provides ratings of the effectiveness of strategies and interventions from a public health perspective. Overall, the strongest, most cost-effective strategies include taxation that increases prices, restrictions on the physical availability of alcohol, drink-driving countermeasures, brief interventions with at risk drinkers and treatment of drinkers with alcohol dependence.

  • 5. Babor, Thomas F.
    et al.
    Casswell, Sally
    Graham, Kathryn
    Huckle, Taisia
    Livingston, Michael
    Rehm, Jürgen
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). La Trobe University, Australia.
    Rossow, Ingeborg
    Sornpaisarn, Bundit
    Alcohol: No Ordinary Commodity - a summary of the third edition2022In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 117, no 12, p. 3024-3036Article in journal (Refereed)
    Abstract [en]

    Background and Aims: This article summarizes the findings and conclusions of the third edition of Alcohol: No Ordinary Commodity. The latest revision of this book is part of a series of monographs designed to provide a critical review of the scientific evidence related to alcohol control policy from a public health perspective.

    Design: A narrative summary of the contents of the book according to five major issues.

    Findings: An extensive amount of epidemiological evidence shows that alcohol is a major contributor to the global burden of disease, disability and death in high-, middle- and low-income countries. Trends in alcohol products and marketing are described, indicating that a large part of the global industry has been consolidated into a small number of transnational corporations that are expanding their operations in Asia, Africa and Latin America. The main part of the book is devoted to a review of strategies and interventions designed to prevent or minimize alcohol-related harm. Overall, the most effective strategies to protect public health are taxation that decreases affordability and restrictions on the physical availability of alcohol. A total ban on alcohol marketing is also an effective strategy to reduce consumption. In addition, drink-driving counter-measures, brief interventions with at-risk drinkers and treatment of drinkers with alcohol dependence are effective in preventing harm in high-risk contexts and groups of hazardous drinkers.

    Conclusion: Alcohol policy is often the product of competing interests, values and ideologies, with the evidence suggesting that the conflicting interests between profit and health mean that working in partnership with the alcohol industry is likely to lead to ineffective policy. Opportunities for implementation of evidence-based alcohol policies that better serve the public good are clearer than ever before as a result of accumulating knowledge on which strategies work best.

  • 6. Babor, Thomas F.
    et al.
    Caulkins, Jonathan
    Fischer, Benedikt
    Foxcroft, David
    Medina-Mora, María Elena
    Obot, Isidore
    Rehm, Jürgen
    Reuter, Peter
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). La Trobe University, Australia.
    Rossow, Ingeborg
    Strang, John
    Drug Policy and the Public Good: a summary of the second edition2019In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 114, no 11, p. 1941-1950Article in journal (Refereed)
    Abstract [en]

    The second edition of Drug Policy and the Public Good presents up-to-date evidence relating to the development of drug policy at local, national and international levels. The book explores both illicit drug use and non-medical use of prescription medications from a public health perspective. The core of the book is a critical review of the scientific evidence in five areas of drug policy: (1) primary prevention programs in schools and other settings; (2) treatment interventions and harm reduction approaches; (3) attempts to control the supply of illicit drugs, including drug interdiction and law enforcement; (4) penal approaches, decriminalization and other alternatives; and (5) control of the legal market through prescription drug regimens. It also discusses the trend towards legalization of some psychoactive substances in some countries and the need for a new approach to drug policy that is evidence-based, realistic and coordinated. The accumulated evidence provides important information about effective and ineffective policies. Shifting the emphasis towards a public health approach should reduce the extent of illicit drug use, prevent the escalation of new epidemics and avoid the unintended consequences arising from the marginalization of drug users through severe criminal penalties.

  • 7. Babor, Thomas F.
    et al.
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Strang, John
    Drug Policy and the Public Good: a summary of the book2010In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 105, no 7, p. 1137-1145Article in journal (Refereed)
    Abstract [en]

    Drug Policy and the Public Good was written by an international group of scientists from the fields of addiction, public health, criminology and policy studies to improve the linkages between drug research and drug policy. The book provides a conceptual basis for evidence-informed drug policy and describes epidemiological data on the global dimensions of drug misuse. The core of the book is a critical review of the cumulative scientific evidence in five general areas of drug policy: primary prevention programmes in schools and other settings; health and social services for drug users; attempts to control the supply of drugs, including the international treaty system; law enforcement and ventures into decriminalization; and control of the psychotropic substance market through prescription drug regimes. The final chapters discuss the current state of drug policies in different parts of the world and describe the need for future approaches to drug policy that are coordinated and informed by evidence.

  • 8.
    Berg, Lisa
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Bäck, Karin
    Vinnerljung, Bo
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet, Sweden.
    Parental alcohol-related disorders and school performance in 16 year olds - a national cohort study2016In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 111, no 10, p. 1795-1803Article in journal (Refereed)
    Abstract [en]

    To study the links between parental alcohol-related disorders and offspring school performance and, specifically, whether associations vary by gender of parent or child and whether associations are mediated by other adverse psychosocial circumstances commonly appearing together with parental alcohol problems, such as parental mental health problems or criminal behaviour.

    Register study in a national cohort.

    Setting

    Sweden.

    740 618 individuals born in Sweden in 1990-1996.

    Parental hospital admissions for alcohol-related disorders and school performance in their offspring, in the final year of compulsory school at age 15-16, was analysed in relation to sociodemographic confounders and psychosocial covariates, using linear and logistic regressions.

    Both mothers’ and fathers’ alcohol-related hospital admissions were associated with lower z-scores of grades and national mathematic tests scores. After adjustment for parental education and sociodemographic confounders, beta-coefficients of z-scores of grades were -0.42 (95% CI -0.45, -0.39) and -0.42 (95 % CI -0.43,-0.40), and beta-coefficients of mathematic tests scores were -0.36 (95% CI -0.39, -0.33) and -0.31 (95% CI -0.33, -0.29), for mothers’ and fathers’ alcohol-related disorders, respectively. Adjusted ORs for not being eligible for secondary school were 1.99 (95% CI 1.84-2.15) and 2.04 (95% CI 1.95-2.15) for mothers’ and fathers’ alcohol-related disorders, respectively. Adjusting the analyses for psychosocial factors in the family almost eradicated the statistical effects of parental alcohol-related disorders on offspring school performance to beta-coefficients of 0.03 to -0.10 and ORs of 0.89 to 1.15. The effect of a mother's alcohol-related hospital admission on school performance was stronger in girls than in boys, whereas no gender differences were seen for a father's alcohol-related hospital admission.

    Conclusions

    In Sweden, alcohol-related disorders in both mothers and fathers are associated with lower school performance in their children at age 15-16, with most of the statistical effects being attributed to psychosocial circumstances of the family, such as parental psychiatric disorders, drug use, and criminality and receipt of social or child welfare interventions.

  • 9.
    Bergmark, Anders
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Drug misuse - psychosocial interventions2009In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, ISSN 0965-2140, Vol. 104, no 4, p. 676-677Article in journal (Refereed)
  • 10.
    Bergmark, Anders
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Mindfulness training: specific intervention or psychological panacea?2010In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 105, no 10, p. 1708-1709Article in journal (Refereed)
  • 11.
    Bergmark, Anders
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    The role of psychopathology as motivator for drug dependency—some moderating remarks2013In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 108, no 4, p. 673-674Article in journal (Other academic)
  • 12. Billieux, Joël
    et al.
    van Rooij, Antonius J.
    Heeren, Alexandre
    Schimmenti, Adriano
    Maurage, Pierre
    Edman, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Blaszczynski, Alexander
    Khazaal, Yasser
    Kardefelt‐Winther, Daniel
    Behavioural Addiction Open Definition 2.0—using the Open Science Framework for collaborative and transparent theoretical development2017In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 112, no 10, p. 1723-1724Article in journal (Other academic)
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  • 13.
    Bishop, Lauren
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences.
    B. Almquist, Ylva
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences.
    Friends' childhood adversity and long-term implications for substance misuse: A prospective Swedish cohort study2021In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 116, no 3, p. 632-640Article in journal (Refereed)
    Abstract [en]

    Background and aims Although an individual's childhood adversity is predictive of later substance misuse, the effect of adversity within an individual's friendship network has not been established. The current study aims to estimate the strength of the association between exposure to childhood adversity among individuals' friends at the onset of adolescence, relative to individuals' own exposure to childhood adversity, and hospitalization for substance misuse between young adulthood and retirement. Design Prospective cohort study. Setting Stockholm, Sweden. Participants Individuals born in 1953, living in Stockholm in 1963, and who nominated three best friends in the 6th grade school class (n = 7180; females = 3709, males = 3471), followed to 2016. Measurements The outcome was hospitalization with a main or secondary diagnosis attributed to substance misuse, reflected in Swedish inpatient records (ages 19-63 years). Five indicators of childhood adversity (ages 0-12 years) were operationalized into composite measures for individuals and their friends, respectively. Friendships were identified using sociometric data collected in the school class setting (age 13 years). Findings Individuals' own childhood adversity does not predict childhood adversity among friends (P > 0.05). Childhood adversity among friends is independently associated with an increased risk of an individual's later substance misuse [hazard ratio (HR) = 1.17, 95% confidence interval (CI) = 1.09-1.24], independently of an individual's own childhood adversity (HR = 1.47, 95% CI = 1.34-1.61). However, childhood adversity among friends does not moderate the association between individuals' own childhood adversity and later substance misuse. Conclusions Within a birth cohort of individuals born in 1950s Stockholm, Sweden, childhood adversity among an individual's friends appears to predict the individual's substance misuse in later life independently of an individual's own exposure to childhood adversity.

  • 14.
    Blomqvist, Jan
    Research and Development Unit (FoU) Social Services Administration, Stockholm, Sweden.
    Striking the balance between science and common sense2002In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 91, no 2, p. 136-137Article in journal (Refereed)
  • 15. Callinan, Sarah
    et al.
    Livingston, Michael
    Dietze, Paul
    Gmel, Gerhard
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). La Trobe University, Australia.
    Age-based differences in quantity and frequency of consumption when screening for harmful alcohol use2022In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 117, no 9, p. 2431-2437Article in journal (Refereed)
    Abstract [en]

    Background and aims: Survey questions on usual quantity and frequency of alcohol consumption are regularly used in screening tools to identify drinkers requiring intervention. The aim of this study was to measure age-based differences in quantity and frequency of alcohol consumption on the Alcohol Use Disorders Identification Test (AUDIT) and how this relates to the prediction of harmful or dependent drinking.

    Design: Cross-sectional survey.

    Setting: Australia.

    Participants: Data were taken from 17 399 respondents who reported any alcohol consumption in the last year and were aged 18 and over from the 2016 National Drug Strategy Household Survey, a broadly representative cross-sectional survey on substance use.

    Measurement: Respondents were asked about their frequency of consumption, usual quantity per occasion and the other items of the AUDIT.

    Findings: In older drinkers, quantity per occasion [β = 0.53, 95% confidence interval (CI) = 0.43, 0.64 in 43–47-year-olds as an example] was a stronger predictor of dependence than frequency per occasion (β = 0.24, 95% CI = 0.17, 0.31). In younger drinkers the reverse was true, with frequency a stronger predictor (β = 0.54, 95% CI = 0.39, 0.69 in 23–27-year-olds) than quantity (β = 0.26, 95% CI = 0.18, 0.34 in 23–27-year-olds). Frequency of consumption was not a significant predictor of dependence in respondents aged 73 years and over (β = −0.03, 95% CI = −0.08, 0.02). Similar patterns were found when predicting harmful drinking. Despite this, as frequency of consumption increased steadily with age, the question on frequency was responsible for at least 65% of AUDIT scores in drinkers aged 53 years and over.

    Conclusions: In younger drinkers, frequent drinking is more strongly linked to dependence and harmful drinking subscale scores on the Alcohol Use Disorders Identification Test (AUDIT) than quantity per occasion, yet quantity per occasion has a stronger influence on the overall AUDIT score in this group. In older drinkers, frequency of consumption is not always a significant predictor of the AUDIT dependence subscale and is a weak predictor of the harmful drinking subscale.

  • 16. Danielsson, Anna-Karin
    et al.
    Falkstedt, Daniel
    Hemmingsson, Tomas
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). Karolinska Institutet, Sweden.
    Allebeck, Peter
    Agardh, Emilie
    Cannabis use among Swedish men in adolescence and the risk of adverse life course outcomes: results from a 20 year-follow-up study2015In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 110, no 11, p. 1794-1802Article in journal (Refereed)
    Abstract [en]

    AimsTo examine associations between cannabis use in adolescence (at age 18) and unemployment and social welfare assistance in adulthood (at age 40) among Swedish men. DesignLongitudinal cohort study. Setting and ParticipantsA total of 49321 Swedish men born in 1949-51, who were conscripted to compulsory military service at 18-20 years of age. MeasurementsAll men answered two detailed questionnaires at conscription and were subject to examinations of physical aptitude psychological functioning and medical status. By follow-up in national databases, information on unemployment and social welfare assistance was obtained. FindingsIndividuals who used cannabis at high levels in adolescence had increased risk of future unemployment and of receiving social welfare assistance. Adjusted for all confounders (social background, psychological functioning, health behaviours, educational level, psychiatric diagnoses), an increased relative risk (RR) of unemployment remained in the group reporting cannabis use >50 times [RR=1.26, 95% confidence interval (CI)=1.04-1.53] only. For social welfare assistance, RR in the group reporting cannabis use 1-10 times was 1.15 (95% CI=1.06-1.26), RR for 11-50 times was 1.21 (95% CI=1.04-1.42) and RR for >50 times was 1.38 (95% CI=1.19-1.62). ConclusionsHeavy cannabis use among Swedish men in late adolescence appears to be associated with unemployment and being in need of social welfare assistance in adulthood. These associations are not explained fully by other health-related, social or behavioural problems.

  • 17. Danielsson, Anna-Karin
    et al.
    Wennberg, Peter
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). Karolinska institutet, Sweden; Stockholm County Council, Sweden.
    Hibell, Björn
    Romelsjö, Anders
    Alcohol use, heavy episodic drinking and subsequent problems among adolescents in 23 European countries: does the prevention paradox apply?2012In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 107, no 1, p. 71-80Article in journal (Refereed)
    Abstract [en]

    Aims  According to the prevention paradox, a majority of alcohol-related problems in a population can be attributed to low to moderate drinkers simply because they are more numerous than heavy drinkers, who have a higher individual risk of adverse outcomes. We examined the prevention paradox in annual alcohol consumption, heavy episodic drinking (HED) and alcohol-related problems among adolescents in 23 European countries.

    Design and setting  Survey data from the 2007 European School Survey Project on Alcohol and Drugs (ESPAD) among 16-year-old students were analysed.

    Participants  A total of 38 370 alcohol-consuming adolescents (19 936 boys and 18 434 girls) from 23 European countries were included.

    Measurements  The upper 10% and the bottom 90% of drinkers by annual alcohol intake, with or without HED, and frequency of HED, were compared for the distribution of 10 different alcohol-related problems.

    Findings  Although the mean levels of consumption and alcohol-related problems varied largely between genders and countries, in almost all countries the heavy episodic drinkers in the bottom 90% of consumers by volume accounted for most alcohol-related problems, irrespective of severity of problem. However, adolescents with three or more occasions of HED a month accounted for a majority of problems.

    Conclusions  The prevention paradox, based on measures of annual consumption and heavy episodic drinking, seems valid for adolescent European boys and girls. However, a minority with frequent heavy episodic drinking accounted for a large proportion of all problems, illustrating limitations of the concept. As heavy episodic drinking is common among adolescents, our results support general prevention initiatives combined with targeted interventions.

  • 18. Demers, A.
    et al.
    Gerretsen, H.
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Rossow, I.
    Ugland, T.
    The Kettil Bruun Society for Social and Epidemiological Research on Alcohol2004In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 99, no 2, p. 161-164Article in journal (Refereed)
    Abstract [en]

    The Kettil Bruun Society for Social and Epidemiological Research on Alcohol (KBS) was established in 1987 and is an independent organization open to all scientists working on problems related to social and epidemiological research on alcohol. The aim of the Society is to promote social and epidemiological research which fosters a comparative understanding of the social aspects of alcohol use and alcohol problems. In line with this the Society also aims at promoting a spirit of international collaboration. The Kettil Bruun Society is based on individual membership and, by 2003, has 197 fully paid-up members, representing 34 different countries over five continents. The main activities include an annual meeting as well as thematic meetings. In these meetings, discussions are emphasized by having precirculated papers and assigned discussants. The KBS also serves as a basis for organizing international collaborative projects. Project meetings or work-shops are often organized around the annual meetings, and the projects tend to run over several years. The Society's primary influence is through the mutual influence of its members on each others' thinking, the work of the projects that KBS sponsors and the influence its members have collectively on the development of the field.

  • 19. Dietze, Paul
    et al.
    Agius, Paul A.
    Livingston, Michael
    Callinan, Sarah
    Jenkinson, Rebecca
    Lim, Megan S. C.
    Wright, Cassandra J. C.
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). La Trobe University, Australia.
    Correlates of alcohol consumption on heavy drinking occasions of young risky drinkers: event versus personal characteristics2017In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 112, no 8, p. 1369-1377Article in journal (Refereed)
    Abstract [en]

    Aims Risky single-occasion drinking (RSOD) by young people is a serious public health issue, yet little is known about the specific circumstances of risky drinking occasions. This study examined the independent effects of event- and individual-specific variables on RSOD. Design Longitudinal cohort study measuring self-reported RSOD and event- and individual-specific variables across two drinking occasions approximately 1 year apart. Setting Metropolitan Melbourne, Australia. Participants A sample of 710 young risky drinkers aged between 18 and 25years and defined as engaging in risky drinking practices (males: consumed alcohol in excess of 10 Australian Standard Drinks (ASD: 10g ethanol) in a single occasion in the previous year; females: consumed alcohol in excess of seven ASD for females in a single occasion in the previous year). Measurements Random digit-dial telephone landline survey of the most recent heavy drinking occasion and socio-demographic variables. The primary outcome was the log of the total drinks consumed in the most recent heavy drinking occasion. Event-specific (e.g. number of drinking locations) and time-varying (e.g. weekly income) and time-invariant (e.g. sex) individual-specific variables were examined as correlates of total drinks consumed. Findings Changes in event-specific characteristics including the length of the drinking occasion (Likelihood Ratio (2)(2)=24.4, P<0.001), the number of drinking locations (Wald (2)((1))=7.6, P=0.006) and the number of different drink types (Wald (2)((1))=13.6, P<0.001) were associated with increases in total drinks consumed, after adjustment for time-invariant and time-variant individual-specific variables such as gender, income level and weekly consumption. Few other effects were noted. Conclusions Event-specific characteristics are important predictors of the number of drinks consumed during risky single occasion drinking (RSOD) and illustrate the importance of event contexts when considering interventions targeting RSOD. The total number of drinks consumed in a RSOD session appears to rise independently with the duration of the drinking event, the number of drinking locations and the number of different types of beverage consumed.

  • 20.
    Enefalk, Hanna
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Swedish alcohol consumption on the threshold of modernity: Legislation, attitudes, and national economy ca 1775-18552013In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 108, no 2, p. 265-274Article in journal (Refereed)
    Abstract [en]

    Aims: We aimed to map the context of the large increase in vodka consumption in Sweden during the transition from early modern to modern times (ca 1775-1855). What were the attitudes to alcohol among the groups that dominated society, and how did these attitudes relate to contemporary legislation and socio-economic change?

    Methods: Qualitative analysis of diaries and memoirs. Information was also collected from legislation, writings of the temperance movement, and previous research.

    Findings: During the period studied, attitudes to alcohol among the socio-economic elite were positive if the drinker was a person of standing, wereas drinking among the working population was scorned and, from the 1830s on, a cause for concern. Legislation was characterized by frequent and radical changes. Consumption levels are difficult to estimate: in the 1820s, agricultural overproduction, liberal legislation and improved distilling methods probably resulted in a major consumption increase. In 1846-53, permissive licensing laws and the industrialization of distilling similarly led to very high consumption levels.

    Conclusions: In Sweden in the late 18th and early 19th centuries the social elite appears to have used alcohol as a tool in their negotiations with the working population; but later, as the spread of wage labour and cheap vodka coincided with Sweden's largest ever population growth, the view that popular drinking must be checked gained support in leading circles.

  • 21.
    Gauffin, Karl
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet, Sweden.
    Vinnerljung, Bo
    Stockholm University, Faculty of Social Sciences, Department of Social Work. National Board of Health and Welfare, Sweden.
    Fridell, Mats
    Hesse, Morten
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet, Sweden.
    Childhood socio-economic status, school failure and drug abuse: a Swedish national cohort study2013In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 108, no 8, p. 1441-1449Article in journal (Refereed)
    Abstract [en]

    Aim To investigate whether socio-economic status (SES) in childhood and school failure at 15 years of age predict illicit drug abuse in youth and young adulthood. Design setting and participantsRegister study in a Swedish national cohort born 1973-88 (n=1405763), followed from age 16 to 20-35 years. Cox regression analyses were used to calculate hazard ratios (HR) for any indication of drug abuse. Measurements Our outcomes were hospital admissions, death and criminality associated with illicit drug abuse. Data on socio-demographics, school grades and parental psychosocial problems were collected from censuses (1985 and 1990) and national registers. School failure was defined as having mean school grades from the final year in primary school lower than -1standard deviation and/or no grades in core subjects. Findings School failure was a strong predictor of illicit drug abuse with an HR of 5.87 (95% CI: 5.76-5.99) after adjustment for age and sex. Childhood SES was associated with illicit drug abuse later in life in a stepwise manner. The lowest stratum had a HR of 2.28 (95% CI: 2.20-2.37) compared with the highest stratum as the reference, when adjusted for other socio-demographic variables. In the fully adjusted model, the effect of SES was greatly attenuated to an HR of 1.23 (95% CI: 1.19-1.28) in the lowest SES category, while the effect of school failure remained high with an HR of 4.22 (95% CI: 4.13-4.31). Conclusions School failure and childhood socio-economic status predict illicit drug abuse independently in youth and young adults in Sweden.

  • 22. Hall, W.
    et al.
    Fischer, B.
    Lenton, S.
    Reuter, P.
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Making space for cannabis policy experiments2011In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 106, no 6, p. 1192-1193Article in journal (Refereed)
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  • 23.
    Honkaniemi, Helena
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS).
    Juárez, Sol Pia
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS).
    Alcohol-related morbidity and mortality by fathers' parental leave: A quasi-experimental study in Sweden2024In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 119, no 2, p. 301-310Article in journal (Refereed)
    Abstract [en]

    Background and Aims: Fathers' parental leave has been associated with decreased risks of alcohol-related hospitalizations and mortality. Whether this is attributable to the health protections of parental leave itself (through stress reduction or behavioral changes) or to selection into leave uptake remains unclear, given that fathers are more likely to use leave if they are in better health. Using the quasi-experimental variation of a reform incentivizing fathers' leave uptake (the 1995 Father's quota reform), this study aimed to assess whether fathers' parental leave influences alcohol-related morbidity and mortality.

    Design: Quasi-experimental interrupted time series and instrumental variable analyses.

    Setting: Sweden.

    Participants: Fathers of singleton children born from January 1992 to December 1997 (n = 220 412).

    Measurements: Exposure was indicated by the child's birthdate before or after the reform and used to instrument fathers' 2- and 8-year parental leave uptake. Outcomes included fathers' hospitalization rates for acute alcohol-related (intoxication; mental and behavioral disorders) and chronic alcohol-related diagnoses (cardiovascular, stomach and other diseases; liver diseases), as well as alcohol-related mortality, up to 2, 8 and 18 years after the first child's birthdate.

    Findings: In interrupted time series analyses, fathers of children born after the reform exhibited immediate decreases in alcohol-related hospitalization rates up to 2 (incidence rate ratio [IRR] = 0.66, 95% confidence interval [CI] = 0.51–0.87), 8 (IRR = 0.74, 95% CI = 0.57–0.96) and 18 years after birth (IRR = 0.72, 95% CI = 0.54–0.96), particularly in acute alcohol-related hospitalization rates, compared with those with children born before. No changes were found for alcohol-related mortality. Instrumental variable results suggest that alcohol-related hospitalization decreases were driven by fathers' parental leave uptake (e.g. 2-year hospitalizations: IRR = 0.16, 95% CI = 0.03–0.84).

    Conclusions: In Sweden, a father's parental leave eligibility and uptake may protect against alcohol-related morbidity.

  • 24.
    Härkönen, Juho
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Sociology. European University Institute, Italy; University of Turku, Finland.
    Lindberg, Matti
    Karlsson, Linnea
    Karlsson, Hasse
    Scheinin, Noora M.
    Education is the strongest socio-economic predictor of smoking in pregnancy2018In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 113, no 6, p. 1117-1126Article in journal (Refereed)
    Abstract [en]

    Aims To investigate socio-economic disparities in smoking in pregnancy (SIP) by the mother's education, occupational class and current economic conditions. Design Cross-sectional analysis with linked survey and register data. Setting South-western Finland. Participants A total of 2667 pregnant women [70% of the original sample (n=3808)] from FinnBrain, a prospective pregnancy cohort study. Measurements The outcome was smoking during the first pregnancy trimester, measured from the Finnish Medical Birth Register. Education and occupational class were linked from population registers. Income support recipiency and subjective economic wellbeing were questionnaire-based measures of current economic conditions. These were adjusted for age, partnership status, residential area type, parental separation, parity, childhood socio-economic background, childhood adversities (the Trauma and Distressing Events During Childhood scale) and antenatal stress (Edinburgh Postnatal Depression Scale). Logistic regressions and attributable fractions (AF) were estimated. Findings Mother's education was the strongest socio-economic predictor of SIP. Compared with university education, adjusted odds ratios (aORs) of SIP were: 2.2 [95% confidence interval (CI)=1.2-3.9; P=0.011] for tertiary vocational education, 4.4 (95% CI=2.1-9.0; P<0.001) for combined general and vocational secondary education, 2.9 (95% CI=1.4-6.1; P=0.006) for general secondary education, 9.5 (95% CI 5.0-18.2; P<0.001) for vocational secondary education and 14.4 (95% CI=6.3-33.0; P<0.001) for compulsory schooling. The total AF of education was 0.5. Adjusted for the other variables, occupational class and subjective economic wellbeing did not predict SIP. Income support recipiency was associated positively with SIP (aOR=1.8; 95% CI=1.1-3.1; P=0.022). Antenatal stress predicted SIP (aOR=2.0; 95% CI=1.4-2.8; P<0.001), but did not attenuate its socio-economic disparities. Conclusions In Finland, socio-economic disparities in smoking in pregnancy are attributable primarily to differences in the mother's educational level (low versus high) and orientation (vocational versus general).

  • 25.
    Jernigan, David
    et al.
    Institute for the Prevention of Alcohol and Other Drug Problems, San Rafael CA, USA.
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    The ambiguous role of alcohol in economic and social development2000In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 95, no 12, Suppl. 4, p. 523-535Article in journal (Refereed)
    Abstract [en]

    An increased and industrialized alcohol supply in a developing society is usually assumed to have positive effects on economic development, although it may be recognized that the effects on public health and order will be negative. There has been little attention to the potential for negative effects on the economic side. This paper directs attention to such factors as unemployment for cottage producers (often female heads of household) and reduced industrial employment as highly-automated "turnkey" brewers are installed. On the other hand, changes in the mode of production of alcoholic beverages may have little impact on the much larger work-force involved in serving or selling alcohol in retail trade. The net contribution of an increased and industrialized alcohol supply in terms of economic development is unclear, but industrialization and development bring with them increased demands for attention and sobriety, e.g. in motorized traffic and on the production line, which increased drinking may undercut. Decisions by international development agencies on investment in alcohol production and distribution should take account of both the positive and negative impacts on economic development as well as on public health. In line with this, the World Bank has recently decided to invest in alcohol industry projects only when there is a strong positive development impact and the project is "consistent with public health issues and social policy concerns".

  • 26. Jiang, Heng
    et al.
    Livingston, Michael
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). La Trobe University, Australia.
    Callinan, Sarah
    Marzan, Melvin
    Brennan, Alan
    Doran, Christopher
    Modelling the effects of alcohol pricing policies on alcohol consumption in subpopulations in Australia2020In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 115, no 6, p. 1038-1049Article in journal (Refereed)
    Abstract [en]

    Aims: To model the effects of a range of alcohol pricing policies on alcohol consumption in subpopulation groups (e.g. alcohol consumption pattern, and age and income groups) in Australia.Design: We used estimated price elasticities to model the effects of proposed pricing policies on consumption for 11 beverage categories among subpopulation groups.Setting: Australia.Participants: A total of 1789 adults (16+ years) who reported they purchased and consumed alcohol in the 2013 Australian International Alcohol Control Study, an adult population survey.Measurements: Mean and percentage changes in alcohol consumption were estimated for each scenario across subgroups. The policy scenarios evaluated included: (1) increasing the excise rate 10% for all off‐premise beverages; (2) replacing the wine equalization tax with a volumetric excise rate equal to the current spirits tax rate; (3) applying a uniform excise tax rate to all beverages equal to the current sprits tax rate and a 10 or 20% increase in it; and(4) introducing a minimum unit price (MUP) on all beverages categories at $1.00, 1.30 or 1.50.Findings: The effects of different tax and MUP policies varied greatly across different subgroups. The effects of the MUP policy on alcohol consumption increased rapidly in the range from $1.00 to $1.50. Applying a uniform tax rate across all beverages equal to current spirits tax rate, or a 10 or 20% increase beyond that, could generate large reductions in overall alcohol consumption in Australia. Compared with the uniform tax rate with or without further tax increase, introducing a MUP at $1.30 or $1.50 could reduce consumption particularly among harmful drinkers and lower‐income drinkers, with comparatively smaller impacts on moderate and higher‐income drinkers.Conclusions: Both uniform excise tax and minimum unit price policies are predicted to reduce alcohol consumption in Australia. Minimum unit price policies are predicted to have a greater impact on drinking among harmful drinkers than moderate drinkers.

  • 27. Jiang, Heng
    et al.
    Xiang, Xiaojun
    Waleewong, Orratai
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). La Trobe University, Australia; University of Melbourne, Australia.
    Alcohol marketing and youth drinking in Asia2017In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 112, no 8, p. 1508-1509Article in journal (Other academic)
  • 28.
    Jonsson, Jakob
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Hodgins, David C.
    Munck, Ingrid
    Carlbring, Per
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Reaching out to big losers leads to sustained reductions in gambling over 1 year: a randomized controlled trial of brief motivational contact2020In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 115, no 8, p. 1522-1531Article in journal (Refereed)
    Abstract [en]

    Background and aims: A previous randomized controlled trial demonstrated that telephone‐ and letter‐based motivational interventions with high‐expenditure gamblers had significant short‐term positive effects on gambling and use of responsible gambling tools. This post‐trial follow‐up examined outcomes in gambling expenditure over 12 months.

    Design: Observational study following a three‐arm randomized controlled trial.

    Setting: Customers of Norsk Tipping (NT) gambling platforms, Norway.

    Participants: A total of 1003 statistical triplets from the top 0.5% of customers based upon annual expenditure, matched on sex, age and net losses. Mean age was 53.4 years; 19% were women, mean yearly loss for 2016 was 88 197 NoK.

    Interventions and comparator: Feedback intervention by telephone, letter or a no‐contact control condition.

    Measurements: Primary outcome measure was gambling theoretical loss, derived from the NT customer database. Secondary outcomes were responsible gambling customer actions and whether or not the participant was retained as an NT customer.

    Findings: Per‐protocol analyses of triplets who received the telephone call or letter as randomly assigned ( = 596) showed a positive and sustained effect over 12 months: the telephone group showed a 30% reduction in theoretical loss ( = 0.44) and the letter group 13% ( = 0.18), both outperforming the control group with a 7% reduction ( = 0.11). The telephone condition was superior to both the letter and control conditions in per‐protocol ( < 0.001) and to control condition in intention‐to‐treat analyses (ITT) ( < 0.001). Individuals in the telephone condition took more responsible gambling actions. The letter condition had better outcomes than the control in the ITT‐only analysis ( < 0.001). More than 93% were still customers a year after the intervention.

    Conclusions: Personal contact with high‐expenditure gambling customers in Norway that provided individualized feedback on expenditures was associated with reduced theoretical losses and greater use of responsible gambling tools over a 12‐month period, compared with no contact. Telephone intervention with customers had a larger impact than a mailed letter.

  • 29. Junna, Liina
    et al.
    Moustgaard, Heta
    Martikainen, Pekka
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences.
    Unemployment from stable, downsized and closed workplaces and alcohol-related mortality2021In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 116, no 1, p. 74-82Article in journal (Refereed)
    Abstract [en]

    Aims To assess the importance of health selection in the association between unemployment and alcohol-related mortality by comparing mortalities of those unemployed from workplaces experiencing different levels of downsizing. The more severe the downsizing, the less dependent unemployment would be on personal characteristics and the weaker the role of health selection. Design We estimated hazards models of unemployment on alcohol-related diseases and poisonings and external causes with alcohol as a contributing cause over follow-ups of 0-5, 6-10 and 11-20 years and at different levels of downsizing (stable, downsized or closed). Setting Finland, 1990 to 2009. Participants A register-based random sample of employees aged 25-63 in privately owned workplaces (n = 275 738). Measurements The outcome was alcohol-related death and the exposure was unemployment. We adjusted for age, sex, year, education, marital status, health status, workplace tenure, industry, region and unemployment rate. Findings Alcohol-disease mortality was elevated among the unemployed throughout the follow-up, regardless of the level of downsizing. At 11-20 years after baseline, those unemployed from stable workplaces had a 2.46 hazard ratio (HR) (95% confidence interval [CI] = 2.14-2.82), those from downsized workplaces 1.94 (95% CI = 1.64-2.30) and those from closed workplaces 2.13 (95% CI = 1.75-2.59), when compared with the controls. Alcohol-related external-cause mortality at 0-5 years follow-up was only associated with unemployment from stable workplaces (HR = 1.39, 95% CI = 1.22-1.58), but over time, an association emerged among those unemployed following downsizing and closure. At 11-20-year follow-up, the HR following downsizing was 1.83 (CI 95% = 1.37-2.45) and 1.54 (95% CI = 1.03-2.28) following closure. Conclusions There is some indication that alcohol-related ill-health may lead to unemployment in Finland. However, the persistent long-term association between unemployment and alcohol-related mortality even after workplace closure may imply a causal relation.

  • 30. Kardefelt-Winther, Daniel
    et al.
    Heeren, Alexandre
    Schimmenti, Adriano
    van Rooij, Antonius J.
    Maurage, Pierre
    Carras, Michelle
    Edman, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Blaszczynski, Alexander
    Khazaal, Yasser
    Billieux, Joel
    How can we conceptualize behavioural addiction without pathologizing common behaviours?2017In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 112, no 10, p. 1709-1715Article in journal (Refereed)
    Abstract [en]

    Following the recent changes to the diagnostic category for addictive disorders in DSM-5, it is urgent to clarify what constitutes behavioural addiction to have a clear direction for future research and classification. However, in the years following the release of DSM-5, an expanding body of research has increasingly classified engagement in a wide range of common behaviours and leisure activities as possible behavioural addiction. If this expansion does not end, both the relevance and the credibility of the field of addictive disorders might be questioned, which may prompt a dismissive appraisal of the new DSM-5 subcategory for behavioural addiction. We propose an operational definition of behavioural addiction together with a number of exclusion criteria, to avoid pathologizing common behaviours and provide a common ground for further research. The definition and its exclusion criteria are clarified and justified by illustrating how these address a number of theoretical and methodological shortcomings that result from existing conceptualizations. We invite other researchers to extend our definition under an Open Science Foundation framework.

  • 31.
    Karlsson, Patrik
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Bergmark, Anders
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Compared with what? An analysis of control group typies in Cochrane and Campbell reviews of psychosocial treatment efficacy with substance use disorders2015In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 110, no 3, p. 420-428Article in journal (Refereed)
    Abstract [en]

    Background and Aims

    A crucial, but under-appreciated, aspect in experimental research on psychosocial treatments of substance use disorders concerns what kinds of control groups are used. This paper examines how the distinction between different control group designs has been handled by the Cochrane and the Campbell Collaborations in their systematic reviews of psychosocial treatments of substance abuse disorders.

    Methods

    We assessed Cochrane and Campbell reviews (n = 8) that were devoted to psychosocial treatments of substance use disorders. We noted what control groups were considered and analysed the extent to which the reviews provided a rationale for chosen comparison conditions. We also analysed whether type of control group in the primary studies influenced how the reviews framed the effects discussed and whether this was related to conclusions drawn.

    Results

    The reviews covered studies involving widely different control conditions. Overall, little attention was paid to the use of different control groups (e.g. head-to-head comparisons vs. untreated controls) and what this implies when interpreting effect sizes. Seven of eight reviews did not provide a rationale for the choice of comparison conditions.

    Conclusions

    Cochrane- and Campbell reviews of the efficacy of psychosocial interventions with substance use disorders seem to underappreciate that use of different control group types yields different effect estimates. Most reviews have not distinguished between different control group designs and therefore have provided a confused picture regarding absolute and relative treatment efficacy. A systematic approach to treating different control group designs in research reviews is necessary for meaningful estimates of treatment efficacy.

  • 32. Kilian, Carolin
    et al.
    Manthey, Jakob
    Kraus, Ludwig
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). IFT Institut für Therapieforschung, Germany; ELTE Eötvös Loránd University, Hungary.
    Mäkelä, Pia
    Moskalewicz, Jacek
    Sieroslawski, Janusz
    Rehm, Jürgen
    A new perspective on European drinking cultures: a model-based approach to determine variations in drinking practices among 19 European countries2021In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 116, no 8, p. 2016-2025Article in journal (Refereed)
    Abstract [en]

    Background and aims In recent decades, alcohol drinking in the European Union has been characterized by increasing homogenization of levels of drinking coupled with an overall decrease. This study examined whether we can still distinguish distinct practices of drinking by addressing two research questions: (1) are drinking practices still characterized by the choice of a certain alcoholic beverage; and (2) how do drinking practices vary across countries?

    Design Cross-sectional study: latent-class analyses of drinking variables and fractional response regression analyses of individual characteristics for individual-level class endorsement probabilities, respectively.

    Setting Nineteen European countries and one autonomous community.

    Participants A total of 27 170 past-year drinkers aged 18-65 years in 2015.

    Measurements Data were collected through the Standardized European Alcohol Survey included frequency of past-year drinking, pure alcohol intake per drink day, occurrence of monthly risky single-occasion drinking and preferred beverage, together with socio-demographic data.

    Findings Three latent classes were identified: (1) light to moderate drinking without risky single-occasion drinking [prevalence: 68.0%, 95% confidence interval (CI) = 66.7-69.3], (2) infrequent heavy drinking (prevalence: 12.6%, 95% CI = 11.5-13.7) and (3) regular drinking with at least monthly risky single-occasion drinking (prevalence: 19.4%, 95% CI = 18.1-20.9). Drinking classes differed considerably in beverage preference, with women reporting a generally higher share of wine and men of beer drinking. Light to moderate drinking without risky single-occasion drinking was the predominant drinking practice in all locations except for Lithuania, where infrequent heavy drinking (class 2) was equally popular. Socio-demographic factors and individual alcohol harm experiences (rapid alcohol on-line screen) explained up to 20.5% of the variability in class endorsement.

    Conclusions Beverage preference appears to remain a decisive indicator for distinguishing Europeans' drinking practices. In most European countries, multiple drinking practices appear to be present.

  • 33.
    Kraus, Ludwig
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). IFT Institut für Therapieforschung, Germany; ELTE Eötvös Loránd University, Hungary.
    Loy, Johanna K.
    Olderbak, Sally
    Trolldal, Bjorn
    Ramstedt, Mats
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). Karolinska Institutet, Sweden.
    Svensson, Johan
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). The Swedish Council for Information on Alcohol and Other Drugs (CAN), Sweden.
    Törrönen, Jukka
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Does the decline in Swedish adolescent drinking persist into early adulthood?2023In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443Article in journal (Refereed)
    Abstract [en]

    Background and aimsSweden 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.DesignData 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).SettingSweden.ParticipantsA total of n = 52 847 respondents (48% females) aged 16 and 30 years were included in this study.MeasurementsFor 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.FindingsThe 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.ConclusionsIn 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.

  • 34.
    Kraus, Ludwig
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). IFT Institut für Therapieforschung, Germany; LTE Eötvös Loránd University, Hungary.
    Olderbak, Sally
    Commentary on Livingston et al.: Do reductions in adolescent drinking really maintain into adulthood?2022In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 117, no 5, p. 1282-1283Article in journal (Other academic)
  • 35.
    Kraus, Ludwig
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences. IFT Institut für Therapieforschung, Germany; ELTE Eötvös Loránd University, Hungary .
    Seitz, Nicki-Nils
    Piontek, Daniela
    Molinaro, Sabrina
    Siciliano, Valeria
    Guttormsson, Ulf
    Arpa, Sharon
    Monshouwer, Karin
    Leifman, Hakan
    Vicente, Julian
    Griffiths, Paul
    Clancy, Luke
    Feijao, Fernanda
    Florescu, Silvia
    Lambrecht, Patrick
    Nociar, Alojz
    Raitasalo, Kirsimarja
    Spilka, Stanislas
    Vyshinskiy, Konstantin
    Hibell, Bjorn
    'Are The Times A-Changin'? Trends in adolescent substance use in Europe2018In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 113, no 7, p. 1317-1332Article in journal (Refereed)
    Abstract [en]

    Aims To estimate temporal trends in adolescents' current cigarette, alcohol and cannabis use in Europe by gender and region, test for regional differences and evaluate regional convergence. Design and Setting Five waves of the European School Survey Project on Alcohol and Other Drugs (ESPAD) from 28 countries between 1999 and 2015. Countries were grouped into five regions [northern (NE), southern (SE), western (WE), eastern Europe (EE) and the Balkans (BK)]. Participants A total of 223 814 male and 211 712 female 15-16-year-old students. Measurements Daily cigarette use, weekly alcohol use, monthly heavy episodic drinking (HED) and monthly cannabis use. Linear and quadratic trends were tested using multi-level mixed-effects logistic regression; regional differences were tested using pairwise Wald tests; mean absolute differences (MD) of predicted prevalence were used for evaluating conversion. Findings Daily cigarette use among boys in EE showed a declining curvilinear trend, whereas in all other regions a declining linear trend was found. With the exception of BK, trends of weekly drinking decreased curvilinear in both genders in all regions. Among girls, trends in WE, EE and BK differed from trends in NE and SE. Monthly HED showed increasing curvilinear trends in all regions except in NE (both genders), WE and EE (boys each). In both genders, the trend in EE differed from the trend in SE. Trends of cannabis use increased in both genders in SE and BK; differences were found between the curvilinear trends in EE and BK. MD by substance and gender were generally somewhat stable over time. Conclusions Despite regional differences in prevalence of substance use among European adolescents from 1999 to 2015, trends showed remarkable similarities, with strong decreasing trends in cigarette use and moderate decreasing trends in alcohol use. Trends of cannabis use only increased in southern Europe and the Balkans. Trends across all substance use indicators suggest no regional convergence.

  • 36.
    Kraus, Ludwig
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). IFT Institut für Therapieforschung, Germany.
    Östhus, Ståle
    Amundsen, Ellen J.
    Piontek, Daniela
    Harkonen, Janne
    Legleye, Stephane
    Bloomfield, Kim
    Makela, Pia
    Landberg, Jonas
    Törrönen, Jukka
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Changes in mortality due to major alcohol-related diseases in four Nordic countries, France and Germany between 1980 and 2009: a comparative age-period-cohort analysis2015In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 110, no 9, p. 1443-1452Article in journal (Refereed)
    Abstract [en]

    Aims: To investigate age, period and cohort effects on time trends of alcohol-related mortality in countries with different drinking habits and alcohol policies.

    Design and setting: Age-period-cohort (APC) analyses on alcohol-related mortality were conducted in Denmark, Finland, Norway, Sweden, France and Germany.

    Participants: Cases included alcohol-related deaths in the age range 20-84 years between 1980 and 2009.

    Measurements: Mortality data were taken from national causes of death registries and covered the ICD codes alcoholic psychosis, alcohol use disorders, alcoholic liver disease and toxic effect of alcohol.

    Findings: In all countries changes across age, period and cohort were found to be significant for both genders [effect value with confidence interval (CI) shown in Supporting information, Table S1]. Period effects pointed to an increase in alcohol-related mortality in Denmark, Finland and Germany and a slightly decreasing trend in Sweden, while in Norway an inverse U-shaped curve and in France a U-shaped curve was found. Compared with the cohorts born before 1960, the risk of alcohol-related mortality declined substantially in cohorts born in the 1960s and later. Pairwise between-country comparisons revealed more statistically significant differences for period (P<0.001 for all 15 comparisons by gender) than for age [P<0.001 in seven (men) and four (women) of 15 comparisons] or cohort [P<0.01 in two (men) and three (women) of 15 comparisons].

    Conclusions: Strong period effects suggest that temporal changes in alcohol-related mortality in Denmark, Finland, Norway, Sweden, France and Germany between 1980 and 2009 were related to secular differences affecting the whole population and that these effects differed across countries.

  • 37. Laslett, A.-M.
    et al.
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Ferris, J.
    Wilkinson, C.
    Livingston, M.
    Mugavin, J.
    Surveying the range and magnitude of alcohol's harm to others in Australia2011In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 106, no 9, p. 1603-1611Article in journal (Refereed)
    Abstract [en]

    Aims  This study aims to document the adverse effects of drinkers in Australia on people other than the drinker.

    Design  Cross-sectional survey.

    Setting  In a national survey of Australia, respondents described the harmful effects they experienced from drinkers in their households, family and friendship networks, as well as work-place and community settings.

    Participants  A randomly selected sample of 2649 adult Australians.

    Measurements  Problems experienced because of others' drinking were ascertained via computer-assisted telephone interviews. Respondent and drinker socio-demographic and drinking pattern data were recorded.

    Findings  A total of 70% of respondents were affected by strangers' drinking and experienced nuisance, fear or abuse, and 30% reported that the drinking of someone close to them had negative effects, although only 11% were affected by such a person ‘a lot’. Women were more affected by someone they knew in the household or family, while men were more affected by strangers, friends and co-workers. Young adults were consistently the most negatively affected across the majority of types of harm.

    Conclusions  Substantial proportions of Australians are affected by other people's drinking, including that of their families, friends, co-workers and strangers. These harms range in magnitude from noise and fear to physical abuse, sexual coercion and social isolation.

  • 38. Laslett, Anne-Marie
    et al.
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). La Trobe University, Melbourne, Australia.
    Kuntsche, Sandra
    Anderson-Luxford, Dan
    Willoughby, Bree
    Doran, Christopher
    Jenkinson, Rebecca
    Smit, Koen
    Egerton-Warburton, Diana
    Jiang, Heng
    Alcohol's harm to others in 2021: Who bears the burden?2023In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 118, no 9, p. 1726-1738Article in journal (Refereed)
    Abstract [en]

    Background and aims: Alcohol's harm to others (AHTO) has become a key driver of national and international alcohol policy. This study aimed to produce a contemporary, comprehensive estimate of the correlates and harms from others' drinking in 2021 in Australia.

    Design, setting, participants and measurements: Across Australia, 2574 adults (1380 women; 1172 men) were sampled via two cross-sectional survey modes: a random-digit dial mobile phone sample of 1000 people and 1574 people from the Life in Australia™ panel survey. In 2021 participants were asked about harms they had experienced from the drinking of family, friends, co-workers and the public in the past year. Applying combined sample weights from each mode, bivariable and adjusted multivariable logistic regressions were used to analyse differences in rates of AHTO by participant gender, age, residence in rural or metropolitan regions, country of birth, education and employment.

    Findings: In 2021, 23.6% reported being negatively affected by strangers' drinking and 21.3% by the drinking of someone they knew, with 34.3% reporting being negatively affected a lot or a little by either; 42.4% of respondents reported specific harms from strangers' drinking. Thus, 48.1% of respondents reported any harm (negative effects or specific harms) from others' drinking. Women, younger people, Australian-born and heavier episodic drinkers reported significantly higher rates of AHTO compared with other respondents. Smaller percentages (7.5%) of participants reported being harmed substantially by others' drinking, including by people they knew (5.8%) or strangers (2.3%). Stratified analyses showed that heavier drinking, furloughed, younger men who were born overseas in English-speaking countries were affected by others' drinking, whereas women were affected regardless of these factors (apart from age).

    Conclusions: More than one-third of Australian adults appear to have been negatively affected by others' drinking in 2021, with women, younger people and heavier drinkers at greater risk. Substantial harm appears to be more likely to arise from the drinking of people Australians know than from strangers' drinking.

  • 39. Livingston, Michael
    et al.
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). Centre for Alcohol Policy Research, Turning Point, Australia; University of Melbourne, Australia.
    Commentary on Norstrom & Svensson (2014) and Rossow et al. (2014): Understanding how population-level alcohol consumption changes2014In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 109, no 9, p. 1456-1458Article in journal (Other academic)
  • 40. Livingston, Michael
    et al.
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). Centre for Alcohol Policy Research, La Trobe University, Australia.
    Chikritzhs, Tanya
    Taylor, Nicholas
    Yuen, Wing See
    Dietze, Paul
    Trends in alcohol-related liver disease mortality in Australia: An age-period-cohort perspective2023In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 118, no 11, p. 2156-2163Article in journal (Refereed)
    Abstract [en]

    Background and Aims

    There have been few systematic attempts to examine how alcohol-related mortality has changed in Australia, and no studies that have explored cohort effects in alcohol-related mortality. This study uses more than 50 years of data to measure age, period and cohort trends in alcohol-related liver disease (ALD) mortality.

    Design, Setting and Cases

    This was a retrospective age-period-cohort analysis of total Australian ALD mortality data from 1968 to 2020 in Australia. There was a total of 35 822 deaths-27 208 men (76%) and 8614 women (24%).

    Measurements

    Deaths from ALD were grouped into 5-year age groups and periods (e.g. deaths for 20-24-year-olds between 1968 and 1972 were combined).

    Findings

    ALD mortality peaked in the late 1970s and early 1980s for both men and women. In age-period-cohort models, mortality was highest for cohorts born 1915-30. For example, men born between 1923 and 1927 had a relative risk of 1.58 [95% confidence interval (CI) = 1.52, 1.64] compared with men born between 1948 and 1952. For women, there was an increase in risk for cohorts born in the 1960s [e.g. the 1963-67 cohort had a relative risk (RR) of 1.16 (95% CI = 1.07, 1.25) compared with women born in 1948-52]. For men, there was a broad decline in mortality over time [e.g. in 2020, the RR was 0.87 (95% CI = 0.82, 0.92) compared with the reference year of 2000]. For women, mortality declined until 2000 and has been stable since.

    Conclusions

    Alcohol-related liver disease mortality has declined across the Australian population since the 1970s and 1980s partly due to cohort-specific shifts as the highest-risk birth cohorts age. For women, this decline had stalled by the year 2000, and cohorts of women born during the 1960s were at higher risk than earlier cohorts, suggesting the need for thoughtful interventions as this population enters its highest-risk years for ALD mortality.

  • 41. Ludwig, Monika
    et al.
    Kräplin, Anja
    Braun, Barbara
    Kraus, Ludwig
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). IFT Institut für Therapieforschung, Germany.
    Gambling experiences, problems, research and policy: gambling in Germany2013In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 108, no 9, p. 1554-1561Article in journal (Refereed)
    Abstract [en]

    Aims The objective of this paper is to present an overview of gambling in Germany, including historical development, legislative and economic changes as well as treatment options and their effectiveness. Methods The available scientific literature and research reports on gambling in Germany were reviewed to obtain relevant information on history, commercialization, legislation, treatment and research agenda. Results Gambling in Germany is characterized by compromises between protective and economic efforts. At present, gambling is illegal in Germany, and provision is subject to the state monopoly. Mere gaming machines (specific slot machines) are not classified as gambling activity, permitting commercial providers. In recent years, implementing regulations for state gambling and gaming machines have been changed. Concerning the treatment of pathological gambling, various options exist; treatment costs have been covered by health and pension insurance since 2001. Information on the effectiveness of treatment in Germany is limited. Similarly, the number of peer-reviewed publications on gambling is small. Conclusions German gambling legislation was subject to major changes in the past years. Based on the available body of research (longitudinal), studies on risk and protective factors and the aetiology of pathological gambling are needed. The effectiveness of pathological gambling treatment in Germany and the impact of gambling regulations on gambling behaviour also need to be investigated.

  • 42. Luukkonen, Juha
    et al.
    Junna, Liina
    Remes, Hanna
    Martikainen, Pekka
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences. University of Helsinki, Helsinki, Finland; Max Planck Institute for Demographic Research, Rostock, Germany.
    The association of lowered alcohol prices with birth outcomes and abortions: A population-based natural experiment2023In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 118, no 5, p. 836-844Article in journal (Refereed)
    Abstract [en]

    Background and Aims: Alcohol use during pregnancy remains an important risk factor for adverse birth outcomes, but little is known regarding how alcohol prices affect pregnancy outcomes on the population level. We assess the associations between decreased alcohol prices with birth outcomes and abortions.

    Design: Using national registers, we used interrupted time-series modelling to compare outcomes of pregnancies conceived before and after a tax cut, resulting in 33% mean decrease of off-premise alcohol prices on 1 March 2004. We also addressed possible heterogeneity of the associations by maternal age and household income.

    Setting: Finland.

    Participants: All registered pregnancies starting 2 years before and 1 year after the alcohol price cut (analysis sample consisted of 169 735 live births and 32 441 abortions).

    Measurements: The outcomes were birth weight, gestational age, the probability of low birth weight (< 2500 g at birth), preterm birth (< 37 weeks of gestation), any congenital malformations and share of registered abortions of pregnancies.

    Findings: On the population level, lowered alcohol prices were associated with an increase in abortions immediately after the price cut [+0.84 percentage points; 95% confidence interval (CI) = 0.2, 1.4]. For birth outcomes, negative associations were observed among women in the lowest income quintile; for example, increased probabilities of low birth weight (+1.5 percentage points; 95% CI = 0.4, 2.6) and preterm birth (+1.98 percentage points; 95% CI = 0.8, 3.2). All changes were strongest immediately after the price cut and attenuated during the course of the following year.

    Conclusions: Lowered alcohol prices in Finland were associated with a short-term increase in adverse birth outcomes among low-income mothers and an overall increase in abortions.

  • 43. Molinaro, Sabrina
    et al.
    Benedetti, Elisa
    Scalese, Marco
    Bastiani, Luca
    Fortunato, Loredana
    Cerrai, Sonia
    Canale, Natale
    Chomynova, Pavla
    Elekes, Zsuzsanna
    Feijao, Fernanda
    Fotiou, Anastasios
    Kokkevi, Anna
    Kraus, Ludwig
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences. IFT Institut für Therapieforschung, Germany; ELTE Eötvös Loránd University, Hungary.
    Rupsiene, Liudmila
    Monshouwer, Karin
    Nociar, Alojz
    Strizek, Julian
    Lazar, Tanja Urdih
    Prevalence of youth gambling and potential influence of substance use and other risk factors throughout 33 European countries: first results from the 2015 ESPAD study2018In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 113, no 10, p. 1862-1873Article in journal (Refereed)
    Abstract [en]

    Background and aims

    Although generally prohibited by national regulations, underage gambling has become popular in Europe, with relevant cross‐country prevalence variability. This study aimed to estimate the prevalence of underage gambling in Europe stratified by type of game and on‐/off‐line mode and to examine the association with individual and family characteristics and substance use.

    Design

    Our study used data from the 2015 European School Survey Project on Alcohol and Other Drugs (ESPAD) cross‐sectional study, a survey using self‐administered anonymous questionnaires.

    Setting

    Thirty‐three European countries.

    Participants

    Sixteen‐year‐old‐year‐old students (n = 93 875; F = 50.8%).

    Measurements

    The primary outcome measure was prevalence of past‐year gambling activity. Key predictors comprised individual behaviours, substance use and parenting (regulation, monitoring and caring).

    Findings

    A total of 22.6% of 16‐year‐old students in Europe gambled in the past year: 16.2% on‐line, 18.5% off‐line. High prevalence variability was observed throughout countries both for mode and types of game. With the exception of cannabis, substance use shows a higher association with gambling, particularly binge drinking [odds ratio (OR) = 1.46, 95% confidence interval (CI) = 1.39–1.53), life‐time use of inhalants (OR = 1.57, 95% CI = 1.47–1.68) and other substances (OR = 1.78, 95% CI = 1.65–1.92)]. Among life habits, the following showed a positive association: truancy at school (OR = 1.26, 95% CI = 1.18–1.35), going out at night (OR = 1.32, 95% CI = 1.26–1.38), participating in sports (OR = 1.30, 95% CI = 1.24–1.37). A negative association was found with reading books for leisure (OR = 0.82%, 95% CI = 0.79–0.86), parents’ monitoring of Saturday night activities (OR = 0.81, 95% CI = 0.77–0.86) and restrictions on money provided by parents as a gift (OR = 0.89, 95% CI = 0.84–0.94).

    Conclusions

    Underage gambling in Europe appears to be associated positively with alcohol, tobacco and other substance use (but not cannabis), as well as with other individual behaviours such as truancy, going out at night and active participation in sports, and is associated negatively with reading for pleasure, parental monitoring of evening activities and parental restriction of money.

  • 44. Nilsson, Anders
    et al.
    Magnusson, Kristoffer
    Carlbring, Per
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Andersson, Gerhard
    Hellner, Clara
    Behavioral couples therapy versus cognitive behavioral therapy for problem gambling: a randomized controlled trial2020In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 115, no 7, p. 1330-1342Article in journal (Refereed)
    Abstract [en]

    Background and aims There is evidence that cognitive behavioral therapy (CBT) is effective for treating problem gambling (PG). Some research points to the possible benefits of involving concerned significant others (CSOs) in treatment. This study compared the efficacy of behavioral couples therapy (BCT) and CBT for both the gambler and the CSO. Design Two parallel-group randomized controlled study comparing two different internet-based treatments for PG. Follow-up measures were conducted at treatment finish, and at 3-, 6- and 12-month post-treatment. Setting Stockholm, Sweden. Participants A total of 136 problem gamblers and 136 CSOs were included in the study: 68 gamblers and 68 CSOs for each treatment condition. The gamblers were on average 35.6 years old and 18.4% were female. CSOs were on average 45.3 years old and 75.7% were women. Interventions A treatment based on BCT was compared with a CBT intervention. Both treatments were internet-based, with 10 therapist-guided self-help modules accompanied by weekly telephone and e-mail support from a therapist. CSOs were given treatment in the BCT condition, but not in the CBT condition. Measurements The primary outcome measures were time-line follow-back for gambling (TLFB-G) and the NORC Diagnostic Screen for Gambling Problems (NODS) for problem gamblers, corresponding to DSM-IV criteria for pathological gambling. Secondary outcomes measures were the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder seven-item scale (GAD-7), the Relation Assessment Scale Generic (RAS-G), the Alcohol Use Disorders Identification Test (AUDIT), the Inventory of Consequences of Gambling for the Gambler and CSO (ICS) and adherence to treatment for both the problem gambler and the CSO. Findings The outcomes of both gambler groups improved, and differences between the groups were not statistically significant: TLFB-G: multiplicative effect = 1.13, 95% confidence interval (CI) = 0.30;4.31); NODS: multiplicative effect = 0.80, 95%, 95% CI = 0.24;2.36. BCT gamblers began treatment to a higher proportion than CBT gamblers: P = 0.002. Conclusions Differences in the efficacy of internet-based behavioral couples therapy and cognitive behavioral therapy for treatment of problem gambling were not significant, but more gamblers commenced treatment in the behavioral couples therapy group.

  • 45.
    Norström, Thor
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Commentary on Pridemore (2014): Drinking and suicide in Russia — strong evidence of a strong link2014In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 109, no 2, p. 189-190Article in journal (Other academic)
  • 46.
    Norström, Thor
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    The role of alcohol in the Russian mortality crisis2011In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 106, no 11, p. 1957-1965Article in journal (Refereed)
    Abstract [en]

    Aims  Alcohol is believed to be an important factor behind the sharp rise in mortality during the period 1990-94 in Russia. However, the rise in the standard alcohol consumption proxy does not seem to be sufficient to explain all the increase in mortality. This study adopts a novel approach to exploring the role of the alcohol factor in the increased mortality by investigating whether the mismatch between trends in mortality and recorded alcohol consumption is due to an underestimation of the consumption increase. Design and measurements  First, the alcohol effect on the male accident rate was estimated using data for the period 1959-89. Next, the estimated alcohol effect and the observed accident mortality rate for the period 1990-98 were used to backcast alcohol consumption during that period. Thirdly, the backcasted alcohol series was used to predict trajectories in alcohol poisoning mortality, the homicide rate and all-cause mortality during the period 1990-98. Findings  There was a markedly stronger increase in the backcasted consumption proxy than in the standard alcohol consumption proxy during the period 1990-98. There was a substantial gap between the observed mortality rates and the rates predicted from the standard alcohol consumption proxy, whereas the predictions from the backcasted alcohol proxy were much closer to the target. Conclusions  Much of the rise in Russian mortality in 1990-94 appears to have been due to the increase in population drinking, but this increase is grossly underestimated by the commonly used consumption proxy combining alcohol sales, estimation of illicit alcohol production and proportion of alcohol-positive violent deaths. 

  • 47.
    Norström, Thor
    et al.
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Miller, Ted
    Services Research Institute Pacific Institute for Research and Evaluation Calverton, MD, USA.
    Holder, Harald
    Prevention Research Center Pacific Institute for Research and Evaluation Berkeley, CA, USA.
    Österberg, Esa
    Alcohol and Drug Research National Institute for Health and Welfare, Helsinki, Finland.
    Ramstedt, Mats
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Rossow, Ingeborg
    Norwegian Institute for Alcohol and Drug Research Oslo, Norway.
    Stockwell, Tim
    Centre for Addictions Research of BC Department of Psychology University of Victoria Victoria, BC, Canada .
    Potential Consequences of Replacing a Retail Alcohol Monopoly with a Private License System: Results from Sweden2010In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 105, no 12, p. 2113-2119Article in journal (Refereed)
    Abstract [en]

    Aim  To examine the potential effects of replacing the Swedish alcohol retail system with a private licensing system on alcohol consumption and alcohol-related harm.

    Design  Two possible scenarios were analysed: (1) replacing the current alcohol retail monopoly with private licensed stores that specialize in alcohol sales or (2) making all alcohol available in grocery stores. We utilized a multiplicative model that projected effects of changes in a set of key factors including hours of sale, retail prices, promotion and advertising and outlet density. Next, we estimated the effect of the projected consumption increase on a set of harm indicators. Values for the model parameters were obtained from the research literature.

    Measurements  Measures of alcohol-related harm included explicitly alcohol-related mortality, accident mortality, suicide, homicide, assaults, drinking driving and sickness absence.

    Findings  According to the projections, scenario 1 yields a consumption increase of 17% (1.4 litres/capita), which in turn would cause an additional 770 deaths, 8500 assaults, 2700 drinking driving offences and 4.5 million sick days per year. The corresponding figures for scenario 2 are a consumption increase of 37.4% (3.1 litres/capita) leading to an additional annual toll of 2000 deaths, 20 000 assaults, 6600 drinking driving offences and 11.1 million days of sick leave.

    Conclusions  Projections based on the research literature suggest that privatization of the Swedish alcohol retail market would significantly increase alcohol consumption and alcohol-related harm.

  • 48.
    Norström, Thor
    et al.
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Pape, H.
    Alcohol, suppressed anger and violence2010In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 105, no 9, p. 1580-1586Article in journal (Refereed)
    Abstract [en]

    Aims Is alcohol related causally to violence, and if so, is the effect of drinking contingent on suppressed anger such that it is strongest among individuals who are highly inclined to withhold angry feelings? We addressed these questions by analysing panel data using a method that diminishes the effects of confounding factors. Design We analysed data on heavy episodic drinking and violent behaviour from the second (1994) and third (1999) waves of the Young in Norway Longitudinal Study ( n = 2697; response rate: 67%). The first difference method was applied to estimate the association between these behaviours, implying that changes in the frequency of violence were regressed on changes in the frequency of drinking. Hence, the effects of time-invariant confounders were eliminated. Analyses were conducted for the whole sample, and for groups scoring low, medium and high on a short version of the STAXI anger suppression scale. Findings Changes in drinking were related positively and significantly to changes in violent behaviour, but the alcohol effect varied with the level of suppressed anger: it was strongest in the high-anger group (elasticity estimate = 0.053, P = 0.011) and weakest (and insignificant) in the low-anger group (elasticity estimate = 0.004, P = 0.806). Conclusions Alcohol use may be related causally to violence, but the effect of drinking is confined to individuals who are inclined to suppress their angry feelings. [ABSTRACT FROM AUTHOR]

  • 49.
    Norström, Thor
    et al.
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Raninen, Jonas
    Is there a link between per capita alcohol consumption and youth drinking? A time–series analysis for Sweden in 1972–20122015In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 110, no 6, p. 967-974Article in journal (Refereed)
    Abstract [en]

    Aims

    To estimate the relationship between per capita alcohol consumption and youth drinking in Sweden during the last 40 years and to estimate the relationship between female and male youth drinking during the 40-year study period.

    Design, setting, participants and measurements

    Per capita alcohol consumption was proxied by official sales data, supplemented by data on unrecorded consumption. Youth consumption was measured by a question on heavy episodic drinking (HED) included in an annual school survey of alcohol and drug habits among Swedish 9th -grade students (15–16 years of age). The annual samples comprise approximately 5000 individuals (with roughly equal numbers of boys and girls) with response rates in the range 80–93%. The study spans the period 1972–2012. Autoregressive integrated moving average (ARIMA) time–series analysis was used to estimate the relation between per-capita alcohol consumption and youth drinking. Ocular inspection of the time–series data suggested a stronger synchronization between the two series in the early period, before the mid-1990s, than in the later period, indicating a structural shift in the relation at issue. We therefore conducted period specific time–series analyses with 1995 as the year of division.

    Results

    There was a statistically significant relation between per capita alcohol consumption and HED among youth for 1972–94. A 1% increase in per capita alcohol consumption was associated with an increase in HED of 1.52% (P = 0.008). The estimate for 1995–2012 (0.12) was well below statistical significance (P = 0.580). The estimated elasticity of the association between boys’ and girls’ HED during 1972–94 was close to unity (0.98, P < 0.001), suggesting proportional changes in boys’ and girls’ drinking. When controlling for per capita consumption, the association was halved (to 0.55) but still significant in table 3 (P = 0.045).

    Conclusions

    Adult and youth drinking in Sweden were synchronized closely during the two last decades of the 20th century, but youth drinking developed an independent trajectory shortly before 2000.

  • 50.
    Norström, Thor
    et al.
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Rossow, I
    On the mis-match between population drinking and drink driving :: response to Gjerde et al.2014In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 109, no 2, p. 333-334Article in journal (Refereed)
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