Relationship Between Educational Level and Attitudes Towards Alcohol Conversations in Healthcare: A Cross-Sectional Survey Conducted in Four European Countries.

To examine the association between educational level and attitudes towards alcohol conversations in healthcare using population-based surveys of adults in England, the Netherlands, Norway, and Sweden; and to compare attitudes towards alcohol conversations in healthcare between these four countries. Cross-sectional surveys were conducted amongst adults in the general population in England ( = 3,499), the Netherlands ( = 2,173), Norway ( = 1,208), and Sweden ( = 3,000). Logistic regression analysis was used to examine associations between attitudes towards alcohol conversations in healthcare and educational level, key demographic variables, alcohol consumption, and country of residence. In all four countries, low educational level ( < 0.001) and male gender ( < 0.001) were associated with holding negative attitudes towards discussing alcohol in healthcare. Risky drinkers had more negative attitudes than low risky drinkers towards discussing alcohol in healthcare ( < 0.001) in all countries except England ( = 0.48), and also reported low levels of perceived honesty and confidence in healthcare ( < 0.001). These findings highlight the importance of considering patients' socio-economic status when developing and implementing alcohol prevention interventions in healthcare.