Thern Emelie, de Munter Jeroen, Hemmingsson Tomas, Davey Smith George, Ramstedt Mats, Tynelius Per, Rasmussen Finn
Child and Adolescent Public Health Epidemiology Unit, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Addiction. 2017 Jun;112(6):1004-1012. doi: 10.1111/add.13750. Epub 2017 Feb 7.
To test if being exposed to increased alcohol availability during adolescence is associated with an increased risk of receiving disability pension due to all-cause, alcohol use disorders and mental disorders.
Register-based population-based study using a natural experiment setting, the alcohol policy change in Sweden (1967-68), with increased access to strong beer in a narrow time window and geographical area. The individuals exposed to the policy change were compared with non-exposed individuals living in the rest of Sweden, excluding a border area.
Sweden.
A total of 518 810 individuals (70 761 in the intervention group; 448 049 in the control group) born 1948-1953, aged 14-20 years during the policy change.
Date and diagnosis of the outcome variable of disability pension due to all-cause, alcohol use disorders and mental disorders were obtained from the Swedish National Social Insurance Agency database from 1971 to 2013. Individual and family level socio-demographic and health-related covariates, as well as a regional level covariate, were included.
Compared with the control group, adolescents exposed to the alcohol policy change were at an increased risk of receiving disability pension due to all-causes [hazard ratio (HR) = 1.09, 95% confidence interval (CI) = 1.07-1.11], alcohol use disorders (HR = 1.17, 95% CI = 1.05-1.30) and mental disorders (HR = 1.19, 95% CI = 1.15-1.23).
In Sweden, a natural experiment with a 43-year follow-up suggests that exposure to increased alcohol availability during adolescence is associated with an increased risk of receiving a disability pension due to all-cause, alcohol use disorder and mental disorder diagnoses.
检验青少年时期接触酒精的机会增加是否与因各种原因、酒精使用障碍和精神障碍而领取残疾抚恤金的风险增加有关。
基于登记的人群研究，采用自然实验设置，即瑞典的酒精政策变化（1967 - 1968年），在狭窄的时间窗口和地理区域内增加了烈性啤酒的可获得性。将受政策变化影响的个体与居住在瑞典其他地区（不包括边境地区）未受影响的个体进行比较。
瑞典。
共有518810名个体（干预组70761名；对照组448049名），出生于1948 - 1953年，在政策变化期间年龄为14 - 20岁。
从瑞典国家社会保险局数据库中获取1971年至2013年因各种原因、酒精使用障碍和精神障碍而领取残疾抚恤金这一结果变量的日期和诊断信息。纳入了个体和家庭层面的社会人口统计学及健康相关协变量，以及区域层面的协变量。
与对照组相比，受酒精政策变化影响的青少年因各种原因领取残疾抚恤金的风险增加[风险比（HR）=1.09，95%置信区间（CI）=1.07 - 1.11]，因酒精使用障碍领取残疾抚恤金的风险增加（HR = 1.17，95% CI = 1.05 - 1.30），因精神障碍领取残疾抚恤金的风险增加（HR = 1.19，95% CI = 1.15 - 1.23）。
在瑞典，一项长达43年随访的自然实验表明，青少年时期接触酒精的机会增加与因各种原因、酒精使用障碍和精神障碍诊断而领取残疾抚恤金的风险增加有关。
