While alcohol’s health effects are well documented, less is known about how health influences alcohol use and whether this varies by socioeconomic position (SEP). This study investigated the association between health-related quality of life (HRQoL), mental health, and alcohol use, and whether SEP moderates these associations. Baseline data from 7097 participants in the 2010 Stockholm Public Health Cohort were used. The exposures were HRQoL and mental health (good, moderate, poor); Outcomes (2014) were heavy episodic drinking (HED: ≥5 units/≥2 times/month) and heavy drinking (men: ≥21 units/week; women: ≥14 units/week). Logistic regression estimated odds ratios (OR), with interaction assessed using relative excess risk of interaction (RERI) and attributable proportion (AP). Joint exposure analyses used good health and high SEP as the reference group. Compared with good HRQoL, moderate (OR: 1.26, 95% CI: 1.02–1.56) and poor HRQoL (OR: 1.39, 95% CI: 1.08–1.78) were associated with higher odds of heavy drinking. Moderate HRQoL and low SEP had increased odds of HED (OR: 1.48, 95% CI: 1.02–2.15) and heavy drinking (OR: 1.62, 95% CI: 1.01–2.60), with evidence of additive interaction (RERI: 0.79; AP: 0.49). Mental health findings were less consistent: good mental health and low SEP was associated with increased HED (OR: 1.35), while moderate mental health and intermediate SEP was associated with decreased HED (OR: 0.66). Findings suggest a dose-response relationship between HRQoL and self-reported heavy drinking and an interaction between moderate HRQoL and low SEP. Associations with mental health were weaker and inconsistent.

The relationship between job demand control (JDC) and hazardous drinking has shown inconsistent findings in the literature. This study investigated whether this association varies by occupational group and specific measures of job demands and job control. Baseline data from the Stockholm Public Health Cohort (2006, 2010) included information on sociodemographic factors, health, occupation, and JDC. JDC categories–active, passive, high strain, and low strain (reference)–were defined based on levels of job control (decision authority, skill utilization) and job demands (contradictory demands, time constraints). Hazardous drinking, assessed at a four-year follow-up, included both heavy episodic drinking (≥5 units/month) and hazardous average consumption (men: >14 units/week; women: >9 units/week). Logistic regression analyses, stratified by occupational group, revealed trends across JDC categories. High strain was generally associated with increased odds of hazardous drinking, while passive and active work appeared more protective. However, these associations varied by occupation, with some showing divergent associations. The associations became more occupation-specific when evaluating job demand and job control measures- such as strong associations for managers and educators with low decision authority and healthcare workers with contradictory demands. Further research on occupation-specific stressors could help identify vulnerable groups for targeted interventions to mitigate hazardous drinking risks.

Aim: The study aimed to assess the extent to which financial and/or mental health problems resulting from the COVID-19 pandemic were associated with an increased risk of alcohol consumption. Methods: Data stemmed from a Swedish cross-sectional population survey (n = 9122) collected during the second half of 2020. Questions were asked about changes in alcohol consumption during the pandemic and to what extent financial and mental health problems were experienced. Logistic regression analysis was used to estimate whether exposure to these problems was related to increasing consumption and as a complementary analysis to decreased drinking. An additive interaction analysis was conducted to assess whether there was a joint effect of these problems. Results: The proportion of respondents who reported increased alcohol consumption was higher among those who had experienced financial or mental health problems, and it rose with the severity of negative experiences. However, findings from logistic regressions (including both exposure variables and covariates) showed that only experiences of mental health problems significantly elevated the risk (odds ratio) of increased consumption. Experiences of mental health problems were also related to a higher likelihood of decreasing consumption, although the odds ratio was lower. No interaction effects were found. Conclusions: Although alcohol consumption overall declined in Sweden during the pandemic, a group experiencing pandemic-related mental health problems increased their drinking. A parallel decline in drinking in a subgroup of individuals experiencing mental health problems adds nuance to the findings and is suggested to be influenced by specific pandemic-related circumstances.

Background Identifying underlying subgroups might be a way to examine the development of co-occurrent substance use and delinquency. The aim of this study was to identify latent classes of substance misuse and delinquency in adolescence and which general risk factors are associated with these classes. Methods Data of two waves from a national representative Swedish birth cohort was used that consisted of 4,013 randomly selected adolescents (Male=1,798, Female=2,201, Missing=14) Latent class analysis was used to identify classes of substance misuse and delinquency at age 17/18 and. logistic regression analysis was used to assess risk factors at age 15/16. Results Identified classes were: “Low/abstainers” (74.80%, n=2858, Male=1191 Female=1656, Missing=11) which acted as reference, “Alcohol only” (22.21%, n=849, Male=420, Female=426, Missing=3), “Polydrug use and crime” (2.15%, n=82, Male=52, Female=30) and “High crime” (0.84%, n=32, Male=30, Females=2). Factors associated with belonging to any classes engaging in substance use and delinquency were lower parental support, supervision, peer problems, and higher conduct problems, sensation-seeking behavior, distrust in society, and truancy. Conclusions Most people did not engage in substance use or delinquency. When accounting for less frequent behaviors such as normative adolescent drinking and one-time events of crime and drug use, about 3% of the population engaged in co-occurring substance use and delinquency. Several different factors from several domains where related to belonging to a class that used substances and/or engaged in delinquency. There were indications that the most extensive users and offender displayed a wide variety of severe level risk factors, which could have implications for targeted interventions. Though, statistical power was a problem and future research should use larger samples or alternative methods.

Background  Recent studies have documented a range of adverse health outcomes associated with excessive social media use among adolescents. Fewer studies have examined potential protective factors in this context. Our study aims to bridge this gap by exploring the relationship between Problematic Social Media Use (PSMU) and poor Self-Reported Health (SRH) among Swedish adolescents, while also examining the potential buffering role of family support.

Methods  The data was sourced from the 2017/18 cross-sectional Swedish Health Behaviour in School-aged Children (HBSC) study, encompassing 3,135 students aged 11, 13, and 15 years. PSMU was measured using the Social Media Disorder Scale and categorized into three levels: low risk of PSMU, moderate risk of PSMU and having PSMU. Poor SRH was defined as a binary variable, with ‘Less than good health’ as the outcome category. Family support was measured using three items that quantified the level of emotional support received, categorized into an index of low, moderate, and high family support. Logistic regression analyses were performed to examine the association between PSMU and poor SRH, adjusting for age, gender, and family affluence. The potential moderating effect of family support was analyzed by including variables to test for both multiplicative and additive interaction between PSMU and family support on the risk of poor SRH.

Results  After adjustment for covariates, the results revealed a graded association between PSMU and poor SRH, with adolescents classified as having PSMU showing the highest odds of poor SRH, followed by those at moderate risk for PSMU. No statistically significant interaction was found on the multiplicative scale. The additive interaction analysis indicated potential trends of a buffering effect of high family support on the risk of poor SRH among adolescents with PSMU, although this was not statistically confirmed [due to small numbers in some of the cells].

Conclusions  Our study revealed a significant, graded relationship between PSMU and poor SRH, highlighting the need to limit excessive social media use among adolescents to prevent health issues. The finding, that high family support may serve as a potential protective factor against poor SRH in adolescents with PSMU underscores the role of family engagement in safeguarding adolescent well-being.

Previous studies have identified educational differences in early labour market exits, yet the mechanisms behind these disparities remain unclear. This study aims to examine to what extent common mental disorders (CMD) and alcohol-related morbidity can explain educational differences in early labour market exit. This cohort study included all men born 1951–53 who underwent conscription examination for military service in Sweden at age 18–20 (n = 136 466). The highest level of educational attainment and early labour market exit, using five different exit routes, was obtained from nationwide registers. Mediation analysis was used to examine the contribution of CMD and alcohol-related morbidity to the educational differences in early labour market exit. Factors measured in childhood, late adolescence, and early adulthood were included as confounders. Lower-educated men were at higher risk of leaving the labour market early. CMD contributed marginally to the educational differences in early exit due to disability pension, long-term sickness absence, and long-term unemployment, explaining up to 4%. Alcohol-related morbidity explained up to 12% of the educational differences in disability pension, long-term sickness absence, and long-term unemployment. Neither CMD nor alcohol-related morbidity were associated with early old-age retirement with and without income. Alcohol-related morbidity appears to be of importance when trying to understand educational differences in some but not all early labour market exit routes. Thus, reducing the negative effects of alcohol consumption could reduce educational inequalities in early exits from the labour market and prolong working life for all individuals regardless of socioeconomic position.

Objective: Alcohol misuse and criminal offending often co-occur, and although previous studies indicate an overlap in risk factors, this evidence originates from studies focusing on either alcohol misuse or criminal offending. Co-occurrence might also stem from the severity or accumulation of risk factors. The aim of the following study was to examine whether risk factors for developing co-occurring alcohol misuse and criminal offending in adolescence are similar or unique, and to examine whether risk factors are more severe or accumulative compared with alcohol misuse only and criminal offending only. Method: Data were used from the prospective longitudinal project Futura01, consisting of 4,013 randomly selected adolescents in Sweden (males: n = 1,798). Outcomes and a wide variety of risk factors were measured by self-report at two time points. Logistic regression analysis was carried out on groups of (a) no behavior (reference), (b) alcohol misuse only, (c) criminal offending only, and (d) co-occurring behaviors. Results: The findings indicated that similar factors predicted co-occurring behaviors for alcohol misuse only and criminal offending only. Regarding severity, only more severe sensation seeking was associated with co-occurring behaviors compared with alcohol misuse and criminal offending only. Instead, an accumulation of risks (i.e., more risk factors present) increased the probability of co-occurring behaviors compared with alcohol misuse only and criminal offending only. Conclusions: The results indicated that the risk factors for developing co-occurring alcohol misuse and criminal offending in adolescence are similar rather than unique and that it is the accumulation of the risk factors, as opposed to their severity, that is associated with co-occurring behaviors when comparing with alcohol misuse and criminal offending only.