Drinking in the home: What does it entail for younger and older Finns?

INTRODUCTION: Studies about drinking in homes are scarce despite the growing importance of the phenomenon. We examined how often different age groups in Finland drink-overall or to intoxication-in their own homes without company beyond the family and in their own or other people's homes with other company, compared to other settings, and on what days and hours of the week this occurs. METHODS: A general population survey carried out in 2016 with event-level data (n = 7124 occasions by 1955 respondents). Key measurements included location, drinking company, amount of alcohol drunk and time of the week. RESULTS: Drinking occasions in which alcohol was drunk at home without visitors made up 74% of all occasions and 73% of all intoxication occasions among people aged 60-79 years and 25% and 5% among 15- to 29-year-olds, respectively. The share of 'with company' occasions in somebody's home varied less by age. Occasions with pre/post drinking in homes and drinking occasions lasting until late at night were seen most often among 15- to 29-year-olds. DISCUSSION AND CONCLUSIONS: The important aspects of home drinking vary greatly by age group and depending on what risk or type of consequence is considered. For older people and for chronic harm, the key aspect is drinking at home without company beyond the family. The more important aspect for younger people and acute harm is pre- and post-drinking in homes before or after going to bars or nightclubs, which results in long evenings with large amounts of alcohol consumed.

Domestication of drinking: a survey study of changes in types of drinking occasions during periods of increasing and decreasing alcohol consumption in the 2000s in Finland.

BACKGROUND AND AIMS: In Finland, per-capita alcohol consumption increased in the early 2000s and decreased after 2007. Our aim was to determine how these changes originated from changes in drinking practices. DESIGN: Repeated cross-sectional general-population surveys. SETTING: Finland in 2000, 2008 and 2016. PARTICIPANTS: Finnish residents aged 15-69 years (n = 6703, response rate 59-78%). MEASUREMENTS: Event-level data on drinking occasions (n = 21 097). Types of drinking occasions (drinking practices) were identified with latent class analysis using occasion characteristics. The aggregated volume of consumption and intoxication occasions were decomposed into contributions from drinking practice classes and years. FINDINGS: Nine drinking occasion types were identified: three at home without company other than family (51% of occasions in 2016), three socializing occasions in different places and with different company (33%) and three party occasion types (16%). Both the frequency of drinking occasion types and the occasion type-specific amounts of alcohol consumed contributed to aggregate-level changes in alcohol use. Drinking at home without external company (with family only; for men, also alone) contributed most to the increase in alcohol use before 2008. Big parties in homes and bars became less common in the 2000s, contributing most to the decline in drinking after 2008. CONCLUSIONS: The rise in per-capita alcohol consumption in Finland in the early 2000s appears to have been linked mainly to an increase in lighter drinking occasions at home without external company. The fall in per-capita drinking after 2007 was linked mainly to a decrease in big parties in homes and in licensed premises. Changes in drinking frequency and the amounts of alcohol consumed per occasion changed in the same direction as alcohol affordability.

Non-Drinkers' Experiences of Drinking Occasions: A Population-Based Study of Social Consequences of Abstaining from Alcohol.

BACKGROUND: People should be able to quit or moderate their drinking without negative social consequences, but studies have shown how nondrinkers often face pressure and negative reactions. As previous research has mostly focused on youth, we conducted a population-level study of the ways adult nondrinkers encounter their drinking companions on drinking occasions and what kinds of reactions they perceive from their social environments. METHOD: The data were based on the Finnish Drinking Habits Survey (FDHS), a general population survey of Finns aged 15-79 collected in 2016 (N = 2,285; 330 nondrinkers; response rate 60%). Characteristics of drinking occasions where nondrinkers participate ("non-drinking occasions") were measured through self-reports of frequency, time, purpose, and social companion on those occasions. Nondrinkers' experiences of non-drinking occasions and reactions from the social environment were measured by question batteries on social consequences. RESULTS: Compared with drinking occasions, non-drinking occasions occurred more often at family events at home than on late-night drinking occasions. Accordingly, nondrinkers reported relatively low levels of negative consequences, and the reported consequences were least frequent in the oldest age group. Nondrinkers reported mostly positive feedback from people around them, more often from family members than from peers. However, negative consequences were reported in all studied groups, most commonly among youth and former drinkers. CONCLUSIONS: The study indicates that nondrinkers' social environments may be more supportive than what has been suggested previously, yet coping mechanisms are required especially from youth and former drinkers. The positive social experiences of being a nondrinker should guide the promotion of moderate and non-drinking.

How Are All Drinking Occasions, Intoxication Occasions, and All Alcohol Consumed Distributed Across Different Drinking Occasion Types? A Typology of Drinking Occasions in Finland.

OBJECTIVE: To understand the contexts and characteristics of drinking occasions, we typologized drinking occasions and examined how different aspects of drinking vary in them and what part of population-level drinking and intoxication occasions each covers. METHOD: A Finnish general population survey in 2016 (n = 2,285) with event-level data on drinking occasions (n = 6,697) was used. Occasion types were identified by latent class analysis. The characteristics of the drinking occasions were location, purpose, company, timing, duration, the amounts and beverages drunk, and estimated blood alcohol concentration (eBAC). RESULTS: Eight drinking occasion classes were identified. The three most common ones were all light drinking occasions at home, with the company varying. Five of the eight types were about socializing with people beyond the family. The heaviest drinking occasion type, "big party nights," had an average eBAC of .12%, which seemed to be connected to the long duration of these occasions. The most important contributors to total population-level intoxication occasions were "big party nights" and "at home with the family" occasions (accounting for 30% and 20%, respectively). In terms of contributions to the population's total alcohol consumption, the order of these classes was reversed (19% and 26%, respectively). Drinking at home with no visitors covered 40% of all the alcohol drunk in Finland. Different types of occasions varied little in beverage type composition. CONCLUSIONS: For acute harm, "big party nights" are important to consider because of the prevalence of intoxication, whereas for chronic harm, drinking at home without visitors is even more important to consider.

Change and continuity in Finnish drinking in the 21st century.

Aim: Alcohol consumption and policy in Finland have undergone a variety of changes in the two last decades. In several cases, trends in both consumption and policy have shifted direction when moving from the first decade of the 21st century to the second one. The aim of the overview is to summarise the trends. Data: The overview draws on results primarily from the cross-sectional Finnish Drinking Habits Survey (FDHS) in 2000, 2008 and 2016, and also from the whole series including altogether seven separate data collections carried out every eight years from 1968 to 2016 and mainly covering Finns aged 15-69 years. Response rates show a falling trend (78% in 2000, 74% in 2008 and 60% in 2016). The overview also makes use of data collected within the European School Survey Project on Alcohol and other Drugs (ESPAD) and, for the elderly, the National FinSote study carried out by the Finnish Institute for Health and Welfare (THL). Results: After an all-time high of 12.7 litres of pure alcohol per capita 15 years and over in 2007, total consumption of alcohol had decreased by 21% by the year 2019. Underage drinking has decreased ever since the millennium shift. Older people's drinking has continued increasing or levelled out. Along with reduced total consumption, heavy episodic drinking (HED) has also decreased, but the differences between manual and white-collar workers in HED have continued to grow. Drinking alcoholic beverages with meals has also declined since 2008. Liberal and restrictive alcohol policy measures have alternated. Conclusions: Finnish drinking culture seems to change at a slow pace; several typical drinking habits have remained unchanged.

Comparing older people's drinking habits in four Nordic countries: Summary of the thematic issue.

Aim: The present article summarises status and trends in the 21st century in older people's (60-79 years) drinking behaviour in Denmark, Finland, Norway and Sweden and concludes this thematic issue. Each country provided a detailed report analysing four indicators of alcohol use: the prevalence of alcohol consumers, the prevalence of frequent use, typical amounts of use, and the prevalence of heavy episodic drinking (HED). The specific aim of this article is to compare the results of the country reports. Findings: Older people's drinking became more common first in Denmark in the 1970s and then in the other countries by the 1980s. Since 2000 the picture is mixed. Denmark showed decreases in drinking frequency, typically consumed amounts and HED, while in Sweden upward trends were dominant regarding prevalence of consumers and frequency of drinking as well as HED. Finland and Norway displayed both stable indicators except for drinking frequency and proportion of women consumers where trends increased. In all four countries, the gender gap diminished with regard to prevalence and frequency of drinking, but remained stable in regard to consuming large amounts. In Norway the share of alcohol consumers among women aged 60-69 years exceeded the share among men. During the late 2010s, Denmark had the highest prevalence of alcohol consumers as well as the highest proportion drinking at a higher frequency. Next in ranking was Finland, followed by Sweden and Norway. This overall rank ordering was observed for both men and women. Conclusion: As the populations aged 60 years and older in the Nordic countries continue to grow, explanations for the drivers and consequences of changes in older people's drinking will become an increasingly relevant topic for future research. Importantly, people aged 80 years and older should also be included as an integral part of that research.

Drinking patterns among Finns aged 60 years and over from the 1990s onwards.

Aim: To analyse prevalence and trends in older people's (60+) alcohol use in Finland in 1993-2018. Data and method: Data on people aged 65+ were obtained from the Health Behaviour and Health among the Finnish Elderly study (HBHFE) for the years 1993-2011 and from its successor the National FinSote Survey for the years 2013-2018. Data for 60-64-year-olds and for the reference group (20-59-year-olds) were obtained from the Health Behaviour and Health among the Finnish Adult Population (HBHFA) study for the years 1993-2011 and from the FinSote study for the years 2013-2018. Four measures were chosen to describe prevalence and trends in drinking patterns in five-year age groups among men and women aged 60+: prevalence of current drinking, prevalence of frequent drinking, typical amounts of drinking and prevalence of heavy episodic drinking (HED). Results: Regarding prevalence of current drinking and frequent drinking, older women have been catching up with men, but older men still consume larger amounts of alcohol per occasion. The long-lasting increase in the prevalence of current drinkers continued in most older female age groups into the 2010s, settled in most older male and some female age groups, and shifted downwards in the oldest male age groups. In most older male and female age groups, the increasing trend in frequent drinking continued to the present. Data on typical amounts consumed and HED were only available for 2013-2018. In that period those measures remained rather stable. Conclusion: More detailed research on drinking patterns among people aged 60+ years is needed for two reasons: older people's drinking is a new cultural phenomenon and alcohol-related social and health harms are increasing in older age groups.

Changes in prevalence and correlates of alcohol-use disorders in Finland in an 11-year follow-up.

AIMS: This study aimed to examine changes in prevalence and correlates of alcohol-use disorders (AUD) between 2000 and 2011. We also explored the impact of using multiple imputation on prevalence estimates, to address survey nonresponse. METHODS: The study used a Finnish nationally representative survey of adults aged 30 years and older in 2000 and in 2011. The Munich Composite International Diagnostic Interview (M-CIDI) was used to diagnose AUD in 6005 persons in 2000 (response rate 75%) and 4381 in 2011 (response rate 55%). Multiple imputation using sociodemographic, health, and registry-linked data on mental health hospitalizations was compared with weights to account for nonresponse. RESULTS: Prevalence of 12-month AUD in Finland decreased from 4.6% (95% CI 4.0-5.1) in 2000 to 2.0% in 2011 (95% CI 1.6-2.4). Lifetime AUD prevalence decreased from 10.8% (95% CI 9.9-11.6) to 7.5% (CI 95% 6.8-8.3) from 2000 to 2011. The reduction was observed for people aged 30-64 years. At both time points, AUD prevalence was higher among individuals aged 30-64, men and those unmarried, widowed or divorced. The observed prevalence changes can be partly attributed to reporting and selection bias. The latter was addressed by multiple imputation. CONCLUSIONS: Alcohol use disorders appear to have decreased in Finland from 2000 to 2011, especially for the 30-64 years age group. Males, younger adults and those unmarried, widowed or divorced had a higher risk of AUD.

Predictors of Persistence of Risky Drinking in Adults: An 11-Year Follow-Up Study.

AIM: To examine the long-term predictors of persistence of risky drinking in a baseline group of risky drinkers in whom alcohol use disorder had not been diagnosed. METHODS: The data was derived from a representative sample of the Finnish adult population aged 30 years or more, surveyed at 2 time points in the years 2000 (n = 5,726) and 2011 (n = 3,848, 67.2% of the baseline sample). Risky drinking was defined using BSQF-measurement (for men, 21 standard UK drinks or more per week; for women 14+ drinks) and not having alcohol abuse or alcohol dependence. The sample of risky drinkers in baseline comprised 642 persons, of whom 380 (59.2%) people provided follow-up data. Multivariable logistic regression models were estimated to identify determinants of persistence of risky drinking. RESULTS: The rate for persistence of risky drinking was 48.7%. Persistence was predicted by daily smoking, low physical activity, and male gender, whereas higher age and later onset of drinking predicted cessation of risky drinking. Daily smoking remained an independent predictor after adjusting for other risk factors. CONCLUSIONS: Health behaviour predicts the persistence of risky drinking in a study population of adults aged 30 and over. These factors should be taken into account when assessing the long-term prognosis on risky drinking.

Decreasing adolescent drinking: Is there evidence of a continuation into future adult cohorts? APC analysis of adolescent drinking in Finland, 1983-2013.

AIMS: Unlike adults, abstaining has increased and regular use of alcohol has decreased among 12-16-year-olds over the past two decades. The paper studies whether these developments will be continued as the adolescent cohorts come of age. METHODS: The Adolescent Health and Lifestyle Survey is a nationally representative monitoring system of the health habits of 12-, 14-, 16-, and 18-year-old Finns, conducted biannually between 1981 and 2013. The prevalence of alcohol use and drunkenness were measured for each 5-year cohort born in 1967-1995. Age-by-cohort trajectories and hierarchical age-period-cohort (APC) modeling were used to assess effects of age, period, and birth cohort. RESULTS: Cohorts differentiate for underage drinking, but not at the age of 18. The younger cohorts postpone their drinking debut compared with older cohorts and thus age profiles are steeper than before. The most recent cohorts born in the 1990s, and the oldest cohorts born in 1967-71, have the highest prevalence in abstinence but drinking has been more prevalent for cohorts born in 1973-1989. APC modeling confirms significant cohort effects, but no significant decrease in drinking or drunkenness at the age of 18 years. Some of the changes can also be attributed to period effects. CONCLUSIONS: Despite the decrease in underage drinking in Finland, 18-year-olds continue to drink similarly from cohort to another. Postponing the onset of drinking has a preventive effect on alcohol-related harms, but a reduction in drinking among adult cohorts is not evident in the future.

Studying ritual and individual orientations to alcohol use: Drinking motives and their connection to intoxication in Finland in the 2000s.

BACKGROUND: Finland was an agricultural country until the 1960s. Thereafter, Finland modernized rapidly. Studies have postulated that as Finland becomes modernized, intoxication-oriented drinking would gradually decrease. Current studies, however, show that heavy episodic drinking has lately become more common among men and women. Simultaneously, drinking is seldom motivated by the purpose of getting drunk. The article tackles this conundrum by approaching drinking motives from a ritual and an individual perspective. We study what kinds of drinking motives currently exist in Finland, their prevalence among different population groups, how they vary by social background, and their association with intoxication. METHODS: The data were collected as part of the nationally representative Drinking Habit Survey in 2008. It consists of verbal descriptions on the most recent drinking occasion (N=521), estimations of its blood alcohol content, and responses to pre-defined standardized motive questions related to the latest drinking occasions (N=8732). RESULTS: Besides the motive 'to get drunk', also the motives of drinking as a 'time-out' ritual, 'to get into the mood' and 'I drunk to brighten up' predict a "wet" drinking occasion. Overall, Finns highlight drinking motives of sociability, relaxation, meal drinking and situational factors. The more educated orientate to their drinking more with motives that express mastery of cultural capital and individuality. The less educated and the young, again, orientate to their drinking more with motives that imply intoxication and external expectations. CONCLUSIONS: Whereas the ritual perspective discloses what kinds of situations predict intoxication, the individual perspective reveals what kinds of individualistic orientations are associated with drunkenness. These perspectives partly speak past each other and are difficult to combine. The article proposes that situational perspective would serve as a bridge between them and enable the incorporation of results from different research traditions.

Long-term effects of changes in Swedish alcohol policy: can alcohol policies effective during adolescence impact consumption during adulthood?

AIMS: To assess long-term effects of alcohol policy in Sweden by estimating the differences between cohorts growing up during periods with liberal alcohol policies and a cohort growing up during a period with restrictive alcohol policy. DESIGN: The data come from repeated cross-sectional surveys conducted in Sweden between 2002 and 2013, and were collected monthly using telephone interviews with a nationally representative sample. Cohorts were constructed by identifying periods when alcohol policy differed between being more liberal or more restrictive. The liberal-period cohorts were merged into one and compared with the restrictive-period cohort. SETTING: Sweden. PARTICIPANTS: A total of 127 480 adult Swedes born between 1951 and 1989. MEASUREMENTS: Monthly volume of alcohol consumption in litres of pure alcohol derived from a beverage-specific graduated quantity-frequency scale. FINDINGS: Relative to the liberal-period reference cohorts (who turned 15 between 1966 and 1977 or 1992 and 2004), the cohort that grew up during a period with restrictive alcohol policy (turning 15 between 1978 and 1991) was found to have lower alcohol consumption (coeff. = -0.039: confidence interval -0.050 to -0.027: P < 0.001). The mean volume for the liberal and restrictive cohorts across all survey years was 0.42 and 0.38 litres of pure alcohol, respectively. Consumption development for the period 2002-13 was, however, the same for both cohort groups. CONCLUSIONS: Men and women in Sweden who grew up during a period with more restrictive alcohol policies currently drink less alcohol than those who grew up during periods with more liberal policies.

Changes in mortality due to major alcohol-related diseases in four Nordic countries, France and Germany between 1980 and 2009: a comparative age-period-cohort analysis.

AIMS: To investigate age, period and cohort effects on time trends of alcohol-related mortality in countries with different drinking habits and alcohol policies. DESIGN AND SETTING: Age-period-cohort (APC) analyses on alcohol-related mortality were conducted in Denmark, Finland, Norway, Sweden, France and Germany. PARTICIPANTS: Cases included alcohol-related deaths in the age range 20-84 years between 1980 and 2009. MEASUREMENTS: Mortality data were taken from national causes of death registries and covered the ICD codes alcoholic psychosis, alcohol use disorders, alcoholic liver disease and toxic effect of alcohol. FINDINGS: In all countries changes across age, period and cohort were found to be significant for both genders [effect value with confidence interval (CI) shown in Supporting information, Table S1]. Period effects pointed to an increase in alcohol-related mortality in Denmark, Finland and Germany and a slightly decreasing trend in Sweden, while in Norway an inverse U-shaped curve and in France a U-shaped curve was found. Compared with the cohorts born before 1960, the risk of alcohol-related mortality declined substantially in cohorts born in the 1960s and later. Pairwise between-country comparisons revealed more statistically significant differences for period (P < 0.001 for all 15 comparisons by gender) than for age [P < 0.001 in seven (men) and four (women) of 15 comparisons] or cohort [P < 0.01 in two (men) and three (women) of 15 comparisons]. CONCLUSIONS: Strong period effects suggest that temporal changes in alcohol-related mortality in Denmark, Finland, Norway, Sweden, France and Germany between 1980 and 2009 were related to secular differences affecting the whole population and that these effects differed across countries.

Age, period and cohort analysis of light and binge drinking in Finland, 1968-2008.

AIMS: To analyse the effects of age, period and cohort (APC) on light and binge drinking in the general population of Finland over the past 40 years. METHODS: All analyses were based on six Drinking Habits Surveys between 1968 and 2008 of representative samples of the Finnish population aged between 15 and 69 (n = 16,400). The number of drinking occasions per year involving 1-2 drinks (light) and 4+ or 6+ drinks (binges) was used as a dependent variable in APC modelling. Descriptive cohort profiles and negative binomial models were used to assess the effects of APC. RESULTS: Descriptive cohort profiles differed for light and binge drinking. No substantial differences were found across cohort profiles for light drinking, while APC modelling predicted declining cohort and increasing period effects. Differences between cohorts were found for binge drinking, with predictions of slightly declining or increasing period and increasing cohort effects. CONCLUSIONS: Light drinking has increased over time for each cohort, with no substantial differences between cohort profiles. Binge drinking has increased with more recent cohorts and there are distinct differences between cohort profiles, especially among women.

Production and sedimentation of peptide toxins nodularin-R and microcystin-LR in the northern Baltic Sea.

This seven-year survey was primarily targeted to quantification of production of nodularin-R (NOD-R), a cyclic pentapeptide hepatotoxin, in Baltic Sea cyanobacteria waterblooms. Additionally, NOD-R and microcystin-LR (MC-LR; a cyclic heptapeptide toxin) sedimentation rates and NOD-R sediment storage were estimated. NOD-R production (70-2450 microg m(-3); approximately 1 kg km(-2) per season) and sedimentation rates (particles; 0.03-5.7 microg m(-2)d(-1); approximately 0.3kg km(-2) per season) were highly variable over space and time. Cell numbers of Nodularia spumigena did not correlate with NOD-R quantities. Dissolved NOD-R comprised 57-100% of total NOD-R in the predominantly senescent, low-intensity phytoplankton blooms and seston. Unprecedentedly intensive MC-LR sedimentation (0.56 microg m(-2)d(-1)) occurred in 2004. Hepatotoxin sedimentation rates highly exceeded those of anthropogenic xenobiotics. NOD-R storage in surficial sediments was 0.4-20 microg kg(-1) ( approximately 0.1 kg km(-2)). Loss of NOD-R within the chain consisting of phytoplankton, seston and soft sediments seemed very effective.