Explanations and implications of the decline in adolescents’ drinking in the Nordic countries – findings from a comparative project

The strong decline in adolescents’ drinking in several Nordic countries since 2000 prompted a research project to examine possible explanations and implications of this trend. The project used comparable data from the European School Survey Project on Alcohol and Other Drugs (ESPAD), which has been conducted among 15-16-year-olds in Denmark, Finland, Iceland, Norway and Sweden every four years from 1995 to 2019. Below we describe the main findings from the project, together with links to the articles.

Possible explanations of the decline in youth drinking

In an article published in 2020, Raitasalo and colleagues [1] found that in Finland, Norway and Sweden the decline in heavy episodic drinking (= HED, which means drinking 6 or more alcohol units per drinking occasion) from 1999 to 2015 was associated with a decline in smoking and perceived access to alcohol, as well as with an increase in perceived parental control.

In another article published two years later, Ramstedt and colleagues [2] found that in Denmark and Sweden, the decline in youth drinking between 2003 and 2015 was associated with restrictive parental attitudes . In Sweden, where drinking declined sharply, these attitudes were more common and became more prevalent over time as compared to Denmark, where drinking declined modestly.

These results indicate that the above-mentioned factors explained, at least partly, the declining trend in youth drinking.

Implications of the decline in youth drinking

Using data from Iceland, Norway and Sweden (2007-2015) Moan and colleagues [3] found in their 2021-study that the downward trend in HED was accompanied by a decline in alcohol-related violence in all three countries. Moreover, in Iceland and Norway the HED-violence association became stronger when HED became less common. This finding is in line with the assumption that drinking poses a higher risk of harm at times when drinking is less common.

Ekholm and colleagues [4] examined this general assumption by extending the analysis to all five Nordic countries and to a broader range of alcohol-related negative consequences. They found that both consumption level and experience of harms declined overall from 2007 to 2015, but with notable differences between the Nordic countries. Only in Iceland, however, did the alcohol – harm association become stronger over time.

Whether the decline in drinking has carried over to young adults was examined by Rossow and colleagues [5] in a 2022-article. Using data from Norway, they found no clear empirical support for the assumption that those who initiated drinking later in adolescence would drink less in young adulthood.

Finally, Rossow and colleagues [6] compared trends in consumption volume and drinking pattern in four Nordic and two Mediterranean countries from 1999 to 2019, in an article published in 2022. At the aggregate level, trends in consumption volume and HED went hand in hand in all countries. Hence, the decline in consumption volume in Nordic countries was accompanied by a similar decline in HED. At the individual level, and in the first part of the period, consumption volume was more strongly associated with HED in the Nordic than in the Mediterranean countries. Over time, when consumption declined in the Nordic countries, this association became weaker.

Societal and policy implications

The results of this project show that there are commonalities across the Nordic countries with regard to trends in drinking, and likely explanations for – and implications of – changes over time. Overall, this may in part reflect homogeneity of the Nordic societies and suggest transferability of alcohol research findings among young people across the Nordic countries.

With regard to implications for prevention, some of the findings point to the important role of parents in preventing adolescents’ alcohol use and related harms, suggesting that prevention efforts should also target parents. Policy implications point to the restricting availability of alcohol. Liberalization of alcohol policy in Finland may negatively affect the positive development in youth drinking, whereas the raising of age limits of buying alcohol in Denmark might have the positive effect of decreasing alcohol consumption among adolescents. These are some of the important topics that needs to be addressed in future studies on alcohol use among adolescents in the Nordic countries.

The article is written by Inger Synnøve Moan, Kirsimarja Raitasalo, Ingeborg Rossow, Johan Svensson, Elin K. Bye, Ola Ekholm, Siri Thor, Veronica Pisinger, Sveinbjörn Kristjánsson & Kim Bloomfield.

References:

1. Raitasalo, K., Kraus, L., Bye, E. K., Karlsson, P., Tigerstedt, C., Törrönen, J, Raninen, J. (2020). Similar countries, similar factors? Studying the decline of heavy episodic drinking in adolescents in Finland, Norway and Sweden. Addiction, 62-71. https://doi.org/10.1111/add.15089
2. Ramstedt, M., Raninen, J., & Larm, P. (2022). Are changes in parenting related to the decline in youth drinking? Evidence from a comparison of Sweden and Denmark. Nordic Studies on Alcohol and Drugs, 1–10. https://doi.org/10.1177/14550725211057638
3. Moan, I. S., Bye, E. K., & Rossow, I. (2021). Stronger alcohol-violence association when adolescents drink less? Evidence from three Nordic countries. European Journal of Public Health, 31 (4), 866-872. https://doi.org/10.1093/eurpub/ckab124
4. Ekholm O, Pisinger V, Jensen HAR, Bloomfield K. (2024). Implications of the decline in adolescent drinking on the experience of alcohol-related consequences in the Nordic countries: A study based on data from the ESPAD project. Nordic Studies on Alcohol and Drugs. DOI: 10.1177/14550725241229016
5. Rossow, I., Moan, I.S., Bye, E.K. (2022). Declining Trend in Adolescent Alcohol Use: Does It Have Any Significance for Drinking Behaviour in Young Adulthood? International Journal of Environmental Research and Public Health, 19, 7887. DOI: 3390/ijerph19137887
6. Rossow, I., Bye, E. K., & Moan, I.S. (2022). The Declining Trend in Adolescent Drinking: Do Volume and Drinking Pattern Go Hand in Hand? International Journal of Environmental Research and Public Health, 19, 7965. DOI: 3390/ijerph19137965