Stronger alcohol-violence association when adolescents drink less? Evidence from three Nordic countries

BACKGROUND: Since 2000, adolescents’ alcohol use and heavy episodic drinking (HED) have declined in the Nordic countries. However, little is known about corresponding trends in alcohol-related harm and possible changes in the alcohol-harm association. The aims are to examine (i) whether the decline in HED was accompanied by a decline in alcohol-related violence (AV) and (ii) whether the strength of the HED-AV association changed concomitant with the decline. METHODS: Analysis of data from the European School Survey Project on Alcohol and Other Drugs (ESPAD), conducted among 15–16-year-olds in Iceland, Norway and Sweden in 2007 and 2015 (n = 17 027). Changes in proportions of AV and alcohol use past 12 months, and mean frequency of HED past 30 days were examined using Pearsons χ(2)-test and F-test, respectively. The HED-AV associations were estimated using logistic regression analysis. RESULTS: HED and AV proportions decreased from 2007 to 2015 in all countries. Among current drinkers (n = 8927), both HED frequency and AV proportion decreased in Norway (P < 0.001) and remained stable in Iceland. In Sweden, AV decreased (P < 0.001) whereas HED remained stable. The magnitude of the HED-AV association increased in Norway (Beta(2015–2007) = 0.145, 95% CI 0.054–0.236), remained the same in Iceland and decreased in Sweden (Beta(2015–2007) = −0.082, 95% CI −0.158 to −0.005). CONCLUSIONS: Among youth in Iceland, Norway and Sweden, heavy episodic drinking and alcohol-related violence declined from 2007 to 2015. Among drinkers, the strength of the alcohol-violence association was moderated by the extent of heavy episodic drinking.