Drinking behaviors of large groups : studies disentangling population drinking in Sweden

Background: The starting point for this thesis was the unexpected development of per capita alcohol consumption and youth drinking in Sweden. There has been an observed decline for both: in the adult population since 2004 and among youth since 2000. Alcohol has at the same time become cheaper and more available. Given these circumstances, the expectations from previous research would be that consumption increased. The recent development in Sweden provided an opportunity to examine how changes in population drinking are dispersed and furthermore how these overall changes transfer to changes in various sub-groups of the population. Objective: The overall aim of this thesis is to disentangle changes in overall population means to get a better understanding of what happens within a population when consumption changes and also, to some extent, what influences those changes. More specifically, the individual studies focus on; (a) Are temporal changes in the general population’s alcohol consumption collective? (b) Is the theory of collectivity of drinking cultures applicable to changes in alcohol consumption also in a population of youth? (c) Is there a transmission of drinking from the adult population to the youth population? (d) Are there differences between generations in alcohol consumption and can these differences be explained by long-term effects of alcohol policy? Method: Studies I & II focused on the dispersion of alcohol consumption within populations and how this changes when there are changes in the overall mean consumption. Means were compared across different sub-groups and across time using both parametric and non-parametric tests. Study III used aggregate time-series analysis to examine the association between changes in per capita alcohol consumption and drinking among youth. Study IV used a fixed-effect regression model and a post-estimation Wald test to examine differences in drinking between cohorts that grew up during periods with different alcohol policies. Results: Studies I & II showed collective displacements of consumption in all sub-groups when the overall mean changed. In absolute terms, the changes were most pronounced among the heaviest drinkers while the relative decrease was inversely related to the initial consumption level. The results from study II further showed that the decline in consumption among the 10 % that drank the most accounted for 37.5 % of the overall decline in youth drinking in Sweden, while the decline among the bottom half that drank the least only accounted for a little more than 14 % of the overall decline. The increasing rate of non-drinkers among youth thus had a marginal effect on the overall level of alcohol consumption among youth. The results from study III showed that there was a positive association between changes in per capita alcohol consumption and changes in youth drinking. This association has however become weaker since 1995 and thus a change in per capita alcohol consumption is not a viable explanation for the decline in youth drinking. Study IV showed that there were significant differences in drinking between cohorts that grew up during periods with different alcohol policies. The cohort that grew up during a more restrictive period had a significantly lower consumption level than the reference cohorts. However, all cohorts changed their consumption in the same way, albeit from different starting points. Discussion and conclusion: Even though the consumption trends during the past decade were unexpected, based on assumptions drawn from previous research, a main conclusion of this thesis is that changes in drinking are collective, for all consumption segments from light to heavy drinkers and for most population sub-groups. The results from all four studies in this thesis lend support to the theory of collectivity of drinking cultures. With the use of different statistical methods and the availability of high quality data, the results corroborate the theory by providing empirical findings of collective displacements of consumption across time. Furthermore, the findings also complement and expand the theory, by showing that adolescents should be incorporated in the collectivity and that there is a collectivity of drinking that transcends generations. A change in per capita alcohol consumption is, however, not a viable explanation for the observed drop in youth drinking

Normalization of Non-Drinking? Health, School Situation and Social Relations among Swedish Ninth Graders That Drink and Do Not Drink Alcohol

Alcohol consumption is a major contributor to the disease burden among adolescents. The adolescent alcohol abstainer is still often depicted as problematic in the research literature and in prominent theoretical frameworks. However, over the past two decades, there has been a marked trend of declining youth drinking in Sweden. The declining trend has led to a shift in the majority behaviour of youth, from drinking to non-drinking. It is plausible that this trend has also shifted the position of non-drinkers. This paper examines the position of non-drinkers in a nationally representative sample of Swedish adolescents. A survey was carried out in 2017 in 500 randomly selected schools. A total of 5549 respondents (15–16-year-olds) agreed to participate and answered the questionnaire. A minority (42.8%) had consumed alcohol during their lifetime. The results show that non-drinkers had better health and school performance when compared to drinkers. The results also showed that there were no differences in the social position between non-drinkers and drinkers. These findings are new and indicate a changed position of non-drinkers among Swedish adolescents. With non-drinking being the majority behaviour among Swedish adolescents this seems to have shifted the position of non-drinkers. There is a need for research on the long-term importance of not drinking during adolescence

Kartläggning av socialtjänstens arbete med våld i nära relationer : - en studie av sju kommuner i nordvästra Stockholm

Intimate partner violence is a problem which is increasingly drawing attention in society. The authority responsible for providing care and support to victims of intimate partner violence and their children is the social services. The purpose of this study was to show how social workers deal with intimate partner violence and to create a description of how this work is currently carried out in seven municipalities in the north-west of Stockholm. This was done through a quantitative survey including all investigating social workers in the municipalities concerned. The results were analysed with concepts from organizational theory. The findings showed that there is a need for further education related to intimate partner violence. The differences observed between the municipalities were derived mainly to the presence of a coordinator for issues concerning violence against women. Furthermore, results showed that social workers believe that the best possibilities to help victims of intimate partner violence lay outside the own organization. To better fulfil their statutory responsibility regarding intimate partner violence the next step for the municipalities would be to make sure that social workers gain further knowledge about intimate partner violence

Tal om alkohol 2012 : en statistisk årsrapport från Monitorprojektet

Monitorprojekte

The relationship between age at first drink and later risk behaviours during a period of youth drinking decline.

AIMS: Alcohol consumption among teenagers in many high-income countries has steadily declined since the early 2000s. There has also been a steady increase in the average age at first drink, a reliable marker of later alcohol problems. This study measured whether young people who initiated drinking early were at increased risk of alcohol problems in young adulthood in recent cohorts where early initiation was comparatively rare. DESIGN: Analysis of six waves of a repeated cross-sectional household survey (2001-16) in Australia. A total of 9576 young adults (aged 20-25 years) who had initiated drinking before the age of 20 years. MEASUREMENTS: Respondents were classified into three groups based on their self-reported age at first drink (< 16, 16-17, 18-19 years). Outcome variables were self-reported experiences of memory loss while drinking, risky and delinquent behaviour while drinking and monthly or more frequent drinking occasions of 11 or more 10-g standard drinks. FINDINGS: Later initiators reported lower levels of all outcomes [e.g. odds ratios (ORs) for memory loss were 0.56, 95% confidence interval (CI) = 0.50, 0.63] for those who first drank at 16 or 17 years compared with those who first drank at age 15 or younger). Significant interactions between age at first drink and survey year showed that early initiation was more strongly associated with harms (e.g. for memory loss, OR = 0.97, 95% CI = 0.94, 0.99 for 18-19 versus 15 or younger) in young adulthood for recent cohorts where early drinking was less common. CONCLUSIONS: The decline in youth drinking may have contributed to a concentration of risk of alcohol problems among those young people who consume alcohol in early adolescence. Early initiation of drinking may be an increasingly important marker of broader risk taking as alcohol becomes less normative for teenagers

Children with problem drinking parents in Sweden: prevalence and risk of adverse consequences in a national cohort born in 2001.

INTRODUCTION: To estimate the prevalence of children with problem drinking parents in Sweden and the extent to which they have an elevated risk of poor health, social relationships and school situation in comparison with other children. METHODS: Survey with a nationally representative sample of Swedish youth aged 15-16 years (n = 5576) was conducted in 2017. A short version of The Children of Alcoholics Screening Test (CAST-6) was used to identify children with problem drinking parents. Health status, social relations and school situation were measured by well-established measures. Overall prevalences for girls and boys were presented as well as relative risks (RR) of harm for children with problem drinking parents compared with other children. RESULTS: A total of 13.1% of the sample had at least one problem drinking parent during adolescence according to CAST-6-a higher proportion of girls (15.4%) than boys (10.8%). This group had an elevated risk of poor general health as well psychosomatic problems compared with other children (RR 1.2-1.9). They were also more likely to use medication for depression, sleeping difficulties and anxiety (RR 2.2-2.6). Their social relations were also worse especially with their father (RR 3.1) and they had more problems at school (RR 2.6). DISCUSSION AND CONCLUSIONS: The risk of problems related to parental drinking goes beyond the most severe cases where parents have been in treatment for their alcohol problem. This is important knowledge since the majority of problem drinkers never seek treatment and the major part of parental problem drinking is found in population samples

Loneliness, belonging and psychosomatic complaints across late adolescence and young adulthood: a Swedish cohort study

Abstract Background Loneliness and belonging refer to social connectedness and are associated with young people’s health; however, the relationship between these constructs and their impact on health is still being discussed. A dual continuum model of belonging and loneliness has been suggested, consisting of four groups depending on the state of loneliness and belonging: socially fulfilled (low loneliness, high belonging), socially indifferent (low loneliness, low belonging), socially searching (high loneliness, high belonging), and socially distressed (high loneliness, low belonging). The aim of this study is to examine loneliness and belonging in a Swedish sample of 17–18-years-olds who were followed over 3 years, and the associations that these aspects share with young people’s psychosomatic complaints during these ages. Methods Swedish cohort data collected among late adolescents (age 17–18 in 2019) who were followed up in young adulthood (age 20–21 in 2022) (n = 2684) was used to examine the associations between loneliness, belonging, and psychosomatic complaints. Loneliness and belonging were measured by single items and the cross-combinations of these. Three psychosomatic complaints were assessed: stomach ache, headache, and difficulties falling asleep, and a summary index was calculated. Results Linear regression analyses showed that loneliness was positively and belonging was negatively cross-sectionally associated with psychosomatic complaints. The socially fulfilled group reported fewer psychosomatic complaints compared to all other groups, while the socially distressed group reported the highest level of psychosomatic complaints. Additional adjustment for sociodemographic characteristics barely affected the estimates. The prospective analysis supported these patterns; however, after adjustment for earlier psychosomatic complaints, the only statistically significant difference in subsequent psychosomatic complaints was found between the socially fulfilled and the socially distressed groups. Conclusions Loneliness and belonging (separately and the cross-combinations of these) were cross-sectionally associated with psychosomatic complaints in late adolescence and in young adulthood. Prospectively, only the most vulnerable group in the dual continuum model, the socially distressed group, experienced more psychosomatic complaints than the socially fulfilled group, indicating a temporal relationship. Knowledge about the more nuanced links may be useful for developing specific public health recommendations and interventions for youth, targeting the most vulnerable groups