Comparable Nordic alcohol statistics difficult to compile since the end of official cooperation

As Chief Specialist at the Finnish Institute for Health and Welfare (THL), Nordic comparisons are among the primary duties of alcohol researcher Thomas Karlsson, who is only too aware of the problems inherent in Nordic alcohol statistics.

“Sales statistics are available from all Nordic countries and, in principle, these can be compared − with the major caveat that we are not dealing with total consumption figures but rather sales in each country. If we look solely at consumption figures, then comparable figures between Finland and Sweden go a fairly long way back.”

In Sweden, the Swedish Council for Information on Alcohol and Other Drugs conducts monitoring measurements that include alcohol procured from unregistered sources, while corresponding telephone interviews are also conducted in Finland.

“In part, the monitoring measurements concept has been copied in Finland for the past 15 years in terms of the private importation of alcoholic beverages. Total consumption figures can be obtained by adding private imports by travellers to sales statistics. We also have small, relatively static amounts that can be added to the total consumption figure;in Finland, this would be homemade and smuggled alcohol plus the alcohol consumed by Finns while abroad.”

Political incentive

Swedish monitoring measurements include ongoing telephone surveys of people between the ages of 17 and 84, totalling some 18,000 calls a year. In Finland, 500 people over the age of 15 are interviewed by telephone every week, giving a total of approximately 26,000 interviews per year. Telephone surveys are also conducted in Norway, where a representative sample of 3,700 people are interviewed each year on topics including alcohol.

“There is no significant political interest in monitoring the scale of unregistered alcohol imports into Norway and where this is done it is solely a matter of studying the phenomenon in and of itself. In Finland and Sweden, however, there are large economic and political incentives to keep track of and study the extent of private alcohol imports. There are also businesses with a vested interest in demonstrating how much alcohol is collected from Estonia and Latvia in order to pressure politicians to introduce a tax to discourage such imports. The same kind of monitoring by private interests also takes place in Sweden. From a research perspective, our primary interest in these figures is to create an overall picture, given that [the amount of] unregistered alcohol remains quite significant,” says Thomas Karlsson.

Data is lacking

As Norway is not part of the EU internal market on this issue, stricter quotas for the import of alcohol remain in place. In Iceland, since 2014 the population’s drinking habits have been measured as part of a broader annual health survey; among other things, providing an estimate of risk consumption. Iceland also estimates total consumption.

“Denmark has completely halted the publication of statistics on total consumption. This is largely due to the lack of figures on which to base an estimate of imports, especially when it comes to alcohol transported across the border from Germany. One might say that there is a lack of political interest in the issue in Denmark and perhaps a lack of interest in financing research into alcohol,” says Thomas Karlsson.

While he compiles Nordic alcohol statistics for THL’s Statistical Yearbook of Alcohol and Drug Statistics, which only publishes sales statistics, Thomas Karlsson has long been an advocate of producing total consumption figures for all Nordic countries.
“For many years, my now retired colleague Esa Österberg compiled the report Information on the Nordic Alcohol Market, which is published by Alko, in which we have long attempted to estimate total consumption with the help of our contacts in the Nordic research community.”

Information on the Nordic Alcohol Market 2019 contains a figure for Denmark’s total consumption, although this is from 2010.

Major health survey

While Statistics Denmark publishes annual sales statistics for alcohol, the agency no longer issues statistics for total consumption as it did between 2000 and 2010. This was based on data from the Danish Ministry of Taxation’s report Status over grænsehandel [Status of Cross-border Trade], which uses a number of sources. Statistics Denmark selected one of these sources, a choice that was the subject of criticism.

“Another reason why the statistics no longer include cross-border trade is that the report is no longer published annually, as different governments have had shifting interests in cross-border trade,” says Christian Lindeskov, head of alcohol and tobacco statistics at Statistics Denmark.

Every four years, the National Institute of Public Health (SIF) conducts a comprehensive survey of the Danish population’s health and illnesses, including questions relating to alcohol consumption. In total, the health habits of 170,000 Danes are mapped. The survey, which is conducted in collaboration with the Danish Health Authority and Danish regions, was last conducted in 2017 and the next will be in 2021.

On the question of why there is no official figure for Denmark’s total alcohol consumption, the Ministry of Health refers to the answer from Statistics Denmark, pointing out that Denmark conducts the aforementioned survey every four years and that the Danish Health Data Authority reports statistics on alcohol-related injuries and publicly funded alcohol treatment on an ongoing basis.
The most recent available official figures for total consumption are those from 2010. Professor Kim Bloomfield of the Centre for Alcohol and Drug Research (CRF) at Aarhus University most recently conducted a study of Danish alcohol consumption in 2011.

“That study was financed by the department for which I work; however, I have not received any funding for a national study since then. Instead, I have been collaborating with SIF and utilising the results of SIF surveys, as they have more up-to-date data. The only problem is that SIF does not conduct a purposefully comparable survey of alcohol consumption − questions related to alcohol consumption are only part of a broader health profile survey.”

“It is not enough to compare sales data”

Kim Bloomfield has been living in Denmark for 20 years and is an active member of the Nordic research community in the field; among other things, she is a member of the editorial board of the journal Nordic Studies on Alcohol and Drugs. In her opinion, Denmark lacks a tradition of interest in international cooperation on alcohol research that one finds in the other Nordic countries.

“This is a historical problem; if you speak with other Nordic researchers, they will say that sometimes Denmark is involved in collaborations and sometimes not. This is a long-standing problem. Denmark has never had a strong temperance movement and alcohol has not previously played a major role in Danish society as a public health issue.”

Kim Bloomfield sees a clear need for comparable Nordic alcohol statistics.

“I think it would be extremely interesting and a great help if we could obtain comparable alcohol statistics from all Nordic countries. It is a real shame that there is no interest and funding for this at a national level. In the other Nordic countries in particular, it is not enough to compare sales data, given that any accurate estimation of how much people drink is dependent on a figure for total consumption.”

Agreement expired

One fundamental problem with Nordic alcohol statistics is the need to divide responsibility and the requirement for a mandate to continuously compile statistics. Since 1987, Nordic statistics on registered alcohol consumption, sales systems, price and taxation developments and certain injury indicators have been published in the journal Nordic Studies on Alcohol and Drugs (NAD), formerly Nordisk alkohol- & narkotikatidskrift.

Previously, statistics were compiled according to an official agreement. The most recent agreement, signed in April 2009, stated that: “the statistics represent a valuable source of knowledge and reference for both researchers and politicians and other policy-makers in the Nordic region, as well as beyond our borders”.

According to the agreement, responsibility for compiling statistics from the five Nordic countries, plus the Faroe Islands and Greenland, was to circulate between the relevant public authorities in Finland, Norway and Sweden. The agreement regulated when each country was to compile statistics. The last authority to bear responsibility was the Swedish National Institute of Public Health, now the Public Health Agency of Sweden. The agreement was extended until 2015 but then expired. The final publication of Nordic alcohol statistics in NAD was in 2017.

A scarcity of resources

Thomas Karlsson recalls attending meetings at THL at which the Nordic alcohol statistics were discussed.

“It is around five years since the issue was discussed at THL. At the time, the responsibility for gathering statistics did not rest with Finland and, in the absence of any responsible individual, staff resources and mandate, the issue was quite simply dropped. It is unfortunate when this kind of thing happens − there is a demand for statistics. In Finland, given the various resourcing challenges we have faced, we were hardly in a position to take on extra responsibilities.”

Thomas Karlsson affirms that an institution with a broader Nordic mandate would be better placed to take on the task of coordinating alcohol statistics; the Nordic Welfare Centre, for example.

Matilda Hellman, editor-in-chief of the journal NAD, points out that neither the Nordic Welfare Centre nor NAD have had the funds to pay researchers to compile statistics.

“The model for research cooperation within the framework of the Nordic Welfare Centre has been based on researchers working within their normal working hours on joint Nordic projects. These days there are barely any resources or scope for these collaborations. Generally speaking, the research cooperation structure maintained by the Nordic Welfare Centre consists of project management and support for meetings and seminars within joint Nordic projects.”

NAD still publishing

NAD’s editor Tom Kettunen explains the journal’s current role when it comes to Nordic alcohol statistics. While the task of publishing statistics remains with NAD, without any official collaboration there are no aggregated figures for the journal to publish.

“In the journal’s official description, we have chosen to continue formulating what we publish as Nordic alcohol statistics, even if some figures are no longer included. The countries no longer follow up some issues and so at the end of last year the journal’s editorial board decided to examine what figures remain available and comparable from country to country; however, it is a laborious task to compile the existing figures.”

There remains a need for Nordic alcohol statistics.

“Nordic alcohol statistics are widely used in research and in grey literature, says Tom Kettunen.