Tobias H. Elgán

Measuring substance use in the club setting: a feasibility study using biochemical markers

BackgroundDuring the last few decades the use of club drugs (e.g., cocaine, amphetamines) has been of increased concern in nightlife settings. Traditionally, surveys have been used to estimate the use of club drugs, however, they mostly rely on self-reports which may not be accurate. Recent advances have allowed for readily accessible drug testing methods such as oral fluid drug testing. Nevertheless, research using oral fluid sampling to measure the frequency of drug use in the club environment is scarce. The objective of this study is to evaluate the feasibility of measuring the frequency of alcohol and drug use among Swedish clubbers using breath alcohol and oral fluid drug testing.MethodThe setting was a 40 hour electronic music dance event (EMDE) on a cruise ship on the Baltic Sea, departing from Sweden, with 875 passengers. Groups of participants at the EMDE were randomly invited to participate. Data were collected with face-to-face and self-administered questionnaires. Further, oral fluid samples were collected to determine illicit drug use, and blood alcohol concentration (BAC) levels were measured using a breath analyzer.ResultsA total of 422 passengers were asked to participate in the study whereof 21 declined (5.0% refusal rate). Of the 401 study participants (accounting for 45.8% of all attendees), 5 declined oral fluid drug testing. Results show that there was a discrepancy between self-reported and actual drug use as 10.1% of the participants were positive on illicit drug use (amphetamines, ecstasy/MDMA, cannabis, cocaine), while only 3.7% of the participants reported drug use during the last 48 hours. The average BAC level was 0.10% and 23.7% had BAC levels ≥ 0.15%, while 5.9% had levels below the detection limit. The mean BAC levels for the illicit drug users were significantly higher (p = 0.004) than for non-drug users (0.13% vs. 0.10%). Self-reported AUDIT-C scores (using a threshold of ≥ 5 for men and ≥ 4 for women) revealed that 76.0% of the men and 80.7% of the women had risky alcohol consumption patterns.ConclusionThis study indicates that it is feasible to conduct breath alcohol and oral fluid drug testing in a Swedish club setting.

Prevalence of adolescents who perceive their parents to have alcohol problems: A Swedish national survey using a web panel

Aims: The primary aim is to estimate the prevalence of Swedish adolescents who perceive their parent(s) to have alcohol problems. Additional research questions pertain to the prevalence of adolescents who think someone close to them drinks too much alcohol and if this has hurt them or caused them problems. Methods: A cross-sectional design was employed using a web-based survey targeted to 1000 Swedish 16–19-year-olds randomly selected from a web panel. The questionnaire included the CAST-6 scale, used to assess whether or not participants perceived their parents’ alcohol consumption as problematic, and questions relating to whether or not they think someone close to them drinks too much and if this has caused them problems. Data was weighted using a post-stratification procedure. Results: The proportion of adolescents classified as having parents with alcohol problems was 20.1%. Further, 44.0% reported that they think someone close to them drinks too much alcohol and 9.6% that this has hurt them or caused them problems. Conclusions: These results indicate that the problem is widespread. Our findings are similar to previous research where a more indirect methodology has been adopted, using either psychiatric interviews or self-reported alcohol consumption of adults, to estimate the magnitude of the problem.

Alcohol prevention at sporting events: study protocol for a quasi-experimental control group study.

BackgroundAlcohol intoxication and overserving of alcohol at sporting events are of great concern, given the relationships between alcohol consumption, public disturbances, and violence. During recent years this matter has been on the agenda for Swedish policymakers, authorities and key stakeholders, with demands that actions be taken. There is promising potential for utilizing an environmental approach to alcohol prevention as a strategy to reduce the level of alcohol intoxication among spectators at sporting events. Examples of prevention strategies may be community mobilization, Responsible Beverage Service training, policy work, and improved controls and sanctions. This paper describes the design of a quasi-experimental control group study to examine the effects of a multi-component community-based alcohol intervention at matches in the Swedish Premier Football League.MethodsA baseline assessment was conducted during 2015 and at least two follow-up assessments will be conducted in 2016 and 2017. The two largest cities in Sweden are included in the study, with Stockholm as the intervention area and Gothenburg as the control area. The setting is Licensed Premises (LP) inside and outside Swedish football arenas, in addition to arena entrances. Spectators are randomly selected and invited to participate in the study by providing a breath alcohol sample as a proxy for Blood Alcohol Concentration (BAC). Actors are hired and trained by an expert panel to act out a standardized scene of severe pseudo-intoxication. Four types of cross-sectional data are generated: (i) BAC levels among ≥ 4 200 spectators, frequency of alcohol service to pseudo-intoxicated patrons attempting to purchase alcohol at LP (ii) outside the arenas (≥200 attempts) and (iii) inside the arenas (≥ 200 attempts), and (iv) frequency of security staff interventions towards pseudo-intoxicated patrons attempting to enter the arenas (≥ 200 attempts).DiscussionThere is an urgent need nationally and internationally to reduce alcohol-related problems at sporting events, and it is essential to test prevention strategies to reduce intoxication levels among spectators. This project makes an important contribution not only to the research community, but also to enabling public health officials, decision-makers, authorities, the general public, and the sports community, to implement appropriate evidence-based strategies.

Alcohol intoxication at Swedish football matches: A study using biological sampling to assess blood alcohol concentration levels among spectators

Alcohol use and alcohol-related problems, including accidents, vandalism and violence, at sporting events are of increased concern in Sweden and other countries. The relationship between alcohol use and violence has been established and can be explained by the level of intoxication. Given the occurrence of alcohol use and alcohol-related problems at sporting events, research has assessed intoxication levels measured through biological sampling among spectators. This cross-sectional study aimed to assess the level of alcohol intoxication among spectators at football matches in the Swedish Premier Football League. Spectators were randomly selected and invited to participate in the study. Alcohol intoxication was measured with a breath analyser for Blood Alcohol Concentration levels, and data on gender, age, and recent alcohol use were gathered through a face-to-face interview. Blood Alcohol Concentration samples from 4420 spectators were collected. Almost half (46.8%) had a positive Blood Alcohol Concentration level, with a mean value of 0.063%, while 8.9% had a Blood Alcohol Concentration level ≥ 0.1%, with a mean value of 0.135%. Factors that predicted a higher Blood Alcohol Concentration level included male gender (p = 0.005), lower age (p < 0.001), attending a local derby (p < 0.001), alcohol use prior to having entered the arena (p < 0.001), attending a weekend match (p < 0.001), and being a spectator at supporter sections (p < 0.001). About half of all spectators at football matches in the Swedish Premier Football League drink alcohol in conjunction with the match. Approximately one tenth have a high level of alcohol intoxication.

Public opinion on alcohol consumption and intoxication at Swedish professional football events

BackgroundAlcohol-related problems at professional sporting events are of increasing concern and alarming reports are often reported in international media. Although alcohol consumption increases the risk for interpersonal violence, it is viewed as a focal element of large football events. Sweden has a long tradition of high public support for strict alcohol-control policies. However, little is known about public opinions on alcohol intoxication and the support for interventions to decrease intoxication at football events. The current study explored the public opinion towards alcohol use, intoxication and alcohol policies at professional football matches in Sweden.MethodsA cross-sectional design was utilized and a random general population sample of 3503 adult Swedish residents was asked to participate in a web survey during 2016 (response rate 68%).ResultsIn total, 26% of the respondents supported alcohol sales at football events. Over 90% reported that obviously intoxicated spectators should be denied entrance or evicted from arenas. The support for regulations limiting alcohol availability varied with background factors such as gender, alcohol use and frequency of football event attendance.ConclusionsThere is a strong public consensus for strategies and policies to reduce alcohol sales and intoxication levels at football matches. This public support has implications for our preventive efforts and will facilitate the implementation of strategies and policy changes.

Alcohol policies and attitudes toward alcohol prevention at Swedish student unions

Aims: High alcohol consumption among young adults is of great concern. About half of all young adults in Sweden are university students, and high alcohol consumption is common in this group. This makes student unions a potential arena for alcohol prevention. Little is known about attitudes toward alcohol prevention and to what extent Swedish student unions have written alcohol policies. The aim of the present study was to investigate whether student union representatives consider alcohol to be a problem, their attitudes toward alcohol prevention, the presence of written alcohol policies at student unions, and factors possibly associated with the existence of such policies. Methods: During November 2014, student union representatives (n = 95) were invited to participate in a web-based questionnaire; data were obtained from 78 unions. Results: The majority (93%) reported positive attitudes toward alcohol prevention, and many also recognised that alcohol consumption could be a problem (47%). Furthermore, 81% reported having an alcohol policy at their student union. Unions that frequently arranged pubs were more likely to have a policy (OR = 1.9). Conclusions: Many participants recognised that alcohol consumption could be a problem and reported positive attitudes toward alcohol prevention in the student union setting. This, together with the fact that the majority of student unions had written alcohol policies, suggests that the student union setting is a promising arena for alcohol prevention.