Alcohol consumption, alcohol policy and alcohol related harm: Case study comparing Sweden and Italy

Background

Sweden and Italy are often portrayed as European extremities regarding life style and public policy. Alcohol consumption and alcohol policy is one example. Since a convergence in alcohol consumption pattern has been observed in Europe, questioning the north-south divide, we aimed to compare over time development of alcohol consumption, alcohol policy and alcohol related burden of disease in the two countries.

Methods

Historical data on consumption level and beverage types in the two countries are reviewed, from 1961 data are obtained from the WHO database. Policy data are extracted from our recently compiled database on alcohol policy in European countries 1990-2023. Burden of disease due to alcohol are extracted from the Global Burden of Disease study for the same time period.

Results

Italy’s alcohol consumption declined substantially during the 1980s and 1990s, while the Swedish consumption has remained relatively stable. Alcohol policy has become more restrictive in Italy, although still below Swedish level of restrictiveness, and occurred mainly after the decline in consumption. Policy level in Sweden has remained relatively stable. The burden of disease caused by alcohol has declined in Italy and is now on a level similar to Sweden.

Conclusions

Sweden and Italy have traditionally been seen as extreme poles in Europe regarding lifestyle, prevention policy and in particular regarding alcohol use. As in many European countries, a convergence has been observed on national level, regarding consumption, policy and burden of disease related to alcohol. Consumption level as well as burden of disease are now rather similar. However, regional differences, age, gender and socioeconomic position need to be considered in prevention and policy, where strong variations remain also within countries.

Key messages

• Sweden and Italy provide an interesting case for assessing development of alcohol consumption, policy and disease burden over time.

• While both countries now have more similar level of alcohol consumption and harm levels, major differences within countries regarding age, sex and socioeconomy need to be considered.