Abstract
Background and Aim
During recent years unregistered alcohol consumption has increased markedly in Sweden, and the market share of the State Monopoly (Systembolaget) has decreased. The sales through Systembolaget are regulated by strict rules. Further, previous research suggests that the intake of unregistered alcohol is associated with a more risky drinking pattern. We test the hypothesis that the larger the market share of Systembolaget, the lower the prevalence of alcohol-related harm. We also address a related issue, namely whether alcohol-related harm responds differently to different components of total alcohol consumption (registered and various forms of unregistered).
Data and Method
Data on consumption of various forms of unregistered alcohol consumption were obtained from monthly surveys. Registered consumption was gauged by sales data from Systembolaget. The harm indicators included two alcohol-related crime indicators (police-reported assaults and drink driving offences), and two indicators on admission to treatment for alcohol-related diagnoses. The montly data were aggregated into quarterly observations separately for southern Sweden, mid-Sweden and northern Sweden. The study period was Q1 2001- Q4 2005. In addition to regional analyses, the data were analyzed by means of time-series analyses (ARIMA-models).
Findings
The findings did not suggest that a high market share for Systembolaget would be associated with lower rates of alcohol-related harm. As to the effects of the various components of total consumption on harm, there was no systematic pattern implying that any specific component would carry a greater risk than any other – most of the estimates were insignificant. However, all harm indicators responded significantly to the comprehensive consumption indicator (including unregistered consumption as well as Systembolaget's sales), suggesting that total consumption still matters.