Harm from others’ drinking : reported negative experiences and predictors in general population surveys

Sammanfattning: Background: Alcohol consumption is among the top risk factors for ill health and premature death and can also lead to a range of problems in relation to other people such as family members, friends, co-workers, and among strangers in public places. Research into harm from other people’s drinking has increased substantially in the last decade and has developed into a separate research field. Previous research has shown that a comprehensive picture of alcohol-related problems in society is only obtained if harm from others’ drinking is taken into account. Moreover, the high prevalence of harm from others’ drinking in many populations suggests that this is relevant to address from a public health perspective. Overall aims: The aim of the present thesis was to add to this research field by investigating some areas of harm from others’ drinking and related predictors in the context of the adult general population of Sweden and 19 European countries. The areas included different types of self-reported severe harm from others’ drinking and the effect of survey administration mode on self-reported experiences of harm from others’ drinking. Related predictors included sociodemographic factors, relationship to the drinker causing harm, one’s own drinking habits, and country-level drinking patterns. Data and method: Data stemmed from comprehensive self-reported adult general population surveys conducted in Sweden (the Habits and Consequences survey) and across 19 European countries (the RARHA SEAS survey). Three of the studies were based on cross-sectional data and one on longitudinal data. To assess the association between self-reported harm from others’ drinking and potential predictors, multiple types of binary regression models were used (Poisson regression with robust error variance, logistic regression, multi-level regression). Results: The prevalence of severe harm, i.e., being harmed “a lot,” from a known or unknown drinker in the preceding 12-month period ranged between 1.2% and 4.9% in the adult general population of Sweden (Study I). Problems were reported more often by women than men. The correlation between one’s own drinking habits and signs of alcohol dependence and experiencing severe harm from a known person’s drinking was modified by gender. One’s own drinking habits, i.e., higher drinking frequency and higher frequency of heavy episodic drinking, increased the risk of severe harm from a known person’s drinking among women, but not among men. Having signs of one’s own alcohol dependence increased the likelihood to report such harm among both men and women, although the association was much stronger among women. Among Swedish adults reporting harm from a known person’s drinking in a baseline survey, the majority (52.5%) reported harm again one year later (Study II). An increased risk of reporting one-year persistence of such harm was found among women, among those who reported harm within closer relationships, e.g., with a partner, parent, or another household member, and among those perceiving harm as more severe at baseline. Experiences of others’ alcohol-related aggressive behavior in the preceding 12-month period were reported by one in four men and women across 19 European countries (Study III). A higher prevalence of heavy episodic drinking at the country level increased the risk of experiencing aggression-related harm at the individual level. However, only a small part of the variance of such harm was explained by the country-level heavy episodic drinking prevalence. Prevalence estimates of harm from strangers’ drinking are likely to be higher in intervieweradministered surveys (telephone interviews) compared with in self-administered surveys (paper-and-pencil or web questionnaires) (Study IV). No such difference between survey modes was found regarding reports of harm from a known person’s drinking. Discussion and conclusion: This thesis has documented new findings in several areas of harm from others’ drinking and related influencing factors at the individual and the country level in Sweden and across European countries. The thesis reinforces the idea that alcohol consumption may not only have consequences for the drinkers themselves, but may also inflict severe problems in interactions with other persons. That negative consequences from alcohol consumption extend beyond the individual drinker is important knowledge from a public health perspective and should be considered in alcohol policies.