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.

Government alcohol monopolies were created in North America and Scandinavia to limit health and social problems. The Swedish monopoly, Systembolaget, reports to a health ministry and controls the sale of all alcoholic beverages with > 3.5% alcohol/volume for off-premise consumption, within a public health mandate. Elsewhere, alcohol monopolies are being dismantled with evidence of increased consumption and harms. We describe innovative modelling techniques to estimate health outcomes in scenarios involving Systembolaget being replaced by 1) privately owned liquor stores, or 2) alcohol sales in grocery stores. The methods employed can be applied in other jurisdictions and for other policy changes. Impacts of the privatisation scenarios on pricing, outlet density, trading hours, advertising and marketing were estimated based on Swedish expert opinion and published evidence. Systematic reviews were conducted to estimate impacts on alcohol consumption in each scenario. Two methods were applied to estimate harm impacts: (i) alcohol attributable morbidity and mortality were estimated utilising the International Model of Alcohol Harms and Policies (InterMAHP); (ii) ARIMA methods to estimate the relationship between per capita alcohol consumption and specific types of alcohol-related mortality and crime. Replacing government stores with private liquor stores (Scenario 1) led to a 20.0% (95% CI, 15.3–24.7) increase in per capita consumption. Replacement with grocery stores (Scenario 2) led to a 31.2% (25.1–37.3%) increase. With InterMAHP there were 763 or + 47% (35–59%) and 1234 or + 76% (60–92%) more deaths per year, for Scenarios 1 and 2 respectively. With ARIMA, there were 850 (334–1444) more deaths per year in Scenario 1 and 1418 more in Scenario 2 (543–2505). InterMAHP also estimated 10,859 or + 29% (22–34%) and 16,118 or + 42% (35–49%) additional hospital stays per year respectively. There would be substantial adverse consequences for public health and safety were Systembolaget to be privatised. We demonstrate a new combined approach for estimating the impact of alcohol policies on consumption and, using two alternative methods, alcohol-attributable harm. This approach could be readily adapted to other policies and settings. We note the limitation that some significant sources of uncertainty in the estimates of harm impacts were not modelled.

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.

Over the past two decades, alcohol consumption in Sweden has grown by 20 per cent as a result of an increasing consumption of wine and strong beer. The rise is driven by a combination of factors such as the higher physical availability and lower real prices of alcohol, which suggests that alcohol has become much more affordable. In addition, the possibilities to bring back cheaper alcohol from other EU countries have been greatly extended during the Swedish EU membership. No definite patterns were found with respect to certain social and demographic changes during the study period. Despite the significant increase in consumption, indicators of alcohol-related harms did not show consistently increasing trends. It is not evident why the increasing availability should have such different effects on various population sub-groups, and there are obviously other relevant factors at play. Widespread political concern at the implications of the rising availability of alcohol has led Sweden to spend more per capita than any other European country on alcohol policy and prevention initiatives. It will be a continuous challenge for policy makers to find measures that limit the harms caused by alcohol in the Swedish society.

Background and Aims: The prevalence of cannabis use based on self‐reports is likely to be underestimated in population surveys, especially in contexts where its use is a criminal offence. Indirect survey methods ask sensitive questions ensuring that answers cannot be identified with an individual respondent, therefore potentially resulting in more reliable estimates. We aimed to measure whether the indirect survey method ‘randomized response technique’ (RRT) increased response rate and/or increased disclosure of cannabis use among young adults compared with a traditional survey.Design: We conducted two parallel nation‐wide surveys during the spring and the summer of 2021. The first survey was a traditional questionnaire‐based one (focusing on substance use and gambling). The second survey applied an indirect survey method known as ‘the cross‐wise model’ to questions related to cannabis use. The two surveys employed identical procedures (e.g. invitations, reminders and wording of the questions)Setting and Participants: The participants were young adults (aged 18–29 years) living in Sweden. The traditional survey had 1200 respondents (56.9% women) and the indirect survey had 2951 respondents (53.6% women).Measurements: In both surveys, cannabis use was assessed according to three time‐frames: life‐time use; use during the past year; and use during the past 30 days.Findings: The estimated prevalence of cannabis use was two‐ to threefold higher on all measures when estimated using the indirect survey method compared with the traditional survey: use during life‐time (43.2 versus 27.3%); during the past year (19.2 versus 10.4%); and during the past 30 days (13.2 versus 3.7%). The discrepancy was larger among males and individuals with an education shorter than 10 years, who were unemployed, and who were born in non‐European countries.Conclusions: Indirect survey methods may provide more accurate estimates than traditional surveys on prevalence of self‐reported cannabis use.

Introduction: The aim of this study was to replicate earlier studies suggesting that changes in parenting have contributed to the recent decline in youth drinking by comparing parenting in a country experiencing a sharp decline in youth drinking (Sweden) with a country with only a small decline (Denmark). Data and analysis: Data stem from self-reported information from 15–16-year-old children in the Swedish and Danish subsamples of ESPAD. Youth drinking was measured by prevalence and frequency of drinking over the past year. Parenting was measured in terms of the extent the child reported that: (1) parents’ attitudes towards offspring drinking are restrictive, (2) parents set up general rules for what their children are allowed to do, and (3) parents have high level of knowledge about where and with whom their children spend time. The association between these indicators of parenting and youth drinking was first estimated with logistic regressions. Second, changes in parenting between 1999 and 2015 were compared between Denmark and Sweden across the study period. Results: Restrictive parental attitudes were associated with a lower likelihood of past-year drinking and frequent drinking in both Sweden and Denmark. This attitude was more common in Sweden, where it also became more prevalent between 2003 and 2015 in contrast to in Denmark. The association between strict parental rule-setting and youth drinking was weak in both countries. A high parental knowledge of the child's whereabouts was linked to a lower likelihood of past-year drinking in Sweden and a lower frequency of drinking in both countries. Parental knowledge of offspring's whereabouts did not develop differently in Sweden and Denmark, with a high and stable proportion in both countries. Conclusion: More restrictive parental attitudes towards youth drinking may have contributed to the decline in youth drinking, whereas the importance of general parental rule-setting and parental knowledge of offspring's whereabouts was not supported.