Long-term effects of changes in Swedish alcohol policy: can alcohol policies effective during adolescence impact consumption during adulthood?

Aims To assess long-term effects of alcohol policy in Sweden by estimating the differences between cohorts growing up during periods with liberal alcohol policies and a cohort growing up during a period with restrictive alcohol policy. Design The data come from repeated cross-sectional surveys conducted in Sweden between 2002 and 2013, and were collected monthly using telephone interviews with a nationally representative sample. Cohorts were constructed by identifying periods when alcohol policy differed between being more liberal or more restrictive. The liberal-period cohorts were merged into one and compared with the restrictive-period cohort. Setting Sweden. Participants A total of 127 480 adult Swedes born between 1951 and 1989. Measurements Monthly volume of alcohol consumption in litres of pure alcohol derived from a beverage-specific graduated quantity-frequency scale. Findings Relative to the liberal-period reference cohorts (who turned 15 between 1966 and 1977 or 1992 and 2004), the cohort that grew up during a period with restrictive alcohol policy (turning 15 between 1978 and 1991) was found to have lower alcohol consumption (coeff. = -0.039: confidence interval -0.050 to -0.027: P < 0.001). The mean volume for the liberal and restrictive cohorts across all survey years was 0.42 and 0.38 litres of pure alcohol, respectively. Consumption development for the period 2002-13 was, however, the same for both cohort groups. Conclusions Men and women in Sweden who grew up during a period with more restrictive alcohol policies currently drink less alcohol than those who grew up during periods with more liberal policies.