Published in Swedish in CAN
100 År: 1901-2001, jubilee number of Alkohol och Narkotika
Sweden in an international perspective: alcohol policy and drinking habits
Centre for Social Research on
Alcohol and Drugs, Stockholm University
Sweden’s period of
greatest influence internationally in alcohol policy was probably around 1900,
in the days prior to the comprehensive Bratt system, including individual
ration-cards, of 1917-1955. In the late
19th century, there was much attention in the English-speaking world
(e.g., Gould, 1893) and elsewhere (for Russia, see McKee, 1997),
as well as in other Nordic countries, to the “Gothenburg system”, originally a
system of municipal ownership of taverns, and eventually also of off-premise
retail shops. The first such system
had actually been set up in Falun in
1850, but it was its implementation in the larger city of Gothenburg which caught
In the late 1890s and early
1900s, the Gothenburg system of government ownership of alcohol sales outlets
became in many places the major competitor to prohibition as the solution to
the “liquor question”. By and large, it
was the solution of the moderate “wets” in the policy debate, and as in Sweden it was detested by
supporters of prohibition. Prohibition
won out in the short run in the United States and Canada, as well as in Russia and several Nordic
countries. But when prohibition was
dismantled, as early as 1919 in Quebec, in the 1920s in
most of the rest of Canada, and in the United States in 1933,
government ownership of off-sales stores became the pattern in all the Canadian
provinces and eventually in 18 of the U.S. states.
Enterprises patterned on the Gothenburg system could also be found by 1920 in Britain, Australia, and the British
colonies in southern Africa (Room, 1993).
A second period of
considerable Nordic influence on thinking about alcohol policy internationally
has been in the last 25 years. The
influence has come from Finland and Norway, as well as Sweden. One aspect of this contribution has been the
term “alcohol policy” itself, which seems to have come into English from Nordic
usage (Room, 1999). Beyond this, Nordic
social and epidemiological research has been prominent in putting forward and
providing research support for what is called in Sweden the “total
consumption model”, discussed elsewhere in this issue. It was a Swedish initiative, also, which was
responsible for the first, eventually short-circuited, effort in 1983 by the
World Health Organization to analyze the issue of the effects of the alcohol
trade on public health (McBride and Mosher, 1985).
These days, Sweden is playing an
important role internationally in putting alcohol policy onto the public health
agenda. This initiative was symbolized
by a policy meeting on young people and alcohol hosted by the Swedish
government in Stockholm in February 2001.
(http://www.youngalcohol.who.dk/home.htm) This was a WHO-EURO health minister’s
meeting on the European Alcohol Action Plan, including all European countries
and the Asian countries formerly part of the Soviet Union. At the same time, it was also a ministerial
meeting of the European Union during the term of the Swedish presidency. In the
wake of the meeting, the first EU declaration with a public health orientation
to alcohol policy was adopted. (http://eu2001.se/eu2001/news/news_read.asp?iInformationID=15578)
In an international
perspective, Swedish concerns about alcohol policy take some particular
forms. Public health is the common
rubric for dealing with alcohol policy internationally, but in Sweden the societal
concerns about the problems of drinking have primarily been oriented to matters
of welfare, safety and order. This way
of thinking about alcohol problems reflects the longstanding forms and habits
of Swedish drinking customs. Swedish
drinkers drink relatively infrequently, compared to other western Europeans. In
a recent comparative study of adult general populations, for instance, Leifman
(forthcoming) found that only 7% of Swedish men and 2% of Swedish women
reported drinking as often as four times a week, while the corresponding
figures for Germany were 18% and 7%,
and for Italy 45% and 30%. While abstention is a minority phenomenon
these days in Sweden (7% of men and 13%
of women), fully 47% of Swedish men and 64% of Swedish women reported drinking
less often than once a week.
On the other hand, when Swedes
do drink, they are quite likely to drink at least five or six drinks at a
time. Swedish men reported drinking the
alcohol equivalent of a whole bottle of wine on 33% of their drinking
occasions, and women on 18%. The
corresponding figures for Germany were 14% and 7%,
and for Italy 13% and 11%.
It is not that Swedish
drinking habits have remained totally unchanged. Abstainers used to be more common -- as
recently as 1965, they were 12% of men and 28% of women. Also, distilled
spirits no longer predominate as the type of alcoholic beverage Swedes drink:
by the mid-1990s, beer had become the dominant beverage type (Leifman,
2001). Drinking in restaurants and
taverns has been increasing, though it still accounts for only about 20% of
total consumption. But the pattern of
relatively infrequent drinking (by European standards), but of intoxication
being a frequent result of drinking, has long been characteristic of Swedish
In the European spectrum of
drinking habits, Sweden is thus near one
end of a continuum. But it should be
recognized that in a wider global perspective, Swedish drinking practices are
often more in the middle of the range (except that there are many more
abstainers in much of the developing world).
In Sweden, 28% of the men who drink as often as weekly drink the alcohol
equivalent of a bottle of wine on at least one occasion in the week. In both Germany and Italy, the corresponding
figure is 15% (Leifman, forthcoming).
But in Mexico, the corresponding
figure is about 50%, and in Nigeria, according to one
study, 69% (Room et al., forthcoming).
The pattern of drinking on weekends rather than daily, but of often
drinking to intoxication, is even more marked in many places in the developing
world than it is in Sweden.
The Swedish alcohol policy
system has developed over many years in response to the specific
characteristics of Swedish drinking customs.
There is much to be learned internationally from the Swedish experience,
given the strong Swedish tradition of experimental and evaluative studies on
alcohol policies. But these comparisons
suggest that it is in the developing world, more than in the rest of western
Europe, that the greatest potential may exist for application of Swedish policy
perspectives and experience.
(1893) The Gothenburg System in America, Atlantic
Monthly 72:538-545. Web: http://cdl.library.cornell.edu/cgi-bin/moa/moa-cgi?notisid=ABK2934-0072-83
(2001) Homogenisation in alcohol consumption in the European Union, Nordic
Studies on Alcohol and Drugs 18 (English supplement): 15-30.
(forthcoming) A comparative analysis of drinking habits in six EU countries in
the year 2000, Contemporary Drug Problems.
McBride, Rob and
Mosher, James F. (1985) Public health implications of the international alcohol
industry: issues raised by a World Health Organization project, British
Journal of Addiction 80:141-147.
McKee, William A.
(1997) Taming the Green Serpent: Alcoholism, Autocracy and Russian Society,
1881-1914. PhD dissertation, history, University of California, Berkeley.
Room, Robin (1993)
The evolution of alcohol monopolies and their relevance for public health, Contemporary
Drug Problems 20:169-187.
Room, Robin (1999)
The idea of alcohol policy, Nordic Studies on Alcohol and Drugs 16
(English supplement): 7-20.
Jernigan, David, Carlini-Marlatt, Beatriz, Gureje, Oye, Mäkela, Klaus,
Marshall, Mac, Medina-Mora, Maria Elena, Monteiro, Maristela, Parry, Charles,
Partanen, Juha, Riley, Leanne and Saxena, Shekhar (forthcoming) Alcohol in
Developing Societies: A Public Health Approach. Helsinki: Finnish Foundation
for Alcohol Studies.
Author’s note: the percentages in the text are taken or recalculated
from Tables 2, 9 and 11 of Leifman, forthcoming and Table 5.5 of Room et al.,