@article{ref1,
title="The connection between per capita alcohol consumption and alcohol-specific mortality accounting for unrecorded alcohol consumption: the case of Finland 1975-2015",
journal="Drug and alcohol review",
year="2019",
author="Norström, Thor and Makela, Pia",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="INTRODUCTION AND AIMS: Unrecorded alcohol consumption has increased strongly in Finland after 1995 when the country joined the European Union. This development may have rendered alcohol sales less trustworthy as a proxy for population drinking, and less powerful as predictor of alcohol-related harm. The study aims to test this contention by analyzing the association between recorded and unrecorded alcohol consumption on the one hand, and alcohol-specific mortality on the other. DESIGN AND METHODS: We analysed age-standardised rates of alcohol-specific deaths for the working-age (15-64 years) population. For alcohol consumption, we used (i) alcohol sales in litres of 100% alcohol per capita, and (ii) estimated unrecorded consumption in litres of 100% alcohol per capita. The data spanned the period 1975-2015. As the data were cointegrated, the relations between mortality and the alcohol indicators were estimated through time-series analysis of the raw data. <br><br>RESULTS: A one litre increase in alcohol sales was associated with an increase in alcohol-specific deaths of 7.590 deaths per 100 000; the corresponding figure for unrecorded consumption was 9.112 deaths per 100 000. Both estimates were statistically significant (P < 0.001), but the difference between them was not significant (P = 0.293). Although recoded consumption captured the main feature of the trends in alcohol-specific mortality, it accounted for only half of its marked increase in 1975-2007, while unrecorded consumption explained the remaining part. <br><br>DISCUSSION AND CONCLUSIONS: Our study confirms previous findings that recorded alcohol consumption is an important determinant of alcohol-specific mortality in Finland. A more novel insight is the importance of unrecorded consumption in this context.<br><br>© 2019 Australasian Professional Society on Alcohol and other Drugs.<p /> <p>Language: en</p>",
language="en",
issn="0959-5236",
doi="10.1111/dar.12983",
url="http://dx.doi.org/10.1111/dar.12983"
}