What Characterizes Municipalities With Stronger Local Alcohol Prevention Efforts in Sweden? A Study of 209 Municipalities During 2011-2021.

AIMS: Over the past 20-25 years, Sweden has placed growing focus on local alcohol prevention, as reflected in national action plans. However, municipal efforts vary considerably. Identifying the factors that influence stronger local alcohol prevention is important, given its association with reduced alcohol-related harm. The present study aims to examine the characteristics of municipalities with more comprehensive alcohol prevention efforts, focusing on: (i) need, indicated by alcohol consumption and related problems; (ii) financial resources; (iii) political orientation; and (iv) sociodemographic and socioeconomic factors.

METHODS

Local alcohol prevention is measured using a developed version of the Alcohol Policy Magnitude Measure (APMM), covering 209 municipalities from 2011 to 2021. Linear and logistic regressions examine how APMM scores relate to factors such as alcohol use, harm, resources, politics and demographics. Both crude and adjusted models assess the robustness of these associations.

RESULTS

Left-wing governance, larger populations and younger demographics were consistently linked to higher alcohol prevention levels. Of four need indicators, only one showed a consistent association. Financial resources were significant only in adjusted models, while education and foreign background showed mixed results. Unemployment was not associated with alcohol prevention, and income was significant only in crude models. These patterns were largely confirmed in analyses focusing on the top 10% of municipalities in terms of prevention activity.

CONCLUSIONS

Stronger alcohol prevention was not linked to higher consumption, harm or resources, but rather to left-wing governance, larger populations and younger residents. This highlights the influence of political and sociodemographic factors on local prevention levels.