Skip to main content

Advertisement

SpringerLink
Log in

The societal cost of alcohol consumption: an estimation of the economic and human cost including health effects in Sweden, 2002

  • Original paper
  • Published:
The European Journal of Health Economics Aims and scope Submit manuscript

Abstract

This article estimates the societal cost of alcohol consumption in Sweden in 2002, as well as the effects on health and quality of life. The estimation includes direct costs, indirect costs and intangible costs. Relevant cost-of-illness methods are applied using the human capital method and prevalence-based estimates, as suggested in existing international guidelines, allowing cautious comparison with prior studies. The results show that the net cost (i.e. including protective effects of alcohol consumption) is 20.3 billion Swedish kronor (SEK) and the gross cost (counting only detrimental effects) is 29.4 billon (0.9 and 1.3% of GDP). Alcohol consumption is estimated to cause a net loss of 121,800 QALYs. The results are within the range found in prior studies, although at the low end. A large number of sensitivity analyses are performed, indicating a sensitivity range of 50%.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Notes

  1. A full account of methods, data and results are reported in Johansson et al. [7].

  2. The included diseases are malignant neoplasms (C00-C14, C15, C16, C22, C32, C50, D00-D48), diabetes (E10-E14), neuro-psychiatric conditions (F10, F32-F33, G31.2, G40-41, G62.1), cardiovascular diseases (I10-15, I20-I24, I25.1-I25.9, I42.6, I47-I49), cerebrovascular diseases (I60-I62, I63-I66, I85), digestive diseases (K29.2, K70, K74, K80, K85, K86.0, K86.1), skin disease (L40), conditions arising during the perinatal period (Q86.0, R78.0) and other diseases (E24.4, G72.1, O35.4, P04.3, T51, Z72.1).

  3. The complete ICD-10 chapters V, W, X and Y, divided into different causes of injuries.

  4. Adjustment by multiplying the AAF for traffic accidents by 2/3 and all other accidents by 4/9.

  5. The age groups used are 0-14, 15–17, 18–29, 30–49, 50–64, 65–79 and 80+.

  6. The groups are abstainers (no alcohol within last year), low consumption (women 0–19.99 g, men 0–39.99 g), hazardous consumption (women 20–39.99 g, men 40–59.99 g) and harmful consumption (women 40+ g, men 60+ g).

  7. Includes 1,500 respondents aged 16–80 each month.

  8. Mainly concerning motor vehicle, water traffic and drowning, and fire accidents as well as homicides.

  9. Additional costs as a consequence of crime are health care and productivity costs, which are accounted for under these headings.

  10. No longer a criminal offence, it involves the police with the task of bringing the person into a safe environment.

  11. No future costs are calculated for direct costs, thus no discount rate has been applied.

  12. Before taxes, i.e. including the contribution to the social welfare system.

  13. Early retirement can be granted fully or in part.

  14. Longer than 14 days and paid for by the national sickness insurance.

  15. The Swedish Survey of Living Conditions (ULF).

  16. http://www.who.int/substance_abuse/research_tools/en/english_whoqol.pdf

  17. Some figures differ between this article and the original report [7] due to minor corrections of mainly computational errors.

  18. The net per capita cost is equivalent to $243 and the gross to $352 (PPP USD).

  19. See Johansson et al. [7] for a full account of methods and results from all sensitivity analyses.

  20. Hybrid approach [12], friction cost method [40], cost in added life-years [41, 21], exclusion of non-market productivity and different valuations of non-market productivity.

  21. The method uses the difference between market production and market consumption at different ages as a value of lost life-years.

  22. 2,800 SEK per capita aged 15 and above.

  23. Where all credible analyses were in the range of 50% of the point estimate of 20.3 billion SEK.

  24. Human capital, hybrid, willingness-to-pay, and demographic method are employed in different studies.

References

  1. Ridolfo, B., Stevenson, C.: The quantification of drug-caused mortality and morbidity in Australia, 1998. Canberra Australian Institute of Health and Welfare, Canberra (2001). http://www.aihw.gov.au/publications/index.cfm/title/6461

  2. Corrao, G., Bagnardi, V., Zambon, A., Arico, S.: Exploring the dose–response relationship between alcohol consumption and the risk of several alcohol-related conditions: a meta-analysis. Addiction 94, 155–1573 (1999)

    Article  Google Scholar 

  3. Fillmore, K.M., Kerr, W.T., Stockwell, T., Chikritzhs, T., Bostrom, A.: Moderate alcohol use and reduced mortality risk: systematic error in prospective studies. Addict. Res. Theory 14, 101–132 (2006)

    Article  Google Scholar 

  4. Room, R., Rossow, I.: The share of violence attributable to drinking. J. Subst. Use 6, 218–228 (2001)

    Article  Google Scholar 

  5. Single, E., Collins, D., Easton, B., Harwood, H., Lapsley, H., Kopp, P., Wilson, E. (eds): International guidelines for estimating the costs of substance abuse, 2nd edn. World Health Organization, Geneva (2003)

  6. Single, E.: International guidelines for estimating the economic costs of substance abuse. In: 2nd Window of Opportunity National Congress, Brisbane, Australia (1995)

  7. Johansson, P., Jarl, J., Eriksson, A., Eriksson, M., Gerdtham, U-G., Hemström, Ö., Hradilova Selin, K., Lenke, L., Ramstedt, M., Room, R.: Swedish costs of alcohol in 2002. SoRAD Rapportserie nr. 36. SoRAD, Stockholm (2006). http://www.sorad.su.se/doc/uploads/publications/ENG%20COA%2025%20oktober.pdf

  8. Markandya, A., Pearce, D.: The social costs of tobacco smoking. Br. J. Addict. 84, 1139–1150 (1989)

    Article  Google Scholar 

  9. Single, E., Robson, L., Rehm, J., Xie, X.: The economic costs of alcohol, tobacco and illicit drugs in Canada 1992. Addiction 93(7), 991–1006 (1998)

    Article  Google Scholar 

  10. NIDA: The Economic Cost of Alcohol and Drug Abuse in the United States—1992. National Institute on Drug Abuse, Rockville (2002). http://www.nida.nih.gov/EconomicCosts/Index.html

  11. Collins, D.J., Lapsley, H.M., Brochu, S., Easton, B., Perez-Gomez, A., Rehm, J., Single, E.: International guidelines for estimation of avoidable costs of substance abuse. Health Canada, Toronto (2006). http://www.hc-sc.gc.ca/hl-vs/pubs/adp-apd/cost-cout-abus/index_e.html

  12. Rehm, J., Baliunas, D., Brochu, S., Fischer, B., Gnam, W., Patra, J., Popova, S., Sarnocinska-Hart, A., Taylor, B.: The social cost of substance abuse in Canada 2002. CCSA, Ottawa (2006). Highlights at: http://www.ccsa.ca/NR/rdonlyres/18F3415E-2CAC-4D21–86E2-CEE549EC47A9/0/ccsa0113322006.pdf

  13. Collins, D.J., Lapsley, H.M.: Counting the cost: estimates of the social costs of drug abuse in Australia in 1998–1999. National Drug Strategy, Monograph Series No. 49. Australian Government Printing Service, Canberra (2002)

    Google Scholar 

  14. UK Strategy Unit (2003) Alcohol misuse: how much does it cost? Cabinet Office, Strategy Unit, London

  15. Jarl, J., Gerdtham, U-G., Lyttkens, C.H., Lithman, T., Merlo, J.: The Danish effect on Swedish alcohol cost: an analysis based on hospitalisation data from southern Sweden. Eur. J. Health. Econ. 7(1), 46–54 (2006)

    Article  Google Scholar 

  16. Mäkelä, P.: Alcohol-related mortality by age and sex and its impact on life expectancy. Eur. J. Public. Health 8, 43–51 (1998)

    Article  Google Scholar 

  17. Lindholm, M.: Alkoholpåverkade personbilsförare inblandade I dödsolyckore. 2002 Publikation 2004:161. Vägverket, Borlänge (2004)

    Google Scholar 

  18. Rehm, J., Room, R., Monteiro, M., Gmel, G., Graham, K., Rehn, N., Sempos, C.T., Frick, U., Jernigan, D.: Alcohol use. In: Ezzati, M., Lopez, A.D., Rodgers, A., Murray C.J.L. (eds.) Comparative Quantification of Health Risks: Global and Regional Burden of Disease Attributable to Selected Major Risk Factors, vol. 1, pp. 959–1108. World Health Organization, Geneva (2004)

    Google Scholar 

  19. Leifman, H., Gustafsson, N.-K.: En skål för det nya millenniet: en studie av svenska folkets alkoholconsumtion i början av 2000-talet [A toast for the new millennium: a study of the Swedish people’s alcohol consumption at the beginning of the 2000s]. SoRAD Forkningsrapport nr. 11. SoRAD, Stockholm (2003). http://www.sorad.su.se/doc/uploads/publications/Soradrapport-51-Swedish.pdf

  20. CAN: Drogutvecklingen i Sverige [Trends in the Use of Alcohol and Drugs in Sweden]. CAN, Stockholm (2004)

  21. Swedish Pharmaceuticals Board (LFN, Läkemedelsförmånsnämnden): General Guidelines on Economic Evaluations LFNAR 2003:2. Pharmaceutical Benefits Board, Solna (2003). http://www.lfn.se/upload/ENG_lfna4003-eng.pdf

  22. Statskontoret: Utnyttja företagshälsovården bättre [Make Better Use of the Workplace Care]. Statskontoret, Stockholm 2001: 29 (2001)

  23. National Board of Health and Welfare: Insatser och klienter i behandlingsenheter inom missbrukarvården den 2 april 2003 [Measures and Clients in Treatment Units]. Socialstryelsen, Stockholm (2003)

  24. Brand, S., Price, R.: The Economic and Social Costs of Crime. Home Office, Research Study, London (2000)

  25. Norström, T.: Effects on criminal violence of different beverage types and private and public drinking. Addiction 93, 689–699 (1998)

    Article  Google Scholar 

  26. Andersson, H.: Anlagda bränders omfattning, motiv och påverkansfaktorer [Extent, Motives and Influences on Arson] Dissertation, Department of Criminology, Stockholm University, Stockholm (1995)

  27. Roos, H-E.: Vandalism i storstad och glesbygd [Vandalism in the Big City and the Suburb]. Byggforskningsrådet/Liber, Lund (1986)

  28. Brottsförebyggande rådet: Våldtäkt: En kartläggning av polisanmälda våldtäkter [Rape: A Mapping of Reported Rapes]. Rapport 2005, vol. 7. Brottsförebyggande rådet, Stockholm (2005)

  29. Pernanen, K., Brochu, S., Cousineau, M.-M., Cournoyer, L.-G., Sun, F.: Attributable fractions for alcohol and illicit drugs in relation to crime in Canada: conceptualization, methods and internal consistency of estimates. Bull. Narc. 52, 1–2, 53–67 (2000). http://www.unodc.org/unodc/en/bulletin/bulletin_2000–01–01_1_page006.html

  30. Pernanen, K., Cousineau, M-M., Brochu, S., Sun, F.: Proportions of Crimes Associated with Alcohol and Other Drugs in Canada. Canadian Centre of Substance Abuse, Ottawa (2002)

  31. Midanik, L.T.: Biomedicalization and alcohol research in Sweden. In: Biomedicalization of Alcohol Studies: Ideological Shifts and Institutional Challenges, pp 123–139. Aldine Transaction, New Brunswick (2006)

  32. Eriksson, A., Fondén, C.: Koll på krogen?—kommunala alkoholhandläggares arbetssituation [Check Up on Restaurants? Local Alcohol Regulation Inspectors’ Work Situation]. SoRAD Rapportserie, nr 31, Stockholms universitet. SoRAD, Stockholm (2006). http://www.sorad.su.se/doc/uploads/publications/SoRADrapport31.pdf

  33. Alkoholinspektionen [The Alcohol Inspection].: Annual report 1999 (2000)

  34. Gold, M.R., Siegel, J.E., Russel, L., Weinstein, M.C. (eds.): Cost-Effectiveness in Health and Medicine. Oxford University Press, New York (1996)

  35. Statistics Sweden. Lönestatistisk årsbok 2002 [Statistical Yearbook of Salaries and Wages 2002]. SCB, Stockholm (2003)

  36. Statistics Sweden. Tidsanvändingsstudien [The Study on Time Use]. SCB, Stockholm (2002). http://www.scb.se/templates/Standard38872.asp

  37. Burström, K., Johannesson, M., Diderichsen, F.: Health-related quality of life by disease and socio-economic group in the general population in Sweden. Health Policy 55, 51–69 (2001)

    Article  Google Scholar 

  38. Kraemer, K.L., Roberts, M.S., Horton, N.J., Palfai, T., Samet, J.H., Freedner, N., Tibbetts, N., Saitz, R.: Health utility ratings for a spectrum of alcohol-related health states. Med. Care 43, 541–550 (2005)

    Article  Google Scholar 

  39. Dubourg, R., Hamed, J., Thorns, J.: Estimating the cost of the impacts of violent crime on victims. In: The Economic and Social Costs of Crime Against Individuals and Households 2003/04, pp. 31–43. UK Home Office (Home Office Online Report 30/05), London (2005). http://www.homeoffice.gov.uk/rds/pdfs05/rdsol1005.pdf

  40. Koopmanschap, M.A., Rutten, F.F.H., van Ineveld, B.M., van Roijen, L.: The friction cost method for measuring indirect costs of disease. J. Health. Econ. 14, 171–89 (1995)

    Article  Google Scholar 

  41. Johannesson, M., Meltzer, D.: Some reflections on cost-effectiveness analysis. Health. Econ. 7, 1–7 (1998)

    Article  Google Scholar 

  42. Scottish Executive: Alcohol misuse in Scotland: trends and costs. Scottish Executive, Edinburgh (2001). http://www.alcoholinformation.isdscotland.org/alcohol_misuse/files/Catalyst_Full.pdf

  43. Gjelsvik, R.: Utredning av de samfunnmessige kostnadene relatert til alkohol [Inquiry into societal costs related to alcohol]. Program for helseekonomi. Nr 07/04 Bergen. University of Bergen, Bergen, Norway (2004)

  44. Karlsson, T., Österberg, E.: A scale of formal alcohol control policies in 15 European countries. Nord. Alkohol Narkotikatidskr. 18 (English suppl.), 117–131 (2001)

  45. Room, R. (ed.): The Effect of Nordic Alcohol Policies—what happens to drinking and harm when alcohol controls change? NAD publication no. 42. NAD, Helsingfors (2002) http://www.nad.fi/pdf/NAD_42.pdf

  46. Allebeck, P., Moradi, T., Jacobsson, A.: Sjukdomsbördan i Sverige och dess riskfaktorer. Svensk tillämpning av WHO:s “DALY-metod” för beräkning av sjukdomsbörda och riskfaktorer [The burden of disease in Sweden and its risk factors. Swedish application of WHO’s “DALY-method” for the calculation of the burden of disease and risk factors]. Statens folkhälsoinstitut, Östersund (2006)

    Google Scholar 

  47. Hemström, Ö.: Per capita alcohol consumption and ischemic heart disease mortality. Addiction 96 (Suppl. 1), S93–S112 (2001)

    Article  Google Scholar 

Download references

Acknowledgements

This project was funded by the Swedish Ministry for Health and Social Affairs and the Swedish Institute of Public Health (for Gerdtham).

Author information

Authors and Affiliations

  1. Health Economic Program (HEP), Department of Clinical Sciences, Lund University, S-205 02, Malmo, Sweden

    Johan Jarl & Ulf-G. Gerdtham

  2. Stockholm Centre for Public Health, Stockholm County Council, Stockholm, Sweden

    Pia Johansson

  3. Centre for Social Research on Alcohol and Drugs (SoRAD), Stockholm University, Stockholm, Sweden

    Antonina Eriksson, Mimmi Eriksson, Klara Hradilova Selin, Mats Ramstedt & Robin Room

  4. Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden

    Örjan Hemström

  5. Centre for Epidemiology, The National Board of Health and Welfare, Stockholm, Sweden

    Örjan Hemström

  6. Department of Criminology, Stockholm University, Stockholm, Sweden

    Leif Lenke

  7. AER Centre for Alcohol Policy Research, Turning Point Alcohol and Drug Centre and University of Melbourne, Melbourne, Australia

    Robin Room

Authors
  1. Johan Jarl
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pia Johansson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Antonina Eriksson
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mimmi Eriksson
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ulf-G. Gerdtham
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Örjan Hemström
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Klara Hradilova Selin
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Leif Lenke
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Mats Ramstedt
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Robin Room
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Johan Jarl.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Jarl, J., Johansson, P., Eriksson, A. et al. The societal cost of alcohol consumption: an estimation of the economic and human cost including health effects in Sweden, 2002. Eur J Health Econ 9, 351–360 (2008). https://doi.org/10.1007/s10198-007-0082-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10198-007-0082-1

Keywords

Search

Navigation