Self-reported harm from others' alcohol, cigarette and illegal drug use in Norway.

AIMS: While it is documented that substance use harms others than the user, less is known about which substances people experience most harm from, and who the victims and perpetrators are. The aims were: (i) to estimate the prevalence of and overlap in self-reported harm from others' alcohol, cigarette, and illegal drug use; (ii) to examine potential differences in the prevalence of harm from close relations' and strangers' use; and (iii) to examine how the prevalence of harm varies according to demographics and the respondents' substance use. METHODS: Population surveys conducted among 16-64-year-old Norwegians in 2012 and 2016 (N = 3407) assessed self-reported harm from others' alcohol, cigarette and illegal drug use with identical measures, demographic variables and the respondents' substance use. RESULTS: Experience of harm from others' alcohol use was most common, followed by others' smoking. For all three substances, a higher proportion experienced harm from close relations' use. Nearly half had experienced harm from others' use of at least one substance. Women and younger participants were more likely to report harm from others' alcohol and cigarette use. While alcohol and illegal drug users were more often harmed by others' use of these substances, smokers reported being less often harmed by others' smoking. CONCLUSIONS: Self-reported harm from others' alcohol, cigarette and illegal drug use corresponds with the prevalence of use of these substances in Norway. For all three substances, close relations' use accounted for more harm than strangers' use. Own substance use was an important correlate of experienced harm.

Latent developmental trajectories of episodic heavy drinking from adolescence to early adulthood: Predictors of trajectory groups and alcohol problems in early adulthood as outcome.

INTRODUCTION AND AIMS: To identify latent developmental episodic heavy drinking (EHD) trajectory groups for Norwegian adolescents, investigate risk factors associated with group membership and to assess differences in alcohol problems between different groups in early adulthood. DESIGN AND METHODS: Data were from 1266 individuals measured at four time points from age 13/14 years to age 26/27 years. Latent class growth analysis was used to identify groups with different EHD development. Multinomial logistic regression was used to investigated if gender, impulsivity, school commitment, parents' socio-economic status, frequency of seeing parents drunk and parental knowledge could predict group membership. Differences in alcohol problem scores at age 26/27 were also assessed. RESULTS: Four trajectory groups were identified: 'stable high', 'early increasers', 'late increasers' and 'stable low'. Membership of the high-risk trajectory groups 'stable high' and 'early increasers' was predicted by high impulsivity, low school commitment, high frequency of seeing parents drunk and low parental knowledge. The risk of alcohol problems at age 26/27 was greater for the 'stable high' group, the 'early increasers' and the 'late increasers' compared with the 'stable low' group. The 'stable high' and 'early increasers' had similar risk of alcohol problems. DISCUSSION AND CONCLUSIONS: Stable high and early increasing EHD in adolescence was associated with more alcohol problems in early adulthood. Such trajectories were predicted by high impulsivity, low school commitment, high frequency of seeing parents drunk and low parental knowledge. [Brunborg GS, Norström T, Storvoll EE. Latent developmental trajectories of episodic heavy drinking from adolescence to early adulthood: Predictors of trajectory groups and alcohol problems in early adulthood as outcome.

Worries about others' substance use-Differences between alcohol, cigarettes and illegal drugs?

BACKGROUND: While it is well documented that many experience harm from others' substance use, little is known about the psychological strain associated with others' use. The aims were: (1) to describe the prevalence of worries about others' alcohol, cigarette and illegal drug use, (2) whose substance use people worry about, (3) the overlap in worries, and (4) to examine how worries about others' use of each substance vary according to demographics, own substance use and experience of harm from others' use. METHODS: A population survey was conducted among 16-64year old Norwegians (N=1667). Respondents' reported on worries about others' alcohol, cigarette and illegal drug use, measures of experiences of harm from others' use of the three substances, and own substance use. RESULTS: Worries about others' drinking were most prevalent. Among those who worried, others' cigarette and illegal drug use caused more frequent worry. While worry about cigarette use was mostly associated with family members' use, worry about others' alcohol and illegal drug use more often concerned friends'/acquaintances' use. About half worried about others' use of at least one substance. Across all three substances, experience of harm from others' substance use was most strongly related to worries. CONCLUSION: Worries about others' substance use are common and reflect the prevalence of use of the substances in the population. In sum, the findings suggest that worry about others' alcohol and illegal drug use is primarily related to acute harm while worry about others' cigarette smoking is more related to chronic harm.

Harm from others' drinking: How problematic do people with and without experience of harm perceive it to be?

BACKGROUND: The aims were (1) to map how problematic people perceive it to be that a person experiences different types of harm from others' drinking, (2) to describe how problematic victims of harm from others' drinking perceive the experience to be, and 3) to investigate how perceptions of harm from others' drinking vary according to demographic characteristics, own drinking and experience of harm. METHODS: 2182 persons in Norway aged 18-69 years participated in a panel web survey in 2013. They responded to questions about six types of harm from others' drinking. RESULTS: Both people with and without experience of harm from others' drinking perceived it as problematic that someone experiences such harm. Moreover, persons with experience of harm perceived their own experience of harm as less problematic than they perceived it that someone else should experience harm. While people with and without experience of harm from others' drinking perceive the same types of harm from others' drinking as least problematic, they differed with regards to which types of harms they perceived as most problematic. Perceptions of harm varied according to demographic characteristics, own drinking and experienced harm. CONCLUSION: The fact that people both with and without experience of harm from others' drinking perceived it as problematic that someone experiences such harm may be used as an argument for implementing and/or retaining effective alcohol policy measures. The contrast in perception of experienced harm and how problematic it is that someone else experiences harm suggest that the questions used within this survey tradition may be too general to provide meaningful information about prevalence and severity of experienced harm from others' drinking. Future research should address this further.

Negative consequences of other people's drinking: Prevalence, perpetrators and locations.

INTRODUCTION AND AIMS: While both policy makers and researchers have shown renewed interest in drinking and harm to others, several questions concerning the issue remain unanswered. The aim of this study was to address some of these questions by: (i) presenting updated figures on the prevalence of experienced harm from other people's drinking in various sub-groups; and (ii) examining in which locations such episodes most often occur and who the perpetrators usually are. DESIGN AND METHODS: Data were obtained from a general population survey among 16- to 79-year-old Norwegians (n = 1947), where experiences of five negative consequences related to other people's drinking (e.g. physical abuse and verbal abuse) were assessed. Those who reported such experiences were asked to specify at which location the last episode occurred and who the perpetrator was. RESULTS: Altogether, 17.3% had experienced one or more problems during the past 12 months. Persons who were young, not living with a partner, an urban resident, with low education and often intoxicated were at increased risk. The direction of statistically significant gender differences depended on the type of problem. While the episodes were spread across different locations (private homes, on-premise outlets and outdoors), perpetrators were more often strangers or friends/acquaintances than partners or family members. DISCUSSION AND CONCLUSIONS: In a preventive perspective, increased knowledge regarding the context of episodes where people experience harm from other people's drinking is important. We have shed some light on this issue by examining the locations and perpetrators of such episodes. [Storvoll EE, Moan IS, Lund IO. Negative consequences of other people's drinking: Prevalence, perpetrators and locations. Drug Alcohol Rev 2016;35:755-762].

Overlap in attitudes to policy measures on alcohol, tobacco and illegal drugs.

BACKGROUND: Effective alcohol, tobacco and illegal drug policies reduce the harm to users and third parties. Knowledge about determinants and interrelations between attitudes held by the general public to different types of policy measures can benefit policy-makers who aim to increase acceptance for effective policy. The present study describes the level of support for various policy measures held by the general public, and investigates the association between attitudes to policy measures on alcohol, tobacco and illegal drug. METHODS: A sample of the Norwegian general population aged 16-64 (N=1803) was interviewed by telephone. Respondents reported demographic information, personal substance use and attitudes to various policy measures. Associations between attitudes were assessed with correlation and regression analysis. RESULTS: Associations between attitudes were strongest for similar policy measures across substance groups (e.g. tax increases on alcohol and tobacco). There was a weaker association between attitudes to different policy measures aimed at the same substance (e.g. tax increase on alcohol and campaigns on alcohol). CONCLUSION: The degree to which people approve or disapprove of the use of particular types of policy measures is irrespective of the targeted substance.

A Cohort Study on Long-Term Adverse Effects of Parental Drinking: Background and Study Design.

Although many studies have addressed adverse outcomes in children of parents with alcohol abuse/dependence, less is known about the possible long-term effects of more normative patterns of parental alcohol consumption, including drinking at lower risk levels and heavy episodic or binge drinking. The extent of harm from parental drinking may therefore be underestimated. With this research proposal, we describe a project that aims to assess possible long-term adverse effects of parental drinking by combining survey and nationwide registry data. Advantages of a longitudinal general population cohort design include that it allows for detailed information on parental drinking through survey data and identification of possible negative long-term health and social outcomes from exposure to parental drinking 1-19 years after exposure through continuously updated nationwide registers. The rich information available from combining survey and registry data allows us to take into account important confounders, mediators, and moderators.

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.

Is Drinking with Parents Associated with High-Risk Drinking among Adolescents?

BACKGROUND/AIMS: What are the implications of drinking with parents (DWP) on adolescents' drinking behavior? We expanded the meagre body of research on this controversial issue by assessing the association between the frequency of DWP and adolescent high-risk drinking, taking a number of parental factors into account. METHOD: Data stemmed from a subsample of 14-17-year-old current drinkers (n = 7,616) who participated in a cross-sectional Norwegian school survey (response rate: 84%). RESULTS: One in four reported DWP during the past year. The higher the frequency of DWP, the higher was the prevalence of high-risk drinking. Parental drunkenness, permissive alcohol-related parenting, and indicators of suboptimal parenting more generally also correlated with DWP. After controlling for these confounders, only frequent DWP remained significantly associated with high-risk drinking. CONCLUSIONS: DWP was related to adolescent high-risk drinking, yet the association was in part attributable to parents' drinking and parenting style. The risk of involvement in high-risk drinking was about the same for adolescents reporting no DWP and infrequent DWP, while it was significantly elevated among those reporting frequent DWP. This study thus demonstrated that the frequency of DWP matters and that parents who drink with their adolescent children differ from other parents in important ways.

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.

Predicting attitudes toward a restrictive alcohol policy: Using a model of distal and proximal predictors.

Previous research on attitudes toward a restrictive alcohol policy has mainly focused on variables such as demographics and own drinking as possible predictors. The present article adds to the existing literature by examining the impact of a set of beliefs and personal experiences with the harm caused by other peoples' drinking. We suggest and test an analytic model in which the predictors are ranked according to their conceptual proximity to attitudes. The data stem from a Web survey in the Norwegian adult population (N = 1,951), mapping the respondents' attitudes toward pricing policy and availability restrictions, belief in the harm-limiting effect of such measures, belief in the harm caused by drinking, and personal experiences with harm from others' drinking. In line with the suggested model, belief in the effectiveness of restrictive measures and belief in the harm caused by drinking appeared as the strongest predictors. Attitudes were less strongly related to own drinking, and particularly to demographics. Altogether, 41% of the variance in attitudes was explained. Negative experience with other peoples' drinking was a statistically significant predictor only among young respondents. The strong relationships between proximal predictors, such as belief in the harm caused by drinking and belief in the harm-limiting effect of restrictive measures and attitudes, indicate that support for a restrictive policy may be increased by focusing on awareness of such issues rather than on more distal predictors. However, further research is needed to acquire more knowledge about the mechanisms behind these associations. (PsycINFO Database Record

Changes in attitudes towards restrictive alcohol policy measures: the mediating role of changes in beliefs.

AIM: From 2005 to 2009, increased support for restrictive alcohol policy measures was observed in the Norwegian population. This article addresses whether this increase was mediated by changes in belief about the effectiveness of restrictive measures and belief about the harm caused by drinking. METHOD: The data were derived from five surveys conducted during the period 2005-2009 (N = 7244). In each survey, we used identical measures of attitudes towards regulation of price and availability, belief in the effectiveness of such measures and belief in the association between overall consumption and harm. RESULTS: During the period, there was an increase in support for restrictive policy measures; in belief in the effectiveness of these measures and in belief in the harm caused by drinking. Increased support for restrictive measures was partly mediated by changes in beliefs in terms of statistically significant indirect effects from both belief in the effectiveness of such measures and belief in the harm caused by drinking. Half of the increased support for restrictive measures could be attributed to changes in beliefs. CONCLUSION: Strengthening people's belief in the effectiveness of restrictive measures and in the harm caused by drinking may increase public support for restrictive alcohol policy measures.

Alcohol-related sickness absence among young employees: gender differences and the prevention paradox.

BACKGROUND: Few studies have examined alcohol-related sickness absence among young employees, although young adults are known to drink quite heavily. There are substantial differences in drinking patterns between men and women, yet gender differences have rarely been the main focus in research on alcohol-related sickness absence. Thus the present paper aims to examine gender differences in the prevalence of alcohol-related sickness absence among young employees in Norway, and in the associations between drinking patterns and such absence. Further, to examine whether the prevention paradox applies to alcohol-related sickness absence among both genders. METHODS: A sample of employed young adults, 49.7% male (N = 1762, mean age = 28.3; SD = 1.9), was obtained from a general population survey of Norwegians. Self-reported measures on alcohol-related sickness absence and various drinking measures were applied. RESULTS: Men reported absence from work due to drinking almost twice as often as women. There was a statistically significant gender difference in the drinking-absence association only for one of the three alcohol measures, indicating a stronger relationship among women. The heaviest drinkers (about 6% of the sample) reported a disproportionally large share of alcohol-related sickness absence (19%), yet the vast majority of such absence was found among the moderate drinkers (81%). CONCLUSIONS: Alcohol-related sickness absence is more common among men than women. This gender difference may reflect differences in drinking habits rather than the likelihood of being absent after drinking. The results indicate that the prevention paradox applies to alcohol-related sickness absence among young employees of both genders.

Long-term trends in alcohol policy attitudes in Norway.

INTRODUCTION AND AIMS: The aim of this study was to describe trends in attitudes to alcohol control policies in Norway over a period of 50 years and to discuss how these trends relate to developments in alcohol policy. DESIGN AND METHODS: Survey data from 17 national population surveys, national statistics and previous publications were applied to describe trends in attitudes to alcohol control polices (access to alcohol and price) and changes in these policies over the period 1962 to 2012. RESULTS: From 1962 to 1999, an increasing proportion of the population reported that regulations on availability of alcohol were too strict and that alcohol prices were too high, whereas in the 2000s this trend was reversed and support for existing control policies increased. Although the pillars of Norwegian alcohol policy--high prices, restricted access and a state monopoly on retail sales-remained, control policies were gradually relaxed throughout the entire period. DISCUSSION AND CONCLUSIONS: Relaxation of strict alcohol control policies in Norway in the first four decades were probably, in part, the result of increasingly liberal public opinion. The subsequent reversed trend in opinions with increasing support for control policies may be due to several factors, for example, consumer-oriented changes in the monopoly system, increased availability and affordability, increased awareness of alcohol-related harm and the effectiveness of control policies. Thus, the dynamics of policies and attitudes may well change over time.

Alcohol use and drunk driving: the modifying effect of impulsivity.

OBJECTIVE: The aim of this study was twofold: (a) to examine how an increase in the frequency of heavy drinking episodes affects the incidence of drunk driving and (b) to examine whether the effect of alcohol use on drunk driving is contingent on impulsivity. METHOD: Two waves of the Young in Norway Longitudinal Study were applied (N = 2,603; response rate: 67%), when the respondents were on average 17 (1994) and 28 (2005) years of age. Measurements consisted of self-reported heavy episodic drinking, drunk driving, and impulsivity. RESULTS: The first difference method was applied to estimate the association between heavy episodic drinking and drunk driving. This means that changes in the frequency of drunk driving were regressed on changes in the frequency of drinking. In this way, the effects of time-invariant confounders were eliminated. The results showed that every additional episode of heavy drinking was associated with a 2.6% increase in the frequency of drunk driving. The increase for males was significantly higher than among females. The analyses supported the hypothesis that impulsivity modifies the association between alcohol use and drunk driving. CONCLUSIONS: The association between drinking and drunk driving is significantly stronger among those with a high score on impulsivity compared with those who have a low score.

Under double influence: assessment of simultaneous alcohol and cannabis use in general youth populations.

BACKGROUND/AIMS: We assessed to what extent adolescents use alcohol and cannabis simultaneously and expanded previous research by estimating the proportion of all events of cannabis use that had occurred in relation to drinking. How the prevalence of this form of polysubstance use co-varied with the overall level of alcohol and cannabis use in different countries was also examined. METHOD: We analysed individual level data from a survey of 14-20 year-olds in Norway (n=16 813) and population level data from the 2003 ESPAD study on substance use among 15-16 year-olds in 35 European countries. RESULTS: The prevalence of simultaneous intake of alcohol and cannabis in the past year among Norwegian youth was 7%. The overall prevalence of cannabis use was only slightly higher (8%), implying that a majority (82%) of the cannabis users had taken the drug in combination with alcohol. Moreover, in about 80% of all incidents of cannabis use, alcohol had been consumed as well. Correspondingly, a majority of the cannabis users in most of the countries in the ESPAD study had used the drug in combination with alcohol. Such simultaneous polysubstance use was more prevalent in countries where cannabis use was relatively widespread and alcohol rather frequently consumed. CONCLUSION: Because adolescents most often combine cannabis with alcohol, their use of the drug may be more harmful than assumed. The results also indicate that cannabis is a complement rather than a substitute for alcohol, suggesting that policies that reduce adolescent drinking may reduce the use of cannabis as well.

Wetter and better? Changes in associations between drunkenness and other problem behaviors among Norwegian youth.

BACKGROUND/AIMS: The consumption of alcohol and the frequency of intoxication among Norwegian youth increased significantly from 1992 to 2002, and we thus asked what, if anything, can be expected to happen to rates of other problem behaviors when heavy drinking becomes more widespread? Do such aggregate level changes in alcohol use imply that individual level associations between drunkenness and behavioral deviance change as well? METHOD: School-based surveys of 16- to 19-year-old Norwegians that were carried out in 1992 (n = 4,744, response rate 97%) and 2002 (n = 5,458, response rate 92%). RESULTS: Contrary to rates of drunkenness, the level of theft/pilfering declined from 1992 to 2002, while rates of aggressive behavior and school misconduct remained unchanged. We assumed that heavy-drinking adolescents were relatively less deviant with regard to non-violent problem behaviors when the youth culture was relatively 'wet' (2002) as compared to the period when it was much 'drier' (1992) and revealed that this was the case. However, the link between drunkenness and aggressive behavior was equally strong at both assessments. CONCLUSION: Differential temporal trends in the associations between drunkenness and various problem behaviors may reflect variations with respect to the etiological significance of alcohol use on such behaviors.

Use of commercial and social sources of alcohol by underage drinkers: the role of pubertal timing.

We have explored whether alcohol use and procurement of alcohol from commercial and social sources vary with pubertal timing. A sub-sample of 9291 Norwegian minors (13-17 year-olds) was extracted from a nationwide school survey (response rate: 92%). Adolescents who had matured early (early developers, EDs) reported higher consumption and more alcohol-related harm than those who had matured late (late developers, LDs) or at the "normal" time (on time developers, ODs). Purchases from on-premise and off-premise outlets were much more important sources of alcohol for EDs than for ODs and LDs - both in relative and absolute terms. Moreover, EDs were somewhat more likely to obtain alcohol from social sources. Taken together, the findings indicate that adolescents who mature early have access to a larger variety of sources of alcohol than adolescents who mature later - which in turn may explain their increased level of drinking.

[Enforcement of the mimimum legal age for purchase of alcohol]. / Håndheves aldersgrensen for å få kjøpt alkohol?

BACKGROUND: Little is known about the enforcement of minimum legal age for purchase of alcohol (18 years) in Norway. We have assessed to what extent this requirement is fulfilled in grocery stores, on-premise outlets and monopoly outlets. MATERIAL AND METHODS: Questionnaires were filled in by 13-17 year-olds who had started drinking. They were asked about the frequency of purchase attempts in grocery stores, on-premise outlets and in monopoly outlets in the past year and how often their attempt to buy alcohol had been refused. RESULTS: Slightly more than 20% of the under-aged alcohol consumers (n = 9,309) had tried to buy beer in grocery stores; a similar proportion had tried to buy alcohol in pubs, bars, etc, and less than 5% had tried monopoly outlets. More than half of the attempts in grocery stores, 80% in on-premise venues and two thirds of those in monopolies were successful (i.e. purchase was not denied). INTERPRETATION: A stricter enforcement of the minimum legal age is likely to reduce availability of alcohol to the under-aged.

[Sources of intoxication--how do adolescents get hold of alcohol?]. / Beruselsens kilder--hvordan ungdom skaffer seg alkohol.

BACKGROUND: Norway has a legal age limit for buying beer and wine of 18, 20 for spirits. Knowledge about how under-aged adolescents procure alcohol and the relative importance of the various sources is important in order to reduce the availability of alcohol among adolescents. MATERIAL AND METHODS: In a national school-based survey among 12,000 students in junior and senior high school a sub-sample comprising 13 to 17-year-old current drinkers were asked to state the frequency with which they had obtained alcohol from 8 different sources in the past 12 months. RESULTS: On average the respondents had obtained alcohol 11 times during the past year. The most frequently used source was "other adolescents" which constituted one third of the total number of times when alcohol had been obtained. Other important sources were "at home" (given or stolen), 20%; "off-premise and on-premise sales" (stores, wine and spirits outlets, bars, pubs etc., 22%; and "other sources", 19%. Older adolescents and those who drank frequently obtained alcohol more often and from a larger number of sources than others. INTERPRETATION: Enforcing the legal age limits in on-premise and off-premise alcohol outlets as well as limiting adolescents' access to alcohol at home may reduce consumption and related harm among adolescents.