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Raitasalo K, Rossow I, Moan IS, Bye EK, Svensson J, Thor S, Ekholm O, Pisinger V, Arnarsson Á, Bloomfield K. Changes in co-use of alcohol and cannabis among Nordic adolescents in the 21st century: Results from the European School Survey Project on Alcohol and Other Drugs study. Drug Alcohol Rev 2024; 43:616-624. [PMID: 37095643 DOI: 10.1111/dar.13672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 04/03/2023] [Accepted: 04/05/2023] [Indexed: 04/26/2023]
Abstract
INTRODUCTION In the 21st century, there has been a decline in alcohol use among adolescents in most Nordic countries, while trends of cannabis use have diverged. We explore how alcohol and cannabis use, respectively, and co-use of the two substances, have changed among Nordic adolescents. Three hypotheses are used to frame the study: (i) cannabis use has substituted alcohol use; (ii) there has been a parallel decline in both substances; and/or (iii) there has been a 'hardening' of users, implying that alcohol users increasingly use cannabis. METHODS Data from the European School Survey Project on Alcohol and Other Drugs, conducted among 15- to 16-year-olds in Denmark, Finland, Iceland, Norway and Sweden (N = 74,700, 49% boys), were used to explore trends of past-year alcohol and cannabis use in the period 2003-2019. RESULTS The proportion of adolescents reporting alcohol use decreased significantly in all Nordic countries except Denmark. The proportion of those using cannabis only was low (0.0%-0.7%) and stable in all countries. The total number of substance use occasions declined among all adolescents in all countries but Denmark. Among alcohol users, cannabis use became increasingly prevalent in all countries but Denmark. DISCUSSION AND CONCLUSIONS We found no support for the 'parallel decline hypothesis' in alcohol and cannabis use among Nordic adolescents. Partially in line with the 'substitution hypothesis', cannabis use accounted for an increasing proportion of all substance use occasions. Our results suggests that the co-use of alcohol and cannabis has become more common, thus also providing support to the 'hardening' hypothesis.
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Affiliation(s)
- Kirsimarja Raitasalo
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | | | - Elin K Bye
- Norwegian Institute of Public Health, Oslo, Norway
| | - Johan Svensson
- Karolinska Institutet, Stockholm University, Stockholm, Sweden
| | - Siri Thor
- Karolinska Institutet, Stockholm University, Stockholm, Sweden
| | - Ola Ekholm
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Veronica Pisinger
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | | | - Kim Bloomfield
- Centre for Alcohol and Drug Research, Aarhus University, Copenhagen, Denmark
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Bramness JG, Heiberg IH, Høye A, Rossow I. Mortality and alcohol-related morbidity in patients with delirium tremens, alcohol withdrawal state or alcohol dependence in Norway: A register-based prospective cohort study. Addiction 2023; 118:2352-2359. [PMID: 37465900 DOI: 10.1111/add.16297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 06/18/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND AND AIMS Little is known about long-term consequences of delirium tremens (DT). This study aimed to compare all-cause and cause-specific mortality and alcohol-related morbidity between patients with: (i) DT, (ii) alcohol withdrawal state (AWS) and (iii) alcohol dependence (AD). DESIGN A national longitudinal health registry study with linked data from the Norwegian Patient Registry and the Norwegian Cause of Death Registry. SETTING Norway. PARTICIPANTS All patients registered in the Norwegian Patient Registry between 2009 and 2015 with a diagnosis of AD (ICD-10 code F10.2), AWS (F10.3) or DT (F10.4) and aged 20-79 years were included (n = 36 287). MEASUREMENTS Patients were categorized into three mutually exclusive groups; those with DT diagnosis were categorized as DT patients regardless of whether or not they had received another alcohol use disorder diagnosis during the observation period or not. Outcome measures were: annual mortality rate, standardized mortality ratios (SMR) for all-cause and cause-specific mortality and proportion of alcohol-related morbidities which were registered in the period from 2 years before to 1 year after the index diagnosis. FINDINGS DT patients had higher annual mortality rate (8.0%) than AWS (5.0%) and AD (3.6%) patients, respectively. DT patients had higher mortality [SMR = 9.8, 95% confidence interval (CI) = 8.9-10.7] than AD patients (SMR = 7.0, 95% CI = 6.8-7.2) and AWS patients (SMR = 7.8, 95% CI = 7.2-8.4). SMR was particularly elevated for unnatural causes of death, and more so for DT patients (SMR = 26.9, 95% CI = 21.7-33.4) than for AD patients (SMR = 15.2, 95% CI = 14.2-16.3) or AWS patients (SMR = 20.1, 95% CI = 16.9-23.9). For all comorbidities, we observed a higher proportion among DT patients than among AWS or AD patients (P < 0.001). CONCLUSIONS People treated for delirium tremens appear to have higher rates of mortality and comorbidity than people with other alcohol use disorders.
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Affiliation(s)
- Jørgen G Bramness
- Department of Drugs and Tobacco, Norwegian Institute of Public Health, Oslo, Norway
- UiT: The Arctic University of Norway, Institute of Clinical Medicine, Tromsø, Norway
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway
| | - Ina H Heiberg
- Center for Clinical Documentation and Evaluation, Tromsø, Norway
- Division of Mental Health and Substance Abuse, University Hospital of North Norway, Tromsø, Norway
| | - Anne Høye
- UiT: The Arctic University of Norway, Institute of Clinical Medicine, Tromsø, Norway
- Center for Clinical Documentation and Evaluation, Tromsø, Norway
- Division of Mental Health and Substance Abuse, University Hospital of North Norway, Tromsø, Norway
| | - Ingeborg Rossow
- Department of Drugs and Tobacco, Norwegian Institute of Public Health, Oslo, Norway
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Tørmoen AJ, Myhre MØ, Kildahl AT, Walby FA, Rossow I. A nationwide study on time spent on social media and self-harm among adolescents. Sci Rep 2023; 13:19111. [PMID: 37925469 PMCID: PMC10625526 DOI: 10.1038/s41598-023-46370-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 10/31/2023] [Indexed: 11/06/2023] Open
Abstract
Self-harm among adolescents has increased in many countries, but few studies have examined possible explanations. One explanation could be the changes in the way adolescents socialize and use of social media. We explored the relationship between past year self-harm and time spent on social media, employing data from a nationwide cross-sectional survey among students in grades 8 through 11 in Norway (N = 37,268). The association was estimated in logistic regression models and we adjusted for identified confounders and stratified on gender, age group and depressive symptoms. A total of 16.1% of the study population reported to have self-harmed in the past year. This proportion was elevated among those spending more than 3 h daily on social media (unadjusted OR = 2.74 (CI 2.58.-2.90)). Adjustment for confounders modified the association (OR = 1.49 (CI 1.39-1.60)). In stratified analyses, adjusted OR did not differ significantly by gender or age The association between time spent on social media and self-harm was weaker among adolescents with severe depressive symptoms (adjusted OR = 1.38 (CI 1.22-1.55)), than among those with mild or no symptoms (adjusted OR = 1.70 (CI 1.56-1.86)). Risk of self-harm was elevated among those who spent 3 or more hours daily on social media, also after controlling for other factors. Further studies are needed to explore the nature and underlying mechanisms of this association. Strengthening the evidence will help informing the development of adequate measures to prevent self-harm.
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Affiliation(s)
- Anita Johanna Tørmoen
- National Centre for Suicide Research and Prevention, University of Oslo, Oslo, Norway.
| | - Martin Øverlien Myhre
- National Centre for Suicide Research and Prevention, University of Oslo, Oslo, Norway
| | - Anine Therese Kildahl
- National Centre for Suicide Research and Prevention, University of Oslo, Oslo, Norway
| | - Fredrik Andreas Walby
- National Centre for Suicide Research and Prevention, University of Oslo, Oslo, Norway
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Girard LC, Griffiths MD, Rossow I, Leino T, Goudriaan AE, Smith OR, Pallesen S. Temporal order of diagnosis between gambling disorder and substance use disorders: Longitudinal results from the Norwegian Patient Registry. Addict Behav Rep 2023; 17:100501. [PMID: 37347048 PMCID: PMC10279774 DOI: 10.1016/j.abrep.2023.100501] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 05/25/2023] [Accepted: 06/02/2023] [Indexed: 06/23/2023] Open
Abstract
Introduction Previous research has established co-occurrence between substance use disorders (SUDs) and gambling disorder (GD). Less well understood is the temporal sequencing of onset between these disorders, and in particular whether SUD is a risk factor for GD. The present study examined the temporal order between registered diagnoses of SUD and GD, stratified by sex. Methods A study with a longitudinal design using objective registry data drawn from the Norwegian Patient Registry was carried out. Among the patients with a registered diagnosis of GD between 2008 and 2018 (N = 5,131; males = 81.8%), those (who in addition) had a registered diagnosis of any SUD (n = 1,196; males = 82.1%) were included. The measures included a registered diagnosis using the ICD-10 of both GD (code F63.0) and SUDs (codes F10-F19) by a health care professional. Binomial tests were used to identify the temporal order between SUD(s) and GD. Co-occurring cases (i.e., cases diagnosed within the same month) were removed in the main analyses. Results Results showed a significant directional path from SUD to GD but no support for the reversed path (i.e., from GD to SUD). This finding was similar overall for (i) both males and females, (ii) when different SUDs (alcohol, cannabis, sedatives, and polysubstance) were examined individually, and (iii) when specifying a 12-month time-lag between diagnoses. Conclusions The findings suggest that experiencing SUD(s) is a risk marker for GD given the temporal precedence observed for patients in specialised healthcare services seeking treatment. These results should be considered alongside screening and prevention efforts for GD.
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Affiliation(s)
- Lisa-Christine Girard
- Department of Psychosocial Science, University of Bergen, Norway
- Department of Special Needs Education, University of Oslo, Norway
| | | | - Ingeborg Rossow
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Norway
| | - Tony Leino
- Department of Health Promotion, Norwegian Institute of Public Health, Norway
| | - Anna E. Goudriaan
- Department of Psychiatry, Amsterdam UMC Location University of Amsterdam, Netherlands
- Amsterdam Public Health, Mental Health, Amsterdam, Netherlands
| | - Otto R.F. Smith
- Department of Psychosocial Science, University of Bergen, Norway
- Department of Health Promotion, Norwegian Institute of Public Health, Norway
- Department of Teacher Education, NLA University College, Norway
| | - Ståle Pallesen
- Department of Psychosocial Science, University of Bergen, Norway
- Norwegian Competence Centre for Gambling and Gaming Research, University of Bergen, Norway
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5
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Babor TF, Casswell S, Graham K, Huckle T, Livingston M, Rehm J, Room R, Rossow I, Sornpaisarn B. Alcohol: No Ordinary Commodity-a summary of the third edition. Addiction 2022; 117:3024-3036. [PMID: 36321607 DOI: 10.1111/add.16003] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 06/29/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND AND AIMS This article summarizes the findings and conclusions of the third edition of Alcohol: No Ordinary Commodity. The latest revision of this book is part of a series of monographs designed to provide a critical review of the scientific evidence related to alcohol control policy from a public health perspective. DESIGN A narrative summary of the contents of the book according to five major issues. FINDINGS An extensive amount of epidemiological evidence shows that alcohol is a major contributor to the global burden of disease, disability and death in high-, middle- and low-income countries. Trends in alcohol products and marketing are described, indicating that a large part of the global industry has been consolidated into a small number of transnational corporations that are expanding their operations in Asia, Africa and Latin America. The main part of the book is devoted to a review of strategies and interventions designed to prevent or minimize alcohol-related harm. Overall, the most effective strategies to protect public health are taxation that decreases affordability and restrictions on the physical availability of alcohol. A total ban on alcohol marketing is also an effective strategy to reduce consumption. In addition, drink-driving counter-measures, brief interventions with at-risk drinkers and treatment of drinkers with alcohol dependence are effective in preventing harm in high-risk contexts and groups of hazardous drinkers. CONCLUSION Alcohol policy is often the product of competing interests, values and ideologies, with the evidence suggesting that the conflicting interests between profit and health mean that working in partnership with the alcohol industry is likely to lead to ineffective policy. Opportunities for implementation of evidence-based alcohol policies that better serve the public good are clearer than ever before as a result of accumulating knowledge on which strategies work best.
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Affiliation(s)
- Thomas F Babor
- Department of Public Health Sciences, University of Connecticut School of Medicine, CT, USA
| | - Sally Casswell
- College of Health, SHORE & Whariki Research Centre, Massey University, Auckland, New Zealand
| | - Kathryn Graham
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto/London, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Taisia Huckle
- College of Health, SHORE & Whariki Research Centre, Massey University, Auckland, New Zealand
| | - Michael Livingston
- National Drug Research Institute, Curtin University, Melbourne, Australia.,Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Jürgen Rehm
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research & Campbell Family Mental Health Research Institute, Toronto, Canada.,Institute of Clinical Psychology and Psychotherapy & Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität, Dresden, Germany.,Center for Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Psychiatry & Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, Victoria, Australia.,Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Ingeborg Rossow
- Department of Alcohol, Tobacco, and Drugs, Norwegian Institute of Public Health, Oslo, Norway
| | - Bundit Sornpaisarn
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Centre for Addiction and Mental Health, Toronto, Canada.,Faculty of Public Health, Mahidol University, Thailand
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Rossow I, Moan IS, Bye EK. Declining Trend in Adolescent Alcohol Use: Does It Have Any Significance for Drinking Behaviour in Young Adulthood? IJERPH 2022; 19:ijerph19137887. [PMID: 35805544 PMCID: PMC9266013 DOI: 10.3390/ijerph19137887] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/25/2022] [Accepted: 06/26/2022] [Indexed: 02/05/2023]
Abstract
Since 2000, adolescent alcohol use has declined substantially in many high-income countries, particularly in Northern Europe. This study examined whether birth cohorts in Norway who experienced different levels of alcohol consumption in mid-adolescence differed in drinking behaviour when they reached young adulthood. We analysed data from annual population surveys in Norway (2012–2021). The analytic sample comprised data from respondents aged 20–29 years (N = 5266), and we applied four birth cohorts (i.e., 1983–1987, 1988–1992, 1993–1996 and 1997–2001). We applied age categories with two- and five-year intervals and tested whether drinking frequency, heavy episodic drinking (HED) and usual number of drinks per drinking occasion during the past 12 months differed by birth cohort in age-specific strata. Possible cohort differences within age groups were tested using Pearson’s Chi square. There were no statistically significant differences between cohorts with respect to drinking frequency or HED frequency. However, the youngest cohort had fewer drinks per occasion when in their early 20s compared to older cohorts. This study showed that birth cohorts who differed substantially in levels of alcohol consumption in mid-adolescence, only to a little extent differed in drinking behaviour in young adulthood.
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Affiliation(s)
- Ingeborg Rossow
- Department of Alcohol, Tobacco, and Drugs, Norwegian Institute of Public Health, Oslo, Norway
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8
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Amundsen EJ, Bretteville-Jensen AL, Rossow I. Patients admitted to treatment for substance use disorder in Norway: a population-based case-control study of socio-demographic correlates and comparative analyses across substance use disorders. BMC Public Health 2022; 22:792. [PMID: 35443672 PMCID: PMC9020072 DOI: 10.1186/s12889-022-13199-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 03/30/2022] [Indexed: 11/26/2022] Open
Abstract
Background Improved knowledge regarding socio-demographic correlates of people with substance use disorders (SUDs) is essential to better plan and provide adequate services for SUD patients and their families, and to improve our understanding of the complex mechanisms underlying progression into and development of various SUDs. This study aimed to: i) describe demographic, economic, and social correlates of people with SUDs in comparison with those of the general population and ii) compare these correlates across SUDs from licit versus illicit substances, as well as across specific SUDs. Methods A national population-based case–control study included all SUD patients enrolled in specialized drug treatment in Norway in 2009–2010 (N = 31 245) and a population control sample, frequency-matched on age and gender (N = 31 275). Data on education level, labour market participation, income level and sources, and family/living arrangement were obtained by linkages to national registers. Results Demographic, economic, and social correlates of SUD patients differed substantially from those of the general population, and across specific SUDs. Among SUD patients, those with illicit – as compared to licit – SUDs were younger (mean quotient = 0.72 [0.71–0.72]), more often had low education level (RR = 1.68 [1.63–1.73]), were less often in paid work (RR = 0.74 [0.72–0.76]) and had lower income (mean quotient = 0.61 [0.60–0.62]). Comparison of patients with different SUD diagnoses revealed substantial demographic differences, including the relatively low mean age among cannabis patients and the high share of females among sedatives/hypnotics patients. Opioid patients stood out by being older, and more often out of work, receiving social security benefits, and living alone. Cocaine and alcohol patients were more often better educated, included in the work force, and had a better financial situation. Conclusion Findings revealed substantial and important differences in socio-demographic correlates between SUD patients and the general population, between SUD patients with illicit and with licit substance use, and across specific SUD patient groups. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13199-5.
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Affiliation(s)
- Ellen J Amundsen
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, POB 222 Skøyen, 0213, Oslo, Norway.
| | - Anne Line Bretteville-Jensen
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, POB 222 Skøyen, 0213, Oslo, Norway
| | - Ingeborg Rossow
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, POB 222 Skøyen, 0213, Oslo, Norway
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9
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Grøtting MW, Bergsvik D, Rossow I. Effect of extended trading hours on alcohol sales in Norway: study protocol for a stepped wedge cluster-randomized trial. Addiction 2022; 117:826-832. [PMID: 34605584 DOI: 10.1111/add.15704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 08/13/2021] [Accepted: 09/07/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS Norwegian alcohol policy measures include national restrictions on sales hours and a state monopoly on retail sales. A 1-hour extension of sales hours on Saturdays in the monopoly outlets took effect from September 2020. We aim to evaluate whether increase in sales hours results in (1) an increase in alcohol sales in the monopoly outlets and (2) an increase in total alcohol sales, including substitution effects from beer sales in grocery stores. DESIGN The extension of Saturday sales hours is implemented within a stepped wedge cluster-randomized trial design. Block randomization of 62 of the 66 Norwegian trade districts allocated monopoly outlets to one of three sequences regarding date of implementation. SETTING AND PARTICIPANTS A total of 228 of 335 in total Norwegian state monopoly outlets are eligible and included. INTERVENTION The extension of sales hours is from 3 p.m. to 4 p.m. starting on the first Saturday in (i) September 2020, (ii) December 2020 or (iii) March 2021. MEASUREMENTS Growth rates in monthly alcohol sales, measured in litres of pure alcohol, in eligible monopoly outlets (primary outcome) are obtained together with beverage-specific sales and alcohol sales in grocery stores (secondary outcomes). The observation period is set to 72 months prior to and 24 months after implementation. FINDINGS Power analyses indicate that this stepped wedge cluster-randomized controlled trial has a power above 90%, even at a high significance level (α = 0.01) and with other conservative model specifications. The planned trial offers a rare opportunity to study possible causal effects of a relatively small change in a widely used alcohol policy measure.
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Affiliation(s)
- Maja Weemes Grøtting
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
| | - Daniel Bergsvik
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
| | - Ingeborg Rossow
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
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Kraus L, Loy JK, Bickl AM, Schwarzkopf L, Volberg RA, Rolando S, Kankainen VE, Hellman M, Rossow I, Room R, Norman T, Cisneros Örnberg J. Self-exclusion from gambling: A toothless tiger? Front Psychiatry 2022; 13:992309. [PMID: 36213894 PMCID: PMC9537465 DOI: 10.3389/fpsyt.2022.992309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 08/30/2022] [Indexed: 11/13/2022] Open
Abstract
While there is evidence for self-exclusion (SE) as an individual-level harm reduction intervention, its effects on reducing harm from gambling at the population level remain unclear. Based on a review of national legal frameworks and SE programs, including their utilization and enforcement in selected high-income societies, the present analysis aims to explore the reach and strengths of SE in the protection of gamblers in these jurisdictions. It places particular emphasis on SE programs' potential to prevent and minimize gambling harm at the population level. The overview examined SE in Finland, Germany, Italy, Massachusetts (USA), Norway, Sweden, and Victoria (Australia). These jurisdictions differ considerably in how gambling is regulated as well as in how SE is implemented and enforced. The reach and extent of enforcement of SE apparently vary with the polity's general policy balance between reducing gambling problems and increasing gambling revenue. But in any case, though SE may benefit individual gamblers and those around them, it does not appear to be capable of significantly reducing gambling harm at the population level. To render SE programs an effective measure that prevents gamblers and those linked to them from financial, social, and psychological harm, utilization needs to be substantially increased by reforming legal regulations and exclusion conditions.
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Affiliation(s)
- Ludwig Kraus
- Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden.,IFT Institut für Therapieforschung, München, Germany.,Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Johanna K Loy
- IFT Institut für Therapieforschung, München, Germany
| | | | | | - Rachel A Volberg
- School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, United States
| | - Sara Rolando
- Eclectica, Institute for Research and Training, Torino, Italy
| | - Veera E Kankainen
- University of Helsinki Centre for Research on Addiction, Control and Governance (CEACG), University of Helsinki, Helsinki, Finland
| | - Matilda Hellman
- University of Helsinki Centre for Research on Addiction, Control and Governance (CEACG), University of Helsinki, Helsinki, Finland
| | | | - Robin Room
- Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden.,Centre for Alcohol Policy Research, La Trobe University, Melbourne, VIC, Australia
| | - Thomas Norman
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, VIC, Australia.,Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, VIC, Australia
| | - Jenny Cisneros Örnberg
- Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden
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11
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Mäkelä P, Rossow I, Moan IS, Bye EK, Kilian C, Raitasalo K, Allebeck P. Measuring changes in alcohol use in Finland and Norway during the COVID-19 pandemic: Comparison between data sources. Int J Methods Psychiatr Res 2021; 30:e1892. [PMID: 34449127 PMCID: PMC8633923 DOI: 10.1002/mpr.1892] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 07/17/2021] [Accepted: 08/12/2021] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To examine (1) how a rapid data collection using a convenience sample fares in estimating change in alcohol consumption when compared to more conventional data sources, and (2) how alcohol consumption changed in Finland and Norway during the first months of the COVID-19 pandemic. METHODS Three different types of data sources were used for the 2nd quarter of 2020 and 2019: sales statistics combined with data on unrecorded consumption; the rapid European Alcohol Use and COVID-19 (ESAC) survey (Finland: n = 3800, Norway: n = 17,092); and conventional population surveys (Finland: n = 2345, Norway: n1 = 1328, n2 = 2189, n3 = 25,708). Survey measures of change were retrospective self-reports. RESULTS The statistics indicate that alcohol consumption decreased in Finland by 9%, while little change was observed in Norway. In all surveys, reporting a decrease in alcohol use was more common than reporting an increase (ratios 2-2.6 in Finland, 1.3-2 in Norway). Compared to conventional surveys, in the ESAC survey fewer respondents reported no change and past-year alcohol consumption was higher. CONCLUSION The rapid survey using convenience sampling gave similar results on change in drinking as conventional surveys but higher past-year drinking, suggesting self-selection effects. Aspects of the pandemic driving alcohol consumption down were equally strong or stronger than those driving it up.
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Affiliation(s)
- Pia Mäkelä
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | | | - Elin K Bye
- Norwegian Institute of Public Health, Oslo, Norway
| | - Carolin Kilian
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | | | - Peter Allebeck
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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Abstract
People with drug use disorders (PWDUD) have elevated prevalence of oral diseases, in particular dental caries (tooth decay), periodontal (gum) disease and xerostomia (dry mouth). When left untreated, these oral health conditions may progress and lead to tooth ache, abscesses and tooth loss, and in turn, to poor chewing functioning and digestion, dental aesthetic problems and reduced wellbeing. Illicit drug use may, per se, cause xerostomia, which in turn increases vulnerability for dental caries. However, the other main drivers of oral diseases and their progression-poor oral hygiene, frequent sugar intake and infrequent dental visits-can mainly be ascribed to the irregular lifestyle, poor economy and mental health problems that often accompany illicit drug use. Establishment of good oral health habits is essential in the dental care for PWDUD. Dental treatment is often comprehensive and challenging; because the patients may have extensive treatment needs but also difficulties adhering to preventive measures and dental appointments. An integrated care approach for PWDUD would likely benefit both their oral and general health.
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Affiliation(s)
- Ingeborg Rossow
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
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Kilian C, Rehm J, Allebeck P, Barták M, Braddick F, Gual A, Matrai S, Petruželka B, Rogalewicz V, Rossow I, Schulte B, Štelemėkas M, Manthey J. Conducting a multi-country online alcohol survey in the time of the COVID-19 pandemic: Opportunities and challenges. Int J Methods Psychiatr Res 2021; 30:e1875. [PMID: 33951258 PMCID: PMC8209885 DOI: 10.1002/mpr.1875] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 03/25/2021] [Accepted: 04/14/2021] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES This contribution provides insights into the methodology of a pan-European population-based online survey, performed without external funding during the COVID-19 pandemic. We present the impact of different dissemination strategies to collect data from a non-probabilistic convenience sample and outline post-stratification weighting schemes, to provide guidance for future multi-country survey studies. METHODS Description and comparison of dissemination strategies for five exemplary countries (Czechia, Germany, Lithuania, Norway, Spain) participating in the Alcohol Use and COVID-19 Survey. Comparison of the sample distribution with the country's actual population distribution according to sociodemographics, and development of weighting schemes. RESULTS The dissemination of online surveys through national newspapers, paid social media adverts and dissemination with the support of national health ministries turned out to be the most effective strategies. Monitoring the responses and adapting dissemination strategies to reach under-represented groups, and the application of sample weights were helpful to achieve an analytic sample matching the respective general population profiles. CONCLUSION Reaching a large pan-European convenience sample, including most European countries, in a short time was feasible, with the support of a broad scientific network.
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Affiliation(s)
- Carolin Kilian
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Jürgen Rehm
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Peter Allebeck
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Miroslav Barták
- Department of Addictology, First Faculty of Medicine and General University Hospital in Prague, Charles University, Praha, Czech Republic
| | - Fleur Braddick
- Clínic Foundation for Biomedical Research (FCRB), Barcelona, Spain.,Clinical Addictions Research Group (GRAC-GRE) Psychiatry Department, Neurosciences Institute, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Antoni Gual
- Clinical Addictions Research Group (GRAC-GRE) Psychiatry Department, Neurosciences Institute, Hospital Clínic, University of Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Silvia Matrai
- Clínic Foundation for Biomedical Research (FCRB), Barcelona, Spain.,Clinical Addictions Research Group (GRAC-GRE) Psychiatry Department, Neurosciences Institute, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Benjamin Petruželka
- Department of Addictology, First Faculty of Medicine and General University Hospital in Prague, Charles University, Praha, Czech Republic
| | - Vladimir Rogalewicz
- Department of Addictology, First Faculty of Medicine and General University Hospital in Prague, Charles University, Praha, Czech Republic
| | | | - Bernd Schulte
- Centre for Interdisciplinary Addiction Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania.,Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Centre for Interdisciplinary Addiction Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
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14
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Abstract
BACKGROUND Since 2000, adolescents' alcohol use and heavy episodic drinking (HED) have declined in the Nordic countries. However, little is known about corresponding trends in alcohol-related harm and possible changes in the alcohol-harm association. The aims are to examine (i) whether the decline in HED was accompanied by a decline in alcohol-related violence (AV) and (ii) whether the strength of the HED-AV association changed concomitant with the decline. METHODS Analysis of data from the European School Survey Project on Alcohol and Other Drugs (ESPAD), conducted among 15-16-year-olds in Iceland, Norway and Sweden in 2007 and 2015 (n = 17 027). Changes in proportions of AV and alcohol use past 12 months, and mean frequency of HED past 30 days were examined using Pearsons χ2-test and F-test, respectively. The HED-AV associations were estimated using logistic regression analysis. RESULTS HED and AV proportions decreased from 2007 to 2015 in all countries. Among current drinkers (n = 8927), both HED frequency and AV proportion decreased in Norway (P < 0.001) and remained stable in Iceland. In Sweden, AV decreased (P < 0.001) whereas HED remained stable. The magnitude of the HED-AV association increased in Norway (Beta2015-2007 = 0.145, 95% CI 0.054-0.236), remained the same in Iceland and decreased in Sweden (Beta2015-2007 = -0.082, 95% CI -0.158 to -0.005). CONCLUSIONS Among youth in Iceland, Norway and Sweden, heavy episodic drinking and alcohol-related violence declined from 2007 to 2015. Among drinkers, the strength of the alcohol-violence association was moderated by the extent of heavy episodic drinking.
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Affiliation(s)
- Inger Synnøve Moan
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
| | - Elin K Bye
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
| | - Ingeborg Rossow
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
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15
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Abstract
In a recent analysis of the effect of the complete advertising ban on alcohol in Norway, I found that the ban led to a decrease in recorded alcohol sales. Jon Nelson offers comments on this study in two regards; my critical comments on his previous study of alcohol advertising bans and the time series analysis in my study. In this response to Nelson, I offer further explanation for my comments on Nelson's previous study and for the appropriateness of the analysis.
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Affiliation(s)
- Ingeborg Rossow
- Department of Alcohol, Drug and Tobacco Research, Norwegian Institute of Public Health, Oslo, Norway
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16
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Abstract
Background Self-harm is prevalent among adolescents and associated with mental health problems and negative life-events. Few studies have examined changes in its prevalence related to these factors. This study explored whether changes in prevalence of self-harm among adolescents had occurred, and to what extent changes in associated factors may have contributed. Methods Two cross-sectional school-based surveys among adolescents (grades 8–10) in Norway were conducted in 2002 (N = 5842) and in 2017/18 (N = 29 063). Past year prevalence of self-harm and identical variables on risk factors was analyzed in hierarchical logistic regression to examine whether and to what extent changes in self-harm correlates could explain periodical change in prevalence of self-harm. Results An increase from 4.1% to 16.2% in self-harm prevalence was observed from 2002 to 2017/18. The increase was relatively larger among girls compared to boys and among 8th graders compared to 10th graders. Among the assessed risk factors for self-harm, depressive symptoms increased, while anti-social behavior, exposure to violent acts and drinking to intoxication decreased. The increase in depressive symptoms contributed to explain increase in self-harm. This contribution was outweighed by the decrease in other risk factors. Conclusions Self-harm prevalence increased 4-fold among Norwegian adolescents over a 15-year period. While exposure to several risk factors for self-harm changed substantially in this period, these risk factors could in sum not explain any of the increase in self-harm.
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Affiliation(s)
- Anita J Tørmoen
- Institute of Clinical Medicine, National Centre for Suicide Research and Prevention, University of Oslo, Oslo, Norway
| | - Martin Myhre
- Institute of Clinical Medicine, National Centre for Suicide Research and Prevention, University of Oslo, Oslo, Norway
| | - Fredrik A Walby
- Institute of Clinical Medicine, National Centre for Suicide Research and Prevention, University of Oslo, Oslo, Norway
| | - Berit Grøholt
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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17
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Bye EK, Bogstrand ST, Rossow I. The importance of alcohol in elderly's hospital admissions for fall injuries: a population case-control study. Nordic Studies on Alcohol and Drugs 2021; 39:38-49. [PMID: 35308463 PMCID: PMC8899276 DOI: 10.1177/14550725211015836] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 04/20/2021] [Indexed: 12/27/2022] Open
Abstract
Background: Fall injuries account for a substantial part of the health burden among elderly persons, and they often affect life quality severely and impose large societal costs. Alcohol intoxication is a well-known risk factor for accidental injuries, but less is known about this association among elderly people. In this study, our aim was to assess whether risk of fall injuries among the elderly is elevated with an intoxication-oriented drinking pattern. Method: We applied a population case-control design and data from persons aged 60 years and over in Norway. Cases comprised patients with fall injuries admitted to a hospital emergency department ( n = 424), and controls were participants in general population surveys ( n = 1859). Drinking pattern was assessed from self-reports of drinking frequency and intoxication frequency. Age and gender-adjusted association between fall injury and drinking pattern was estimated in logistic regression models. Fall injuries were considered alcohol-related if blood alcohol concentration exceeded 0.01% and/or the patient reported alcohol intake within six hours prior to injury. Results: The risk of fall injuries was highly elevated among those reporting drinking to intoxication monthly or more often ( OR = 10.2, 95% CI 5.5–19.0). Among cases, the vast majority of those with alcohol-related fall injuries (64 of 68) reported drinking to intoxication. Conclusions: A drinking pattern comprising alcohol intoxication elevated the risk of fall injuries among elderly people. As alcohol use is a modifiable risk factor, the findings suggest a potential to curb the number of fall injuries and their consequences by employing effective strategies to prevent intoxication drinking among the elderly.
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Affiliation(s)
- Elin K. Bye
- Norwegian Institute of Public Health, Oslo, Norway
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18
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Manthey J, Kilian C, Carr S, Bartak M, Bloomfield K, Braddick F, Gual A, Neufeld M, O'Donnell A, Petruzelka B, Rogalewicz V, Rossow I, Schulte B, Rehm J. Use of alcohol, tobacco, cannabis, and other substances during the first wave of the SARS-CoV-2 pandemic in Europe: a survey on 36,000 European substance users. Subst Abuse Treat Prev Policy 2021; 16:36. [PMID: 33902668 PMCID: PMC8072737 DOI: 10.1186/s13011-021-00373-y] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2021] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND SARS-CoV-2 reached Europe in early 2020 and disrupted the private and public life of its citizens, with potential implications for substance use. The objective of this study was to describe possible changes in substance use in the first months of the SARS-CoV-2 pandemic in Europe. METHODS Data were obtained from a cross-sectional online survey of 36,538 adult substance users from 21 European countries conducted between April 24 and July 22 of 2020. Self-perceived changes in substance use were measured by asking respondents whether their use had decreased (slightly or substantially), increased (slightly or substantially), or not changed during the past month. The survey covered alcohol (frequency, quantity, and heavy episodic drinking occasions), tobacco, cannabis, and other illicit drug use. Sample weighted data were descriptively analysed and compared across substances. RESULTS Across all countries, use of all substances remained unchanged for around half of the respondents, while the remainder reported either a decrease or increase in their substance use. For alcohol use, overall, a larger proportion of respondents indicated a decrease than those reporting an increase. In contrast, more respondents reported increases in their tobacco and cannabis use during the previous month compared to those reporting decreased use. No distinct direction of change was reported for other substance use. CONCLUSIONS Our findings suggest changes in use of alcohol, tobacco and cannabis during the initial months of the pandemic in several European countries. This study offers initial insights into changes in substance use. Other data sources, such as sales statistics, should be used to corroborate these preliminary findings.
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Affiliation(s)
- Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany.
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany.
- Department of Psychiatry, Medical Faculty, University of Leipzig, Semmelweisstraße 10, 04103, Leipzig, Germany.
| | - Carolin Kilian
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
| | - Sinclair Carr
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany
| | - Miroslav Bartak
- First Faculty of Medicine and General Teaching Hospital Prague, Department of Addiction, Charles University, Apolinarska 4, 128 00, Prague 2, Czech Republic
| | - Kim Bloomfield
- Centre for Alcohol and Drug Research, Aarhus University, Tuborgvej 160, 2400, Copenhagen, NV, Denmark
- Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
- Health Promotion Department of Public Health, University of Southern Denmark, Niels Bohrs Vej 9, DK-6700, Esbjerg, Denmark
- Alcohol Research Group, Public Health Institute, 6001 Shellmound Street, Suite 450, Emeryville, CA, 94608, USA
| | - Fleur Braddick
- Clínic Foundation for Biomedical Research (FCRB), 08036, Barcelona, Spain
- Clinical Addictions Research Group (GRAC-GRE) Psychiatry Department, Neurosciences Institute, Hospital Clínic, University of Barcelona, 08036, Barcelona, Spain
| | - Antoni Gual
- Clínic Foundation for Biomedical Research (FCRB), 08036, Barcelona, Spain
- Clinical Addictions Research Group (GRAC-GRE) Psychiatry Department, Neurosciences Institute, Hospital Clínic, University of Barcelona, 08036, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036, Barcelona, Spain
| | - Maria Neufeld
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
- WHO European Office for the Prevention and Control of Noncommunicable Diseases (NCD Office) 9 Leontyevsky Pereulok, Moscow, Russian Federation, 125009
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada
| | - Amy O'Donnell
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Newcastle Upon Tyne, NE2 4AX, UK
| | - Benjamin Petruzelka
- First Faculty of Medicine and General Teaching Hospital Prague, Department of Addiction, Charles University, Apolinarska 4, 128 00, Prague 2, Czech Republic
| | - Vladimir Rogalewicz
- First Faculty of Medicine and General Teaching Hospital Prague, Department of Addiction, Charles University, Apolinarska 4, 128 00, Prague 2, Czech Republic
| | - Ingeborg Rossow
- Norwegian Institute of Public Health, Dept of Alcohol, Tobacco and Drugs, N-0213, Oslo, Norway
| | - Bernd Schulte
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany
| | - Jürgen Rehm
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, M5T 1P8, Canada
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Medical Sciences Building, 1 King's College Circle, Room 2374, Toronto, Ontario, M5S 1A8, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, M5S 3M1, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, Ontario, M5T 1R8, Canada
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya Street 8, b. 2, Moscow, Russian Federation, 119991
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19
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Rossow I, Bye EK, Moan IS, Kilian C, Bramness JG. Changes in Alcohol Consumption during the COVID-19 Pandemic-Small Change in Total Consumption, but Increase in Proportion of Heavy Drinkers. Int J Environ Res Public Health 2021; 18:4231. [PMID: 33923567 PMCID: PMC8073387 DOI: 10.3390/ijerph18084231] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/13/2021] [Accepted: 04/14/2021] [Indexed: 12/20/2022]
Abstract
Little is known about possible changes in alcohol consumption distribution during the COVID-19 pandemic. We estimated how individual changes in alcohol consumption during the pandemic translated into changes in: (i) mean consumption; (ii) dispersion of consumption distribution; and (iii) prevalence of heavy drinkers. We employed data from two independent web-surveys of Norwegian adults collected between April and July 2020 and limited to those reporting past year alcohol consumption (N1 = 15,267, N2 = 1195). Self-reports of changes in drinking behavior were quantified, assuming change being relative to baseline consumption level. During the pandemic, we found a small increase (Survey 1) or no change (Survey 2) in estimated mean alcohol consumption (which parallels to total consumption). However, in both surveys, the dispersion of the distribution increased significantly (p < 0.001). For most respondents, an average modest decline in consumption was found. However, the small fraction with the highest baseline consumption increased their consumption substantially, and in effect, the proportion of heavy drinkers increased markedly (p < 0.001). In conclusion, quantifications of reported changes in alcohol consumption during the pandemic suggest that the upper 5 to 10% of the drinkers increased their consumption and hence the prevalence of heavy drinkers increased, despite little or no change in total alcohol consumption.
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Affiliation(s)
- Ingeborg Rossow
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, 0213 Oslo, Norway; (E.K.B.); (I.S.M.); (J.G.B.)
| | - Elin K. Bye
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, 0213 Oslo, Norway; (E.K.B.); (I.S.M.); (J.G.B.)
| | - Inger Synnøve Moan
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, 0213 Oslo, Norway; (E.K.B.); (I.S.M.); (J.G.B.)
| | - Carolin Kilian
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, 01187 Dresden, Germany;
| | - Jørgen G. Bramness
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, 0213 Oslo, Norway; (E.K.B.); (I.S.M.); (J.G.B.)
- Institute of Clinical Medicine, UiT—The Arctic University of Norway, 9019 Tromsø, Norway
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, 2381 Brumunddal, Norway
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20
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Rossow I. The alcohol advertising ban in Norway: Effects on recorded alcohol sales. Drug Alcohol Rev 2021; 40:1392-1395. [DOI: 10.1111/dar.13289] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 03/10/2021] [Accepted: 03/10/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Ingeborg Rossow
- Department of Alcohol, Drug and Tobacco Research Norwegian Institute of Public Health Oslo Norway
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21
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Bramness JG, Bye EK, Moan IS, Rossow I. Alcohol Use during the COVID-19 Pandemic: Self-Reported Changes and Motives for Change. Eur Addict Res 2021; 27:257-262. [PMID: 33839730 PMCID: PMC8089433 DOI: 10.1159/000515102] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 02/05/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND In Europe, the COVID-19 pandemic triggered a range of restrictive measures, which may have impacted alcohol consumption. OBJECTIVES We explored perceived changes in alcohol consumption, their association with sociodemographic characteristics and past year alcohol consumption, and self-reported reasons for change after CO-VID-19 restrictions in Norway. METHOD A web-based survey was sent to Norwegians aged 18 years and older in June-July 2020. Respondents reporting any past year alcohol use (n = 1,200) were asked whether they drank less, approximately the same, or more after the COVID-19 restrictions compared to before and reasons for drinking less or more. RESULTS Almost a third (29.9%) reported they drank less, whereas 13.3% reported they drank more. Females, younger respondents, and Oslo residents were more likely to report both less and more drinking (p values between 0.001 and 0.029). Past year alcohol use was associated with less drinking (OR = 0.93; p < 0.001) and more drinking (OR = 1.07; p < 0.001). More drinking was also associated with living with child(ren) (p = 0.023) and high educational level (p = 0.029). The most frequently reported reasons for drinking less pertained to fewer social occasions and less on-premise drinking, whereas reasons for drinking more pertained to treating oneself to something good and fewer consequences of drinking more. CONCLUSIONS After the COVID-19 restrictions were implemented, a substantial proportion of Norwegians changed their drinking behaviour.
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Affiliation(s)
- Jørgen G. Bramness
- Department of Drug and Tobacco Research, Norwegian Institute of Public Health, Oslo, Norway,Institute of Clinical Medicine, UiT − The Arctic University of Norway, Tromsø, Norway,* Jørgen G. Bramness,
| | - Elin K. Bye
- Department of Drug and Tobacco Research, Norwegian Institute of Public Health, Oslo, Norway
| | - Inger Synnøve Moan
- Department of Drug and Tobacco Research, Norwegian Institute of Public Health, Oslo, Norway
| | - Ingeborg Rossow
- Department of Drug and Tobacco Research, Norwegian Institute of Public Health, Oslo, Norway
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22
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Babor TF, Casswell S, Rehm J, Room R, Rossow I. A Festival of Epiphanies: Three Revelations in Support of Better Alcohol Control Policies. J Stud Alcohol Drugs 2021. [DOI: 10.15288/jsad.2021.82.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Thomas F. Babor
- Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, Connecticut
| | - Sally Casswell
- SHORE and Whariki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Jürgen Rehm
- Institute for Mental Health Policy Research & Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Institute of Clinical Psychology and Psychotherapy & Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität, Dresden, Germany
- Center for Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, Victoria, Australia
- Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Ingeborg Rossow
- Norwegian Institute of Public Health, Department of Alcohol, Drugs, and Tobacco, Oslo, Norway
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23
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Sulkunen P, Babor TF, Cisneros Örnberg J, Egerer M, Hellman M, Livingstone C, Marionneau V, Nikkinen J, Orford J, Room R, Rossow I. Setting Limits: Gambling, Science and Public Policy-summary of results. Addiction 2021; 116:32-40. [PMID: 33084199 DOI: 10.1111/add.15241] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/17/2020] [Accepted: 08/21/2020] [Indexed: 11/26/2022]
Abstract
The gambling industry has grown into a global business in the 21st century. This has created the need for a new emphasis on problem prevention. This article highlights the core themes of the book Setting Limits: Gambling, Science and Public Policy, taking a broad view of the consequences of gambling for society as a burden on health, well-being and equality. The book covers the extent of gambling and gambling-related problems in different societies and presents a critical review of research on industry practices, policy objectives and preventive approaches, including services to people suffering from gambling and its consequences. It discusses the developments in game characteristics and gambling environments and provides evidence on how regulation can affect those. Effective measures to minimize gambling harm exist and many are well supported by scientific evidence. They include restrictions on general availability as well as selective measures to prevent gamblers from overspending. The revenue generated from gambling for the industry, governments, and providers of public services funded from gambling returns presents an obstacle to developing policies to implement harm-reduction measures. A public interest approach must weigh these interests against the suffering and losses of the victims of gambling.
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Affiliation(s)
- Pekka Sulkunen
- Centre for Research on Addiction, Control and Governance (CEACG), Faculty of Social Sciences, University of Helsinki, Finland
| | - Thomas F Babor
- Department of Community Medicine, University of Connecticut School of Medicine Connecticut, USA
| | | | - Michael Egerer
- Centre for Research on Addiction, Control and Governance (CEACG), Faculty of Social Sciences, University of Helsinki, Finland
| | - Matilda Hellman
- Centre for Research on Addiction, Control and Governance (CEACG), Faculty of Social Sciences, University of Helsinki, Finland
| | - Charles Livingstone
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Virve Marionneau
- Centre for Research on Addiction, Control and Governance (CEACG), Faculty of Social Sciences, University of Helsinki, Finland
| | - Janne Nikkinen
- Centre for Research on Addiction, Control and Governance (CEACG), Faculty of Social Sciences, University of Helsinki, Finland
| | - Jim Orford
- School of Psychology, University of Birmingham, UK, and King's College London, UK
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia and Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
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24
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Rossow I, Mäkelä P. Public Health Thinking Around Alcohol-Related Harm: Why Does Per Capita Consumption Matter? J Stud Alcohol Drugs 2021; 82:9-17. [PMID: 33573718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023] Open
Abstract
OBJECTIVE Alcohol per capita consumption (APC) is used for monitoring harmful alcohol exposure in populations and assessing progress with goals set internationally and nationally. Recently, the alcohol industry challenged the use of this indicator. Here, we assessed the validity of APC as an indicator for reducing alcohol-related harm. METHOD We conducted a narrative review of association between population-level drinking and harm rates, and the underlying mechanisms of this association. RESULTS A substantial literature demonstrates quite consistently close associations between APC and population harm levels for various types of health and social harms. Across populations with different total consumption, the distribution of consumption displays a fairly fixed shape, with no clear distinction between heavy drinkers and other drinkers. The mean consumption in a population is closely associated with the prevalence of heavy drinking; an increase in APC arises from a change in the whole distribution, heavy drinkers included. Although risk of harms from drinking increases with consumption, it seems that for many harm types the majority of drinkers, who do not drink heavily, account for a large proportion of harms from alcohol. CONCLUSIONS By reducing APC, decreases in drinking among heavy drinkers as well as among ordinary drinkers will lead to fewer alcohol-related harms. The evidence strongly suggests public health gains from universal policies targeting APC. Reducing APC is furthermore an investment in future public health, as it is likely an efficient way of preventing people from becoming very heavy drinkers, who may cause themselves and others severe health and social problems.
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Affiliation(s)
- Ingeborg Rossow
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
| | - Pia Mäkelä
- Alcohol, Drugs and Addictions Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
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Affiliation(s)
- Ingeborg Rossow
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
| | - Pia Mäkelä
- Alcohol, Drugs and Addictions Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
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Pape H, Rossow I, Bukten A. Alcohol Problems among Prisoners: Subgroup Variations, Concurrent Drug Problems, and Treatment Needs. Eur Addict Res 2021; 27:179-188. [PMID: 33321498 DOI: 10.1159/000511253] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 08/28/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS Alcohol problems in the prison population are understudied, underdetected, and undertreated. Our aims were to identify subgroups of inmates whose pre-prison drinking behavior indicated a high need for alcohol-related interventions, to assess the prevalence of concurrent alcohol and drug problems, and to compare dual-dependent inmates and those who were alcohol-dependent alone with respect to the severity of their drinking problems. METHODS Data stemmed from the nationwide Norwegian Offender Mental Health and Addiction (NorMA) study. Both male (n = 1,356) and female (n = 90) inmates took part in the study, representing about 40% of the prison population in Norway at the time of the data collection (2013-2014). Pre-prison substance use problems were assessed using the Alcohol Use Disorders Identification Test (AUDIT) and the Drug Use Disorders Identification Test (DUDIT). RESULTS A majority (55%) had an AUDIT positive screen (score ≥8), which is indicative of alcohol problems of some severity, and 18% were possible alcohol-dependent (score ≥20). A positive screen was associated with younger age, lower education, violent offending, driving while intoxicated (DWI), and previous criminal convictions. Two-thirds (68%) of those who screened positive on the AUDIT had also a DUDIT positive screen (score ≥6), and a similar overlap between possible alcohol dependence and possible drug dependence (score ≥25) was observed. Inmates with possible dual dependence (12% of all) had higher mean scores on the AUDIT than those with possible alcohol dependence only (7% of all). CONCLUSIONS More than half of the prisoners in Norway had AUDIT scores that indicated they could benefit from alcohol-related interventions, and the prevalence was elevated in younger, less educated groups of previously convicted DWI, and violent offenders. Alcohol problems were most often combined with drug problems, and possible dual dependence was associated with particularly severe drinking problems.
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Affiliation(s)
- Hilde Pape
- University College of Norwegian Correctional Service, Lillestrøm, Norway, .,Norwegian Institute of Public Health, Oslo, Norway,
| | | | - Anne Bukten
- Norwegian Centre for Addiction Research, The University of Oslo, Oslo, Norway.,Section for Clinical Addiction Research, Oslo University Hospital, Oslo, Norway
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Babor TF, Casswell S, Rehm J, Room R, Rossow I. A Festival of Epiphanies: Three Revelations in Support of Better Alcohol Control Policies. J Stud Alcohol Drugs 2021; 82:5-8. [PMID: 33573717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023] Open
Affiliation(s)
- Thomas F Babor
- Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, Connecticut
| | - Sally Casswell
- SHORE and Whariki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Jürgen Rehm
- Institute for Mental Health Policy Research & Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Institute of Clinical Psychology and Psychotherapy & Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität, Dresden, Germany
- Center for Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Medical Sciences Building, Toronto, Ontario, Canada
- Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, Victoria, Australia
- Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Ingeborg Rossow
- Norwegian Institute of Public Health, Department of Alcohol, Drugs, and Tobacco, Oslo, Norway
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Rossow I, Amundsen EJ, Samuelsen SO. Socio-economic differences in all-cause mortality in people with alcohol use disorder: a prospective cohort study. Addiction 2021; 116:53-59. [PMID: 32267578 DOI: 10.1111/add.15070] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 01/08/2020] [Accepted: 04/01/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND AIMS While alcohol-attributable mortality rates are higher in low socio-economic status (SES) groups, less is known about SES differences in all-cause mortality in alcohol use disorder (AUD). The aim of this study was to explore whether there are SES differences in people with AUD, regarding (i) treatment admission, (ii) all-cause mortality risk and (iii) relative mortality risk. DESIGN AND SETTING A prospective cohort study in Norway, follow-up period from 2009-10 to 2013. Data on SES and mortality were obtained through linkages to national registries, using national unique ID numbers. PARTICIPANTS AUD patients (age 20+) admitted to treatment in 2009-10 (n = 11 726) and age and gender frequency-matched controls from the general population (n = 12 055). MEASUREMENTS The SES indicator was education level (low, intermediate and high). Mortality was calculated as deaths per 1000 person-years during the 4-year observation period. FINDINGS Admission to AUD treatment was elevated in the low compared with the high SES categories (OR = 3.31, 95% CI = 3.09, 3.55). Among AUD patients, mortality risk was elevated in the low SES category (HR = 1.23, 95% CI = 1.04, 1.45). Relative mortality risk from AUD was significantly higher in the high SES (HR = 8.65, 95% CI = 6.16, 12.14) compared with the low SES categories (HR = 3.29, 95% CI = 2.61, 4.15). CONCLUSION Admission to treatment for alcohol use disorders in Norway appears to decrease with increasing socio-economic status, and relative mortality risk from alcohol use disorder appears to increase with increasing socio-economic status.
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Affiliation(s)
- Ingeborg Rossow
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
| | - Ellen J Amundsen
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
| | - Sven Ove Samuelsen
- Department of Mathematics, University of Oslo, Oslo, Norway.,Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
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Rossow I, Grøtting MW. Evaluation of an alcohol policy measure employing a randomised controlled trial design: Why was it possible? Drug Alcohol Rev 2020; 40:468-471. [PMID: 33336834 DOI: 10.1111/dar.13230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 11/22/2020] [Accepted: 11/23/2020] [Indexed: 12/01/2022]
Abstract
Some of the best evidence of effects of control policies on alcohol availability stems from controlled experimental studies in the Nordic state-owned alcohol monopolies. Publications from these studies do not, however, explain the process leading up to the implementation of changes in policy measures under controlled experimental conditions. In September 2020, the Norwegian state alcohol monopoly started the implementation of extended trading hours, employing a randomised controlled trial design. In this commentary, we give an account of the process leading up to this implementation and how the monopoly considered various pro- and contra-arguments in this regard. This case illustrates that willingness to contribute to strengthened scientific evidence on alcohol control policies can be embedded in the social responsibility of a state alcohol monopoly.
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Affiliation(s)
- Ingeborg Rossow
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
| | - Maja Weemes Grøtting
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
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Rossow I, Træen B. Alcohol use among older adults: A comparative study across four European countries. Nordic Studies on Alcohol and Drugs 2020; 37:526-543. [PMID: 35308653 PMCID: PMC8899285 DOI: 10.1177/1455072520954335] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 08/12/2020] [Indexed: 01/07/2023] Open
Abstract
Aims: (i) To examine whether mean consumption and prevalence of at-risk drinking are highly correlated across samples of older adults, and (ii) to explore whether sociodemographic and health characteristics of alcohol use differ across countries. Method: Cross-sectional surveys were conducted in four European countries, Norway, Denmark, Belgium, and Portugal, applying identical data collection methods and survey instruments in general population samples of older adults aged 60 to 75 years. Alcohol consumption was measured as units of alcohol per week, which provided the basis for categorising the two outcome measures: abstention (0 units/week) and at-risk drinking (8+ units/week). Cross-tabulations and logistic regression models were estimated to examine associations between sociodemographic and health characteristics on the one hand and alcohol abstention and at-risk drinking on the other. Results: Prevalence of abstention was highest in Portugal and lowest in Denmark, whereas at-risk drinking was more prevalent in Denmark and Belgium compared to Norway and Portugal. Among country- and gender-specific samples of drinkers, there was a strong positive correlation between mean consumption and prevalence of at-risk drinkers. Female gender characterised abstention, whereas male gender characterised at-risk drinking in all four countries. Other sociodemographic characteristics and indicators of health and wellbeing were differently associated with abstention and at-risk drinking across the four countries. Conclusions: A strong regularity in the distribution of alcohol consumption was observed in the samples of older adults. Gender was the only common factor associated with drinking behaviour across the four countries.
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Pape H, Rossow I. Less adolescent alcohol and cannabis use: More deviant user groups? Drug Alcohol Rev 2020; 40:118-125. [PMID: 32808718 DOI: 10.1111/dar.13146] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/10/2020] [Accepted: 07/13/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION AND AIMS Adolescent drinking and cannabis use in Norway declined in the 2000s, and we tested the assumption that psychosocial problems were more strongly related to substance use when the prevalence was quite low (2012/2013) than when it was considerably higher (2002). DESIGN AND METHODS Data stemmed from school surveys of almost 20 000 students aged 14-17 years in 2002 and 2012/2013 in the four largest cities in Norway. We assessed how various deviant behaviours and depressive mood were related to past-year measures on any alcohol intoxication, frequent intoxication (6+ times) and any cannabis use, and tested whether the associations varied significantly by survey year. RESULTS The prevalence of any intoxication episodes dropped markedly from 2002 (50%) to 2012/2013 (28%), as did the prevalence of frequent intoxication (29% vs. 10%) and any cannabis use (15% vs. 7%). Deviant behaviours and depressive mood were either more closely related to the drinking outcomes in 2012/2013 than in 2002, or the associations showed no temporal change. None of the associations with cannabis use varied significantly by survey year. DISCUSSION AND CONCLUSION The assumption that psychosocial problems correlated more strongly with alcohol and cannabis use in a low-prevalence period (2012/2013) as compared to a high-prevalence period (2002) was partly supported, but only with respect to drinking. The strength of the associations with cannabis use was stable, which may reflect that the proportion reporting any use of the drug was low even in the relatively 'high-prevalence' period.
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Affiliation(s)
- Hilde Pape
- The Research Department, University College of Norwegian Correctional Service, Lillestrøm, Norway.,Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
| | - Ingeborg Rossow
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
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Rossow I, Pape H, Torgersen L. Decline in adolescent drinking: Some possible explanations. Drug Alcohol Rev 2020; 39:721-728. [DOI: 10.1111/dar.13132] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/16/2020] [Accepted: 06/17/2020] [Indexed: 12/27/2022]
Affiliation(s)
- Ingeborg Rossow
- Department of Alcohol, Tobacco and Drugs Norwegian Institute of Public Health Oslo Norway
| | - Hilde Pape
- Department of Alcohol, Tobacco and Drugs Norwegian Institute of Public Health Oslo Norway
- The Research Department University College of Norwegian Correctional Service Lillestrøm Norway
| | - Leila Torgersen
- Department of Child Health and Development Norwegian Institute of Public Health Oslo Norway
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Scheffels J, Buvik K, Tokle R, Rossow I. Normalisation of non‐drinking? 15–16‐year‐olds' accounts of refraining from alcohol. Drug Alcohol Rev 2020; 39:729-736. [DOI: 10.1111/dar.13084] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 04/01/2020] [Accepted: 04/06/2020] [Indexed: 12/18/2022]
Affiliation(s)
- Janne Scheffels
- Department of Alcohol, Tobacco and Drugs Norwegian Institute of Public Health Oslo Norway
| | - Kristin Buvik
- Department of Alcohol, Tobacco and Drugs Norwegian Institute of Public Health Oslo Norway
| | - Rikke Tokle
- Department of Alcohol, Tobacco and Drugs Norwegian Institute of Public Health Oslo Norway
| | - Ingeborg Rossow
- Department of Alcohol, Tobacco and Drugs Norwegian Institute of Public Health Oslo Norway
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Rossow I. Health care or social welfare in commissioning and purchasing of alcohol and other drug treatment: A comment to Ritter and van de Ven. Drug Alcohol Rev 2019; 38:123-124. [DOI: 10.1111/dar.12902] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Accepted: 01/09/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Ingeborg Rossow
- Department of Alcohol, Drugs, and Tobacco; Norwegian Institute of Public Health; Oslo Norway
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Rossow I, McCambridge J. The handling of evidence in national and local policy making: a case study of alcohol industry actor strategies regarding data on on-premise trading hours and violence in Norway. BMC Public Health 2019; 19:44. [PMID: 30626353 PMCID: PMC6327455 DOI: 10.1186/s12889-018-6348-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 12/19/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Effective alcohol policy measures conflict with the interests of the alcohol industry. In this study we addressed how various alcohol industry actors in Norway have responded to research findings and police data relating to the possible impacts of changes in on-premise trading hours on violent offending. METHODS A content analysis of documents was undertaken. The documents comprised i) hearing statements from policy processes on on-premise trading hours at the national level, and in 15 Norwegian cities, and ii) newspaper articles and other media coverage of this topic in Norway. RESULTS Alcohol industry actors employed a range of strategies to shape the use of evidence regarding on-premise trading hours and violence. Nationally, the relevance of the international research literature was questioned before the publication of an unfavourable national study which was criticized directly. This led to commissioned attacks on the findings, constructing what were claimed to be disagreements between experts, emphasis on the complexity of violence and the role of confounding variables, and deflecting attention to alternative interventions. The handling of evidence at the local level was importantly different, where different industry actors and forms of evidence, notably police data, were involved in debates. CONCLUSION Alcohol industry actors employed various strategies to shape perceptions and use of evidence to advance their interests. The particular strategies and arguments changed over time as new data and research became available, and also varied between the national and the local levels, and by categories of industry actors.
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Affiliation(s)
- Ingeborg Rossow
- Department of Alcohol, Drug and Tobacco Research, Norwegian Institute of Public Health, POB 4404 Nydalen, N-0403 Oslo, Norway
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36
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Buvik K, Rossow I. Favorable Effects Under Irrelevant Conditions: A Commentary to Woodall et al. (2018). J Stud Alcohol Drugs 2018; 79:680-681. [PMID: 30422778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023] Open
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37
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Buvik K, Rossow I. Favorable Effects Under Irrelevant Conditions: A Commentary to Woodall et al. (2018). J Stud Alcohol Drugs 2018. [DOI: 10.15288/jsad.2018.79.680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Rossow I. The total consumption model applied to gambling: Empirical validity and implications for gambling policy. Nordisk Alkohol Nark 2018; 36:66-76. [PMID: 32934551 PMCID: PMC7434123 DOI: 10.1177/1455072518794016] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 06/29/2018] [Indexed: 11/30/2022] Open
Abstract
Aim: The total consumption model (TCM) originates from studies of the distribution
of alcohol consumption and posits that there is a strong association between
the total consumption and the prevalence of excessive/harmful consumption in
a population. The policy implication of the TCM is that policy measures
which effectively lead to a reduction of the total consumption, will most
likely also reduce the extent of harmful consumption and related harms.
Problem gambling constitutes a public health issue and more insight into
problem gambling at the societal level and a better understanding of how
public policies may impact on the harm level, are strongly needed. The aim
of this study was to review the literature pertaining to empirical validity
of the TCM with regard to gambling behaviour and problem gambling and, on
the basis of the literature review, to discuss the policy implications of
the TCM. Methods: The study is based on a literature mapping through systematic searches in
literature databases, and forward and backward reference searches. Results: The literature searches identified a total of 12 empirical studies that
examined the total consumption model or provided relevant data. All but one
of these studies found empirical support for the TCM; that is, a positive
association between population gambling mean and prevalence of excessive or
problem gambling. Such associations were found both with cross-sectional
data and with longitudinal data. Conclusion: There is a small but fairly consistent literature lending empirical support
to the total consumption model. An important policy implication is that
interventions which are successful in reducing overall gambling are likely
also to reduce problem gambling incidence.
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Abstract
This article addresses whether an association between alcohol consumption and homicide can be established in analyses of Canadian time series data and, if so, whether the strength of the association varies across Canadian provinces and with respect to male and female victim rates. Time series analyses on differenced series of annual aggregate-level data on alcohol sales and homicide rates for the period 1950–1999 were performed for Canadian provinces and the country as a whole. Total alcohol sales were positively and statistically significantly associated with total homicide rates in two provinces and with male homicide rates in three provinces. The effect of alcohol sales was somewhat stronger for male homicide rates than for female homicide rates in two provinces. Pooling of estimates yielded a statistically significant association between alcohol sales and homicide rates for Canada. The findings support the hypothesis that alcohol sales tend to have an impact on homicide rates, and more so in certain provinces and for male homicide rates.
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Pape H, Rossow I, Brunborg GS. Adolescents drink less: How, who and why? A review of the recent research literature. Drug Alcohol Rev 2018; 37 Suppl 1:S98-S114. [PMID: 29573020 DOI: 10.1111/dar.12695] [Citation(s) in RCA: 111] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 02/15/2018] [Accepted: 02/20/2018] [Indexed: 01/26/2023]
Abstract
ISSUES Today's teenagers have been described as a sober generation and we asked: 'What is known about the recent decline in youth drinking?' APPROACH A literature review (2005-2017). KEY FINDINGS Research from wealthier parts of the world provides solid evidence of less alcohol use by youth since the millennium shift. Some studies show that this is reflected at all levels of consumption, but there are also indications that the heaviest drinkers have not reduced their drinking. The decrease is predominately seen in underage youth, and has been larger for boys than for girls in several countries. Teenagers across social strata drink less, but some disadvantaged subgroups have not followed the downward trend. Underage drinkers have apparently not become a more deviant group as the prevalence of drinking has dropped, indicating no hardening of the group. The major gap in the literature pertains to the issue of underlying driving forces. We found no evidence in support of the widespread assumption that the digital revolution has been of importance. A decline in parenting practices that are conductive to underage drinking has occurred in several countries, but studies examining whether these changes have contributed to less alcohol use by youth are almost non-existent. IMPLICATIONS To inform alcohol policy and prevention, it is imperative to find out why teenage drinking has decreased in a fairly consistent way across numerous countries. CONCLUSION Future research into the issue of falling prevalence rates of youth drinking should focus on possible explanatory factors at the population level rather than at the individual level.
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Affiliation(s)
- Hilde Pape
- Norwegian Institute of Public Health, Oslo, Norway.,The Research Department, University College of Norwegian Prison Service, Lillestrøm, Norway
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Pape H, Rossow I, Andreas JB, Norström T. Social Class and Alcohol Use by Youth: Different Drinking Behaviors, Different Associations? J Stud Alcohol Drugs 2018; 79:132-136. [PMID: 29227242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Abstract
OBJECTIVE Low socioeconomic status (SES) is related to hazardous alcohol use in adults, and the association seems to be stronger for more deviant and harmful drinking behaviors. We examined whether a similar pattern was present among adolescents. METHOD Data stem from a Norwegian school survey of 14- to 17-year-olds (n = 12,966; response rate in participating schools: 86%). Parental education (high/ middle vs. low) was our main SES indicator. The outcomes comprised lifetime and past-year drinking and intoxication, and past-year symptoms of excessive drinking. We used Poisson regression to estimate relative risks (RR) and post-estimation Wald F tests to compare coefficient estimates. RESULTS Parental education was related inversely to the lifetime measures of drinking and intoxication among all students but the 17-year-olds. The impact on any intoxication episodes was significantly stronger than that on any alcohol use only among the 14-year-olds (RR = 1.79, 95% CI [1.31, 2.43] vs. RR = 1.21, 95% CI [0.98, 1.49]) (p < .001). Among past-year drinkers at all ages (14-17 years; n = 7,796), the differential impact of low parental education was particularly large with respect to the frequency of intoxication (RR = 1.68, 95% CI [1.39, 2.02]) compared with the frequency of drinking (RR = 1.42, 95% CI [1.24, 1.62]) (p < .001) and frequent symptoms of excessive drinking (RR = 1.80, 95% CI [1.47, 2.20]) compared with any symptoms (RR = 1.07, 95% CI [1.01, 1.14]) (p < .001). A similar but somewhat less clear pattern emerged when using an alternative indicator for low parental SES. CONCLUSIONS Parents' social standing was inversely related to alcohol use by youth and related more strongly so to more deviant and harmful drinking behaviors.
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Affiliation(s)
- Hilde Pape
- Department of Substance Use, Norwegian Institute of Public Health, Oslo, Norway
| | - Ingeborg Rossow
- Department of Substance Use, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Thor Norström
- Department of Substance Use, Norwegian Institute of Public Health, Oslo, Norway
- Swedish Institute for Social Research, Stockholm University, Stockholm, Sweden
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Pape H, Rossow I, Andreas JB, Norström T. Social Class and Alcohol Use by Youth: Different Drinking Behaviors, Different Associations? J Stud Alcohol Drugs 2018. [DOI: 10.15288/jsad.2018.79.132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Hilde Pape
- Department of Substance Use, Norwegian Institute of Public Health, Oslo, Norway
| | - Ingeborg Rossow
- Department of Substance Use, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Thor Norström
- Department of Substance Use, Norwegian Institute of Public Health, Oslo, Norway
- Swedish Institute for Social Research, Stockholm University, Stockholm, Sweden
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Norström T, Rossow I, Pape H. Social inequality in youth violence: The role of heavy episodic drinking. Drug Alcohol Rev 2017; 37:162-169. [PMID: 28656699 DOI: 10.1111/dar.12582] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 05/19/2017] [Accepted: 05/30/2017] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND AIMS Alcohol use is an important risk factor for violence, and violent behaviour is more prevalent in lower socioeconomic status (SES) groups. The aim of this study was to examine whether the SES difference in youth violence can be explained by differential exposure to-and/or differential vulnerability to-heavy episodic drinking (HED). In the latter case, effect modification by impulsivity could be assumed. DESIGN AND METHODS We analysed cross-sectional data from a school survey of 15- to 17-year-olds in Norway (n = 9853). We employed two measures of low-SES group. Associations between SES, HED and violence were estimated by Poisson regressions, applying a residual centring procedure to test effect modification. RESULTS Violent behaviour frequency, HED frequency and impulsivity scores were all elevated in the low-SES group. The SES difference in violent behaviour was significantly reduced when adjusting for HED. The stronger association between HED and violence in the low, compared with the medium-SES/high-SES group, was modified when accounting for impulsivity. Sensitivity analyses suggested robust findings. DISCUSSION AND CONCLUSIONS The findings lend support to both the differential exposure hypothesis and to the differential vulnerability hypothesis as well as the hypothesis of an enhancing effect of impulsivity on the HED-violence association. The SES difference in youth violence can be accounted for by: (i) an elevated prevalence of HED in low-SES groups; and (ii) a stronger than average link between HED and violence in low-SES groups due to their higher than average impulsivity score. [Norström T, Rossow I, Pape H. Social inequality in youth violence: The role of heavy episodic drinking. Drug Alcohol Rev 2017;00:000-000].
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Affiliation(s)
- Thor Norström
- Swedish Institute for Social Research, Stockholm University, Stockholm, Sweden.,Department of Drug Policy, Norwegian Institute of Public Health, Oslo, Norway
| | - Ingeborg Rossow
- Department of Drug Policy, Norwegian Institute of Public Health, Oslo, Norway
| | - Hilde Pape
- Department of Substance Use, Norwegian Institute of Public Health, Oslo, Norway
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Abstract
AIMS To estimate whether parental socio-economic status (SES) is associated with adolescent drinking, and the degree to which a possible association may be accounted for by various parental factors. DESIGN AND SETTING Cross-sectional Norwegian school survey from 2006 (response rate: 86%). PARTICIPANTS Students aged 13-14 years (n = 5797), 15-16 years (n = 6613) and 17-18 years (n = 5351), of whom 51% were girls. MEASUREMENTS Parents' education was our main SES indicator, and we distinguished between low (7%) and middle/high (93%) educational level. The outcomes comprised past-year drinking and intoxication. We also applied measures on general parenting, parents' alcohol-related permissiveness and parental intoxication. The main analyses were conducted using Poisson regression. FINDINGS Parents' education had no statistically significant impact on alcohol use among the 17-18-year-olds, while 13-16-year-olds with low educated parents had an elevated relative risk (RR) of both drinking [RR = 1.21, 95% confidence interval (CI) = 1.13-1.29] and intoxication (RR = 1.32, 95% CI = 1.21-1.44). The RRs became statistically insignificant when including all the parental factors as covariates in the regression models. Among adolescents who had consumed alcohol, low parental education was related to more frequent drinking (RR = 1.24, 95% CI = 1.11-1.38) and intoxication episodes (RR = 1.42, 95% CI = 1.22-1.66). Again, the RRs became statistically insignificant when we accounted for all the parental factors. This pattern was replicated when we applied an alternative indicator for low parental SES. CONCLUSIONS Adolescent drinking in Norway appears to be related inversely to parents' social standing. The elevated risk of low socio-economic status vanishes when general parenting, alcohol-related parental permissiveness and parents' drinking are accounted for.
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Affiliation(s)
- Hilde Pape
- Norwegian Institute of Public Health, Oslo, Norway
| | - Thor Norström
- Norwegian Institute of Public Health, Oslo, Norway.,Swedish Institute for Social Research, Stockholm University, Stockholm, Sweden
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45
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Abstract
Background There is a renewed interest in alcohol's harm to others (AHTO), and survey studies in the general population are often used to estimate the extent of harm, to address the severity and variety of harms, and to identify the victims of such harm. While cross-sectional survey studies are attractive in several respects, they also entail several methodological challenges. Aim We discuss some of these issues, paying particular attention to the problems of causal attribution, transferability, survey data collection and range of harms. Conclusions We offer some suggestions for study design to enhance causal inferences from studies examining alcohol's harm to others.
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Affiliation(s)
| | - Mats Ramstedt
- Swedish Council for Information on Alcohol and Other Drugs
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46
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Abstract
Aims This paper summarizes and discusses the trends in alcohol consumption and various types of alcohol related-harm in the five Nordic countries—Denmark. Finland, Iceland, Norway and Sweden. Results and Conclusions The development in alcohol consumption versus alcohol-related harm is mixed. In some cases the trends are fairly parallel whereas in other cases they are diverging. This article lays out the different potential methodological and substantive explanations for the diverging trends. as well as discussing their likely explanatory value. Although we have observed that trends in alcohol consumption are not necessarily followed by similar trends in all indicators of alcohol-related harm, we conclude that there is still in general reason to assume that a significant change in total alcohol consumption in a Nordic country is—all other things being equal—likely to be followed by a change in the same direction in various alcohol-related harms in that population.
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Affiliation(s)
- Ingeborg Rossow
- Norwegian Institute for Alcohol and Drug Research P.O. BOX 565 Sentrum, N-0105 Oslo
| | - Pia Mäkelä
- Alcohol and Drug Research Group National Research and Development Centre for Welfare and Health P.O. BOX 220 00531 Helsinki Finland
| | - Esa Österberg
- Alcohol and Drug Research Group National Research and Development Centre for Welfare and Health P.O. BOX 220 00531 Helsinki Finland
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47
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Abstract
Thor Norström & Ingeborg Rossow: Beverage specific effects on suicide The authors analyze the relationship between suicide and beverage specific indicators of alcohol sales in Norway and Sweden. The data comprised aggregate time series for Norway (1918–1994) and Sweden (1948–1994). The suicide indicator was the number of male suicides per 100,000 inhabitants (15+). The beverage specific indicators were sales of beer, spirits and wine (liters 100 % ethanol per inhabitant, 15+). The beverage specific effects on suicide were estimated by means of ARIMA-models. For Norway as well as Sweden, there was a statistically significant relationship between suicide on the one hand, and sales of beer (in Sweden retail sales only) and spirits on the other. A common finding in the two countries was the absence of any effect of wine sales. A tentative interpretation of the findings is that spirits and beer sales are markers of the prevalence of an important risk group for suicide, i.e., heavy drinkers. The fact that beer seems to be of greater importance in this context in Norway – which might be attributable to differences between the two countries in the availability of this beverage – is a reminder of how culturally bounded the findings are.
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48
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Abstract
BACKGROUND No review has used a meta-analytic approach to estimate common odds ratios (ORs) for the effect of acute use of alcohol (AUA) on suicide attempts. We aim to report the results of the first meta-analysis of controlled epidemiological studies on AUA and suicide attempt. METHOD The English-language literature on Medline, PsycINFO and Google Scholar was searched for original articles and critical review on AUA and suicide attempt (period 1996-2015). Studies had to report an OR estimate for this association. Common ORs and 95% confidence intervals (CIs) from random effects in meta-analyses for any AUA and two levels of alcohol use on suicide attempt were calculated. RESULTS In all, seven studies provided OR estimates for the likelihood of suicide attempt by AUA, compared with those who did not drink alcohol. Studies used case-control (n 3) and case-crossover designs (n 4). Meta-analysis revealed a common OR of 6.97 (95% CI 4.77-10.17) for any AUA. Using four studies, 'low levels of acute drinking' resulted in an OR of 2.71 (95% CI 1.56-4.71) and 'high levels' had an OR of 37.18 (95% CI 17.38-79.53). CONCLUSIONS AUA is associated with increased likelihood of a suicide attempt, particularly at high doses. Such data should be incorporated into estimates of the burden of disease associated with alcohol use, which are currently limited by a consideration of only alcohol's chronic effects. Future research should focus on the mechanisms through which AUA confers risk for attempt.
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Affiliation(s)
| | - Courtney Bagge
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Mississippi
| | | | | | | | - Ingeborg Rossow
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo
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49
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Abstract
Background: Sedative-hypnotic drugs (i.e., tranquilizers and sleeping pills) are more often used among the elderly compared to other age groups. Concomitant use of alcohol and sedative-hypnotic drugs constitutes a particularly high risk factor for accidental injuries among the elderly. However, few studies have addressed the prevalence of concomitant alcohol and sedative-hypnotic drug use and knowledge about the characteristics of such use is meagre. Aim: To assess the prevalence of concomitant alcohol and sedative-hypnotic drug use among elderly people and to explore the characteristics of such concomitant use. Data and method: Data stemmed from cross-sectional population surveys in Norway, conducted in the period 2012–2015 (sub-sample 60–79 years: N = 1920). Results: Respondents reported frequencies of use of sedatives (tranquilizers), hypnotics (sleeping pills) and alcohol consumption in the preceding 12 months. Sedative-hypnotic drug use was reported by 25%, and 19% reported both such drug use and alcohol use in the past year. Concomitant use, suggesting simultaneous intake of alcohol and drugs, was reported by 6%. Conclusions: Concomitant use was more often reported by women, hazardous alcohol users, non-working respondents, and by those in the lower income groups and those living alone. Health personnel need to take into consideration the risks associated with concomitant use and to inform their patients accordingly.
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50
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Affiliation(s)
- Kristin Buvik
- Norwegian Institute of Public Health, Department of Drug Policy, Pb 4404, Nydalen, 0403 Oslo, Norway
| | - Ingeborg Rossow
- Norwegian Institute of Public Health, Department of Drug Policy, Pb 4404, Nydalen, 0403 Oslo, Norway
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