Effect of screening and advising on alcohol habits in Sweden: A repeated population survey following nationwide implementation of screening and brief intervention

Abstract

Aims: To examine: (a) to what extent individuals in contact with heath care had been asked and advised on their alcohol habits; (b) how self-reports of alcohol consumption and patient characteristics affected the probability of being asked and advised on alcohol consumption; (c) the potential effect of alcohol advice on readiness and ability to change, across levels of high alcohol consumption. Methods: A repeated cross-sectional public health postal questionnaire in Uppsala County among 18-84 year old, covering a period of a national programme encouraging alcohol screening, brief interventions and motivational interviewing (2004-2012). Response rates were 65.5-52.2%. Respondent who stated that they had visited health-care services had a further question on whether the staff asked questions about habits including alcohol, and whether the staff had given them advice concerning the same habits. AUDIT-C was the measure of alcohol consumption, and there was a question on wanting to cut down on drinking and/or needing support to do so. Results: Screening for and advising patients on alcohol consumption increased during the period, but there were no decreases in population-level consumption. Screening occurred independent of self-reports of AUDIT-C and varied with other individual characteristics. Advice was associated with AUDIT-C score. Being advised increased the likelihood of wanting to reduce drinking, both among those scoring above the national hazardous consumption levels and at higher scores. Conclusions: Screening and advising on alcohol habits in health care impacted individual readiness and ability to change. Population-level effects have yet to be proven. Short summary: Screening for and advising patients on alcohol consumption increased following a national programme encouraging alcohol screening, brief interventions and motivational interviewing. Overall consumption levels remained unchanged. Screening was largely systematic. The positive effect of advice on wanting to cut back drinking was similar in moderate and high drinkers.