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Harms from others drinking in Sweden. findings from a pilot study comparing three different survey approaches. Mats Ramstedt, Erica Sundin STAD (Stockholm Prevents Alcohol and Drug Problems). Background.
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Harms from others drinking in Sweden findings from a pilot study comparing three different survey approaches Mats Ramstedt, Erica Sundin STAD (Stockholm Prevents Alcohol and Drug Problems)
Background • Increasing interest in alcohol’s harm to others (HTO) in Sweden - the new Swedish ANDT-strategy contains as one specific goal that HTO should be reduced. • In order to follow-up this goal, questions on HTO have been included in a pilot study on use and harm related to ANDT initiated by the Ministry of health and social affairs • STAD in collaboration with KI were commissioned to set up this pilot study which also focuses on assessing abuse/dependence of ANDT and to address methodological issues in surveys.
Aim Overall: present some basic findings from this study with regards to the experience of HTO in the Swedish population. Specific questions: • How common is it that people experience HTO and are some groups more exposed than others e.g. depending on gender, age and drinking habits? • To what extent do estimates of HTO differ between different survey approaches in particular surveys with low and high non-response rates?
The pilot study • 3 different survey approaches with different ambitions to increase response rates and with different modes of data collection. • Surveys include identical questions about: Background, Use of ANDT, Abuse/dependence of ANDT (e.g. DSM-4), Harms from others use of ANDT substances • Data collection nov 2011 – april 2012 • Report submitted to the Soc. Ministry in June 2012
The surveys Two extra ambitious procedures with introductory letter and reward voucher 1. Post and web questionnaires • Choose between post or web survey 2. Diagnostic telephone interviews • Telephone interview with interviewers specially trained in assessing dependence Standard procedure 3. Regular telephone interview • Swedish “Monitoring project” – the same standard procedure
Questions about harms from others drinking Inspired by work in Austalia/WHO but no space for anydetailedquestions in this pilot – only a fewroughitemsapplied 1. Harm from whom? • Harm from people close to the respondent • Harm from strangers 2. How serious? • A lot – A little (subjective)
Harm from someone close to the respondent 1. In the last 12 months, are there people in your life, who you would consider to be a fairly heavy drinker, or someone who drinks a lot sometimes? (for example anyone in you family, ex-partner, friends, co-worker) 2. Have that person/those persons drinking negatively affected you in some way within the last 12 months? 3. Overall, how much has that person/those persons drinking affected you negatively? - A lot – A little
Harm from a “stranger” 1. Have you, within the last 12 months, been negatively affected by a stranger or a person you do not know? 2. Overall, how much has that person/those persons drinking affected you negatively? - A lot – A little
Importance of “own” drinking habits • Drinking frequency – no association to harm from strangers or drinkers known to the respondent • Binge drinking frequency – association with harm from strangers but not with people known to respondent • Alcohol dependence/abuse – strongly related with harm from strangers and known to respondent
Conclusions Many people experience harm from others drinking in Sweden: • in particular: women, younger people, people with drinking problems • somewhat more common to experience harm from known persons than from strangers – in particular more serious harm (a lot) On the other hand: • a majority have no close person drinking too much and of those who have, only a minority experience harm • most people report that they were only “a little” affected
Conclusions • Methodological findings • The non-response rate was not as crucial as expected for HTO-questions – at least similar results were often obtained in surveys with low compared and with high response rates • Still, the highest figures were obtained in the diagnostic interview with highest response rate
Limitations • Our knowledge of what the respondents really mean is limited e.g. • What they mean by “negatively affected” – in what sense? • Relationship between respondent and the known drinker unknown – family friends etc. • The context – private or public? • Magnitude of the harm unknown – what is “a little” and “ a lot”?
Proceeding • More analyses will be conducted: overlap between ANDT use and problems including harms from others substance use • Hopefully, it will be decided that a larger study will be conducted this fall (2012)