Aim: To (i) examine several factors associated with trends in heavy episodic drinking (HED) in Finland, Norway and Sweden, (ii) investigate similarities in these associations across the countries and (iii) analyse the contribution of these factors to the trend in HED and the differences across the countries. Design and Setting: Observational study using five waves of the European School Survey Project on Alcohol and Other Drugs (ESPAD) from Finland, Norway and Sweden between 1999 and 2015. Participants: A total of 18 128 male and 19 121 female 15‐ to 16‐year‐old students. Measurements: Monthly HED, perceived access to alcohol, truancy, parental control, leisure time activities and daily smoking. The Cochran–Armitage test was used to examine linear time trends in HED. Logit regression models using the Karlson–Holm–Breen (KHB) method were fitted for each country separately, including all the independent variables together with time and adjusted for family status, parental education and gender. Findings: In Finland, Norway and Sweden, perceived access to alcohol, truancy and daily smoking decreased significantly between 1999 and 2015 whereas risk perceptions, parental control and participation in sports increased in the same period. The confounding percentage of all the independent variables related to the trend in HED was 48.8%, 68.9% and 36.7% for Finland, Norway and Sweden, respectively. Decline in daily smoking ( P < 0.001) and perceived access to alcohol ( P < 0.001) were positively and increase in parental control ( P < 0.001) negatively associated with the decline in HED in all three countries. Changes in truancy, going out with friends, and engaging in sports and other hobbies had little or no impact on the decline in HED or displayed no consistent results across the countries. Conclusions: The decline in adolescent heavy episodic drinking in Finland, Norway and Sweden between 1999 and 2015 appears to be associated with a decline in adolescent daily smoking and perceived access to alcohol and an increase in parental control.

Aims: To analyse trends in alcohol consumption among young people in Sweden between 2004 and 2012, to test whether the theory of collectivity of drinking cultures is valid for a population of young people and to investigate the impact of an increasing proportion of abstainers on the overall per capita trends. Methods: Data were drawn from an annual survey of a nationally representative sample of students in year 11 (17–18 years old). The data covered 9 years and the total sample comprised 36,141 students. Changes in the overall per capita consumption were tested using linear regression on log-transformed data, and changes in abstention rates were tested using logistic regression. The analyses were then continued by calculating average consumption in deciles. Results: Alcohol consumption among year 11 students declined significantly among both boys and girls between 2004 and 2012. These changes were reflected at all levels of consumption, and the same results were found when abstainers were excluded from the analyses. The increasing proportion of abstainers had a minimal effect on the overall decline in consumption; rather, this was driven by a decline in consumption among the heaviest drinkers. Conclusion: The theory of collectivity of drinking cultures seems valid for understanding changes in alcohol consumption among Swedish year 11 students. No support was found for a polarization of alcohol consumption in this nationally representative sample.

Introduction: To estimate the prevalence of children with problem drinking parents in Sweden and the extent to which they have an elevated risk of poor health, social relationships and school situation in comparison with other children.Methods: Survey with a nationally representative sample of Swedish youth aged 15–16 years (n = 5576) was conducted in 2017. A short version of The Children of Alcoholics Screening Test (CAST‐6) was used to identify children with problem drinking parents. Health status, social relations and school situation were measured by well‐established measures. Overall prevalences for girls and boys were presented as well as relative risks (RR) of harm for children with problem drinking parents compared with other children.Results: A total of 13.1% of the sample had at least one problem drinking parent during adolescence according to CAST‐6—a higher proportion of girls (15.4%) than boys (10.8%). This group had an elevated risk of poor general health as well psychosomatic problems compared with other children (RR 1.2–1.9). They were also more likely to use medication for depression, sleeping difficulties and anxiety (RR 2.2–2.6). Their social relations were also worse especially with their father (RR 3.1) and they had more problems at school (RR 2.6).Discussion and Conclusions: The risk of problems related to parental drinking goes beyond the most severe cases where parents have been in treatment for their alcohol problem. This is important knowledge since the majority of problem drinkers never seek treatment and the major part of parental problem drinking is found in population samples.

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.

Previous studies have shown a close association between drinking motives and drinking behaviour among adolescents. However, there is a lack of evidence from the Nordic countries since few studies covering this topic have been carried out in this context. The present study among Swedish adolescents aims to examine (1) the prevalence of different drinking motives, (2) how drinking motives are associated with drinking frequency and heavy drinking frequency, and (3) whether the associations are moderated by sex. A nationally representative sample (n = 5,549) of Swedish adolescents (aged 15–16 years) answered a questionnaire in school. Of these, 2,076 were drinkers and were included in our study. Eighteen items from the Modified Drinking Motives Questionnaire-Revised (Modified DMQ-R) were used. Bivariate relationships between motives and drinking were examined with correlations. Linear regression models were used to assess the links between motives and drinking. Moderating effects of sex were examined with interactions. Most common were social motives, followed by enhancement, coping-anxiety, coping-depression, and conformity motives. Coping-depression motives were slightly more common among girls. Conformity motives were associated with a lower frequency of drinking and heavy drinking while enhancement, social and coping-depression motives were associated with a higher frequency of both outcomes. No associations were found for coping-anxiety motives. No moderation effect of sex was found. Approach motives (social/enhancement) are the most prevalent drinking motives among Swedish adolescents. These also have the strongest association for both frequency of drinking and frequency of heavy drinking. This shows that Swedish adolescents drink to achieve something positive, rather than to avoid something negative, raising implications for prevention and intervention.