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  • 1. Azar, Denise
    et al.
    White, Victoria
    Bland, Stephanie
    Livingston, Michael
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Chikritzhs, Tanya
    Durkin, Sarah
    Gilmore, William
    Wakefield, Melanie
    ‘Something's Brewing’: the changing trends in alcohol coverage in Australian newspapers 2000–20112014In: Alcohol and Alcoholism, ISSN 0735-0414, E-ISSN 1464-3502, Vol. 49, no 3, p. 336-342Article in journal (Refereed)
    Abstract [en]

    Aims: The portrayal of alcohol in the news media, including newspapers, plays an important role in influencing societalnorms and setting public agendas. We present the first large-scale examination of news coverage of alcohol-related issues in Australiannewspapers.

    Method: Content analysis was performed on a sample of alcohol-related newspaper articles (n = 4217) published acrossAustralia from 2000 to 2011. Articles were coded for type, theme, prominence, topic slant, opinion slant and sources/spokesperson.

    Results: Across the period, the most common themes were promotion (21%), drink-driving (16%) and restrictions/policy (16%).Themes of restrictions/policy and responsible beverage services became more common over time. Promotion and business-related articlessignificantly declined over time. Overall, the topic slant of the majority of news related articles disapproved of alcohol use. Disapproval increased over time while approval of alcohol use decreased. While the slant of opinion pieces was predominantly approvingof alcohol, this decreased over time. Presence of an alcohol industry representative in articles declined over time.

    Conclusion: Thepresentation of alcohol use in Australian newspapers became more disapproving over time, which may suggest that harmful alcohol usehas become less acceptable among the broader Australian community.

  • 2. Balldin, Jan
    et al.
    Berglund, Kristina J.
    Berggren, Ulf
    Wennberg, Peter
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Fahlke, Claudia
    TAQ1A1 Allele of the DRD2 Gene Region Contribute to Shorter Survival Time in Alcohol Dependent Individuals When Controlling for the Influence of Age and Gender. A Follow-up Study of 18 Years2018In: Alcohol and Alcoholism, ISSN 0735-0414, E-ISSN 1464-3502, Vol. 53, no 3, p. 216-220Article in journal (Refereed)
    Abstract [en]

    Aims: To investigate the influence of the A1 allele of the TAQ1A polymorphism in the dopamine D2 receptor (DRD2) gene region on mortality in adult individuals with alcohol dependence. Methods: The study sample consisted of 359 alcohol-dependent individuals treated for severe alcohol withdrawal symptoms in 1997. Years of survival was studied in an 18-year follow-up. In the analyses, gender and age were controlled for. Results: At the 18-year follow-up, 53% individuals had deceased. The analyses showed that older age (P < 0.001), male gender (P < 0.05) and carrying the A1 allele (P < 0.01) all significantly and independently contributed to shorten years of survival. Among the deceased individuals, the genotype A1+ was the only significant contributor to shorten years of survival. Conclusions: An important contribution of the present study is that in alcohol dependence the Taq1A1 allele of the DRD2 gene region is a risk factor for premature death of similar importance as the well-known risk factors of age and gender. Short Summary: We investigated the influence of A1 allele of the TAQ1A polymorphism in DRD2 receptor gene region on mortality in alcohol-dependent individuals in an 18-year follow-up. Age, gender and the A1 allele contributed to shorten years of survival. Among the deceased, the A1+ was the only contributor to shorten years of survival.

  • 3. Bond, Jason
    et al.
    Witbrodt, Jane
    Ye, Yu
    Cherpitel, Cheryl J.
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). University of Melbourne, Australia; Turning Point Alcohol and Drug Centre, Australia.
    Monteiro, Maristela G.
    Exploring Structural Relationships Between Blood Alcohol Concentration and Signs and Clinical Assessment of Intoxication in Alcohol-Involved Injury Cases2014In: Alcohol and Alcoholism, ISSN 0735-0414, E-ISSN 1464-3502, Vol. 49, no 4, p. 417-422Article in journal (Refereed)
    Abstract [en]

    Aims: Although the relationship between the Y90 (blood alcohol concentration, BAC) and Y91 (clinician intoxication assessment) ICD-10 codes has received attention recently, the role of 10 signs of intoxication in the Y91-Y90 relationship has not been studied yet. This work examines these signs in the estimation of alcohol intoxication levels of patients in medical settings. Methods: Collected and analyzed were data on 1997 injured emergency room patients from 17 countries worldwide reporting drinking prior to injury or presenting with a non-zero BAC from 17 countries worldwide. A model is estimated describing how the 10 signs inform the Y91, Y90 prediction with the goal of the use of observations on patients in place of a biological measure. Results: Signs were consistent with a single underlying construct that strongly predicted Y91. Smell of alcohol on breath predicted Y91 above its contribution through the construct and was stronger for those with tolerance to alcohol than for those without. Controlling for Y91, no sign further contributed to prediction of Y90 indicating that Y91 incorporated all intoxication sign information in predicting Y90. Variance explained was high for Y91 (R-2 = 0.84) and intoxication signs (above 0.72 for all but smell on the breath, 0.57) and lower for Y90 (0.38). Conclusion: Intoxication assessments are well predicted by overall intoxication severity, which itself is well represented by intoxication signs along with differential emphasis on smell of alcohol on breath, especially for those with alcohol tolerance. However, BAC levels remain largely unexplained by intoxication signs with a clinician's assessment serving as the primary predictive measure.

  • 4. Callinan, Sarah
    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.
    Livingston, Michael
    Jiang, Heng
    Who Purchases Low-Cost Alcohol in Australia?2015In: Alcohol and Alcoholism, ISSN 0735-0414, E-ISSN 1464-3502, Vol. 50, no 6, p. 647-653Article in journal (Refereed)
    Abstract [en]

    Debates surrounding potential price-based polices aimed at reducing alcohol-related harms tend to focus on the debate concerning who would be most affected-harmful or low-income drinkers. This study will investigate the characteristics of people who purchase low-cost alcohol using data from the Australian arm of the International Alcohol Control study. 1681 Australians aged 16 and over who had consumed alcohol and purchased it in off-licence premises were asked detailed questions about both practices. Low-cost alcohol was defined using cut-points of 80A cent, $1.00 or $1.25 per Australian standard drink. With a $1.00 cut-off low income (OR = 2.1) and heavy drinkers (OR = 1.7) were more likely to purchase any low-cost alcohol. Harmful drinkers purchased more, and low-income drinkers less, alcohol priced at less than $1.00 per drink than high income and moderate drinkers respectively. The relationship between the proportion of units purchased at low cost and both drinker category and income is less clear, with hazardous, but not harmful, drinkers purchasing a lower proportion of units at low cost than moderate drinkers. The impact of minimum pricing on low income and harmful drinkers will depend on whether the proportion or total quantity of all alcohol purchased at low cost is considered. Based on absolute units of alcohol, minimum unit pricing could be differentially effective for heavier drinkers compared to other drinkers, particularly for young males.

  • 5. de Matos, Elena Gomes
    et al.
    Kraus, Ludwig
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). IFT Institut für Therapieforschung, Germany.
    Pabst, Alexander
    Piontek, Daniela
    Does a Change Over All Equal a Change in All? Testing for Polarized Alcohol Use Within and Across Socio-Economic Groups in Germany2015In: Alcohol and Alcoholism, ISSN 0735-0414, E-ISSN 1464-3502, Vol. 50, no 6, p. 700-707Article in journal (Refereed)
    Abstract [en]

    This study aimed at testing whether drinking volume and episodic heavy drinking (EHD) frequency in Germany are polarizing between consumption levels over time. Polarization is defined as a reduction in alcohol use among the majority of the population, while a subpopulation with a high intake level maintains or increases its drinking or its EHD frequency. The polarization hypothesis was tested across and within socio-economic subgroups. Analyses were based on seven cross-sectional waves of the Epidemiological Survey of Substance Abuse (ESA) conducted between 1995 and 2012 (n = 7833-9084). Overall polarization was estimated based on regression models with time by consumption level interactions; the three-way interaction with socio-economic status (SES) was consecutively introduced to test the stability of effects over socio-economic strata. Interactions were interpreted by graphical inspection. For both alcohol use indicators, declines over time were largest in the highest consumption level. This was found within all SES groups, but was most pronounced at low and least pronounced at medium SES. The results indicate no polarization but convergence between consumption levels. Socio-economic status groups differ in the magnitude of convergence which was lowest in medium SES. The overall decline was strongest for the highest consumption level of low SES.

  • 6.
    Eklund, Jenny
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    af Klinteberg, Britt
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Alcohol use and patterns of delinquent behaviour in male and female adolescents2009In: Alcohol and Alcoholism, ISSN 0735-0414, E-ISSN 1464-3502, Vol. 44, no 6, p. 607-614Article in journal (Refereed)
    Abstract [en]

    Aims: The overall aim was to study patterns of delinquent behaviour in relation to adolescent alcohol use. The more specific aims were to examine whether alcohol use varied between groups of adolescents with different patterns of delinquent behaviour, and to explore whether the association between delinquent behaviour patterns and alcohol use was similar for males and females.

    Methods:The participants were male (n = 406) and female (n = 532) adolescents in the eighth grade (age 14 years) in a medium-sized city of Sweden. We used information about self-rated alcohol use and different types of delinquent behaviour. 

    Results: The results revealed that the occurrence of excessive alcohol use and drunkenness varied between groups of adolescents with different delinquency patterns, and that the associations between alcohol use and patterns of delinquent behaviours were relatively similar for males and females. Adolescents with patterns characterized by more serious non-violent delinquency or by violent delinquency reported the highest occurrence of alcohol use and frequency of drunkenness. Adolescents with well-adjusted behaviour or occasional minor delinquency were less likely to report drinking large amounts of alcohol or to the point of feeling drunk. 

    Conclusions: The present results further emphasize the importance of distinguishing between different offender groups when examining the relationship between delinquent behaviour and associated problems, such as excessive alcohol use.

  • 7. Groß, Cornelius
    et al.
    Kraus, Ludwig
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). IFT Institut für Therapieforschung, Munich, Germany.
    Piontek, Daniela
    Reis, Olaf
    Zimmermann, Ulrich S.
    Prediction of long-term outcomes in young adults with a history of adolescent alcohol-related hospitalization2016In: Alcohol and Alcoholism, ISSN 0735-0414, E-ISSN 1464-3502, Vol. 51, no 1, p. 47-53Article in journal (Refereed)
    Abstract [en]

    Aims: Empirical data concerning the long-term psychosocial development of adolescents admitted to inpatient treatment with alcohol intoxication (AIA) are lacking. The aim of this study was to identify the factors that, at the time of admission, predict future substance use, alcohol use disorders (AUD), mental health treatment, delinquency and life satisfaction.

    Methods: We identified 1603 cases of AIA treated between 2000 and 2007 in one of five pediatric departments in Germany. These former patients were invited to participate in a telephone interview. Medical records were retrospectively analyzed extracting potential variables predicting long-term outcomes.

    Results: Interviews were conducted with 277 individuals, 5–13 [mean 8.3 (SD 2.3)] years after treatment, with a response rate of 22.7%; of these, 44.8% were female. Mean age at the interview was 24.4 (SD 2.2) years. Logistic and linear regression models revealed that being male, using illicit substances and truancy or runaway behavior in adolescence predicted binge drinking, alcohol dependence, use of illicit substances and poor general life satisfaction in young adulthood, explaining between 13 and 24% of the variance for the different outcome variables.

    Conclusions: This naturalistic study confirms that known risk factors for the development of AUD also apply to AIA. This finding facilitates targeted prevention efforts for those cases of AIA who need more than the standard brief intervention for aftercare.

  • 8.
    Gustafsson, Nina-Katri
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Changes in alcohol availability, price and alcohol-related problems and the collectivity of drinking cultures: What happened in southern and northern Sweden?2010In: Alcohol and Alcoholism, ISSN 0735-0414, E-ISSN 1464-3502, Vol. 45, no 5, p. 456-467Article in journal (Refereed)
    Abstract [en]

    Aims. There were two aims with this paper; first to study whether alcohol-related self-reported problems behaved in the same way as alcohol consumption in southern Sweden -- assumed to be affected by a decrease in Danish spirits tax and increased Swedish travellers’ import quotas. The second aim was to study whether the results in southern and northern Sweden followed the predictions of Skog’s theory of collectivity of drinking cultures. Methods. Analysis was carried out on a sample from the general Swedish population for southern and northern Sweden separately. Two indexes for alcohol-related problems were computed and analysed by sex, age, income and alcohol consumption level. Results. Although there were no large changes in the number of persons reporting alcohol-related problems, the general trend in data for various sub-populations was a decrease in the southern site and an increase in the northern site. The increase among men noted in alcohol consumption in the northern site was found among alcohol-related problems as well. However, various population subgroups changed in different directions and did not move in concert over the population distribution. Conclusions. Analyses conformed that alcohol-related problems according to the two indexes used were behaving similarly to alcohol consumption, but less divergent. Skog’s theory could not be confirmed, alcohol-related problems did not change collectively within the population.

  • 9. Hanschmidt, Franz
    et al.
    Manthey, Jakob
    Kraus, Ludwig
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). IFT Institut für Therapieforschung, Germany.
    Scafato, Emanuele
    Gual, Antoni
    Grimm, Carsten
    Rehm, Jürgen
    Barriers to Alcohol Screening Among Hypertensive Patients and the Role of Stigma: Lessons for the Implementation of Screening and Brief Interventions in European Primary Care Settings2017In: Alcohol and Alcoholism, ISSN 0735-0414, E-ISSN 1464-3502, Vol. 52, no 2, p. 572-579Article in journal (Refereed)
    Abstract [en]

    Aims

    1. To quantify barriers to alcohol screening among hypertensive patients reported by primary healthcare professionals. 2. To examine whether education and screening frequency measures are associated with stigma-related barriers.

    Methods

    A web survey was conducted among 3081 primary healthcare professionals from France, Germany, Italy, Spain and the UK. Participants were asked about perceived barriers to alcohol screening as free-text response. The replies were independently categorized by two raters. Stigma-related barriers were predicted by logistic regressions with education, knowledge on alcohol as risk factor and frequency of alcohol screening.

    Results

    In France and Italy, almost half of the reported barriers were stigma-related, whereas time constraints were cited most commonly in Spain and the UK. In Germany, nearly half of respondents rated the importance of alcohol screening for hypertension as low. Perception that regular screening is inappropriate or associated with too much effort, beliefs that screening is unnecessary, and insufficient knowledge of screening tools were cited as further barriers. Professional education on alcohol use was consistently rated to be poorer than the equivalent education on hypertension, and only a minority of respondents perceived alcohol as important risk factor for hypertension. Stigma-related barriers could not be significantly predicted by education, knowledge or screening frequency in most models.

    Conclusions

    Overall, regular alcohol screening among hypertensive patients seems to be widely accepted, but further education (Germany) and structural support (Spain, UK) could contribute to increase screening rates. In France and Italy, screening uptake could be improved by addressing stigma.

    Short Summary

    Alcohol screening among hypertensive patients was largely accepted among general practitioners from five different European countries. Reported screening barriers varied between countries and included time constraints, stigma and underrated importance of alcohol. Results did not indicate a positive impact of education and screening frequency on perception of stigma as barrier to screening.

  • 10. Jayasekara, Harindra
    et al.
    MacInnis, Robert J.
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). La Trobe University, Australia; The University of Melbourne, Australia.
    English, Dallas R.
    Long-Term Alcohol Consumption and Breast, Upper Aero-Digestive Tract and Colorectal Cancer Risk: A Systematic Review and Meta-Analysis2016In: Alcohol and Alcoholism, ISSN 0735-0414, E-ISSN 1464-3502, Vol. 51, no 3, p. 315-330Article, review/survey (Refereed)
    Abstract [en]

    Cancers of female breast, upper aero-digestive tract (UADT) (oral cavity, pharynx, larynx, oesophagus) and colorectum are causally related to alcohol consumption. Although alcohol consumption is likely to vary during life, the few studies that have explicitly measured lifetime consumption or intake over time have not been summarised. We therefore conducted a systematic review and meta-analysis. Studies were identified by searching the Medline, CINAHL (Cumulative Index to Nursing and Allied Health Literature) and Scopus databases through January 2015 using broad search criteria. Studies reporting relative risks (RR) for quantitatively defined categories of alcohol consumption over time for breast, UADT or colorectal cancer were eligible. A two-stage random-effects meta-analysis was used to estimate a dose-response relationship between alcohol intake and each cancer site. RRs were also calculated for the highest relative to the lowest intake category. Sixteen articles for breast, 16 for UADT and 7 for colorectal cancer met the eligibility criteria. We observed a weak non-linear dose-response relationship for breast cancer and positive linear dose-response relationships for UADT and colorectal cancer. The pooled RRs were 1.28 (95% confidence interval, CI: 1.07, 1.52) for breast, 2.83 (95% CI: 1.73, 4.62) for UADT, 4.84 (95% CI: 2.51, 9.32) for oral cavity and pharynx, 2.25 (95% CI: 1.49, 3.42) for larynx, 6.71 (95% CI: 4.21, 10.70) for oesophageal and 1.49 (95% CI: 1.27, 1.74) for colorectal cancer. Our findings confirm dose-dependent associations between long-term alcohol intake and breast, UADT and colorectal cancer.

  • 11. Jiang, Heng
    et al.
    Callinan, Sarah
    Laslett, Anne-Marie
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). La Trobe University, Australia; The University of Melbourne, Australia.
    Measuring Time Spent Caring For Drinkers and Their Dependents2017In: Alcohol and Alcoholism, ISSN 0735-0414, E-ISSN 1464-3502, Vol. 52, no 1, p. 112-118Article in journal (Refereed)
    Abstract [en]

    Aims: To quantify the extent of time spent by family and friends caring for drinkers and their dependents, to estimate the cost of this time and to measure which factors predict time spent caring. Methods: Data are from a nationwide Alcohol's Harm to Others Survey of 2649 Australians, in which 778 respondents reported they were harmed by a known drinker. Time spent on four caring activities was self-reported by these respondents and tallied to estimate how many hours they spent caring for the drinker, the drinker's children or other dependents. Bivariate and multivariate linear regression models were employed to examine factors predicting time spent caring. Results: Respondents who reported they were harmed by a drinker they knew had spent on average 32 h caring for this drinker and their dependents in the past 12 months. Applying these figures to the Australian population, but discounting by 90% because this time may be seen be a voluntary demonstration of connection, an annual cost of caring in 2008 would amount to AU$ 250 million. A significant positive association was found between time spent caring and the drinking level and drinking frequency of the heavy drinking other person. Conclusion: Caring for drinking family members, friends, co-workers and a drinker's dependents can be a substantial burden. Policy approaches that reduce population drinking and individual risky drinking levels are potential means to reduce the burden of caring due to others' drinking.

  • 12. Jiang, Heng
    et al.
    Livingstone, Michael
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). Turning Point Alcohol & Drug Centre, Australia; University of Melbourne, Australia .
    Dietze, Paul
    Norström, Thor
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Kerr, William C.
    Alcohol Consumption and Liver Disease in Australia: A Time Series Analysis of the Period 1935–20062014In: Alcohol and Alcoholism, ISSN 0735-0414, E-ISSN 1464-3502, Vol. 49, no 3, p. 363-368Article in journal (Refereed)
    Abstract [en]

    Aims: The aim of the study was to examine for Australia whether the link between population alcohol consumption and liver disease mortality varies over time, using 71 years of data. Methods: Overall and gender-specific rates of liver disease mortality were analysed in relation to total alcohol consumption as well as for different beverage types by using autoregressive integrated moving average (ARIMA) time series methods. Separate models were developed for the entire time period and for two sub-periods (1935–1975, 1976–2006). Results: A 1-l increase in adult per capita consumption of pure alcohol led to a rise of ∼10% in overall liver disease mortality rates and a 11 and 9% increase in female and male liver disease mortality, respectively. The strength of the relationship between per capita consumption and liver disease mortality diminished over time. Spirits consumption was found to be the main driving factor in liver mortality rates between 1935 and 1975, while beer consumption was found to be the most significant predictor in liver diseases in the last three decades. In a comparative perspective, the effect of per capita alcohol consumption on liver disease in Australia is similar to the USA, Southern and Eastern Europe countries, but weaker than in Canada and western European countries. Conclusion: An increase in per capita alcohol consumption in Australia is likely to lead to an increase in liver disease. Changes in the most important beverage over the study period suggest substantial shifts in drinking patterns and preferences among the heaviest Australian drinkers.

  • 13. Karlsson, Gunilla
    et al.
    Halldin, Jan
    Leifman, Anders
    Bergman, Hans
    Romelsjö, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Hospitalization and mortality succeeding drunk driving and risky driving2003In: Alcohol and Alcoholism, ISSN 0735-0414, E-ISSN 1464-3502, Vol. 38, no 3, p. 281-286Article in journal (Refereed)
    Abstract [en]

    AIMS:The association between drunk driving (DD) and/or risky driving (RD) offences and subsequent hospitalization and mortality was studied during a 25-year period.

    METHODS:Information about drinking habits and psychosocial factors for the 8122 conscripts from Stockholm County in 1969-1970 was linked to register data on hospitalization, mortality, DD and RD.

    RESULTS:Analyses comparing background characteristics of DD and RD groups showed that the prevalence of problem behaviour and drug use was highest in the RD group. The relative risk (RR) for hospitalization after DD and/or RD was significantly elevated in multivariate logistic regression analysis for all the studied diagnostic categories (alcohol diagnoses, narcotic diagnoses, suicide attempts, psychoses, E-codes, all diagnoses), and was especially high for alcohol (RR = 7.2) and diagnosis of drug misuse (RR = 9.2). The RR of all hospitalization was 1.5 for the DD group, 1.8 for the RD group, and 1.9 for those who had been sentenced both for drunk driving and risky driving (DRD), all of which were significantly increased. The RR of death was significantly elevated in all three groups.

    CONCLUSIONS:The results show a significantly increased risk of hospitalization and mortality both in the DD and the RD group. From a public health and traffic safety perspective, this implies a need for developing and implementing better prevention strategies.

  • 14.
    Kraus, Ludwig
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). IFT Institut für Therapieforschung, Germany.
    Eriksson Tinghög, Mimmi
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Lindell, Annette
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Pabst, Alexander
    Piontek, Daniela
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). University of Melbourne, Australia; Turning Point Alcohol and Drug Centre, Australia.
    Age, Period and Cohort Effects on Time Trends in Alcohol Consumption in the Swedish Adult Population 1979-20112015In: Alcohol and Alcoholism, ISSN 0735-0414, E-ISSN 1464-3502, Vol. 50, no 3, p. 319-327Article in journal (Refereed)
    Abstract [en]

    Aims: In Sweden, alcohol abstention has increased over the last 20 years and consumption has recently decreased after a peak in 2004. To understand the dynamics of these trends the present study aims at estimating age, period and cohort (APC) effects on trends in alcohol use prevalence as well as overall and beverage-specific volume of drinking over the last three decades. Methods: APC analysis of seven cross-sectional surveys from 1979 to 2011 was conducted using cross-classified random effects models (CCREMs) by gender. The nationally representative samples comprised 77,598 respondents aged 16-80 years. Outcome measures were 30-day prevalence of alcohol use and overall as well as beverage-specific alcohol volume. Results: Trends in prevalence, overall and beverage-specific volume were significantly affected by APC. The period effects of prevalence and overall volume showa small decline after an increase up to the year 2005. Mean beer and wine volume levelled off after a peak in 2005 and volume of spirits drinking decreased constantly. Predicted alcohol prevalence rates in male cohorts (1945-1985) remained generally at the same level, while they declined in post-World War II female generations. Results point to high overall and beverage-specific consumption among cohorts born in the 1940s, 1950s and 1980s. Conclusions: High consuming cohorts of the 1940-1950s were key in rising consumption up to 2005. Progression through the life course of these cohorts, a decrease in prevalence and drinking volume in successive cohorts seem to have contributed to the recent downward trend in alcohol use in Sweden.

  • 15.
    Landberg, Jonas
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences. Karolinska Institutet, Sweden.
    Danielsson, Anna-Karin
    Falkstedt, Daniel
    Hemmingsson, Tomas
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences. Karolinska Institutet, Sweden.
    Fathers' Alcohol Consumption and Long-Term Risk for Mortality in Offspring2018In: Alcohol and Alcoholism, ISSN 0735-0414, E-ISSN 1464-3502, Vol. 53, no 6, p. 753-759Article in journal (Refereed)
    Abstract [en]

    Aim: This study examined associations between fathers' alcohol consumption and risk for total and cause-specific mortality in offspring. Short summary: We examined the associations between fathers' alcohol consumption and total and cause-specific mortality in adult offspring. Fathers' alcohol consumption was associated with increased risk of alcohol-related mortality in offspring. The association appeared to be weaker for causes of death in which alcohol plays a smaller, or less direct, role. Methods: Data on fathers' alcohol consumption, and offspring's risky use of alcohol, smoking, mental health and contact with police/childcare authorities were collected among 46,284 men (sons) aged 18-20 years, during conscription for compulsory military training in 1969/70. Data on offspring mortality were obtained from the National Cause of Death register, 1971-2008. The mortality outcomes included total mortality, alcohol-related causes of death and violent causes of death (categorized into suicides vs violent/external causes excluding suicides). Results: Compared to sons whose fathers never used alcohol, the risk for total and alcohol-related mortality among sons increased with the father's consumption level. The risk of violent death was significantly elevated among sons whose fathers drank alcohol occasionally or often, but the risk of suicide increased in the highest consumption category only. After adjustment for covariates, the results remained for alcohol-related mortality whereas they were significantly attenuated, or disappeared, for total mortality, violent death and suicide. Conclusions: Fathers' alcohol consumption is associated with increased risk of alcohol-related mortality in the offspring. Alcohol use among fathers also increases the offspring's risk of later total mortality, suicide and violent death, but these associations appear to be mediated or confounded by factors related to parental drinking and/or adverse childhood psychosocial circumstances.

  • 16. Landberg, Jonas
    et al.
    Hübner, Lena
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Changes in the Relationship Between Volume of Consumption and Alcohol-Related Problems in Sweden During 1979-20032014In: Alcohol and Alcoholism, ISSN 0735-0414, E-ISSN 1464-3502, Vol. 49, no 3, p. 308-316Article in journal (Refereed)
    Abstract [en]

    Aims: The aim of the study was to investigate (i) whether the strength of the relationship between self-reported volume of consumption and alcohol-related problems has become weaker in Sweden, and (ii) whether such a change can be related to temporal changes in drinking patterns or to changes in the distribution of consumption and related problems in the population. Methods: Three cross-sectional general population surveys conducted in Sweden in 1979, 1995 and 2003 yielded data on 5650 Swedish adults aged 18-69 years. The relationship between self-reported volume of consumption and self-reported alcohol-related problems was estimated using Poisson regression models. Analyses of drinking patterns focused on changes in frequency of drinking, volume per occasion and frequency of drinking to intoxication. Lorenz curves were used to analyse the distributions of consumption and alcohol-related problems. Results: Poisson regression estimates revealed that the relationship between volume of consumption and alcohol-related problems became weaker over time; a 10% per cent change in self-reported volume of consumption was associated with a smaller per cent change in the number of experienced problems in 2003 (5%) compared with 1995 (6%) and 1979 (7%). This change was not related to a hypothesized general shift towards a more southern European style of drinking, as no such tendency was found. Conclusion: The changed relationship appears to be a reflection of a redistribution of consumption and alcohol-related problems in the population, such that a larger share of all consumption and related problems occurs among light or moderate drinkers in 2003 compared with 1979.

  • 17. O'Brien, Paula
    et al.
    Gleeson, Deborah
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). La Trobe University, Australia.
    Wilkinson, Claire
    Commentary on 'Communicating Messages About Drinking': Using the 'Big Legal Guns' to Block Alcohol Health Warning Labels2018In: Alcohol and Alcoholism, ISSN 0735-0414, E-ISSN 1464-3502, Vol. 53, no 3, p. 333-336Article in journal (Other academic)
    Abstract [en]

    Like the tobacco industry, the alcohol industry, with the support of governments in alcohol exporting nations, is looking to international trade and investment law as a means to oppose health warning labels on alcohol. The threat of such litigation, let alone its commencement, has the potential to deter all but the most resolute governments from implementing health warning labeling.

  • 18. Rehm, J.
    et al.
    Anderson, P.
    Gual, A.
    Kraus, Ludwig
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Marmet, S.
    Nutt, D. J.
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). University of Melbourne, Australia; Turning Point Alcohol & Drug Centre, Australia.
    Samokhvalov, A. V.
    Scafato, E.
    Shield, K. D.
    Trapencieris, M.
    Wiers, R. W.
    Gmel, G.
    The tangible common denominator of substance use disorders: a reply to Commentaries to Rehm et al. (2013a)2014In: Alcohol and Alcoholism, ISSN 0735-0414, E-ISSN 1464-3502, Vol. 49, no 1, p. 118-122Article in journal (Refereed)
    Abstract [en]

    In response to our suggestion to define substance use disorders via ‘heavy use over time’, theoretical and conceptual issues, measurement problems and implications for stigma and clinical practice were raised. With respect to theoretical and conceptual issues, no other criterion has been shown, which would improve the definition. Moreover, heavy use over time is shown to be highly correlated with number of criteria in current DSM-5. Measurement of heavy use over time is simple and while there will be some underestimation or misrepresentation of actual levels in clinical practice, this is not different from the status quo and measurement of current criteria. As regards to stigma, research has shown that a truly dimensional concept can help reduce stigma. In conclusion, ‘heavy use over time’ as a tangible common denominator should be seriously considered as definition for substance use disorder.

  • 19. Rehm, J.
    et al.
    Marmet, S.
    Anderson, P.
    Gual, A.
    Kraus, Ludwig
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Nutt, D. J.
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). University of Melbourne.
    Samokhvalov, A. V.
    Scafato, E.
    Trapencieris, M.
    Wiers, R. W.
    Gmel, G.
    Defining substance use disorders: do we really need more than heavy use?2013In: Alcohol and Alcoholism, ISSN 0735-0414, E-ISSN 1464-3502, Vol. 48, no 6, p. 633-640Article in journal (Refereed)
    Abstract [en]

    Aims: The aim of the study was to explore whether the concept of heavy substance use over time can be used as definition of substance use disorder. Methods: Narrative review. Results: Heavy use over time clearly underlies the neurobiological changes associated with current thinking of substance use disorders. In addition, there is evidence that heavy use over time can explain the majority of social problems and of burden of disease (morbidity and mortality). A definition of substance use disorders via heavy use over time would avoid some of the problems of current conceptualizations, for instance the cultural specificity of concepts such as loss of control. Finally, stressing the continuum of use may avoid the high level of stigmatization currently associated with substance use disorders.Conclusion: ‘Heavy substance use over time’ seems to be a definition of substance use disorders in line with results of basic research and epidemiology. Additionally, it reduces stigmatization. This approach should thus be further explored.

  • 20. Saunders, John B.
    et al.
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Enhancing the ICD System in Recording Alcohol’s Involvement in Disease and Injury2012In: Alcohol and Alcoholism, ISSN 0735-0414, E-ISSN 1464-3502, Vol. 47, no 3, p. 216-218Article in journal (Refereed)
    Abstract [en]

    Among the tasks facing those who code alcohol-related disorders in an international classification of disease are an examination of the multiple places in which the involvement of alcohol and other psychoactive substances (and their associated disorders) are captured and finding out how this can be optimized for clinical and epidemiological purposes. It is important to adjust the current coding system so that the involvement of alcohol in injuries is routinely recorded. The suggestions by Touquet and Harris (2012) for enhancing the International Classification of Diseases (ICD) system are valuable input for this process, pointing to the importance of codes that can be used in the emergency-department environment both for capturing alcohol´s involvement and to point to the necessary therapeutic response.

  • 21. Thor, Siri
    et al.
    Karlsson, Patrik
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Landberg, Jonas
    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.
    Social Inequalities in Harmful Drinking and Alcohol-Related Problems Among Swedish Adolescents2019In: Alcohol and Alcoholism, ISSN 0735-0414, E-ISSN 1464-3502Article in journal (Refereed)
    Abstract [en]

    Aims: The study aims to examine how socio-economic status (SES) among youth is related to binge-drinking and alcohol-related problems using three SES indicators: (i) SES of origin (parental education level), (ii) SES of the school environment (average parental education level at student’s school) and (iii) SES of destination (academic orientation).

    Methods: Cross-sectional data on upper secondary students (n= 4448) in Sweden. Multilevel logistic and negative binomial regression were used to estimate the relationship between each SES indicator and binge-drinking and alcohol-related problems, respectively.

    Results: Only SES of destination was significantly associated with binge-drinking, with higher odds for students in vocational programmes (OR= 1.42, 95% CI= 1.13–1.80). For the second outcome, SES of destination (rr=1.25; 95%CI=1.08–1.45) and SES of the school environment (rr=1.19, 95% CI=1.02–1.39) indicated more alcohol-related problems in vocational programmes and in schools with lower-educated parents. After adjustment for drinking patterns, the relationship remained for SES of the school environment, but became non-significant for SES of destination.

    Conclusion: Our results suggest that the SES gradient among youth is stronger for alcohol-related problems than for harmful drinking. By only focusing on SES differences in harmful alcohol use, researchers may underestimate the social inequalities in adverse alcohol-related outcomes among young people. Our findings also support the notion that the environment young people find themselves in matters for social inequalities in alcohol-related harm.

  • 22. Waleewong, Orratai
    et al.
    Laslett, Anne-Marie
    Chenhall, Richard
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences. University of Melbourne, Australia; La Trobe University, Australia.
    Seeking Help for Harm from Others' Drinking in Five Asian Countries: Variation Between Societies, by Type of Harm and by Source of Help2018In: Alcohol and Alcoholism, ISSN 0735-0414, E-ISSN 1464-3502, Vol. 53, no 6, p. 667-673Article in journal (Refereed)
    Abstract [en]

    Aims: This study aims to measure the prevalence rates and patterns of help-seeking behavior as a consequence of being harmed by drinkers in five Asian countries (India, Sri Lanka, Vietnam, Lao PDR and Thailand). Methods: A total of 9832 respondents aged 18-65 years from the WHO/ThaiHealth Collaborative Project were surveyed between 2012 and 2014 about their experiences of being negatively affected due to another's drinking, and whether and where they sought help, focusing on four adverse aspects of harms from others' drinking. Results: The prevalence of seeking help from any source in the past year due to harm from others' drinking ranged from 7% to 20%. The most common service used by those who were affected by other people's drinking was asking for help from friends, followed by calling the police and using health-related services. The largest proportion of help-seeking was among those reporting property harm, followed by those being harmed physically and sexually by drinkers. Conclusion: Given a wide range of harms from others' drinking in the general population and different needs of those affected, prevalence rates for help-seeking behavior due to others' drinking in South and South East Asian countries were low and the help sought was often informal. There is a large knowledge gap in our understanding of the mechanisms of help-seeking behavior and the pathways for access to help among those affected. Further studies are important for enhancing the social response services available and making these more accessible to those who need help.

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