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Abstract
Aim To test if being exposed to increased alcohol availability during adolescence is associated with an increased risk of receiving disability pension due to all-cause, alcohol use disorders and mental disorders.
Design Register-based population-based study using a natural experiment setting, the alcohol policy change in Sweden (1967-1968), with increased access to strong beer in a narrow time window and geographical area. The individuals exposed to the policy change were compared to non-exposed individuals living in the rest of Sweden, excluding a border area.
Setting Sweden
Participants A total of 518 810 individuals (70 761 in the intervention group; 448 049 in the control group) born 1948-1953, aged 14-20 years old during the policy change.
Measurements Date and diagnosis of the outcome variable of disability pension due to all-cause, alcohol use disorders and mental disorders was obtained from the Swedish National Social Insurance Agency database from 1971 to 2013. Individual and family level sociodemographic and health related covariates, as well as a regional level covariate was included.
Findings Compared to the control group, adolescents exposed to the alcohol policy change were at an increased risk of receiving disability pension due to all-causes (HR 1.09, 95% CI 1.07-1.11), alcohol use disorders (HR 1.17, 95% CI 1.05-1.30) and mental disorders (HR 1.19, 95% CI 1.15- 1.23).
Conclusion The results obtained in a natural experimental setting suggests that being exposed to increased alcohol availability during adolescence is associated with an increased risk of receiving disability pension due to all-cause, alcohol use disorders and mental disorders.
Design Register-based population-based study using a natural experiment setting, the alcohol policy change in Sweden (1967-1968), with increased access to strong beer in a narrow time window and geographical area. The individuals exposed to the policy change were compared to non-exposed individuals living in the rest of Sweden, excluding a border area.
Setting Sweden
Participants A total of 518 810 individuals (70 761 in the intervention group; 448 049 in the control group) born 1948-1953, aged 14-20 years old during the policy change.
Measurements Date and diagnosis of the outcome variable of disability pension due to all-cause, alcohol use disorders and mental disorders was obtained from the Swedish National Social Insurance Agency database from 1971 to 2013. Individual and family level sociodemographic and health related covariates, as well as a regional level covariate was included.
Findings Compared to the control group, adolescents exposed to the alcohol policy change were at an increased risk of receiving disability pension due to all-causes (HR 1.09, 95% CI 1.07-1.11), alcohol use disorders (HR 1.17, 95% CI 1.05-1.30) and mental disorders (HR 1.19, 95% CI 1.15- 1.23).
Conclusion The results obtained in a natural experimental setting suggests that being exposed to increased alcohol availability during adolescence is associated with an increased risk of receiving disability pension due to all-cause, alcohol use disorders and mental disorders.
| Original language | English |
|---|---|
| Pages (from-to) | 1004–1012 |
| Number of pages | 9 |
| Journal | Addiction |
| Volume | 112 |
| Issue number | 6 |
| Early online date | 7 Feb 2017 |
| DOIs | |
| Publication status | Published - Jun 2017 |
Keywords
- Natural experiment
- adolescent alcohol consumption
- disability pension
- alcohol policy
- alcohol availability
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