Predictors of One-Year Persistence of Harm From a Known Person's Drinking: Findings From a Longitudinal Population-Based Study in Sweden.

OBJECTIVE: Few studies have investigated the persistence over time of experiences of harm from a known person's drinking. The aim of this study was to describe 1-year persistence and investigate its predictors at baseline. Potential predictors included the harmed person's sociodemographic factors, their own drinking habits, their relationship to the person causing harm, and the type of negative experience. METHOD: The sample included respondents who reported experiencing harm from a known person's drinking in a general population survey in 2013 and participated in a follow-up survey in 2014 (n = 1,203). One-year persistence of experienced harm was defined as reporting any harm in both surveys. We investigated potential baseline predictors of persistence by estimating relative risks and 95% confidence intervals through modified binary Poisson regression analyses with robust error variance. RESULTS: One-year persistence of experiencing any type of harm from a known person's drinking was seen in 52.5% of those reporting harm at baseline and was higher among women (56.7%) than men (43.3%). Reporting harm from a partner, parent, or other household member significantly predicted 1-year persistence, as did severity of overall perceived harm at baseline. CONCLUSIONS: In Sweden, 1-year persistence of experienced harm from a known person's drinking is common in most individuals. The risk of experiencing such harm is higher among women, when harm occurs within close relationships, and when it is experienced as severe at baseline. Support to individuals in these situations is crucial.

Prevalence of cannabis use among young adults in Sweden comparing randomized response technique with a traditional survey.

BACKGROUND AND AIMS: The prevalence of cannabis use based on self-reports is likely to be underestimated in population surveys, especially in contexts where its use is a criminal offence. Indirect survey methods ask sensitive questions ensuring that answers cannot be identified with an individual respondent, therefore potentially resulting in more reliable estimates. We aimed to measure whether the indirect survey method 'randomized response technique' (RRT) increased response rate and/or increased disclosure of cannabis use among young adults compared with a traditional survey. DESIGN: We conducted two parallel nation-wide surveys during the spring and the summer of 2021. The first survey was a traditional questionnaire-based one (focusing on substance use and gambling). The second survey applied an indirect survey method known as 'the cross-wise model' to questions related to cannabis use. The two surveys employed identical procedures (e.g. invitations, reminders and wording of the questions) SETTING AND PARTICIPANTS: The participants were young adults (aged 18-29 years) living in Sweden. The traditional survey had 1200 respondents (56.9% women) and the indirect survey had 2951 respondents (53.6% women). MEASUREMENTS: In both surveys, cannabis use was assessed according to three time-frames: life-time use; use during the past year; and use during the past 30 days. FINDINGS: The estimated prevalence of cannabis use was two- to threefold higher on all measures when estimated using the indirect survey method compared with the traditional survey: use during life-time (43.2 versus 27.3%); during the past year (19.2 versus 10.4%); and during the past 30 days (13.2 versus 3.7%). The discrepancy was larger among males and individuals with an education shorter than 10 years, who were unemployed, and who were born in non-European countries. CONCLUSIONS: Indirect survey methods may provide more accurate estimates than traditional surveys on prevalence of self-reported cannabis use.

Country-Level Heavy Episodic Drinking and Individual-Level Experiences of Harm from Others' Drinking-Related Aggression in 19 European Countries.

INTRODUCTION: There is limited knowledge about how individual experiences of harm from others' drinking are influenced by heavy episodic drinking (HED) at the country level. The present study aimed to assess (1) the association between the country-level prevalence of HED and the risk of experiencing harm from others' drinking-related aggression and (2) if HED at the country level modifies the association between consumption of alcohol per capita (APC) and such harm. METHODS: Outcome data from 32,576 participants from 19 European countries stem from the RARHA SEAS study. Self-reported harm from others' drinking included having been verbally abused, harmed physically, or having serious arguments. Data on country-level drinking patterns were derived from the World Health Organization. Associations between country-level prevalence of monthly HED and experiences of aggression (at least 1 of 3 studied harms) were derived through multilevel models - adjusted for country-level age structure and by including the respondent's own HED patterns as a mediator. RESULTS: A 1% increase in the prevalence of monthly HED was associated with 5% higher odds (odds ratio [OR] 1.05) of experiencing others' alcohol-related aggression among men, and 6% (OR 1.06) among women. The results suggest that the association between APC and harm was stronger in countries with high prevalences of HED, but the modifying effect could not be confirmed. DISCUSSION/CONCLUSION: Harm from others' drinking-related aggression depends not only on individual factors but is also influenced by the drinking patterns of the population. However, the country-level prevalence of HED only explains a small part of the variance of this type of harm.

Severe harm from others' drinking: A population-based study on sex differences and the role of one's own drinking habits.

INTRODUCTION AND AIMS: Despite the fact that many studies have focused on harm from others' drinking, there is a lack of knowledge regarding severe forms of these harms. This study aimed to assess sex differences in the prevalence of severe harm from others' drinking and sex-specific associations with one's own drinking. DESIGN AND METHODS: The data originated from a Swedish cross-sectional population survey (n = 15 576). Adjusted odds ratios of self-reported experiences of severe harm (harmed 'a lot') from others' drinking were calculated using logistic regression models. Additive interactions were used to determine sex-specific associations between own drinking and harm. RESULTS: The past-year prevalence of severe harm from known and unknown drinkers was higher among women (4.9% and 1.8%, respectively) than men (1.9% and 1.2%, respectively). Alcohol dependence predicted such harm for both sexes. No association with severe harm from known drinkers was found for male drinkers and binge drinkers, whereas female drinkers and binge drinkers reported more experiences of such harm. These differences indicated a supper-additive interaction (RERI: 0.92-1.47) and signs of having alcohol dependence among women indicated an even higher interaction (RERI: 5.37). DISCUSSION AND CONCLUSIONS: Women suffer more frequently from severe harm from others' drinking. Men and women report different experiences of severe harm from known people's drinking conditioning on their drinking behaviour. Sex-specific longitudinal studies are warranted to examine the relation between different behaviours and these harms. Whether these findings hold in settings with different drinking cultures and social norms should be explored.

Cross-sectional surveys of financial harm associated with others' drinking in 15 countries: Unequal effects on women?

INTRODUCTION AND AIMS: That physical, emotional and social problems occur not only to drinkers, but also to others they connect with, is increasingly acknowledged. Financial harms from others' drinking have been seldom studied at the population level, particularly in low- and middle-income countries. Whether financial harm and costs from others' drinking inequitably affect women is little known. The study's aim is to compare estimates and correlates of alcohol's financial harm to others than the drinker in 15 countries. METHODS AND MATERIALS: Cross-sectional surveys of Alcohol's Harm To Others (AHTO) were conducted in Australia, Brazil, Chile, Denmark, India, Ireland, Lao PDR, New Zealand, Nigeria, Sri Lanka, Sweden, Switzerland, Thailand, the US and Vietnam. PARTICIPANTS: 17,670 men and 20,947 women. MEASUREMENT: The prevalence of financial harm in the last year was assessed as financial trouble and/or less money available for household expenses because of someone else's drinking. ANALYSIS: Meta-analysis and country-level logistic regression of financial harm (vs. none), adjusted for gender, age, education, rurality and participant drinking. RESULTS: Under 3.2 % of respondents in most high-income countries reported financial harm due to others' drinking, whereas 12-22 % did in Thailand, Sri Lanka and India. Financial harm from others' drinking was significantly more common among women than men in nine countries. Among men and women, financial harm was significantly more prevalent in low- and middle- than in high-income countries. CONCLUSIONS: Reports of financial harm from others' drinking are more common among women than among men, and in low- and middle-income than in high-income countries.

Are differences in population prevalence of alcohol's harm to others related to survey administration mode?

INTRODUCTION AND AIMS: This study assessed the comparability of estimates of alcohol's harm to others across different administration modes in Swedish general population surveys. Harm was categorised as harm from strangers' drinking and harm from heavy drinkers known to the respondent. DESIGN AND METHODS: Three surveys were conducted in 2011/2012 (n = 6841), including identical questions. One was based on self-administered postal or Web questionnaires, and two were based on computer-assisted telephone interviews of which one included a more ambitious procedure in terms of for example monetary incentives to the respondents. Pearson χ2 -tests were used to compare differences in the prevalence of harm. To estimate potential effects of survey mode, the samples were pooled, and multivariate Poisson regression models with mode as explanatory variable were used, adjusting for socio-demographic and behavioural factors. RESULTS: Respondents in the two computer-assisted telephone interviews were more likely to report harm from strangers' drinking compared with respondents in the self-administered postal or Web questionnaires. However, no significant differences were found between survey modes concerning reports of harm from known people's drinking. DISCUSSION AND CONCLUSIONS: A survey mode based on interviews seems to facilitate reports of harm from strangers' drinking. This does not apply to reports of harm from known people's drinking. Therefore, the comparability of estimates of alcohol's harm to others between survey modes depends on the type of harm being studied. [Sundin E, Landberg J, Galanti MR, Room R, Ramstedt M. Are differences in population prevalence of alcohol's harmto others related to survey administration mode?

Measuring tobacco dependence in the general population: Evaluation of the Cigarette Dependence Scale (CDS-12) and its adaptation to smokeless tobacco use (STDS-12) in two Swedish surveys.

AIMS: The 12-item Cigarette Dependence Scale (CDS-12) is an instrument suitable to assess tobacco dependence in non-clinical populations. The aim of this study was twofold: a) to evaluate the scale's performance in a smoking population including non-daily smokers; b) to explore the scale's adaptation to the assessment of dependence on smokeless tobacco. METHODS: In a cross-sectional study we investigated performance and construct validity of the CDS-12 and of its adaptation to smokeless tobacco (STDS-12) in two Swedish population samples. The first sample consisted of young adults (1246 ever daily smokers and 1086 ever daily snus (the Swedish type of moist oral snuff) users between 19 and 28 years of age). The second sample included 1229 current smokers and 855 current users of snus between 16 and 84 years of age. Score distribution, internal consistency, factor structure, and associations with other indicators of tobacco dependence were analysed. RESULTS: Both scales had a small amount of missing answers (below 2% in most items) and had acceptable internal consistency. Factor analyses suggested a one-factor model. CDS-12 score and proportions classified as dependent were significantly higher among daily smokers compared to non-daily smokers, positively correlated with the number of cigarettes, and negatively with quit attempts as well as their duration. The same pattern was seen for STDS-12, apart from correlation with quit attempts. CONCLUSIONS: Both the CDS-12 and its adaptation to smokeless tobacco, tested for the first time in this study, appear to perform well in population-based samples including young and non-daily tobacco users.

Prevalence of children whose parents have a substance use disorder: Findings from a Swedish general population survey.

AIMS: The present study examined the prevalence of Swedish children living with at least one parent whom has a substance use disorder (SUD), i.e. either an alcohol use disorder (AUD) or a drug use disorder (DUD). METHODS: A 2013 cross-sectional survey of a nationally representative sample (n = 15,576) of the Swedish adult population 17-84 years of age was used. The response rate was 59.3%. SUDs were measured using selected parts of the Mini International Neuropsychiatric Interview (MINI), derived from the 4th edition of the diagnostic and statistical manual of mental disorders (DSM-IV). In total, 3778 parents with 7448 children under the age of 18 years participated. RESULTS: The proportion of children whose parent had a SUD was 4.6%, implying that around 90,000 children in Sweden experience this situation. Having a parent with an AUD was most common (3.7%), while 0.7% and 0.2% had a parent with a DUD and both (AUD plus DUD), respectively. CONCLUSIONS: Our results showed that a substantial number of children in Sweden have parents with a SUD and that it is important to consider both alcohol and drugs, when estimating the size of this group. Our findings call for further strategies to support these children and their families.

Experienced Harm from Other People's Drinking: A Comparison of Northern European Countries.

OBJECTIVE: This study addresses how experienced harm from other people's drinking varies between six Northern European countries by comparing 1) the prevalence of experienced harm and 2) the correlates of harm. METHOD: The data comprise 18-69-year olds who participated in general population surveys in Denmark, Finland, Iceland, Norway, Sweden, and Scotland during the period 2008-2013. Comparative data were available on five types of harm: physical abuse, damage of clothes/belongings, verbal abuse, being afraid, and being kept awake at night. RESULTS: This study shows that harms from other's drinking are commonly experienced in all six countries. Being kept awake at night is the most common harm, while being physically harmed is the least common. The proportions that reported at least one of the five problems were highest in Finland and Iceland and lowest in Norway, but also relatively low in Sweden. Across countries, the level of harm was highest among young, single, urban residents, and for some countries among women and those who frequently drank to intoxication themselves. CONCLUSIONS: The study revealed large differences in the prevalence of harm in countries with fairly similar drinking cultures. However, the correlates of such experiences were similar across countries. Possible explanations of the findings are discussed, including differences in study design.

Harm Experienced from the Heavy Drinking of Family and Friends in the General Population: A Comparative Study of Six Northern European Countries.

BACKGROUND: Epidemiological research on alcohol-related harm has long given priority to studies on harm to the drinker. A limitation with this perspective is that it neglects the harm drinking causes to people around the drinker, and thus, it fails to give a full picture of alcohol-related harm in society. AIM: The aim was to compare the prevalence and correlates of experiencing harm from the heavy drinking by family and friends across the Nordic countries and Scotland and to discuss whether potential differences match levels of drinking, prevalence of binge drinking, and alcohol-related mortality. DATA AND METHOD: Data from recent national general population surveys with similar questions on experiences of harms from the drinking of family and friends were collected from Sweden, Finland, Denmark, Norway, Iceland, and Scotland. RESULTS: National estimates of the overall population prevalence of harm from the drinking of family and friends ranged from 14% to 28% across these countries, with the highest prevalence in Finland, Iceland, and Norway and lower estimates for Denmark, Sweden, and Scotland. Across all countries, the prevalence of harm from heavy drinking by family and friends was significantly higher among women and young respondents. CONCLUSION: This study revealed large differences in the prevalence of harm across the study countries, as well as by gender and age, but the differences do not match the variation in population drinking and other indicators of harm. The implications of the findings for future research are discussed.

Reducing youth violence related to student parties: Findings from a community intervention project in Stockholm.

BACKGROUND: During the spring of 2007, the police reported a marked increase in violence and binge drinking related to high school student graduation parties on weekday nights at restaurants in Stockholm city. This spurred a multi-component community intervention project to reduce these problems. AIMS: This study aims to evaluate the impact of the intervention on youth-related violence on weekday nights in 2008-2010. DESIGN AND METHOD: The outcome measure entailed the number of violence-related emergency room visits on weekday nights (10:00 pm-6:00 am) by adolescents aged 18-20 years. The study period was 1 April-31 May, which is when most student graduation parties took place. The data covered the years 2005-2010, with three data points before the intervention, and three after the intervention was introduced. Because the intervention was expected to apply to weekdays only, the control series involved a corresponding indicator pertaining to weekend nights (10:00 pm-6:00 am). The intervention effect was assessed by means of difference-in-differences estimation. RESULTS: The estimated intervention effect according to the difference-in-differences estimation models was a statistically significant 23% reduction of violence among young people. DISCUSSION AND CONCLUSION: This type of intervention is a promising measure of preventing youth violence and deserves to be continued. Such continuation would also provide additional data required for a more conclusive assessment.

Hazardous drinking among restaurant workers.

BACKGROUND/AIMS: We address three research questions pertaining to Swedish restaurant workers: (i) What is the prevalence of hazardous drinking? (ii) How is the consumption of alcohol distributed? (iii) Does the prevention paradox apply? METHODS: Data were collected by administering the Alcohol Use Disorders Identification Test (AUDIT) among restaurant workers who attended a 2-day Responsible Beverage Service training in Stockholm during the period from October 2008 to December 2009. The control group comprised a sample representative of the general Swedish population. We restricted the analyses to the age span 18-59 years, which yielded a sample size of 579 for restaurant workers and 434 for the general population. RESULTS: The prevalence of hazardous drinking as measured by AUDIT (8+ for men and 6+ for women) was markedly higher among restaurant workers than in the general population. The difference was especially pronounced among females below 30 years of age. We found no difference between restaurant workers and the general population in the distribution of alcohol consumption. About 76% of the drinking problems were found in the lower part of the consumption distribution (bottom 88%), which supports the prevention paradox. CONCLUSIONS: Restaurant workers comprise a high-risk group with respect to drinking.