The purpose of this study was first to compare 18-19-year-old male abstainers with alcohol consumers, and especially light consumers, regarding degree of sociability as indicated by their (in)security in the company of others, their number of close friends, intimate conversations with friends and their popularity in school. Secondly, we analysed the importance of antecedents to and covariates of abstinence. In addition, the significant antecedents and covariates gave us information as to abstinence patterns. The study was based on a survey of all Swedish males, 18-19 years old, conscripted for military service in 1969-70. Data had been collected by means of questionnaires and psychological interviews, giving measures of each respondent's social background, psychiatric/psychological and psychosomatic health status, substance use, deviant behaviour and degree of sociability. Poor sociability was more common among the abstainers than among all the other categories of drinkers, including the light consumers. The conscripts' social background, and especially their fathers' drinking habits, had the strongest effects in explaining abstinence. Sixty-two per cent of all abstainers had non-drinking fathers, compared to 28% of the light consumers. As to the majority of abstainers, this indicates a link between the social background of temperance and their own reported abstinence. Their poor sociability could be a consequence of abstaining at a young age when abstinence is uncommon. Those who abstained despite a drinking father showed a worsening psychological status, suggesting a link between psychologically impaired health, poor sociability and abstinence. Though the abstainers were the least sociable, the difference between the abstainers, the light consumers and the moderate consumers in other categories were generally small.(ABSTRACT TRUNCATED AT 250 WORDS)
AIMS: To establish whether alcohol abuse as a risk factor in suicidal behaviour would be different in parasuicide compared to completed suicide, and to explore the relative impact of alcohol abuse on completed suicide among parasuicides. DESIGN: A 25-year follow-up study by linking data from military conscription, inpatient treatment and death register. PARTICIPANTS: A cohort of 46,490 Swedish male conscripts born in 1950-51. MEASUREMENTS: Psychiatric diagnosis was recorded at conscription, diagnoses related to alcohol abuse and suicidal behaviour were recorded at any inpatient treatment during follow-up, and underlying cause of death was recorded for those who died during follow-up. FINDINGS: Bivariate analyses showed alcohol abusers to have an elevated risk of attempted suicide (OR = 27.1) as well as completed suicide (OR = 4.7), but in the latter case to a significantly lesser extent. Correspondingly, alcohol abusers constituted a significantly larger proportion of the parasuicides (33.3%) than of the completed suicides (10.0%). A relatively stronger impact of alcohol abuse on parasuicide than on completed suicide remained after controlling for psychiatric co-morbidity, the adjusted odds ratios for attempted suicide and completed suicide being 8.8 and 2.4, respectively. Attempted suicide was a highly significant risk factor for completed suicide (OR = 13.5). Among those who attempted suicide, alcohol abusers were found to have a significantly lower risk of completed suicide than other suicide attempters (OR = 0.46). CONCLUSION: The significantly stronger association between alcohol abuse and attempted suicide compared to completed suicide may be viewed in the light of possible impact of intoxication and impulsiveness on non-fatal suicidal behaviour in alcohol abusers.
The Baltic Sea region today is a scene of a double transition: the eastern transformation and the western integration. As a consequence, alcohol-related issues are undergoing extensive changes. As part of a study of prevalence and perception of social problems around the Baltic Sea (the Baltica Study), alcohol issues have been studied from four perspectives: official statistics, mass media, public opinion and views of influential groups. The Baltic Sea region contains countries from the top and from the bottom of the European statistics on alcohol consumption (Latvia and Sweden respectively). Alcohol has been an important political issue in the transition of many countries (Russia and Poland just before the transition, Sweden and also Finland in their processes of European Union integration). For the medically oriented alcohol research community, the most important finding is that the medical profession and medical and epidemiological arguments play a secondary role in most of the countries when it comes to the definition of the problem.
Two Swedish alcohol surveys were compared in a search for a reasonable explanation of the large difference in their coverage rates, namely 75% and 28%. In many respects both surveys conducted in the late 1980s by large, well-known institutes, are of a similar type with rather large samples of Swedes. The technique used in the survey with a very high coverage rate (Survey A) takes into consideration the actual drinking pattern of the population studied (i.e., the concentration of drinking on weekends). By dividing a "normal week's consumption" into four units (Monday-Thursday, Friday, Saturday and Sunday), the technique allows one to average periods with varying drinking habits. In the survey with a low coverage rate (Survey B) a "normal week's consumption" was not so divided. A test of internal validity within Survey A underlined the general finding that its higher coverage rate was due to this division. A test of the external validity at aggregate level did not support assumptions about "telescoping" effects in A. Both A and B had a normal week as a basis of measurement for investigating typical drinking habits. The literature concerning differences in coverage rates focuses on the measurement of modal habits versus mean habits. The main explanation of differences is that methods that focus on modal habits (i.e., the Quantity-Frequency Scale) generate a lower coverage rate than do methods that elicit the arithmetic mean (i.e., the last-week recall). Since A and B both belong to the former type of scale, this does not explain our results.
BACKGROUND. One of the major methodological problems in measuring alcohol consumption in a general population and in selected groups is underreporting. METHODS. The present study is based on a general health questionnaire survey of a random sample of about 4000 adults aged 20-74 years in an inner-city area in each of two major Swedish cities in 1991. The questionnaire included items both about alcohol consumption frequency and the usual amount of intake--the commonly used quantity-frequency (QF) method--and other questions about the consumption during work-days and weekends during a 'normal week'--the period-specific normal week (PSNW) method. RESULTS. With a few exceptions, the reported mean consumption and the proportion of high consumers was higher with the latter approach, irrespective of sex, age, socio-demographic factors, smoking and health status, i.e. for variables which are commonly used as confounders or effect modifiers. The differences between the methods was greater among women. The internal non-response rate was higher with the PSNW method but the non-responders had a comparatively low consumption, when measured with the QF method. CONCLUSION. The PSNW method has higher validity and greater precision for the measurement of alcohol consumption and, thus, is superior to the QF method. The sex differences are notable and warrant further studies focusing on sex-related modes of answering.
AIM: To study the effect of changes in per capita alcohol sales and indicators of alcoholism treatment on admissions to inpatient care and mortality for liver cirrhosis and alcoholism, alcohol intoxication and alcohol psychosis (AAA). DESIGN: Bivariate and multivariate time series analyses was conducted by applying the ARIMA-modelling technique. SETTING AND PARTICIPANTS: All analyses were conducted on quarterly data from Stockholm County 1980-94 with a population of 1.7 million people. MEASUREMENTS: Data on sales of alcohol and disulfiram/calcium carbimide were used as input variables. Inpatient data (from the Stockholm Inpatient Care Register) and mortality data (from the Cause of Death Register) on all cases with alcoholism, alcohol psychosis and alcohol intoxication (AAA) and liver cirrhosis as underlying or contributory diagnoses were used as output variables. FINDINGS: Alcohol sales affected the cirrhosis rate. For cirrhosis mortality, but not for cirrhosis admissions, the effect was not only direct but also distributed over time. Significant direct and time lag effects of alcohol sales on both AAA series and cirrhosis admissions were found only during earlier, shorter periods, e.g. 1980-90. All four output series showed significant effects of sales of disulfiram/calcium carbimide and were the only significant predictors for the two AAA endpoints for the whole study period. CONCLUSIONS: These results suggest that to reduce the rate of alcohol-related problems caused by socially deteriorated and severely alcohol-dependent subjects (i.e. AAA), reduction of overall consumption should be complemented by treatment of alcohol-dependent subjects.
During the first decades following the end of World War II, registers were the predominant data source in Sweden for studying alcohol-related problems and, before the abolition of the rationing system, also for mapping drinking habits. This was possible due to the strict individual control system of alcohol that dominated in Sweden for many decades. With the gradual shift from individual control to general control in the 1960s, and 1970s, the possibility of using registry data was reduced, and for the past 20 years or so they have almost never been used to study the relationship between drinking and social problems. Instead, not only drinking levels and drinking patterns, but also social problems associated with alcohol, have slowly but to an increasing extent been measured by self-reported questions in general population surveys. This paper discusses experiences gained from working with self-reported survey data on alcohol-related social problems in Sweden for the past few years and describes discrepancies between register- and survey-based analyses. Swedish examples suggest that it is unlikely that survey data can be used successfully to estimate the prevalence of serious alcohol-related social problems in society. Survey data may be more suitable for estimating risks associated with different drinking levels and drinking patterns in the general population on an ordinal level. However, there is still much room for improvement in the Swedish alcohol surveys that include questions on alcohol problems.