AARHUSUNIVERSITET

CHANGES IN ALCOHOL CONSUMPTION IN DENMARK: A COMPARISON OF NATIONAL SURVEYS FROM 2003 AND 2011

Kim Bloomfield, Dr.P.H. 1,2 ,Ulrike Grittner, Ph.D.2,3

1Centre for Alcohol and Drug Research, Aarhus University, Denmark 2Department for Biostatistics and Clinical Epidemiology, Charité – University Medicine Berlin, Germany3Centre for Stroke Research Berlin, Germany

For presentation at the 141st annual meeting of the American Public Health Association, Boston, MA, USA

AARHUSUNIVERSITET

•First dedicated national survey on alcohol and drugs conducted by CRF in 2011

• Extensive questions on alcohol use (consumption, problems, harms, contexts, attitudes). Also drug and tobacco use.

• Almost identical questions on alcohol consumption and problems as were asked in 2003 in relation to the Nordic Tax Study and GENACIS.

BACKGROUND

2

AARHUSUNIVERSITET

ALCOHOL CONSUMPTION, ETHANOL, LITRES PER CAPITA 14+ YEARS, 2000-2010 (SOURCE: STATISTICS DENMARK)

3

10

10,5

11

11,5

12

12,5

13

13,5

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

2005: rank 18 out of 189 countries (Source: GISAH); among Nordic countries: rank 1

> per day

PURPOSE OF THE STUDY

4

• To present new prevalence data for alcohol use and problems in Denmark

• To investigate possible changes over time by comparing present data with those from the 2003 survey.

AARHUSUNIVERSITET

METHODS - SAMPLE

•2003 survey conducted August/September

•N = 2030

•CATI with RDD

•Cooperation rate = 50%

•Age range 15-99; 44% men, 56% women

5

AARHUSUNIVERSITET

METHODS - SAMPLE• 2011 survey conducted

September/October

• N = 5133

• Split mode: first internet, then telephone

• Response rate = 64%

• Age range = 15-79; 47% men, 53% women

6

AARHUSUNIVERSITET

METHODS - MEASURES

•Current drinking, heavy drinking (>10/20 grams per day for women/men), RSOD (5+ units/occasion), quantity per drinking day

•Selected AUDIT problem items

•Control variables: age, marital status, household status, children, employment, education, income, survey mode, survey year

7

AARHUSUNIVERSITET

METHODS – STATISTICAL APPROACH

prevalence/distributions by gender, age, year, administration mode

Multivariate linear and logistic regressions

Risk curves for alcohol problems and consumption

8

AARHUSUNIVERSITET

9

** ***

Current drinking by year and mode

AARHUSUNIVERSITET

HEAVY DRINKING >10/20 GR. ETHANOL PER DAY BY WAVE AND MODE

10

AARHUSUNIVERSITET

MONTHLY RSOD BY YEAR & MODE

11

AARHUSUNIVERSITET

HEAVY DRINKING (10/20+ GRAMS ETHANOL PER DAY, OR (95%CI)

12

AARHUSUNIVERSITET

HEAVY DRINKING (10/20+ GRAMS ETHANOL PER DAY, OR (95%CI)

13

AARHUSUNIVERSITET

MONTHLY RSOD OR (95%CI)

14

Men WomenR2 0.15 0.22

Age (centred, in decades) 0.62 (0.59-0.66) 0.59 (0.54-0.64)

Age (centred, squared) -- --

Marital statusMarried or partnership

-- 0.79 (0.64-0.96)

Having children 0.69 (0.59-0.81) 0.57 (0.47-0.71)

Employment statusWorking, studying /apprentice

-- 1.60 (1.22-2.11)

Educational level Middle or high

-- --

Income Middle or high

1.28 (1.08-1.52) --

survey year (forced into the model, ref: 2003)

1.03 (0.87-1.23) 0.98 (0.73-1.32)

Admin. Mode for 2011 web (ref: telephone)

-- 1.32 (1.02-1.70)

Age*children 1.41 (1.27-1.57) 1.58 (1.38-1.82)

AARHUSUNIVERSITET

QUANTITY PER DRINKING DAY DRINKERS ONLY

15

*

*

AARHUSUNIVERSITET

PROBLEMS SCORE

16

AARHUSUNIVERSITET 6+ PROBLEMS SCORE, ALL RESPONDENTS

17

OR (95%CI)

Men WomenR2 0.21 0.21Age (centred, in decades) 0.63

(0.57-0.70)0.54

(0.47-0.63)Marital statusMarried or partnership

0.59 (0.44-0.79)

0.48 (0.31-0.72)

Having children 0.61 (0.43-0.86)

0.56 (0.34-0.93)

Employment statusWorking, studying or apprentice

-- --

Educational level Middle or high

1.49 (1.08-2.04)

--

Income Middle or high

0.74 (0.54-0.99)

--

survey year (forced into the model, ref: 2003)

1.15 (0.73-1.83)

2.98 (1.63-5.45)

Admin. Mode for 2011 web (ref: telephone)

2.45 (1.70-3.53)

--

AARHUSUNIVERSITET

18

risk curves for young men

AARHUSUNIVERSITET

19

risk curves for young women

AARHUSUNIVERSITET

1. Current drinking ↓ slightly

2. Heavy drinking ↓

3. RSOD stable ↔

4. Problem prevalence ↑among drinking women

5. Risk curves: higher problems prevalence in 2011 for same drinking amounts in young women

6. administration mode effect (higher values for web-respondents) for some measures

20

SUMMARY

AARHUSUNIVERSITET

DISCUSSION

• Paradoxical trends seen earlier in North America?

• Similar trends have begun to appear in “wet countries” - Europe: Geneva, Île-de-France, now DK

21

AARHUSUNIVERSITET

DISCUSSIONExplanations could be:

1. Items of CAGE + AUDIT measure differing social norms (e.g., guilt)

2. Changing sensibility for problems (only for women)

3. Norms have changed

4. Polarization (e.g., Svensson)

5. Further research to look at consumption distribution and registry/treatment data

6. Methodological analysis on administration mode effect

22

AARHUSUNIVERSITET

Thank you!

23