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

Aims: The aim of this study was to investigate: (1) whether self-reported acute alcohol-related consequences among adolescents in the Nordic countries have declined in concert with the decline in alcohol consumption; (2) whether the relationship between alcohol consumption and alcohol-related consequences has strengthened; and (3) whether the decline in alcohol-related consequences can be attributed to the decline in alcohol consumption. Methods: Data are from the European School Survey Project on Alcohol and Other Drugs (ESPAD) cross-sectional surveys in 2007, 2011 and 2015. Participants were students aged 15-16 years in 2007 (n = 16,035), 2011 (n = 14,765) and 2015 (n = 13,517). Alcohol consumption variables included lifetime and 12-month alcohol use, volume ethanol at last drinking occasion and heavy episodic drinking in the past 30 days. Self-reported acute alcohol-related consequences were measured as a sum index of experiencing the following at least once within the last 12 months: (1) an accident or injury; (2) being victimised by robbery or theft; or (3) had trouble with the police. Results: For all alcohol indicators, adolescent alcohol use decreased between 2007 and 2015. The highest prevalence estimates were found in Denmark, and here only the number of current drinkers decreased significantly. In addition, a decreasing trend in self-reported acute alcohol-related consequences was observed. We did not find a strengthening of the alcohol consumption consequences association from 2007 to 2015, except in Iceland. When all surveys were combined, the decrease in alcohol-related consequences could be explained by a decrease in alcohol consumption. Conclusions: Overall, adolescents aged 15-16 years exhibited decreasing trends in both alcohol consumption, less markedly in Denmark, and in our sum index of alcohol-related consequences between 2007 and 2015. Except for Iceland, we found no support for a strengthening of the alcohol-consequences association with declining drinking among adolescents.