Kirsimarja Raitasalo

The role of the spouse in regulating one's drinking

This article examines the relationship between experiences of external influence from spouses and partners to influence ones drinking and ones own concern over drinking; whether spouses control attempts and concern over ones own drinking are in congruence; how the level of drinking and the frequency of drinking to intoxication and the estimate of the spouses level of drinking are related, for women and men belonging to different sociodemographic groups. Using data from the 2000 Finnish Drinking Habit Survey (n = 1337), our results show that (1) drinking habits – especially drinking large quantities on a single occasion – are strongly related to both external control from the spouse and ones own concern about drinking and (2) there are significant differences between genders in the level of control from the spouse and concern over ones own drinking habit. These results are important when planning treatment and prevention for drinkers and their families.

Old enough for a beer? Compliance with minimum legal age for alcohol purchases in monopoly and other off-premise outlets in Finland and Norway.

AIM To assess whether government monopoly outlets comply better with minimum legal age for purchase of alcohol compared to other off-premise outlets for alcohol sales. METHODS Under-age-appearing 18-year-olds attempted to purchase alcohol in off-premise outlets applying identical procedures in Finland (n = 290) and Norway (n = 170). Outcomes were measured as whether or not the buyers were asked to present an identity (ID) card and whether or not they succeeded in purchasing alcohol. RESULTS The buyers were asked to present an ID card in slightly more than half the attempts, and they succeeded in purchasing alcohol in 48% of the cases. The buyers were more likely to be requested to present an ID card and less likely to succeed in purchasing alcohol in monopoly outlets compared to other types of outlets, and also when other outcome predictors, such as age and gender of salesperson and crowdedness in the outlet, were taken into account. CONCLUSION Monopoly outlets may facilitate compliance with minimum legal age for purchase of alcohol.

Perceptions of addictions as societal problems in Canada, sweden, Finland and st. Petersburg, Russia.

Aims: This study reports on the relative gravity people attribute to various addictive behaviors with respect to other societal concerns in four northern populations with different history, social policy and treatment alternatives for addicted individuals. Methods: Random population surveys were conducted in Canada, Sweden, Finland and St. Petersburg, Russia. In Finland and Sweden, the survey was conducted by mail, in Canada and St. Petersburg by phone. As a part of this survey, the respondents were asked to assess the gravity of various societal problems, some of which involved various addictive behaviors. The data were analyzed by descriptive statistical methods, factor analysis, contextual analysis and multiple regression analysis. Results: Hard drugs, criminality and environmental issues belonged to the topmost problems in all data samples. Overall, Finns and Canadians appeared the least worried about various societal problems, Swedes seemed the most worried and St. Petersburgian views were the most polarized. Two factors were extracted from the combined data. Factor 1 covered criminal behavior and various addictions; it was named Threats to Safety factor. Factor 2 comprised social equality issues. The country context explained 12.5% of the variance of the safety factor and 7.9% of the equality factor. Conclusions: Despite some cultural variation in the gravity assessments, the central core of the social representation of addictive behaviors tends still to be linked with ‘badness’ since they were mainly grouped with various forms of criminal behavior in all these countries.

Drinking in the presence of underage children: Attitudes and behaviour

The ambivalent characteristic of the Finnish drinking culture is particularly evident in the context of family life. While drinking to intoxication in the home environment is widely tolerated, attitudes towards drinking in the presence of children appear negative, and there is broad political concern about harms to children. This study aims to both illuminate the attitudes towards drinking and the actual drinking behaviour of parents living with their children. We use data on 19–59-year old Finns from a general population survey (n = 2046). Respondents were asked about their drinking habits, recent drinking occasions and attitudes to drinking. Men under 40 years of age without underage children at home drank significantly more and more often to intoxication than those who had underage children. In a similar manner, women in all age groups without children at home drank significantly more often to intoxication than those who had children at home. Drinking to intoxication while children are present was almost unanimously considered inappropriate. Yet almost 40% of respondents considered it acceptable to drink to intoxication in the childs company if someone else is looking after the child. There was a significant relationship between these attitudes and actual behaviour among women. The drinking culture in Finland is very permissive, with intoxication often considered suitable for childrens eyes as long as their safety is guaranteed. Prevention efforts should continue to target these attitudes and behaviour.

Mothers who abuse alcohol and drugs: Health and social harms among substance-abusing mothers of small children in three child cohorts

AIMS – The study looks at the prevalence and register-based indicators of substance abuse-related harms among mothers of small children. We examined the living conditions, various health and social harms and the differences between the users of different kinds of substances (alcohol only vs. drugs only vs. alcohol and other drugs). DATA & METHODS – Population-level register data was collected of all biological mothers of three Finnish birth cohorts (1991, 1997, 2002) describing the womens social problems, health and use of services during the period when the child was under seven years old. RESULTS – The substance-abusing mothers of small children had a higher rate of mortality and psychological disorders and increased risk of using hospital services than the comparison group. Their children had been taken into custody dramatically more often than the children of the comparison group. Also, mothers with substance abuse problems had lower education and income level, and their purchases of prescribed psychopharmacological medications were manifold compared to other mothers. Mixed use of both alcohol and illegal drugs coincided with the highest prevalence of health and social problems. CONCLUSIONS – Substance-abusing mothers of small children are in a serious risk of health and social problems ranging from poverty to poor mental health and high mortality. The study shows also that the social and health care professionals have a potentially important role in giving support to the mothers and their children, as the substance-abusing mothers have had several contacts with them. Prevention of harms to children of substance-abusing mothers should perhaps focus more on the possibilities offered by these contacts in different health and social services.

Retrieval strategies and cultural differences in answering survey questions on drinking: A cross-national comparison

Aim. This research compares retrieval strategies and cultural differences in answering survey questions using protocol analysis on four alcohol use items: frequency of drinking, quantity of drinking, frequency of drunkenness, and the context of drinking in the last 12 months. Data. The data came from a project to improve the comparability of health behaviour surveys in Europe (the EuroHIS study). The participating countries were Finland, Germany, Italy and the Netherlands, results from which form the basis of this article. In each country 21 to 45 voluntary respondents were recruited for interviews. Results. Overall, the comparison between the four countries shows: (a) a remarkable similarity in profiles of cognitive strategies in answering survey questions, (b) an equally remarkable difference in the number of uses of different strategies and (c) important differences relating to cultural understanding on certain specific questions. Conclusions. These results suggest variation across countries in cognitive strategies and cultural sensitivity with respect to survey questions on alcohol. Part of these differences can be interpreted in the context of differences in drinking patterns and culture. Although differences in cognitive strategies and cultural sensitivity are embedded in drinking patterns and drinking culture, these differences do not necessarily invalidate the answers to the survey questions. However, further and more controlled studies are needed to assess the extent to which there are cross-national differences in the validity of answers to questions about alcohol consumption.

The impact of a self-help pamphlet on reducing risk drinking among 30- to 49-year-old men in Helsinki, Finland

This study evaluates the impact of a self-help pamphlet designed to support self-control of drinking. It was conducted in Helsinki, Finland, in 2001 and 2002 and focused on men between 30 and 49 years of age. The respondents were randomly selected in an intervention and a control area and compared with each other before and after the intervention using independent samples (N = 4418) The results support previous findings showing that interventions like this serve as a supplement to other prevention and early treatment measures. Although the results were encouraging, there is a need for more in-depth studies in the field.

Mental health and alcohol use: a cross-sectional study of the Finnish general population

BACKGROUND The connections between alcohol use, mental health problems and mental well-being have been under-researched. We examined the links between different aspects of alcohol use and positive and negative aspects of mental health, and the effect of protective social factors on these links. METHODS A cross-sectional general population survey of Finns aged 15-69 years was carried out in 2008 (n = 2725, response rate 74%). The included aspects of alcohol use were the frequency and volume of drinking, binge drinking and hazardous drinking using Alcohol Use Disorders Identification Test (AUDIT). The included aspects of mental health were subjective well-being (life satisfaction), self-efficacy (sense of mastery) and psychological distress using the General Health Questionnaire. The protective social factors examined were social support (loneliness, having a confidant) and socioeconomic status. RESULTS Binge drinking and, particularly, hazardous drinking were associated with different aspects of mental health. The proportion of respondents with poor mental well-being increased when binge drinking was more frequent than monthly, and when respondents scored ≥6 on the AUDIT scale. Abstainers reported poor sense of mastery and former drinkers additionally reported poor satisfaction with life. Frequency and volume of drinking did not have a consistent connection with mental health. These associations between alcohol use and mental health did not depend on the protective social factors. CONCLUSIONS Frequent binge drinking and alcohol problems are associated with poor mental health, especially with a lack of life satisfaction and psychological distress. This result applies equally to lower and higher social status groups.

Parental substance abuse and risks to children’s safety, health and psychological development

Abstract Aims: This study looks at the connection between parents’ substance abuse and their 0–6 years old children’s somatic and psychological health. Methods: A retrospective population-based cohort study based on Finnish health care and social welfare registers. The participants were all children born in Finland in 1997 (N = 58,667) and 2002 (N = 55,146) and their biological parents. Children were followed up for hospitalisations because of injuries, somatic illness and psychiatric disorders. The association between hospitalisations and parents’ substance abuse as well as living with the abusing parent were estimated using logistic regression. Findings: Children’s hospitalisations for all reasons were more prevalent if the mother or the father had a substance abuse problem. Mother’s substance abuse increased the children’s risk of hospitalisations for somatic illness (OR = 1.34) and psychiatric disorders (OR = 1.33, father’s substance abuse increased the risk of hospitalisation because of psychiatric disorders (OR = 1.18). The risks were even higher if both parents were substance abusers. Conclusions: Parents’ substance abuse can cause a variety of harms to children, which may be related to unsafe environment, long-standing stress, and non-adequate responding to the child’s needs. Multi-professional work with substance abusing parents and their children is crucial in order to reduce children’s risks for poor health.

Benzodiazepine use among mothers of small children: a register-based cohort study

AIMS To compare benzodiazepine (BZD) purchases in different groups of mothers of small children. DESIGN Prospective population-based cohort study based on the Finnish social and health care registers. SETTING Finnish women of child-bearing age. PARTICIPANTS All women who gave birth in 2002 in Finland (n = 54 519). MEASUREMENTS Latent class analysis (LCA) was used to create a typology of mothers according to their substance abuse status, psychiatric disorders and socio-demographic characteristics. The mothers were followed-up yearly for purchases of benzodiazepines, starting 4 years before the childs birth and continuing up to the childs 7th birthday. BZD purchases in different mother groups were compared using negative binomial hurdle models. FINDINGS The five mother types identified by LCA were mothers with substance abuse (1%), mothers with psychiatric disorders (1%), mothers with a risk of social marginalization (11%), mothers with minor social problems (18%) and mothers with no identified problems (69%; the comparison group). Mothers with substance abuse problems had the highest odds of purchasing BZDs [odds ratio OR = 27.5, 95%CI = 22.9-33.0; RR = 20.2, 95%CI = 14.9-27.3. The change in time was similar in all groups: the probability of purchasing and the number of purchases were lowest during pregnancy and the year of the childs birth. CONCLUSIONS In Finland, among mothers of young children, prevalence of benzodiazepine use is reduced during pregnancy and the childs first year, and then increases as the child grows older. Mothers with substance abuse and psychiatric disorders are at particularly high risk of benzodiazepine use.