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  • 1.
    Alexius, Susanna
    Stockholm University, Faculty of Social Sciences, Stockholm Centre for Organizational Research (SCORE). Stockholm School of Economics, Sweden.
    Assigning responsibility for gambling-related harm: scrutinizing processes of direct and indirect consumer responsibilization of gamblers in Sweden2017In: Addiction Research and Theory, ISSN 1606-6359, E-ISSN 1476-7392, Vol. 25, no 6, p. 462-475Article in journal (Refereed)
    Abstract [en]

    This study is an inquiry into how actors in the Swedish gambling industry, gambling problem prevention and support structures articulate responsibility for the problems that arise from gambling. A main point made in the study is that responsibility for the gambling-related harm is actively constructed and reproduced in a hegemonic way that situates the main responsibility for the emergence and handling of gambling-related harm on the individual gambler and that relies heavily on the individual's capacity to control and adjust his/her consumption to prevent gambling related harm. Drawing on extensive ethnographical fieldwork on responsible gambling practices in the Swedish context, the author brings attention to the often-unproblematized view of contemporary responsible gambling measures, and the need to develop a self-reflexive critical analysis of the ways in which responsibility is divided and assigned in this politicized market and wider policy field. As a conceptual contribution, an analytical distinction is suggested between measures of direct responsibilization (teaching and training gamblers to be responsible) and measures of indirect responsibilization (teaching and training intermediaries in the market, such as gambling agents and support association staff, to relinquish responsibility on behalf of the gambling consumer). The results indicate that such a distinction is fruitful for a nuanced understanding of contemporary responsibility policies and practices.

  • 2.
    Bogren, Alexandra
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Alcohol short-circuits important part of the brain': Swedish newspaper representations of biomedical alcohol research2017In: Addiction Research and Theory, ISSN 1606-6359, E-ISSN 1476-7392, Vol. 25, no 3, p. 177-187Article in journal (Refereed)
    Abstract [en]

    The media has a central role in communicating and constructing health knowledge, including communicating research findings related to alcohol consumption. However, research on news reporting about alcohol is still a relatively small field; in particular, there are few studies of the reporting of biomedical alcohol and drug research, despite the assumed increasing popularity of biomedical perspectives in public discourse in general. The present article addresses the representational `devices' used in Swedish press reporting about biomedical alcohol research, drawing on qualitative thematic analysis of the topics, metaphors, and optimist versus critical frames used in presenting biomedical research findings. In general, the press discourse focuses on genetic factors related to alcohol problems, on the role of the brain and the reward system in addiction, and on medication for treating alcohol problems. Metaphors of `reconstruction' and `reprograming' of the reward system are used to describe how the brain's function is altered in addiction, whereas metaphors of `undeserved reward' and `shortcuts' to pleasure are used to describe alcohol's effects on the brain. The study indicates that aspects of the Swedish press discourse of biomedical alcohol research invite reductionism, but that this result could be understood from the point of view of both the social organization of reporting and the intersection of reporting, science, and everyday understandings rather than from the point of view of the news articles only. Moreover, some characteristics of the media portrayals leave room for interpretation, calling for research on the meanings ascribed to metaphors of addiction in everyday interaction.

  • 3. Delle, Simone
    et al.
    Seitz, Nicki-Nils
    Atzendorf, Josefine
    Mühlig, Stephan
    Kraus, Ludwig
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences. IFT Institut für Therapieforschung, Germany; ELTE Eötvös Loránd University, Hungary.
    Motives for not drinking alcohol: why adults in late middle age abstain2022In: Addiction Research and Theory, ISSN 1606-6359, E-ISSN 1476-7392, Vol. 30, no 2, p. 126-133Article in journal (Refereed)
    Abstract [en]

    Background: Older individuals are not only more sensitive to the impact of alcohol but also face significant health risks from alcohol-drug interactions. To alter current drinking patterns, it is crucial to understand the motives for abstention of adults in late middle age.

    Objectives: We hypothesized that, for adults in late middle age, socio-demographic characteristics and health-related factors predict alcohol abstinence; and that current motives for abstention vary between subgroups of abstainers.

    Method: Data on adults aged 50-64 years (n = 2,308) came from the German Epidemiological Survey of Substance Abuse (ESA). Logistic regression was used to examine the association between different types of abstinence and socio-demographic and health-related variables.

    Results: Low income, low education and poor self-rated physical health predicted 12-month abstinence. Men with a chronic disease had a 9.5 % chance to be abstinent, whilst it was 17.7 % for women. Main motives for older lifetime abstainers were 'dislike of taste or smell', 'loss of control' and 'family constraints'. For 12-month abstainers, it was 'loss of control', 'health constraints' and 'dislike of taste or smell'.

    Conclusion: Poor health in middle-aged drinkers offers an opportunity to recommend reduction or cessation of alcohol use by explaining the negative health effects from alcohol. Future research investigating abstention needs to differentiate between lifetime and 12-month abstainers.

  • 4.
    Edman, Johan
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Berndt, Josefine
    Stockholm University, Faculty of Humanities, Department of History.
    Oniomaniacs: the popular framing of consumption as a disease2018In: Addiction Research and Theory, ISSN 1606-6359, E-ISSN 1476-7392, Vol. 26, no 6, p. 431-438Article in journal (Refereed)
    Abstract [en]

    The aim of this article is to examine the framing of excessive consumption as a disease-like condition in the Swedish press during the years 1992-2012. Against a theoretical background discussing medicalisation, we have analysed the characteristics of problematic consumption framed as a disease, as well as the presumed causes of and responses to this problem. Alongside and intertwined with a structural and a rationalisation perspective, we find discussions and explanations of problematic consumption as a disease all through the investigated period. Class and gender are noticeable components of the core problem description, but the reductionist assumption of addiction as a brain disease seems to point to a problem beyond historical and social context. The disease conceptualisation of problematic consumption can be seen as a compensatory perspective in an individualising and consumption affirming society. However, this perspective is ultimately decided by politics and not by research. Despite being a frequently occurring perspective on a conceptual level in Sweden, it is not a legitimate description in legislation or as a cause for public treatment interventions.

  • 5.
    Ekendahl, Mats
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Danish heroin prescription in Swedish print media: exploring the silent agreements of harm reduction and zero tolerance2012In: Addiction Research and Theory, ISSN 1606-6359, E-ISSN 1476-7392, Vol. 20, no 5, p. 423-434Article in journal (Refereed)
    Abstract [en]

    Sweden's response to drug problems has long been governed by zero tolerance, as manifested by the motto 'a drug-free society' and the criminalisation of drug use. In this context, the legitimacy of methadone maintenance treatment and other interventions often depicted as harm reduction has been questioned. This highlights that solutions to drug problems are circumscribed by culture-specific ideologies and definitions of reality that are articulated in different discourses. The study aims to elucidate how Denmark's decision in 2008 to launch heroin prescription (a controversial form of maintenance treatment) was addressed in Swedish print media, and identify how key concepts such as 'heroin users' and 'treatment' were attributed with meaning. In order for the analysis to go beyond apparent differences between the discourses of harm reduction and zero tolerance, specific interest was placed in constructions that were shared by protagonists on the issue of heroin prescription. The data encompasses 29 articles (news agency announcements plus daily press) that were analysed with focus on binary oppositions and then coded thematically. Four themes were identified: 'Users as passive victims'; 'Methadone as benchmark'; 'Treatment as necessity' and 'Swedish drug policy as unique'. These themes appear as presuppositions, or silent agreements, that precede different understandings of heroin prescription in Swedish press. It is concluded that the media representations reproduced traditional constructions of heroin users as victims in need of society's help. The relevance of characterising heroin prescription as a 'new way' of handling heroin dependence problems is discussed.

  • 6.
    Forsström, David
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Spångberg, Jessika
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences. Public Health Agency of Sweden, Sweden.
    Pettersson, Agneta
    Brolund, Agneta
    Odeberg, Jenny
    A systematic review of educational programs and consumer protection measures for gambling: an extension of previous reviews2021In: Addiction Research and Theory, ISSN 1606-6359, E-ISSN 1476-7392, Vol. 29, no 5, p. 398-412Article, review/survey (Refereed)
    Abstract [en]

    Introduction: Besides supply reduction, preventive interventions to reduce harm from gambling include interventions for the reduction of demand and to limit negative consequences. Several interventions are available for gamblers, e.g. limit-setting. Reviews have been published examining the evidence for specific measures as well as evaluating the effect of different measures at an overall level. Only a few of these have used a systematic approach for their literature review. The aim of this systematic review and meta-analysis is twofold. First, to assess the certainty of evidence of different preventive measures in the field of educational programs and consumer protection measures, including both land-based and online gambling. The second is to present shortcomings in eligible studies to highlight what type of information is needed in future studies.

    Method: This systematic review included measures administered in both real-life settings and online. Twenty-eight studies fulfilled our inclusion criteria and had low or moderate risk of bias.

    Results: The results showed that only two measures (long term educational programs and personalized feed-back) had an impact on gambling behavior. Follow-up period was short, and measures did not include gambling as a problem. The certainty in most outcomes, according to GRADE, was very low. Several shortcomings were found in the studies.

    Discussion: We concluded that the support for preventive measures is low and that a consensus statement regarding execution and methods to collect and analyze data for preventive gambling research is needed. Our review can serve as a starting point for future responsible gambling reviews since it evaluated certainty of evidence.

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  • 7. Hellman, Matilda
    et al.
    Cisneros Örnberg, Jenny
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Livingstone, Charles
    Gambling policy studies: a field that is growing in size and complexity2017In: Addiction Research and Theory, ISSN 1606-6359, E-ISSN 1476-7392, Vol. 25, no 6, p. 433-435Article in journal (Other academic)
  • 8.
    Härkönen, Janne
    et al.
    Finnish Foundation for Alcohol Studies.
    Törrönen, Jukka
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Mustonen, Heli
    National Institute for Health and Welfare.
    Mäkelä, Pia
    National Institute for Health and Welfare.
    Changes in Finnish drinking occasions between 1976 and 2008 – The waxing and waning of drinking contexts2013In: Addiction Research and Theory, ISSN 1606-6359, E-ISSN 1476-7392, Vol. 21, no 4, p. 318-328Article in journal (Refereed)
    Abstract [en]

    A deeper understanding of drinking practices of a population requires a study of the situations in which people drink, i.e. the context of drinking. This study explores the changes and continuities in the prevalence and nature of drinking in terms of place, company, time and the social drinking context, during a period when overall alcohol consumption in Finland grew by half and drinking culture at large was transformed radically. Analyses were based on two national drinking habits surveys with a representative sample of the Finnish population aged 15–69 years in 1976 (N = 2835) and 2008 (N = 2725). In addition, original semi-qualitative data in 2008 were utilized, using a 15-category social drinking context typology, with the results contrasted to previously reported results from 1976. Overall, the number of drinking occasions increased between 1976 and 2008. A major part of the increase comprised drinking in home settings and with one's partner. The weekly rhythm of drinking was also concentrated on weekends even more than before. Changes in the nature of drinking showed that the typical degree of intoxication decreased for men and increased for women. The proportion of heavy drinking occasions decreased for men especially in home settings and for women, remained the same across drinking contexts except for single gender contexts. Changes in social drinking contexts reflected an overall shifting of drinking into the private sphere, with a major increase in the proportion of evenings at home and sauna drinking.

  • 9.
    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; Eötvös-Loránd-Universität, Hungary.
    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.
    Livingston, Michael
    Pennay, Amy
    Holmes, John
    Törrönen, Jukka
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Long waves of consumption or a unique social generation? Exploring recent declines in youth drinking2020In: Addiction Research and Theory, ISSN 1606-6359, E-ISSN 1476-7392, Vol. 28, no 3, p. 183-193Article in journal (Refereed)
    Abstract [en]

    Background: There is growing evidence for recent declines in adolescent alcohol use in the Western world. While these changes have been subject to scientific debate, the reasons for this downward trend are not yet understood.Method: We consider broader theoretical framings that might be useful in understanding declines in youth drinking. In particular, we reflect on the historical observations of ‘long waves of alcohol consumption’, the ‘Total Consumption Model’, and the ‘Theory of Social Generations’. Based on this, we explore some of the main hypotheses that are presently discussed as possible explanations for changes in youth drinking.Results: We suggest there may have been a change in the social position of alcohol as a social reaction to the negative effects of alcohol, but also emphasize the importance of changes in technology, social norms, family relationships and gender identity, as well as trends in health, fitness, wellbeing and lifestyle behavior. As a result of the interplay of these factors, the ‘devaluation’ of alcohol and the use of it may have contributed to the decrease in youth drinking.Conclusions: For interrupting the recurrent cycle of the ‘long waves of alcohol consumption’, we need to take advantage of the present change in sentiment and “lock in” these changes by new control measures. The model of change presented here hinges on the assumption that the observed change in the position the present young generation takes on alcohol proceeds through the life course, eventually reducing alcohol use in the whole population.

  • 10.
    Kraus, Ludwig
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). IFT Institut für Therapieforschung, Germany.
    Schulte, Bernd
    Manthey, Jakob
    Rehm, Juergen
    Alcohol screening and alcohol interventions among patients with hypertension in primary health care: an empirical survey of German general practitioners2017In: Addiction Research and Theory, ISSN 1606-6359, E-ISSN 1476-7392, Vol. 25, no 4, p. 285-292Article in journal (Refereed)
    Abstract [en]

    Background: Alcohol is one of the least intervened risk factors in the management of hypertension at the primary care level. In order to improve alcohol interventions, a better understanding of knowledge, attitudes and clinical practice of lifestyle interventions in the management of hypertension is needed.Method: As a part of a European study (France, Germany, Italy, Spain, UK), 211 German general practitioners (GPs) were recruited in Bavaria and Hamburg and surveyed via an Internet-based questionnaire. Results were compared with the European sample (n=2870).Results: One-third of the patients seen by German GPs had hypertension (36.2%, standard deviation (SD): 14.6) and among cases with hypertension, less than half were ever screened for alcohol (4.5 out of 10 patients). The foremost reasons for not screening for alcohol were that alcohol was not considered a major risk factor for hypertension plus the lack of knowledge of appropriate alcohol screening instruments. The majority of German GPs managed patients with hazardous drinking levels themselves or in their practice (71.3%, 95% confidence interval (CI): 64.6-77.2%), but only 42.0% (95% CI: 35.2-49.0%) managed alcohol dependent patients. German screening rates were slightly lower but interventions of screened positive patients higher than the European average.Conclusions: Rates of alcohol screening in patients with hypertension in primary health care may be increased by improving GPs knowledge of alcohol as a major risk factor for hypertension, increasing GPs education on alcohol and screening instruments, and providing reimbursement. This may increase treatment of alcohol problems in patients with hypertension and reduce hypertension.

  • 11. Laslett, Anne-Marie
    et al.
    Stanesby, Oliver
    Graham, Kathryn
    Callinan, Sarah
    Karriker-Jaffe, Katherine J.
    Wilsnack, Sharon
    Kuntsche, Sandra
    Waleewong, Orratai
    Greenfield, Thomas K.
    Gmel, Gerhard
    Florenzano, Ramon
    Hettige, Siri
    Siengsounthone, Latsamy
    Wilson, Ingrid M.
    Taft, Angela
    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.
    Children's experience of physical harms and exposure to family violence from others' drinking in nine societies2020In: Addiction Research and Theory, ISSN 1606-6359, E-ISSN 1476-7392, Vol. 28, no 4, p. 354-364Article in journal (Refereed)
    Abstract [en]

    Aim: To study caregiver reports of children's experience of physical harm and exposure to family violence due to others' drinking in nine societies, assess the relationship of harm with household drinking pattern and evaluate whether gender and education of caregiver affect these relationships. Method: Using data on adult caregivers from the Gender and Alcohol's Harm to Others (GENAHTO) project, child alcohol-related injuries and exposure of children to alcohol-related violence (CAIV) rates are estimated by country and pooled using meta-analysis and stratified by gender of the caregiver. Households with and without heavy or harmful drinker(s) (HHDs) are compared to assess the interaction of caregiver gender on the relationship between reporting HHD and CAIV, adjusting for caregiver education and age. Additionally, the relationship between caregiver education and CAIV is analyzed with meta-regression. Results: The prevalence of CAIV varied across societies, with an overall pooled mean of 4% reported by caregivers. HHD was a consistent correlate of CAIV in all countries. Men and women in the sample reported similar levels of CAIV overall, but the relationship between HHD and CAIV was greater for women than for men, especially if the HHD was the most harmful drinker (MHD). Education was not significantly associated with CAIV. Conclusions: One in 25 caregivers with children report physical or family violence harms to children because of others' drinking. The adjusted odds of harm are significantly greater (more than four-fold) in households with an HHD, with men most likely to be defined as this drinker in the household.

  • 12.
    Månsson, Elinor
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Bogren, Alexandra
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Health, risk, and pleasure: The formation of gendered discourses on women's alcohol consumption2014In: Addiction Research and Theory, ISSN 1606-6359, E-ISSN 1476-7392, Vol. 22, no 1, p. 27-36Article in journal (Refereed)
    Abstract [en]

    Based on a summary and discussion of our previousstudies of media portrayals of gender and alcohol inrelation to the general, societal discourses of risk andpleasure, we aim to develop the gender theoreticalunderstanding of alcohol as a health issue. We arguethat even though the media provide various implicitor explicit instructions for women on how to act,both warnings and encouragements to drink areframed within basic gendered assumptions thatconcern women’s dealing with alcohol. Because ofthis, the discourses that construct women’s drinkingas either risky or pleasurable are in fact not separate,but rather two sides of the same coin. Drawing onthis analysis, we argue that much of the research onalcohol consumption and sex difference – and inparticular on women’s drinking – lacks in itsunderstanding of the gendered ideas and assumptionsthat frame and influence these practices.

  • 13.
    Månsson, Josefin
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Ekendahl, Mats
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Legitimacy through scaremongering: the discursive role of alcohol in online discussions of cannabis use and policy2013In: Addiction Research and Theory, ISSN 1606-6359, E-ISSN 1476-7392, Vol. 21, no 6, p. 469-478Article in journal (Refereed)
    Abstract [en]

    In Sweden, prohibitionist drug policy has contributed to making cannabis an illegal drug, viewed as dangerous, while alcohol is considered a legitimate recreational commodity. But the official Swedish cannabis discourse is now being contested on internet. In virtual environments an often employed way to try to legitimize cannabis use is by comparing it to alcohol. This indicates the importance of analyzing how substances are attributed with meaning in various contexts. This study aims to describe and analyze the discursive role of alcohol in Swedish online discussions of cannabis use and policy. Approximately 700 alcohol-related comments, posted during one year period, were retrieved from the cannabis-section of Swedish Flashback Forum (a website open for public viewing). The sample was analyzed qualitatively with analytical tools such as nodal points, analogies, distinctions and typological examples. Two concepts, danger and discrimination, were identified as nodal points in a cannabis legalization discourse, and provided a backdrop from which comparisons between alcohol and cannabis were made meaningful. We have found that cannabis and alcohol ‘‘changed places’’ in these online discussions. The participants drew on a prohibitionist cannabis discourse but applied its arguments to alcohol; alcohol was thereby given the role of the ‘‘ideal enemy’’ while cannabis was presented as a harmless plant rejected by society on moral rather than scientific grounds. The relevance of acknowledging and reflecting upon the influence that online ‘‘talk’’ has on young people’s attitudes towards drugs is discussed.

  • 14.
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    A blast from the past – Temperance as the source of all our troubles.: [commentary on a paper by Stanton Peele]2010In: Addiction Research and Theory, ISSN 1606-6359, E-ISSN 1476-7392, ISSN 1606-6359 (printed) ,1476-7392 (electronic), Vol. 18, no 4, p. 383-385Article in journal (Refereed)
  • 15.
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Drinking and intoxication when the children are around: Conflicting norms and their resolutions2011In: Addiction Research and Theory, ISSN 1606-6359, E-ISSN 1476-7392, Vol. 19, no 5, p. 402-403Article in journal (Refereed)
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  • 16.
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Multicultural contexts and alcohol and drug use as symbolic behaviour2005In: Addiction Research and Theory, ISSN 1606-6359, E-ISSN 1476-7392, Vol. 13, no 4, p. 321-331Article in journal (Refereed)
    Abstract [en]

    Diverse forms of cultural contact, from living together in the same society to tourism, are considered in terms of what they mean for substance use. In a multicultural society, ethnicities are partly assigned and partly constructed, and can also be a performance in front of an audience of others. Alcohol or drug use or nonuse often becomes an ethnic marker, which helps to sustain differentiations in patterns. Drinking and drug use patterns in immigrant communities are thus not simply a matter of acculturation to some "mainstream”. Cultural diffusion may flow in both directions. In the modern world, mass tourism has also become a vehicle for cultural contact and transmission of drinking and drug use, although tourists' behaviour is often different from their behaviour back home. Studies of psychoactive substance use in multicultural contexts need to take account both of the symbolism of the use, particularly in the context of the performance of ethnicity, and of the influence of power and status relations on the ethnic performance and its reception.

  • 17.
    Room, Robin
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). La Trobe University, Australia.
    Greenfield, Thomas K.
    Holmes, John
    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.
    Livingston, Michael
    Pennay, Amy
    Törrönen, Jukka
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Supranational changes in drinking patterns: factors in explanatory models of substantial and parallel social change2020In: Addiction Research and Theory, ISSN 1606-6359, E-ISSN 1476-7392, Vol. 28, no 6, p. 467-473Article in journal (Refereed)
    Abstract [en]

    Background: That there have been 'long waves' of consumption in parallel in different societies has previously been noted. Now there is a sustained drop in drinking among youth in most of Europe, Australia and North America. Can such changes be understood in a common frame? In terms of inexorable historical phenomena or forces, like Kondratieff waves? In terms of generational shifts, with a younger generation reacting against the habits of an older? Method: Such conceptual models for understanding the dynamics of social change are examined in terms of their potential contribution in explaining when and how substantial changes in levels of consumption occur roughly in concert in different societies, with particular reference to the decline in drinking and heavy drinking in current youth cohorts. Results and Conclusion: Timing tends to rule out economic change as a factor in the current widespread decline in youth drinking. The technological revolution of the electronic web and the smart phone seems a primary explanation, with the widespread change in social presentation and interaction - in habitus - between parents and children also involved. Directions for further research are suggested.

  • 18.
    Roumeliotis, Filip
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Drug prevention, politics and knowledge: Ideology in the making2014In: Addiction Research and Theory, ISSN 1606-6359, E-ISSN 1476-7392, Vol. 22, no 4, p. 336-347Article in journal (Refereed)
    Abstract [en]

    The quest for rational and effective methods for political action has long been at the forefront of Swedish drug policy and prevention. This article focuses on the ideological dimension of Swedish drug prevention policy during the years 1981–2011 by examining the knowledge utilisation in the construction of drugs as a political problem. Ten public reports have been analysed in terms of how drugs are constructed as problems in policy proposals, including an analysis of how knowledge is used in proposals for preventive measures. There was a marked shift in the 1990s in how the drug issue was constructed as a problem and what preventive measures should be taken. What used to be an issue of social exclusion that should be managed politically on a structural level now became a behavioural concern and a matter of liberal drug values. Values, then, were to be addressed by methods aimed at modifying individual behaviour. The analysis suggests that drug prevention today has been constructed in a way that precludes reading drugs as a problem of social exclusion. Drugs are constructed as a problem to be handled by experts rather than politics, which helps to circumvent demands for political accountability and the very possibility of constructing drugs as a political problem.

  • 19.
    Rødner Sznitman, Sharon
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    An examination of the normalization of cannabis use among 9th grade school students in Sweden and Switzerland2007In: Addiction Research and Theory, ISSN 1606-6359, E-ISSN 1476-7392, Vol. 15, no 6, p. 601-616Article in journal (Refereed)
    Abstract [en]

    This article attempts to improve the models and theories researchers use when investigating drug use in the normal population. The study systematically investigates two dimensions of the normalisation thesis, namely behavioural and cultural normalisation. Whilst the former is measured based on national prevalence rates, the measurement of the latter dimension is based on parameters used in social control theory. More concretely, cultural normalisation is measured based upon the comparative strength of social bonds of cannabis users vs. non-users. The regression analysis, conducted on a Swedish and Swiss student sample, suggests that cannabis users in both the countries are reasonably bounded to conventional society, yet total cultural normalisation does not exist as social bond factors successfully separate users from non-users. Furthermore, the study shows that cultural cannabis normalisation does not necessarily follow behavioural cannabis normality. As such the study brings light to the fact that the normalisation concept may be useful to the investigation of drug-taking in very different drug-taking contexts.

  • 20.
    Samuelsson, Eva
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences.
    Sundqvist, Kristina
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences.
    Binde, Per
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences.
    Configurations of gambling change and harm: qualitative findings from the Swedish longitudinal gambling study (Swelogs)2018In: Addiction Research and Theory, ISSN 1606-6359, E-ISSN 1476-7392, Vol. 26, no 6, p. 514-524Article in journal (Refereed)
    Abstract [en]

    Background: Gambling participation and problems change over time and are influenced by a variety of individual and contextual factors. However, gambling research has only to a small extent studied gamblers’ own perceptions of transitions in and out of problem gambling.Method: Qualitative telephone interviews were made with 40 gamblers who had repeatedly participated in the Swelogs Swedish Longitudinal Gambling Study. The framework approach was used for analyses, resulting in a multiple-linkage typology.Results: Our analyses revealed four configurations of gambling: (a) stable low frequency with no or minor harm, (b) decreasing high frequency with occasional harm, (c) fluctuating with moderate harm, and (d) increasing high frequency with substantial harm. Natural recovery and return to previous levels of gambling intensity were common. Change occurred either gradually, as a result of adjustment to altered personal circumstances, or drastically as a consequence of determined decisions to change. Personal and contextual factors such as psychological well-being, supportive relationships, and meaningful leisure activities played a part in overcoming harmful gambling and keeping gambling on a non-problematic level. Gambling advertising was commonly perceived as aggressive and triggering.Conclusions: The experience of harm is highly subjective, which should be taken into account when developing preventive measures. Considering the fluid character of gambling problems, help and support should be easily accessible and diversified. To repeatedly be interviewed about gambling and its consequences can contribute to increased reflection on, and awareness of, one’s own behaviours and the societal impacts of gambling.

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  • 21.
    Samuelsson, Eva
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Wallander, Lisa
    Disentangling practitioners’ perceptions of substance use severity: a factorial survey2014In: Addiction Research and Theory, ISSN 1606-6359, E-ISSN 1476-7392, Vol. 22, no 4, p. 348-360Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to examine the influence of user, staff and work unit characteristics on addiction care practitioners’ assessments of the severity of alcohol and drug use. A factorial survey was conducted among 489 social workers, therapists, nurses, doctors and executives from 77 addiction care units in the three largest Swedish counties. Staff assessed the severity of 10 fictive scenarios, vignettes (n = 4724), describing persons with varying social characteristics who were users of alcohol, cannabis or cocaine. The effects of user, respondent and work-unit variables on the practitioners’ severity assessments were estimated using multilevel regression analysis. The results show that perceived severity was influenced not only by the substance, the frequency and character of the negative consequences of the use, but also by the age, socio-economic status and family situation of the user. Women, older respondents and respondents with a medical education rather than a social work education were on average more inclined to assess the vignettes as being more severe. Analyses of various interactions revealed that practitioners viewed the drinking of young men as being less severe than that of young women. Doctors saw women's use as more problematic than men's, irrespective of the context. To conclude, alcohol and drug consumption is judged by different norms, depending on various characteristics of the users, of the practitioners and also of their workplaces. To avoid potential negative consequences of the application of such varying standards in addiction care, more individual reflection and workgroup discussion are needed.

  • 22. Simonen, Jenni
    et al.
    Törrönen, Jukka
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Tigerstedt, Christoffer
    Femininities of drinking among Finnish and Swedish women of different ages2014In: Addiction Research and Theory, ISSN 1606-6359, E-ISSN 1476-7392, Vol. 22, no 2, p. 98-108Article in journal (Refereed)
    Abstract [en]

    This article discusses femininities of drinking in Finland and in Sweden. It compares how Finnish and Swedish women define accepted and desired drinking-related femininity. It also asks how femininity related to drinking is constructed and to what traits it is associated with. According to the general assumption increased intoxication oriented drinking among women means that drinking habits and behavior between women and men have becomemore similar. We rather suggest that women have not only adopted intoxication oriented drinking but they connect it to their feminine identity by shapingit according to their own needs and actions. The analysis is made by using focus group interviewsfrom Finland and Sweden from four different agegroups (20 years, 25–30 years, 35–40 years and 50–60 years) and from two educational levels. The data has been analyzed by examining how Finnish and Swedish women construct femininities of drinking while interpreting the pictures of drinking situations.The analysis shows that there is variety offemininities of drinking. Age seems to be animportant factor in the construction of femininities; younger and older Finnish and Swedish women relate different traits to drinking-related femininity.It seems that the composition of drinking related gender identity has broadened from traditional hegemonic feminine values to versatility. This relates to the expansion of drinking related actions and the strengthening of drinking related agency among women. Based on these findings, younger generations seem to have a wider variety of drinking related repertoires and ways to interpret femininity than older generations.

  • 23.
    Skogens, Lisa
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    von Greiff, Ninive
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Berlin, Marie
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Bergmark, Anders
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    A 30-year follow-up of substnace misusers in Sweden – differences and predictors of mortality between women and men2019In: Addiction Research and Theory, ISSN 1606-6359, E-ISSN 1476-7392, Vol. 27, no 4, p. 328-336Article in journal (Refereed)
    Abstract [en]

    Background: Differing results on gender specific factors related to mortality risks among substance misusers highlights the need for further research. The present article is based on a 30-year follow-up study on substance misusers treated in residential care for drug problems in Sweden in 1982-1983 aiming to identify and compare gender differences in predictors of mortality.

    Method: Original data consists of personal interviews with 1163 substance misusers treated in inpatient units in Sweden during 1982-1983. The outcome variable is death retrieved from the National Cause of Death Register held by the National Board of Health and Welfare. Gender differences and similarities regarding predictors of mortality was estimated in univariate and multivariate models, using Cox proportional hazards models.

    Results: School failure, imprisonment and being a parent without custody of the child seem to constitute risk factors for mortality among women, but not among men. A social network of friends seemed to be more important for men. Treatment-dropout was a significant risk factor for premature death among men, but not among women. Both gender reporting alcohol as their self-reported most dominant substance misuse showed higher mortality risks compared with those with stimulants as dominant substance misuse.

    Conclusions: Imprisonment was highly predictive of mortality for the women, suggesting that this group is important to pay particular attention to. Suggested differences in the importance of social factors need to be investigated more thoroughly. The substantial hazard revealed for women with polydrug misuse including alcohol calls for attention to this in treatment for substance misuse.

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  • 24. Sleczka, Pawel
    et al.
    Braun-Michl, Barbara
    Schwarzkopf, Larissa
    Spörrle, Matthias
    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, Munich, Germany; ELTE Eötvös Loránd University, Budapest, Hungary.
    Why do they gamble and what does it mean? Latent class analysis of gambling motives among young male gamblers2022In: Addiction Research and Theory, ISSN 1606-6359, E-ISSN 1476-7392, Vol. 30, no 6, p. 431-440Article in journal (Refereed)
    Abstract [en]

    BACKGROUND Motives to gamble are important in the functional analysis of problematic gambling. This study examines the possibility of classifying young male gamblers based on their motives to gamble and compares the identified groups to validate the obtained classification.

    METHOD Based on a screening survey among 2,681 young men from Bavaria, n=170 frequent or problem gamblers (Mage = 22.3 years, SD = 2.5) were recruited to participate in a survey with a 2-year follow-up. Latent class analyses (LCA) were conducted based on baseline answers to 10 items measuring five domains of gambling motives: enhancement, coping, self-gratification, and social and financial motives. The identified classes were compared regarding baseline gambling attitudes and impulsiveness as well as gambling behavior and gambling disorder (GD) criteria at baseline and follow-up.

    RESULTS Analyses revealed a four-class solution based on reported motives: ‘primarily fun-motivated gamblers’ (n=100, 58.8%), who gambled mostly for fun; ‘asset and self-gratification seekers’ (n=19, 11.2%) with a high risk of GD at baseline; ‘thrill seekers’ (n=42, 24.7%) with high impulsiveness; and ‘polymotivated coping gamblers’ (n=9, 5.3%) with a higher risk of GD than the ‘primarily fun-motivated gamblers’ in cross-sectional and longitudinal analyses.

    CONCLUSIONS The identified group differences support the validity of the classification. ‘Thrill seekers’ and ‘polymotivated coping gamblers’ correspond to the impulsive and emotionally vulnerable pathways described by Blaszczynski and Nower (2002) respectively. The two other groups appear to be subtypes of the behaviorally conditioned type. Motivation-based classification offers a promising approach to identifying individuals with an elevated risk of GD.

  • 25.
    Storbjörk, Jessica
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). University of Melbourne, Australia; AER Centre for Alcohol Policy Research, Australia.
    The two worlds of alcohol problems: Who is in treatment and who is not?2008In: Addiction Research and Theory, ISSN 1606-6359, E-ISSN 1476-7392, Vol. 16, no 1, p. 67-84Article in journal (Refereed)
    Abstract [en]

    In the study “Women and Men in Swedish Alcohol and Drug Treatment,” it is possible to compare alcohol consumption and problems among respondents in the general population with those in clients entering alcohol treatment. The differences between these groups have led researchers to talk about the “two worlds” of alcohol problems-in general and in clinical populations. The aim of this article is to study the relative strength of factors in predicting entering and the clinical population. The studied factors are demographics and marginalization; volume and frequency of drinking; alcohol dependence; social response to drinking (suggestions to cut down or seek treatment by informal actors, e.g. family and friends, and formal actors such as employer, the social services or judicial system); and treatment history. The client sample includes 1202 clients (71% men) interviewed face-to-face when entering inpatient and outpatient treatment facilities in Stockholm. In the general population survey, 3557 persons aged 18-75 years were interviewed. The two samples differ significantly. As expected, clients were older, more marginalized and reported more severe alcohol problems, and many reported previous treatment experiences and social responses. Logistic regression analyses show that previous treatment, unemployment/institutionalization and having an unstable living situation are the strongest predictors of who is in treatment, followed by age, alcohol dependence and frequency of drinking. Formal pressures to cut down or seek treatment are also important and males are more likely to be in treatment. The results support a notion of the treatment system as a place for handling marginalized people, beyond and beside their extent of drinking.

  • 26.
    Storbjörk, Jessica
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Ullman, Sara
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    A prospective study of mortality up to eight years after starting treatment for alcohol and drug problems in Stockholm county: 2000-20082012In: Addiction Research and Theory, ISSN 1606-6359, E-ISSN 1476-7392, Vol. 20, no 5, p. 402-413Article in journal (Refereed)
    Abstract [en]

    Background and aim: Research indicates an association between substance use and premature death and that misuse of illicit drugs is more closely linked to mortality than alcohol misuse. Given that these studies often are based on homogeneous treatment populations, we sought to analyse long-term mortality among both alcohol and drug misusers in a representative treatment system sample by examining: (1) excess death ratios (SMR, standardised mortality ratio) in comparison with the general population and (2) risk factors for mortality within the sample. Method: Prospective study (N = 1659; 28% women) interviewed when starting treatment in Stockholm County, 2000-2002, and followed-up with regard to mortality up to 8 years after baseline. Analyses were based on death certificates and intake interview data (demographics, social situation/support, ICD-10 alcohol/drug dependence, treatment experiences). The strength of the study is the prospective design, that we have been able to link mortality to interview data, and to reach a heterogeneous treatment population. Results: (1) SMR was 5.7 (no sex difference). (2) Logistic regression showed that being older, male, retired and having reported living with a substance misuser were identified as risk factors for mortality within the sample. Housing organised by authorities and no dependence on alcohol/drugs were protective factors. The mortality risk did not differ between alcohol and drug-dependent cases. Neither was homelessness, living situation (3 years) nor education predictive of mortality. Conclusions: No difference regarding mortality risk between treated alcohol and drug-dependent patients in Sweden is found when controlling for age.

  • 27.
    Törrönen, Jukka
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Roumeliotis, Filip
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Masculinities of drinking as described by Swedish and Finnish age-based focus groups2014In: Addiction Research and Theory, ISSN 1606-6359, E-ISSN 1476-7392, Vol. 22, no 2, p. 126-136Article in journal (Refereed)
    Abstract [en]

    This article deals with masculinities in drinkingby analysing how focus groups from Sweden and Finland discuss male and female drinking in diverse drinking situations. It argues that women’s strengthened independency in working life, their increased drinking in domestic and public settings,and their entrance into drinking situations that used to be male dominated have challenged the cultural domination of traditional masculinity in drinking and made drinking styles a more diverse and heterogeneous phenomenon within and across gender groups. The analysis shows that the focus groups construct masculinities in which manhood is associated with creativity, depression, violence,virility, flaˆneurism, nurture, homosociability, business masculinity and weakness. These masculinities oppose, interlace or intermingle with femininitiesand change the shape depending on the situation,drinking company and the perspective of the viewer.Their broad spectrum shows that, in Finland and Sweden, there are multiple independent and strong drinking masculinities and femininities, none of which is given a self-evident hegemony over theothers. Thus, the study points out that the masculinities and femininities of today are not reducible to any single hierarchy of dominant and subordinate masculinities. For the current hegemonic masculinities, it seems to be typical that they vary locally, regionally and globally, intersect in specific wayswith class, age and generation, and form multidimensional, paradoxical and tension-driven relationships with each other and with femininities.

  • 28.
    Wicki, Matthias
    et al.
    Research Department, Swiss Institute for the Prevention of Alcohol and Drug Problems (SIPA), Lausanne, Switzerland.
    Gustafsson, Nina-Katri
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Mäkelä, Pia
    National Institute for Health and Welfare (THL), Helsinki, Finland.
    Gmel, Gerhard
    Research Department, Swiss Institute for the Prevention of Alcohol and Drug Problems (SIPA), Lausanne, Switzerland.
    Dimensionality of drinking consequences: Cross-cultural comparability and stability over time2009In: Addiction Research and Theory, ISSN 1606-6359, E-ISSN 1476-7392, Vol. 17, no 1, p. 2-16Article in journal (Refereed)
    Abstract [en]

    Despite the long tradition for asking about the negative social and health consequences of alcohol consumption in surveys, little is known about the dimensionality of these consequences. Analysing cross-sectional and longitudinal data from the Nordic Taxation Study collected for Sweden, Finland, and Denmark in two waves in 2003 and 2004 by means of an explorative principal component analysis for categorical data (CATPCA), it is tested whether consequences have a single underlying dimension across cultures. It further tests the reliability, replicability, concurrent and predictive validity of the consequence scales. A one-dimensional solution was commonly preferable. Whereas the two-dimensional solution was unable to distinguish clearly between different concepts of consequences, the one-dimensional solution resulted in interpretable, generally very stable scales within countries across different samples and time.

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