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Socioeconomic position and alcohol-related harm in Danish adolescents
  1. Sanne Pagh Møller,
  2. Veronica Sofie Clara Pisinger,
  3. Anne Illemann Christensen,
  4. Janne S Tolstrup
  1. National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
  1. Correspondence to Dr Janne S Tolstrup, National Institute of Public Health, University of Southern Denmark, Copenhagen 1455, Denmark; jst{at}


Background In adults, it has consistently been observed that with equal alcohol consumption levels, alcohol harms individuals with low socioeconomic position (SEP) more than individuals with high SEP. It is unknown if this so-called alcohol harm paradox is also present in adolescents. We aim to test the hypothesis that low SEP is associated with more alcohol-related harm as compared with higher SEP in Danish adolescents.

Methods We used survey data from the Danish National Youth Study 2014 including 70 566 students from 119 high schools. Alcohol-related harm was measured by self-report as having been in a fight, involved in an accident, had problems with parents or friends, had sex that was regretted afterwards and done drugs that was regretted afterwards, because of alcohol. Further, a combined measure was constructed defined as having experienced any harm more than once within the last year. SEP was measured as parents’ educational level, family income, parents’ employment status and experiencing financial strain in the family. Analyses were adjusted by age, sex, perceived ethnicity, class type and binge drinking.

Results Lower SEP was associated with higher odds of experiencing alcohol-related harm more than once as compared with highest SEP, and lower SEP was associated with higher odds of having been in a fight, problems with parents or friends, sex and regretting afterwards or drugs and regretting afterwards, as compared with highest SEP. These associations were statistically significant. Adjustment for the frequency of binge drinking did not change results.

Conclusion The alcohol harm paradox exists in Danish adolescents, and this should be addressed in future prevention strategies to reduce the risk of alcohol-related harm among adolescents.

  • adolescents
  • alcohol
  • alcohol-related harm
  • socioeconomic differences

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  • Contributors SPM and JT planned and designed the study. SPM was responsible for data management and analyses, and drafted the manuscript. All the authors contributed to the interpretation of study results, critical revision of the paper and approval of the final version, and agree to be accountable for all aspects of this article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Approval of the study was obtained from the Danish Data Protection Agency (J. No. 2013-54-0526).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data may be obtained from a third party and are not publicly available.