Similar countries, similar factors? Studying the decline of heavy episodic drinking in adolescents in Finland, Norway and Sweden

Abstract

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.

Decline in adolescent drinking: Some possible explanations

“…A slight increase in spending time with parents was found in a Swedish study, yet this change was not independently related to the decline in adolescent drinking [17]. What did make a difference was a large reduction in leisure-time social interaction with peers, which corroborates the results of other recent studies [14,[17][18][19]. However, the frequency of 'going out with friends' increased among Finnish youth in the 2000s, and paradoxically, Raitasalo et al [12] found that this change-in a statistical sense-explained some of the reduction in drinking.…”

“…The single most important factor to explain the decline in drinking in our study was the decrease in time hanging out with friends in the evening. Some previous studies [14,17–19] have also found that a decrease in hanging out with friends contributed to a decrease in drinking. The decrease in unsupervised socialising with peers probably implies fewer opportunities for drinking to intoxication.…”

“…Thus, concurrent with the downward drinking trend in the 2000s, substantial cross-national changes in adolescents' lifestyles, leisure-time activities and priorities have occurred. First, most studies indicate that hanging out with friends in the evenings occurs less frequently [14,17,18], and that a marked increase in time spent on screen activities has occurred [28]. Some studies have also found an increase in spending time with parents [17,29], as well as other changes that are indicative of closer ties to parents [30,31].…”

“…Educational commitment is inversely related to adolescent drinking [20], and it has also been suggested that stronger school conscientiousness may have fostered the decline in drinking [2,12]. Some countries have witnessed a weak parallel decline in truancy [12,21,22], and a recent study found that a small proportion of the reduction in youth drinking in both Norway, Sweden and Finland could be ascribed to a decline in skipping school [14]. Other indicators of school conscientiousness, such as time spent on homework, have barely been taken into account.…”

“…The most robust evidence was identified for shifts in parental practices, notably stricter alcohol‐related parenting and increased monitoring. Additional evidence that improved parental monitoring may have contributed to the decline in drinking has been published recently [11–14]. However, parental monitoring has consistently been operationalised as parents' knowledge about their offspring's whereabouts, and such knowledge is generally not attained through parents' surveillance and control, but through adolescents' free disclosure [15].…”