Aim: The aim of the study was to examine whether changes in alcohol consumption over time differ according to beverage types, and to what extent socioeconomic, lifestyle and health-related factors predict beverage-specific trajectories in Sweden. Study design: We included participants from the Stockholm Public Health Cohort who were surveyed repeatedly in 2002, 2010 and 2014. Alcohol consumption trajectories were constructed for 13,152 individuals with valid information on amount and frequency of drinking. Preferred beverage types (i.e., beer, wine or spirits) were defined based on the most consumed beverages. Multinomial logistic regression was used to quantify individual predictors of different trajectories, overall and by beverage type. Results: Overall 56.9% of respondents were women, the mean age was 49.2 years, SD (13.1). Wine was cited as the preferred beverage for 72.4% of participants, and stable moderate drinking was the most common trajectory regardless of beverage type (68.2%, 54.9% and 54.2% in individuals with wine, beer and spirits as preferred beverages, respectively). Associations between drinking trajectories and baseline lifestyle factors did not differ by beverage type. Lower socioeconomic position (SEP) was associated with unstable moderate wine drinking (for unskilled manual SEP: adjusted odds ratio [aOR] 1.54, 95% confidence interval [CI] 1.23, 1.93), unstable heavy beer drinking (for skilled manual SEP: aOR 1.99, 95% CI 1.14, 3.52; and unskilled manual SEP: aOR 1.72, 95% CI 1.05, 2.82), and former beer drinking trajectory (for skilled manual SEP: aOR 1.81; 95% CI 1.21, 2.72; and unskilled manual SEP: aOR 1.66; 95% CI 1.17, 2.37). Conclusion: Lower SEP was associated with unstable heavy drinking of beer, former beer drinking, and unstable moderate wine drinking trajectories indicating that targeted alcohol prevention programmes need to focus on these groups.
Background: Organising alcohol retail systems with more or less public ownership has implications for health and the economy. The aim of the present study was to estimate the economic, health, and social impacts of alcohol use in Finland in 2018 (baseline), and in two alternative scenarios in which current partial public ownership of alcohol retail sales is either increased or fully privatised. Methods: Baseline alcohol-attributable harms and costs were estimated across five categories of death, disability, and criminal justice. Two alternate alcohol retail systems were defined as privately owned stores selling: (1) only low strength alcoholic beverages (public ownership scenario, similar to Sweden); or (2) all beverages (private ownership scenario). Policy analyses were conducted to estimate changes in alcohol use per capita. Health and economic impacts were modelled using administrative data and epidemiological modelling. Results: In Finland in 2018, alcohol use was estimated to be responsible for €1.51 billion (95% Uncertainty Estimates: €1.43 billion, €1.58 billion) in social cost, 3,846 deaths, and 270,652 criminal justice events. In the public ownership scenario, it was estimated that alcohol use would decline by 15.8% (11.8%, 19.7%) and social cost by €384.3 million (€189.5 million, €559.2 million). Full privatisation was associated with an increase in alcohol use of 9.0% (6.2%, 11.8%) and an increase in social cost of €289.7 million (€140.8 million, €439.5 million). Conclusion: The outcome from applying a novel analytical approach suggests that more public ownership of the alcohol retail system may lead to significant decreases in alcohol-caused death, disability, crime, and social costs. Conversely, full privatisation of the ownership model would lead to increased harm and costs.
Background: In Australia, harmful drinking among students aged 18-24 years in tertiary education residential accommodation (TRA) remains high, placing students at higher risk of harms than non-TRA and university peers. Aim: The aim of this study was to identify the context-specific factors distinctive to TRAs that supported a heavy drinking culture among students. Conducted across three sites in Melbourne, Australia, the purpose of the study was to inform the development of context-specific harm reduction interventions for these sites. Methods: Five focus groups were conducted with 32 students to examine their lived experience of drinking within the distinctive environments of their TRAs. The data were examined using thematic data analysis. Results: Three themes were identified: (1) routine drinking in TRAs; (2) drinking for social inclusion in the TRA; and (3) TRA alcohol governance and students' self-regulation. The data show that factors contributing to these TRA drinking cultures included: liberty to store alcohol and drink on campus; freshers' belief that admission to the TRA was conditional on "partying hard"; students' belief that staff supported the TRA drinking culture; and poor dissemination and operationalisation of TRA alcohol policy. Collectively, these factors fostered an environment that enabled frequent and heavy alcohol consumption among residents. Conclusions: The TRA drinking cultures were supported by social and regulatory factors specific to these institutions and, in particular, by a liberal approach to TRA alcohol governance and poorly disseminated alcohol policy that made widespread heavy drinking possible. Drinking cultures in TRAs can be changed through appropriate interventions that include nuanced policy and effective governance.
The World Health Organization has rated alcohol abuse as one of the leading risk factors for population health worldwide and emphasises the relevance of alcohol affordability (AA) measures as important instruments to monitor alcohol control policy. The present study suggests an AA index that is suitable for measuring AA in Sweden, where off-premises alcohol is exclusively distributed by Systembolaget, the government-owned chain of liquor stores. Sweden provides uniform off-premises prices for alcohol and extensive register data, which profits the accuracy of this index. By allowing for AA comparisons across types of alcoholic beverages (beer, wine, spirits) and price categories, as well as across population groups (age, sex and family composition), and by being transferable to other Nordic countries with uniform off-premises prices, this study will facilitate governmental monitoring and supervision of the alcohol policy in Nordic countries. The suggested AA index is defined as the ratio of the median equivalised disposable income and the price per litre of 100% ethanol for alcohol, scaled to equal 100% in the base year. The income can be measured for the reviewed population or a subgroup, and the price measure can include all sold alcoholic beverages or separate them by beverage type and/or price category. Thereby, the index measures the number of litres of 100% ethanol that are affordable with the median income. Applying the index to the publicly available data for 2011-2019 from Statistics Sweden and Systembolaget reveals that alcohol in Sweden generally became more affordable, with high-priced alcoholic beverages becoming comparably more affordable than low-priced alcohol. However, low-priced beer became less affordable over the last decade. Future studies may validate the AA index against alcohol consumption.
Aims: To follow up on exchange students' alcohol use, drug use, mental health, self-rated health, and risky sexual behaviour after a semester abroad and to compare them with students who remained on campus. Methods: The study design was a follow-up study based on a previous baseline survey of 114 prospective exchange students and 451 campus students. Of the original 565 students, 48 (42.1%) prospective exchange students and 209 (43.3%) campus students responded to the follow-up. Both the baseline survey and the follow-up survey included the General Health Questionnaire 12, one single item from Self-Rated Health, and nine items from Knowledge, Attitudes and Sexual Behaviour in Young People in Sweden. Results: We found a statistically significant increase in the weekly consumption of alcohol among exchange students after their semester abroad. A larger proportion of exchange students had sex with a new partner and sex with more than three partners during their semester abroad compared to follow-up campus students. Conclusions: Our findings indicate that exchange students consume alcohol more frequently during their semester abroad and indulge in sexually risky behaviour. Exchange students' use of alcohol and sexually risky behaviour could be associated with even greater risks due to them being in an unknown environment, unfamiliar culture, and with limited support from family and friends. This highlights the need for further research on exchange students' experiences, especially concerning alcohol use and sex while abroad.
This commentary reflects on the strengths of the paper by Warde et al. entitled "Situated drinking: the association between eating and alcohol consumption in Great Britain". It suggests that practice-theoretical approaches towards studying contemporary connections between foods, food events and alcoholic drinks provides an excellent basis for overcoming the analytical limits of fields such as food studies, drinks studies, alcohol studies and related areas. This is especially so if Warde et al.'s quantitative methodology were to be yoked to two further sources of inspiration, namely Mary Douglas's structuralist analysis of food combinations within food events and Stephen Mennell's utilisation of the concepts and concerns of Norbert Elias to produce a systematic historical sociology of food. An extended inter-paradigmatic approach to the study of how alcoholic drinks relate to foods and eating practices emerges as a result.
Aims: This paper examines the co-occurrence of drinking alcohol and eating in Great Britain. Applying a practice-theoretical framework, it attends primarily to the nature and characteristics of events - to social situations. It asks whether drinking events involving food are significantly different from those without, whether differences are the same at home as on commercial public premises, and whether differences are the same for men and women. The focus is especially on episodes of drinking with meals at home, an infrequently explored context for a substantial proportion of contemporary alcohol consumption. Data: Employing a secondary analysis of commercial data about the British population in 2016, we examine reports of 47,645 drinking events, on commercial premises and at other locations, to explore how eating food and consumption of alcoholic beverages affect one another. Three types of event are compared - drinking with meals, with snacks, and without any food. Variables describing situations include group size and composition, temporal and spatial parameters, beverages, purposes, and simultaneous activities. Basic sociodemographic characteristics of respondents are also examined, with a special focus on the effects of gender. Results: Behaviours differ between settings. The presence of food at a drinking episode is associated with different patterns of participation, orientations, and quantities and types of beverage consumed. Gender, age, and class differences are apparent. Conclusions: Patterns of alcohol consumption are significantly affected by the accompaniment of food. This is a much-neglected topic that would benefit from further comparative and time series studies to determine the consequences for behaviour and intervention.

