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Introduction Acute and chronic alcohol use are well-known risk factors for accidents and injuries, and concurrent psychoactive drug use can increase injury risk further. Phosphatidylethanol (PEth) 16:0/18:1 is a biomarker used to determine alcohol consumption the previous 3–4 weeks. The aim was to investigate the prevalence of chronic alcohol use in trauma patients, as determined by PEth 16:0/18:1 concentrations, and how excessive chronic alcohol use relate to demographic variables, injury mechanisms and drug use. Setting Patients received at Norwegian trauma hospitals from March 2019 to February 2020. The study is part of the Impairing Drugs and Alcohol as Risk factors for Traumatic Injuries study. Methods All patients aged ≥ 16 years received with trauma team were included in the study. Data on injury date and mechanism, gender and age was registered. Blood samples were analyzed for 22 psychoactive medicinal and illicit drugs, ethanol and phosphatidylethanol 16:0/18:1. Regression analyses were conducted to assess associations between alcohol use and gender, age, injury mechanism and drug use. Results and Conclusion Of the 4845 patients included in the study, 10% had PEth 16:0/18:1 concentration ≥ 600 nM (~430 ng/mL), indicative of excessive chronic alcohol use. Being male, between 44-61 years old, involved in violence, and testing positive for medicinal drugs was associated with excessive chronic alcohol use. Excessive chronic alcohol use was common among males, middle-aged, patients with violence as injury mechanism and those with medicinal drug use. These findings emphasize the need to detect and treat excessive chronic alcohol use among trauma patients. [ABSTRACT FROM AUTHOR]

Background: Shortage of nurses and instability in the nursing workforce due to turnover have become a global concern. Purpose: The aim of this study was to investigate whether symptoms of psychological distress mediated the impact of age, gender, workplace bullying, job satisfaction, and hardiness on turnover intention when controlling for living with children,marital status, percentage of full-time equivalent, and number of night shifts last year andwhether the same variables (except full-time equivalent and number of night shifts last year) could predict real turnover. Methods: In all, 1,246 nurses took part in a survey in 2008/2009 (T1) assessing symptoms of insomnia, sleepiness, anxiety, depression, fatigue, alcohol consumption, age, gender, workplace bullying, job satisfaction, and hardiness. Three years (T2) later they completed a survey assessing turnover intention, living with children, marital status, percentage of full-time equivalent, and number of night shift last year. A total of 99 nurses had left the nursing profession during this period. Results: Workplace bulling was positively related to turnover intention, whereas job satisfaction and hardiness were negatively related to turnover intention. The impact of all three predictors was partly mediated by symptoms of insomnia and anxiety. Age was negatively whereas male gender was positively associated with turnover intention. These effects were partly mediated by harmful alcohol use. Nurses who were living with a partner at T2 and nurses with high scores on fatigue at T1 were more prone to leave the nursing profession during the study period compared to their counterparts. Conclusion: Symptoms like insomnia, anxiety, and alcohol consumption may mediate the impact of working conditions and personality traits associated with turnover intention in nurses. Practice Implications: Interventions aiming at counteracting bullying, improving job satisfaction, and alleviating fatigue may reduce turnover intention/turnover. [ABSTRACT FROM AUTHOR]

Background: In Europe, the COVID-19 pandemic triggered a range of restrictive measures, which may have impacted alcohol consumption. Objectives: We explored perceived changes in alcohol consumption, their association with sociodemographic characteristics and past year alcohol consumption, and self-reported reasons for change after CO-VID-19 restrictions in Norway. Method: A web-based survey was sent to Norwegians aged 18 years and older in June–July 2020. Respondents reporting any past year alcohol use (n = 1,200) were asked whether they drank less, approximately the same, or more after the COVID-19 restrictions compared to before and reasons for drinking less or more. Results: Almost a third (29.9%) reported they drank less, whereas 13.3% reported they drank more. Females, younger respondents, and Oslo residents were more likely to report both less and more drinking (p values between 0.001 and 0.029). Past year alcohol use was associated with less drinking (OR = 0.93; p < 0.001) and more drinking (OR = 1.07; p < 0.001). More drinking was also associated with living with child(ren) (p = 0.023) and high educational level (p = 0.029). The most frequently reported reasons for drinking less pertained to fewer social occasions and less on-premise drinking, whereas reasons for drinking more pertained to treating oneself to something good and fewer consequences of drinking more. Conclusions: After the COVID-19 restrictions were implemented, a substantial proportion of Norwegians changed their drinking behaviour. [ABSTRACT FROM AUTHOR]

Aims: The aim of the current study was to provide estimates of the distribution of alcohol-related problems in a large sample of college and university students. We also sought to examine trends in the distribution of alcohol-related problems from 2010 to 2018. Methods: Data stem from a recent national health survey from 2018 for higher education in Norway (the SHoT study) in which 50,054 full-time students (69.1% women; 30.9% men) aged 18–35 years participated. The Alcohol Use Disorders Identification Test (AUDIT) was used to assess potential alcohol-related problems. Data on demographic characteristics were also collected. Results: More than half of the male students (52.8%) and 4 out of 10 of the female students (40.1%) reported risky, harmful or dependent alcohol use. Compared to women, men had an increased risk of risky alcohol use (relative risk ratio (RRR) = 1.57), harmful alcohol use (RRR = 2.45) and dependent alcohol use (RRR = 2.73). Younger students had higher rates of risky and harmful alcohol use compared with older students, while rates of dependent alcohol use were similar across the age span. Several demographic variables were associated with alcohol use. The trend analyses revealed that the rates of risky, harmful and dependent alcohol use, as well as mean AUDIT scores, among the students have remained relatively stable over the past 8 years. Conclusions: Alcohol use remains an important health concern among Norwegian college and university students, and the present study confirms the high rates of alcohol-related problems, and the need to address the issue within this population. [ABSTRACT FROM AUTHOR]

Negative life events (NLE) have been associated with increased alcohol use (AU) during adolescence. However, whether this risk association may be modified by leisure activities such as sports participation (SP) remains poorly understood. This study examined whether accumulated family-specific NLE in particular were associated with greater AU, and if so, whether SP moderated this association to reduce AU among high-NLE adolescents. We examined five annual assessments from a nationwide cohort of 3,422 Norwegian adolescents (13-15 year-olds; 55.3 % girls at baseline) who participated in the MyLife study. At each assessment, adolescents reported their AU on the Alcohol Use Disorders Identification Test-Concise (AUDIT-C), the number of family-specific NLE in the past 12 months, SP days in the past 30 days, and multiple sociodemographic and individual-level characteristics (covariates). Changes over time in AU as a function of NLE, SP, and their interaction (NLExSP) were examined with a set of partially nested growth curve models. AU increased non-linearly over time in all models. The fully adjusted best-fitting model showed significant NLExSP interactions (estimate = -0.013, 95% CI [-0.02, -0.006]), such that the initial AUDIT-C scores were lower for high-NLE adolescents with high SP and greater for high-NLE adolescents with low SP. Further, linear increases in AU over time were marginally steeper for high-NLE adolescents with high SP (NLExSPxTime estimate = 0.034, 95% CI [-0.0002, 0.007]). Thus, SP appeared to have a protective role in reducing AU for high-NLE youth primarily during middle school years. Prevention efforts thus may utilize organized sports for youth facing family-specific NLE as a resource early on., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

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. [ABSTRACT FROM AUTHOR]

Aims: To examine the prevalence of and trends in older adults' (60–79 years) alcohol use in Norway between 1985 and 2019. Methods: Data stem from two repeated cross-sectional surveys in the Norwegian population: Statistics Norway's Health and Living Conditions Surveys from 1985 (N = 7799), 1995 (N = 3518) and 2005 (N = 6487), and the Norwegian Institute of Public Health's (NIPH) annual surveys on alcohol, tobacco and drug use from 2012/2013 (N = 4047), 2014/2015 (N = 4378), 2016/2017 (N = 4264) and 2018/2019 (N = 4330). The following measures were used to examine trends in alcohol use among women and men aged 60 and older: drinking status, drinking frequency, number of drinks per occasion, and frequency of heavy episodic drinking (HED). Results: Between 1985 and 2019, there has been a substantial increase in the proportions of older adults in Norway who drink alcohol and who drink relatively often. The increase was particularly marked between 1985 and 2012/2013, and for elderly women. However, the majority of older adults drink small amounts of alcohol on typical drinking occasions, illustrating that the increased frequency of drinking is not accompanied by a corresponding increase in risky drinking. Conclusions: There has been a marked increase in alcohol use among older adults the past 30 years, particularly among older women, suggesting that the age and gender gap traditionally found in alcohol use in Norway is diminishing. Due to the lower alcohol tolerance among elderly, monitoring the changing trends in alcohol use in this group, as well as the possible consequences of these changes, is important. [ABSTRACT FROM AUTHOR]

The study investigates correlates (i.e. demographics, personality, alcohol use and alcohol-related harm, alcohol expectancies, and mental health) of different alcoholic beverage preferences (i.e. beer/alcopops/cider, wine, and liquor/spirits). Data were collected by an online survey during fall 2016. Participants were invited to the survey based on participation in a former survey that was sent to students in Bergen, Norway, in fall 2015. The current sample consists of 5,217 participants. A multinomial regression analysis was conducted, where alcoholic beverage preferences comprised the dependent variable. Several correlates were associated with beverage preferences. For instance, being a woman and the personality trait conscientiousness were inversely related to a preference for beer/alcopops/cider while positively associated with a preference for wine. Preferences for wine or liquor/spirits were positively associated with depression and inversely related to anxiety. Conscientiousness as a personality trait might be a common factor in the relationship between wine preference and favourable health outcomes, and this trait should be controlled for in future studies. The current findings seem contrary to the assumed gender equality in Norway, where the strong association between sex and alcoholic beverage preferences suggests that traditional gender divisions prevail even in the current young and urban sample. [ABSTRACT FROM AUTHOR]

Aims: There is increased concern about the use of alcohol and illicit drugs in nightlife settings. Most studies of substance use in nightlife settings are from the patrons' perspective, which leaves an understudied population – the nightclub staff. The aim of this paper is to study self-reported alcohol and substance use among staff at licensed premises in Norway: types of illicit drugs used, attitudes towards drugs, and observed drug use among patrons. Methods: A survey was conducted at server-training courses in 20 different cities in Norway during 2015. The survey included: demographics, respondents' own alcohol and drug experience, attitudes towards drug use, and observed drug use among patrons at licensed premises. Results: Data were collected from 912 staff working at licensed premises. A majority reported alcohol use in the past year, and 61% reported alcohol use two or more times a month. Overall, 45% of the respondents reported ever-used of illicit drugs. The four most commonly used drugs among staff were cannabis, cocaine, ecstasy/MDMA, and amphetamine. The majority of respondents supported Norway's strict drug laws, and 63% reported observing drug-intoxicated patrons at licensed premises during the past six months. Conclusions: The proportion of frequent drinkers and heavy episodic drinking among staff at licensed premises was high, and the prevalence of illicit drug use was much higher compared with the general population. Thus, staff at licensed premises can be considered a risk-group for alcohol and illicit drug use and therefore represent an important target population in club drug-prevention programmes. [ABSTRACT FROM AUTHOR]

Background: How youth perceive harmfulness of risk behaviors such as substance use relates to their engagement in those behaviors. Yet, little is known about how different substance use modes (i.e., variations in amounts and use frequencies) are perceived. We investigated how adolescent perceptions of harmfulness of various alcohol- and cannabis use modes changed over time, compared to one another, and related to actual substance use behaviors.Methods: We examined nationally-representative repeated cross-sectional samples of 16-year olds in Norway, assessed in 2007, 2011, and 2015 (NTotal = 9296) as part of the European School Survey Project on Alcohol and Other Drugs (ESPAD). Adolescents reported their: 1) lifetime alcohol- and cannabis use, and 2) perceived harmfulness of various alcohol- and cannabis use modes.Results: Prevalence estimates for perceived harmfulness: 1) remained high and stable, or increased for alcohol use modes, and 2) declined for all cannabis use modes (i.e., using 1-2 times, occasionally, and regularly) since 2007-cohort. High quantity daily drinking was more commonly perceived as harmful than minimal or occasional cannabis use. Even though culturally-relevant use modes (i.e., weekend heavy drinking and experimental cannabis use) were not most commonly endorsed as harmful, only perceptions of those use modes as harmful were inversely associated with actual substance use.Conclusions: How adolescents from Norway perceived harmfulness of alcohol- and cannabis use depended on the specific substance, its use modes, and secular cohort. Perceived harmfulness was associated with measures of actual substance use predominantly along the culturally- and adolescent-relevant modes of use. [ABSTRACT FROM AUTHOR]

Abstract: Aims: To investigate how use of alcohol, illicit drugs and tobacco come from substance‐specific pathways and from pathways general to all three substances through adolescent development. Design: Analysis of population‐based survey. Adolescent twins reported alcohol use (AU), tobacco use (TU) and illicit drug use (IDU) in three waves (2006, 2008, 2010). Restructuring data by age allowed for variance decomposition into age‐ and substance‐specific and common genetic and environmental variance components. Setting: Norway. Participants: Seven national twin birth cohorts from 1988 to 1994, totalling 1483 pairs (558 monozygotic; 925 dizygotic, same and opposite sex). Measurements: Six‐point Likert scores of AU, TU and IDU on items from the Monitoring the Future Study. Findings: Substance use was found to be highly heritable; a2 = 0.73 [95% confidence interval (CI) = 0.61–0.94] for AU, a2 = 0.36 (CI = 0.18–0.52); d2 = 0.49 (95% CI = 0.29–0.62) for IDU and a2 = 0.46 (95% CI = 0.23–0.54); d2 = 0.05 (95% CI = 0.00–0.07) for TU during the whole adolescence period. General substance use (GSU) was also highly heritable at each age and averaged a2 = 0.57 (95% CI = 0.48–0.66). There was a high genetic carry‐over from earlier age to later age. Genetic effects on GSU at ages 12–14 years were still detectable 4 years later. New substance (general and specific)‐genetic effects also appeared. IDU demonstrated significant non‐additive genetic effects (ages 12–14 years). Shared environment had a small impact on AU only. There was almost no non‐shared environmental carry‐over from age to age, the effect probably due partly to reliability deficiency. Common genetic effects among substance and substance‐specific genetic effects were observed at each age‐period. Conclusions: Among Norwegian adolescents, there appear to be strong genetic effects on both substance‐specific and comorbid use of alcohol, illicit drugs and tobacco; individual differences in alcohol use can be explained partially by family background. [ABSTRACT FROM AUTHOR]

Objective: To describe potential differences in unhealthy behaviours among ethnic Norwegian adolescents and minority adolescents from countries within the European Union, European Economic Area or US (EU/EEA countries) and adolescents from non-EU/EEA countries. Specifically, we aimed to investigate ethnic differences in use of alcohol, tobacco and illicit drugs, and potential confounding due to socio-demographic characteristics. Design: Cross-sectional population-based study of adolescents aged 16–19 (N = 10,122), with self-reported ethnicity as grouping variable, and self-reported use of alcohol, tobacco and illicit drugs as dependent variables. Results: We found that minority adolescents from EU/EEA and non-EU/EEA countries differed from ethnic Norwegian adolescents on important indicators of unhealthy behaviours. Compared to Norwegian adolescents, adolescents from EU/EEA were more likely to report having tried to smoke, to be a daily smoker and to ever having tried an illicit drug (adjusted odds ratio (OR) ranging from 2.01 to 3.74). They were, however, less likely to have tried snus (a form of smokeless tobacco; adjusted OR 0.64; confidence interval (CI) 95% 0.43–0.97) and to report daily snus use (adjusted OR 0.31; CI95% 0.15–0.67). There were no differences in having tried alcohol. Non-EU/EEA adolescents were less likely to have ever tried alcohol (OR 0.24; CI95% 0.18–0.31), snus (OR 0.47; CI95% 0.34–0.65) and to smoke (0.68; CI95% 0.52–0.91), and less likely to report daily snus use (OR 0.36; CI95% 0.21–0.62) compared to Norwegian adolescents. There were no differences with regard to having tried illicit drugs and reporting being a daily smoker. All differences observed were robust to adjustment for age, gender and family socio-economic status. Conclusion: The presents study identified important differences in unhealthy behaviours across different ethnic groups in Norway. The differences in the prevalence of unhealthy behaviours among ethnic minorities are still relevant in a public health perspective, and potential mechanisms should be investigated further. [ABSTRACT FROM PUBLISHER]

Background: Alcohol use is a global health issue and may influence activity performance in a variety of domains, including the occupational and domestic spheres. The aim of the study was to examine the influence of annual drinking frequency and binge drinking (≥6 units at one occasion) on activity impairments both at work (sickness presenteeism) and outside the workplace. Methods: Employees (n = 3278), recruited from 14 Norwegian private and public companies, responded to a questionnaire containing questions from the Alcohol Use Disorders Identification Test (AUDIT) and the Workplace Productivity and Activity Impairment questionnaire (WPAI). Results: Multiple hierarchical regression analyses revealed that binge drinking was associated with both sickness presenteeism and impaired daily activities, even after controlling for gender, age, educational level, living status and employment sector. Annual drinking frequency was associated with impaired daily activities, but not sickness presenteeism. Conclusions: Binge drinking seems to have a stronger influence on activity performance both at work and outside the workplace than drinking frequency. Interventions targeting alcohol consumption should benefit from focusing on binge drinking behavior. [ABSTRACT FROM AUTHOR]

Background: A clearer understanding of the etiological overlap between DSM-IV personality disorders (PDs) and alcohol use (AU) and alcohol use disorder (AUD) is needed. To our knowledge, no study has modeled the association between all 10 DSM-IV PDs and lifetime AU and AUD. The aim of the present study is to identify which PDs are most strongly associated with the phenotypic, genetic, and environmental risks of lifetime AU and AUD, and to determine if these associations are stable across time.Methods: Participants were Norwegian twins assessed at two waves. At Wave 1, 2801 twins were assessed for all 10 DSM-IV PD criteria, lifetime AU, and DSM-IV AUD criteria. At Wave 2, six of the 10 PDs were again assessed along with AU and AUD among 2393 twins. Univariate and multiple logistic regressions were run. Significant predictors were further analyzed using bivariate twin Cholesky decompositions.Results: Borderline and antisocial PD criteria were the strongest predictors of AU and AUD across the two waves. Despite moderate phenotypic and genetic correlations, genetic variation in these PD criteria explained only 4% and 3% of the risks in AU, and 5% to 10% of the risks in AUD criteria, respectively. At Wave 2, these estimates increased to 8% and 23% for AU, and 17% and 33% for AUD.Conclusions: Among a large Norwegian twin sample, borderline and antisocial PD criteria were the strongest predictors of the phenotypic and genotypic liability to AU and AUD. This effect remained consistent across time. [ABSTRACT FROM AUTHOR]

Background: The aims were (1) to map how problematic people perceive it to be that a person experiences different types of harm from others' drinking, (2) to describe how problematic victims of harm from others' drinking perceive the experience to be, and 3) to investigate how perceptions of harm from others' drinking vary according to demographic characteristics, own drinking and experience of harm.Methods: 2182 persons in Norway aged 18-69 years participated in a panel web survey in 2013. They responded to questions about six types of harm from others' drinking.Results: Both people with and without experience of harm from others' drinking perceived it as problematic that someone experiences such harm. Moreover, persons with experience of harm perceived their own experience of harm as less problematic than they perceived it that someone else should experience harm. While people with and without experience of harm from others' drinking perceive the same types of harm from others' drinking as least problematic, they differed with regards to which types of harms they perceived as most problematic. Perceptions of harm varied according to demographic characteristics, own drinking and experienced harm.Conclusion: The fact that people both with and without experience of harm from others' drinking perceived it as problematic that someone experiences such harm may be used as an argument for implementing and/or retaining effective alcohol policy measures. The contrast in perception of experienced harm and how problematic it is that someone else experiences harm suggest that the questions used within this survey tradition may be too general to provide meaningful information about prevalence and severity of experienced harm from others' drinking. Future research should address this further. [ABSTRACT FROM AUTHOR]

Introduction and Aims: Adolescence is a period in which many have an onset of alcohol use, but there is much heterogeneity in the individual development of alcohol use. Further, there is a general increase in depressive symptoms from early to late adolescence, but less is known about how different alcohol habit trajectories are associated with symptoms of depression. The aims of the present study were: to identify trajectories of alcohol consumption and drinking to intoxication during adolescence (age 13-18 years); and examine to what extent the different trajectories of alcohol use were associated with symptoms of depression over the same age span, from early to late adolescence.Methods: Data from the Norwegian Longitudinal Health Behaviour Study were employed. Latent class growth analyses were employed to identify different trajectories of both alcohol consumption and drinking to intoxication. The resulting trajectories for each participant were used to estimate the gender-adjusted association between different development of alcohol use and symptoms of depression.Results: Four trajectories of both alcohol consumption and drinking to intoxication were identified. The trajectories with an early onset of alcohol consumption or drinking to intoxication were associated with higher levels of depressive symptoms compared with late onset or stable low use trajectories.Conclusions: The findings from the present study suggest that early onset developmental trajectories of alcohol use are associated with depression. Therefore, broad assessment and interventions targeting both alcohol and depression may be indicated among early onset alcohol users, especially if they report increasing levels of consumption. [Skogen JC, Knudsen AK, Hysing M, Wold B, Sivertsen B. Trajectories of alcohol use and association with symptoms of depression from early to late adolescence: The Norwegian Longitudinal Health Behaviour Study. Drug Alcohol Rev 2016;35:307-316]. [ABSTRACT FROM AUTHOR]

Objectives: In this study, we examined changes in alcohol consumption in the aftermath of a natural disaster, as well as possible predictors of both increased and decreased drinking. Study design: Observational longitudinal study. Methods: Repatriated Norwegian adults who resided in areas affected by the 2004 Southeast Asia tsunami completed a questionnaire at 6 and 24 months postdisaster (N = 649). Results: Weekly alcohol consumption and frequency of intoxication did not change significantly from 6 to 24 months postdisaster at the population level: 18.3% (n = 116) increased their alcohol consumption while 21.1% (n = 125) showed a reduction. Increased drinking was not predicted by severity of disaster exposure, post-traumatic stress, or measures of psychological functioning. Reduced alcohol consumption was predicted by younger age and social withdrawal, but not by any of the other study variables. Conclusion: Our findings indicate that the tsunami experience had only minor effects on alcohol consumption, in contrast to some studies suggesting a relationship between trauma exposure and increased alcohol consumption. [ABSTRACT FROM AUTHOR]

Persons with alcohol use disorder (AUD) and drug use disorder (DUD) have a lower life expectancy than the general population. We examined the burden of somatic diseases among persons with AUD or DUD and investigated impact of socioeconomic status (SES) and mental health disorders on the co-occurrence of somatic diseases in these groups. We performed a retrospective, register-based cohort study with a 6-year follow-up of persons (aged ≥18 y) with AUD (13,478) or DUD (16,659). Cox regression analyses were used to estimate hazard ratios (HRs) of somatic diseases. Patients with DUD were, on average, 10 years younger at the point of diagnosis than patients with AUD. Mental illnesses were prominent in both groups (AUD: 40.5%, and DUD: 46.9% vs 3.5% in controls). Adjusting for mental disorders, the risk of all somatic diseases among the AUD and DUD groups was reduced by 30%. Some of the elevated risk of somatic diseases among persons with AUD and DUD is explained by low SES, though less than that explained by the presence of mental disorders. The diseases with highest risk among AUD patients were metabolic disorders (16.9-fold) and hypertension (14.8-fold), and among AUD patients, viral hepatitis (23.3-fold), after adjusting for low SES and mental disorders. Persons with AUD had a higher risk of most somatic diseases, while those with DUD had specific risks for infections and viral hepatitis. Mental health disorders and SES adjusted the associations regarding most somatic diseases. In general, improvement of socio-economic conditions, preferably in combination with professional support to self-manage mental health problems, will reduce the risk of somatic illness in both groups. For DUD patients, available sterile user equipment will reduce the risk of viral hepatis. • Mental illness and SES increase the risk of somatic illness in patients with SUD • AUD and DUD patients have increased risk for different somatic diseases • AUD patients are approximately ten years older than DUD patients when they receive a SUD diagnosis [ABSTRACT FROM AUTHOR]

Background: Little population-based data among middle-aged adults exists examining the relationships between depressive symptoms, alcohol use, and socio-economic status (SES). This study aimed to describe the relationships between depressive symptoms and alcohol use at different levels of SES and to determine differences across SES levels among a population-based sample of 40 and 45 year old adults in Norway.Methods: This analysis was based on data from two Norwegian health studies conducted in 2000 and 2001, and included community-dwelling Norwegian men and women aged 40 and 45 years. Self-reported frequency and quantity of alcoholic drinks was used to calculate past-year typical quantity of drinks consumed and frequency of 5+ drinks per occasion, or heavy episodic drinking (HED). Depressive symptoms were assessed with the 10-item Hopkins Symptom Checklist, and SES was measured as education level and employment status. To observe the association between depressive symptoms and alcohol use at each level of SES we fitted multinomial logistic regression models using each alcohol outcome as a dependent variable stratified by level of education and employment. To observe differences across levels of SES, we examined the interaction between depressive symptoms and SES level in multinomial logistic regression models for each alcohol measures.Results: Having depressive symptoms was significantly associated with an increased risk of 5+ typical drinks among people in the lowest (RRR = 1.60, p ≤ 0.05) education level, and not among people in the highest. Conversely, significant associations were observed among all levels of employment. For frequency of HED, depressive symptoms was not significantly associated with frequency of HED at any education level. Depressive symptoms was associated with 13+ past year HED episodes among people with no employment (RRR = 1.97, p ≤ 0.05), and part-time employment (RRR = 2.33, p ≤ 0.01), and no association was observed among people with full-time employment. A significant interaction was observed for depressive symptoms and employment for risk of 13+ past-year HED episodes.Conclusions: The results show a variety of associations between depressive symptoms and alcohol use among people with lower SES, and suggest type of alcohol use and SES measure may influence the observation of an association between depressive symptoms and alcohol use at different SES levels. [ABSTRACT FROM AUTHOR]

Background and aims An early age of alcohol initiation ( AAI) is associated with and has been hypothesized to be a cause of alcohol use disorders ( AUD) in adulthood. Results from twin studies, however, indicate that AAI is an indicator of risk for AUD. We aimed to test a causal hypothesis versus a risk indicator hypothesis for the relationship between early AAI and AUD. Design A population-based twin study using biometric twin modelling. Setting Norway. Participants A population-based sample of 1336 Norwegian twins. Measurements Life-time DSM- IV AUDs were assessed by structured clinical interview and AAI by questionnaire. Findings The risk indicator model in which the association between AAI and AUD was explained by common vulnerability was the best fitted to the data. The heritability was 37% [95% confidence interval ( CI) = 21%, 53%] for AAI and 62% (95% CI = 51%, 73%) for AUD. Genetic risk for AAI accounted for 44% (95% CI = 17%, 71%) of the total genetic risk for AUD and the correlation between genetic factors for AAI and AUD was −0.66 (95% CI −0.87, −0.46). Individual-specific environmental risk for AAI explained only 1% (95% CI = 0%, 3%) of the risk for AUD. Shared environmental factors did not influence AUD, but accounted for 25% (95% CI = 7%, 35%) of the variance in AAI. Conclusions The association between early age of alcohol initiation and alcohol use disorders in later life does not reflect a causal relationship, but is due almost entirely to common genetic risk factors. [ABSTRACT FROM AUTHOR]

Background: Alcohol drinking is a risk factor for harm and disease. A low level of drinking among non-Western immigrants may lead to less alcohol-related harm and disease. The first aim of this study was to describe frequency of drinking in two generations of immigrants in Oslo, contrasting the result to drinking frequency among ethnic Norwegians. The second aim was to study how frequency of drinking among adult immigrants was associated with social interaction with their own countrymen and ethnic Norwegians, acculturation, age, gender, socioeconomic factors and the Muslim faith. Method: The Oslo Health Study (HUBRO) was conducted during the period 2000 to 2002 and consisted of three separate surveys: a youth study (15-16-year-olds, a total of 7343 respondents, response rate 88.3%); adult cohorts from 30 to 75 years old (18,770 respondents, response rate 46%); the five largest immigrant groups in Oslo (aged 20-60 years, a total of 3019 respondents, response rate 39.7%). Based on these three surveys, studies of frequency of drinking in the previous year (four categories) were conducted among 15-16-year-olds and their parents' generation, 30-60-year-old Iranians, Pakistanis, Turks and ethnic Norwegians. A structural equation model with drinking frequency as outcome was established for the adult immigrants. Results: Adults and youth of ethnic Norwegian background reported more frequent alcohol use than immigrants with backgrounds from Iran, Turkey and Pakistan. Iranians reported a higher drinking frequency than Turks and Pakistanis. In the structural equation model high drinking frequency was associated with high host culture competence and social interaction, while high own culture competence was associated with low drinking frequency. Adult first-generation immigrants with a longer stay in Norway, those of a higher age, and females drank alcohol less frequently, while those with a higher level of education and work participation drank more frequently. Muslim immigrants reported a significantly lower drinking frequency than non-Muslims, although this did not apply to Iranians. Conclusions: The existence and growth in Western societies of immigrant groups with low-level alcohol consumption contributed to a lower level of consumption at the population level. This may imply reduced drinking and alcohol-related harm and disease even among ethnic Norwegians. [ABSTRACT FROM AUTHOR]

Background: In this paper, we investigate cross-sectional and prospective relationships between various socioeconomic indicators and different health behaviours among boys and girls at ages 13-21, and whether socioeconomic status (SES) is related to changes in health behaviour over time. Methods: The study is based on a 10-year, two-generation prospective cohort study of health and lifestyle factors among a sample of Norwegian adolescents and their parents. Data presented here were collected at the ages of 13 (baseline), 15, 18 and 21. Parental and adolescent reports of socioeconomic factors were assessed along with a number of health-enhancing and health-compromising behaviours, both as single behaviours and as part of health behaviour indices. Results: Relatively few significant relationships are observed between parental occupation and adolescents' reported health behaviour when the latter is analysed as single behaviours. A significant, but weak, social gradient in health-enhancing behaviour is observed when measuring health behaviour as composite indices rather than single forms of behaviour. This is apparent both when applying parental SES variables or adolescents' own educational aspirations as proxy measures of their socioeconomic status. Conclusion: Future investigations of the presence of a social gradient in adolescent health behaviour should focus on composite measures of health behaviour. Further research is needed on potential mediating mechanisms behind the SES-health behaviour relationships in youth. [ABSTRACT FROM AUTHOR]

Aims To assess the association between drinking behaviour among adolescents with both immigrant and native backgrounds with aspects of acculturation. Design Cross-sectional school survey among 15–16 year olds. Setting and participants All students, a total of 8361, in 10th grade during spring 2000 and 2001 in Oslo, Norway with response rate 88.3%. The sample consisted of 1213 students with an immigrant background and 4627 students with a Norwegian background. Measurements Indicators of the length of the acculturation process were assessed as first versus second generation and in terms of length of stay in Norway. The proportion of Muslim students in school was an indicator of social environment ‘dryness’. Drinking behaviour was assessed as drinking alcohol ever, drinking frequency and intoxication frequency. Findings A smaller proportion of immigrant students were current drinkers, frequent drinkers and drank to intoxication compared with adolescents with a Norwegian background. Adjusted two-level analyses showed that alcohol drinking was less common among immigrant students with a short stay in Norway and with a large proportion of Muslim students in school. In those with a Norwegian background there was a larger proportion of abstainers, and those who drank did so less frequently and were less frequently intoxicated the larger the proportion of Muslim students there was in their school. Conclusion Drinking behaviour among adolescents in a multicultural and heterogeneous society seems to reflect a bi-directional acculturation process where the majority population tend to adapt to the behaviours of the immigrant population which in turn, to a varying degree, tends to adapt to the behaviour of the majority population. [ABSTRACT FROM AUTHOR]

Little is known about possible changes in alcohol consumption distribution during the COVID-19 pandemic. We estimated how individual changes in alcohol consumption during the pandemic translated into changes in: (i) mean consumption; (ii) dispersion of consumption distribution; and (iii) prevalence of heavy drinkers. We employed data from two independent web-surveys of Norwegian adults collected between April and July 2020 and limited to those reporting past year alcohol consumption ( N 1 = 15,267, N 2 = 1195). Self-reports of changes in drinking behavior were quantified, assuming change being relative to baseline consumption level. During the pandemic, we found a small increase (Survey 1) or no change (Survey 2) in estimated mean alcohol consumption (which parallels to total consumption). However, in both surveys, the dispersion of the distribution increased significantly ( p < 0.001). For most respondents, an average modest decline in consumption was found. However, the small fraction with the highest baseline consumption increased their consumption substantially, and in effect, the proportion of heavy drinkers increased markedly ( p < 0.001). In conclusion, quantifications of reported changes in alcohol consumption during the pandemic suggest that the upper 5 to 10% of the drinkers increased their consumption and hence the prevalence of heavy drinkers increased, despite little or no change in total alcohol consumption.

Background: For alcohol, the association with socioeconomic status (SES) is different than for other public health challenges - the associations are complex, and heterogeneous between socioeconomic groups. Specifically, the relationship between alcohol consumption per se and adverse health consequences seems to vary across SES. This observation is called the 'alcohol harm paradox'. This study aims to describe different patterns of alcohol use and potential problems. Next, the associations between sub-groups characterized by different patterns of alcohol use and potential problems, and age, gender, educational level, full-time employment, occupational level and income is analysed., Methods: Employing data from the ongoing cross-sectional WIRUS-study, N = 4311 participants were included in the present study. Individual response patterns of the ten-item Alcohol Use Disorders Identification Test (AUDIT) were analysed and latent class analysis (LCA) was used to identify latent groups. Next, the associations between the classes identified in the best fitting LCA-model and sociodemographic factors were analysed and presented., Results: We identified three classes based on the response patterns on AUDIT. Class 1 was characterised by low-level alcohol consumption and very low probability of negative alcohol-related consequences related to their alcohol consumption. Class 2 was characterised by a higher level of consumption, but despite this, class 2 also had a relatively low probability of reporting negative alcohol-related consequences. Class 3, however, was characterised by high levels of alcohol consumption, and a high probability of reporting negative consequences of their consumption. The classes identified were systematically differentially associated with the included measures of SES, with class 3 characterised by younger age, more males and lower educational attainment., Conclusions: Our findings highlight the interconnectedness of alcohol consumption and alcohol-related consequences. Furthermore, the identified classes and SES yields further insights into to intricate relationship between various socioeconomic factors, alcohol use patterns and related negative consequences.

Background: The degree to which the relationship between alcohol use and sleeplessness is unidirectional or reciprocal is unclear due to great variation among the results of previous studies. The aim of the present study was to investigate if the relationship between alcohol use and sleeplessness is bidirectional by exploring how the change in and stability of alcohol use were related to sleeplessness, and vice versa, how the change in and stability of sleeplessness were related to alcohol use, in a longitudinal study spanning 13 years., Method: Data were collected from 9941 adults who participated in two waves (T1: 1994-1995, and T2: 2007-2008) of the Tromsø Study, a Norwegian general population health study. Alcohol use was measured by questions asking about the frequency of drinking, amounts of alcohol normally consumed and the frequency of binge drinking, whereas sleeplessness was measured by one item asking about the frequency of experiencing sleeplessness. Variables representing change in and stability of consumption of alcohol and sleeplessness from T1 to T2 were created. Logistic regression analyses, stratified by gender, were used to analyze the data., Results: Men reporting stable high (OR = 2.11, p. < .001) or increasing (OR = 1.94, p. < .01) consumption of alcohol from T1 to T2 had a significantly higher risk of reporting sleeplessness at T2. Likewise, men experiencing stable (OR = 1.84, p. < .01) or increasing (OR = 1.78, p. < .001) sleeplessness from T1 to T2 had a significantly higher risk of reporting high consumption of alcohol at T2. No significant effects were detected among women., Conclusion: The findings indicate a bidirectional relationship between high consumption of alcohol and sleeplessness only among men. Thus, healthcare professionals ought to be informed about the health risks associated with excessive drinking and struggling with sleeplessness, especially in men.

Background: Alcohol use by employees is associated with negative consequences for the workplace in terms of absence and poor work performance. The aims of this study were to map the prevalence of alcohol-related absence and inefficiency using survey data from a broad sample of employees, and to explore how alcohol-related absence and presenteeism are experienced and handled using data from qualitative interviews., Methods: The prevalence data stems from a web survey completed by 1940 Norwegian employees aged 20-74 years. The qualitative data consists of analyses of 24 interviews with managers, co-workers of heavy drinking employees, and heavy drinking employees, from various lines of businesses., Results: 1-2% reported alcohol-related full day absence in the last 12 months, and 2% reported partial day absence; 11% reported inefficiency due to drinking the previous day. Analyses of interview data revealed that alcohol-related absence and presenteeism may cause a range of economic and practical problems. Managers reported spending a lot of resources and effort on single cases. In addition, the results showed how the presence of a heavy drinking employee may have a negative impact on the broader psychosocial environment, and cause concern for workplace safety. Due to consideration of the drinker's well-being and fear of negative reactions, problem cases can last for years., Conclusions: Despite the relatively low prevalence of alcohol-related absence and inefficiency, the study suggest that the alcohol-related problems of a few, or only one, employee may still have substantial and far-reaching negative consequences for the workplace., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Aim: To evaluate the effectiveness of the Healthy School and Drugs programme on alcohol, tobacco and marijuana use among Dutch early adolescents., Design: Randomized clustered trial with two intervention conditions (i.e. e-learning and integral)., Setting: General population of 11-15-year-old adolescents in the Netherlands., Participants: A total of 3784 students of 23 Dutch secondary schools., Measurements: Structured digital questionnaires were administered pre-intervention and at 32 months follow-up. The primary outcome measures were new incidences of alcohol (life-time and 1-month prevalence), tobacco (life-time and 1-month prevalence) and marijuana use (life-time prevalence)., Findings: Main effect analyses showed no programme effects on incidences of alcohol consumption (life-time prevalence: e-learning condition: B = 0.102, P = 0.549; integral condition: B = -0.157, P = 0.351; 1-month prevalence: e-learning condition: B = 0.191, P = 0.288; integral condition: B = -0.140, P = 0.445), tobacco consumption (life-time prevalence: e-learning condition: B = 0.164, P = 0.444; integral condition: B = 0.160, P = 0.119; 1-month prevalence: e-learning condition: B = 0.088, P = 0.746; integral condition: B = 0.261, P = 0.093), or marijuana consumption (life-time prevalence: e-learning condition: B = 0.070, P = 0.732; integral condition: B = 0.186, P = 0.214)., Conclusion: The non-significant impact of the Healthy School and Drugs programme (a Dutch school-based prevention programme for early adolescents) on incidences of alcohol, tobacco and marijuana use indicates that the programme is either ineffective or implemented inadequately., (© 2014 Society for the Study of Addiction.)

Objectives: To investigate whether maternal negative affectivity, a tendency to frequent negative emotions and views, is associated with light alcohol use and binge drinking during pregnancy., Design: Cohort., Setting: Norway 1999-2008., Population: The study includes complete information on 66 111 pregnant women and their partners., Methods: We used data from the Norwegian Mother and Child Cohort study (MoBa) representing 39% of the pregnant population., Main Outcome Measures: Light alcohol use (0.5-2 units one to four times per month) and binge drinking (an intake of 5 alcohol units or more) measured with the Alcohol Use Disorder Identification Test-Consumption (AUDIT-C)., Results: For each unit increase in maternal negative affectivity the odds for light alcohol use increased with 27% in the first trimester [95% confidence interval (CI) 1.19-1.36], and 28% in the second trimester (95% CI 1.18-1.39). With respect to binge drinking, each unit increase in maternal negative affectivity was associated with 55% higher odds in the first trimester (95% CI 1.44-1.67), and 114% higher odds in the second trimester (95% CI 1.70-2.69)., Conclusions: Negative affectivity is associated with both light alcohol use and binge drinking during pregnancy. The mechanisms mediating the relation between negative affectivity and alcohol use in pregnancy should be investigated further., (© 2013 Nordic Federation of Societies of Obstetrics and Gynecology.)