title: Drinking less but greater harm: could polarized drinking habits explain the divergence between alcohol consumption and harms among youth?
abstract: OBJECTIVE
  This paper describes changes in alcohol consumption among Swedish youth over the past decade with the aim of exploring the polarization hypothesis, which asserts that while a majority of young drinkers have reduced their alcohol consumption, a subgroup have increased their drinking substantially, resulting in greater harm.
  
  
  METHODS
  We analysed repeated cross-sectional self-report data from 45,841 15-16-year olds and 40,889 18-19-year-old high-school students living in the Stockholm municipality between 2000 and 2010. The questionnaire assessed alcohol and drug use, and risk factors for alcohol misuse. Changes over time at different levels of consumption are presented by age and gender.
  
  
  RESULTS
  We find evidence of a polarization effect in youth drinking, with consumption reducing significantly over the past 10 years among all young people, except the heaviest drinkers, where consumption and binge drinking tended to increase. The dispersion in per capita consumption also increased over time, indicating more heavy drinkers. The total number of risk factors for alcohol misuse decreased among most survey participants from 2000 to 2010, but with variability between years.
  
  
  CONCLUSIONS
  Polarized drinking habits are a likely explanation for the recent divergence between per capita alcohol consumption, which has decreased, and alcohol-related hospitalizations, which have increased sharply among Swedish youth in recent years. We suggest that ongoing social changes could be affecting young people in the form of greater disparities, which are associated with a higher incidence of social problems generally, including heavy drinking.
authors: Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Stockholm 171 76, Sweden.
authors: Mats
authors: M
authors: Hallgren
authors: Håkan
authors: H
authors: Leifman
authors: Sven
authors: S
authors: Andréasson
mesh_terms: D000293:Adolescent; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000639:trends; D019973:Alcohol-Related Disorders / Q000453:epidemiology*; D063425:Binge Drinking / Q000453:epidemiology* / Q000639:trends; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D013695:Temperance / Q000706:statistics & numerical data / Q000639:trends; D055815:Young Adult