The Link Between Alcohol Sales and Alcohol-Related Harm in Finland, 1995-2016.

Objective A key assumption in Finnish alcohol policy is that the officially registered alcohol consumption (i.e., alcohol sales) is closely related to alcohol-related harm. During the last two decades, a sizable part of total alcohol consumption, however, comprises unrecorded consumption, which may potentially make alcohol sales less powerful as a predictor of alcohol-related harm. This article thus aims to estimate the relationship between alcohol sales and alcohol-related harm on the basis of more recent Finnish time-series data. Method Data on alcohol sales (liters of 100% alcohol/capita age 15 years and older) were obtained from the National Institute for Health and Welfare in Finland. As indicators of harm, we used police-reported assaults and three forms of mortality: alcohol-specific mortality, accidents, and suicide. Quarterly data on mortality and alcohol sales spanned the period 1995-2016, and data on police-reported offenses covered the period 1990-2016. Data were analyzed by SARIMA (Seasonal Autoregressive Integrated Moving Average) modeling. Results A positive and significant association between alcohol sales and all harm indicators was found. A 1-L increase in alcohol sales per capita was associated with a 20% increase in alcohol-specific mortality, a 12% increase in assaults, and a 5%-6% increase in accidents and suicide. These estimates are in line with earlier findings estimated on data for the period when unrecorded alcohol consumption was less common in Finland. Conclusions The results provide support for a continued strong relationship between alcohol sales and alcohol-related harm in Finland. Policy measures aimed at lowering alcohol sales were supported from these results.