Alcoholic beverage preferences among teenagers in Finland before and after the 2018 alcohol law change

Rese arc h re port Al c o h oli c b e v e r a g e p r ef er e n c es a m o n g t e e n a g ers i n Fi nl a n d b ef or e a n d aft er t h e 2 0 1 8 al c o h ol l a w c h a n g e T o mi Li nt o n e n Fi n nis h F o u n dati o n f or Alc o h ol St u di es, H elsi n ki, Fi nla n d S u vi A hti n e n Fi n nis h F o u n dati o n f or Alc o h ol St u di es, H elsi n ki, Fi nla n d A n n e K o n u Ta m p er e U niv ersity, Ta m p er e, Fi nla n d A bst r a ct Ai ms: T h e alc o h ol la w c ha ng e i n Fi nla n d i n t h e b egi n ni ng of 2 0 1 8 was f or ecast t o s hift alc o h ol sal es fr o m alc o h ol m o n o p ol y st or es t o gr oc ery st or es. T h e tr e n d of d ecli ni ng a d ol esc e nt alc o h ol us e was pr e dict e d t o e n d. T his st u dy ai m e d t o pr ovi d e a m or e d etail e d vi e w o n u n d er-ag e dri n ki ng c ha ng e t hr o ug h a nalysi ng alc o h olic b ev erag e us e pr ef er e n c es a m o ng 1 4 a n d 1 6 y ear ol ds i n Fi nla n d fr o m 2 0 1 7 t o 2 0 1 9. M et h o ds: Nati o nally r e pr es e ntativ e s urv eys of a d ol esc e nt h ealt h b e havi o urs i n Fi nla n d fr o m 2 0 1 7 (n ¼ 2 4 5 1) a n d 2 0 1 9 ( n ¼ 2 1 1 9) a m o ng 1 4 a n d 1 6 y ear ol ds w er e a nalys e d usi ng cr oss-ta b ulati o ns a n d l ogisti c r egr essi o n m o d elli ng. B ev erag e data w er e c o d e d fr o m a n o p e ne n d e d q u esti o n c o nc er ni ng t h e lat est dri n ki ng occasi o n. R es ults: T h e pr o p orti o n of 1 4 a n d 1 6-y earol d girls r e p orti ng dri n ki ng alc o h ol was 4 1 % i n 2 0 1 7 a n d 4 5 % i n 2 0 1 9. T h e c orr es p o n di ng pr o p orti o ns a m o ng b oys w er e 3 9 % i n 2 0 1 7 a n d 4 3 % i n 2 0 1 9. T h e s har e of alc o h ol c o ns u m e d i n t h e f or m of b e er, alc o p o ps a n d ci d er i ncr eas e d a m o ng girls fr o m 5 5 % t o 7 5 %, b ut t h e a p par e nt i ncr eas e a m o ng b oys fr o m 6 9 % t o 7 6 % was n ot statistically sig nifica nt. T h e o nly b ev erag e ty p e cat eg ory t hat i ncr eas e d i n p o p ularity fr o m t h e y ear 2 0 1 7 t o 2 0 1 9 was alc o p o ps. C o n cl usi o ns: T h e la w c ha ng e bri ngi ng str o ng alc o p o ps, b e er a n d ci d er i nt o gr oc ery st or es i ncr eas e d t h eir c o ns u m pti o n – es p ecially a m o ng t h e u n d er-ag e d. C o m pr e h e nsi v e m eas ur es i ncl u di ng ta xati o n, r estri cti o ns o n S u b mitt e d: 1 3 S e pt e m b er 2 0 1 9; ac c e pt e d: 1 0 F e br uary 2 0 2 0 C or r es p o n di n g a ut h or: T o mi Li nt o n e n, Fi n nis h F o u n dati o n f or Alc o h ol St u di es, Ma n n er h ei mi nti e 1 6 6, H elsi n ki, 0 0 2 7 1 Fi nla n d. E mail: t o mi.li nt o n e n @al k o h olit ut ki m ussaati o.fi N or dic St u di es o n Alc o h ol a n d Dr ugs 1–12 ªT h e A ut h or(s) 2 0 2 0 Articl e r e us e g ui d eli n es: sag e p u b.c o m/j o ur nalsp er missi o ns D OI: 10.1177/1455072520910547 j o ur nals.sag e p u b.c o m/ h o m e/ na d Cr eativ e C o m m o ns N o n C o m m ercial C C B YN C: T his arti cl e is distri b ut e d u n d er t h e t er ms of t h e Cr eativ e C o m m o ns Attri b uti o nN o n C o m m er cial 4. 0 Lic e ns e ( htt ps:// cr eati v ec o m m o ns. org/lic e ns es/ bync/ 4. 0/) w hic h p er mits n o n-c o m m ercial us e, r e pr o d ucti o n a n d distri b uti o n of t he w or k wit h o ut f urt h er p er missi o n pr ovi d e d t h e origi nal w or k is attri b ut e d as s p ecifi e d o n t he S A G E a n d O p e n Acc ess pag es ( htt ps:// us.sag e p u b.c o m/ e nus/ na m/ o p e n-acc ess-at-sag e). a dv ertisi ng a n d sal es aff e cti ng t h e p o p ulati o n t otal c o ns u m pti o n ar e als o li k ely t o r e mai n t h e k eys t o r e d uci ng al c o h ol c o ns u m pti o n a m o ng a d ol esc e nts. I n a d diti o n, eff ectiv e ag e-li mit c o ntr ol a n d sa ncti o ns agai nst n egl ecti ng ag e-r estricti o n e nf orc e m e nt ar e n e e d e d. K e y w o r ds a d ol esc e nt, alc o h ol, alc o p o p, b ev erag e ty p e Al c o h ol p oli c y i n m ost N or di c c o u ntri es ( Fi nla n d, Icela n d, N or w a y a n d S w e de n) has traditi o n all y reste d o n t hre e m ai n pillars: restricti o ns o n b usi n ess i nt er ests i n t h e al c o h ol d o mai n, restricti o ns o n t h e a v aila bilit y of alc oh oli c b e vera g es, a n d restricti o ns o n aff or d a bilit y b y m e a ns of alc o h ol t a xati o n ( Br u u n et al., 1 9 7 5). Fi nla n d h a d a n alc o h ol m o n o p ol y fr o m 1 9 3 2 u ntil Fi nla n d j oi n e d t he E U i n 1 9 9 5: pr od u cti o n, i m p ort, e x p ort a n d s al es as w ell as s u p er visi o n a n d c o ntr ol w er e i n g o v er n m e nt ha n ds ( Ma¨ k ela¨, O ¨ster ber g, & S ul k u n e n, 1 9 8 1). T h e o nl y e x c e pti o n w as t h e a v ail a bilit y of m e di u m-str e n gt h b e er i n gr o cer y st ores fr o m 1 9 6 9. R el ati n g t o E U r e q uir e m e nts, t h e ne w Alc o h ol A ct ( 1 1 3 4/ 1 9 9 4) i n cl u d e d t h e a b olis h me nt of t h e m o n o p ol y o n alc o h ol i m p orts, e x p orts, pr o d u cti o n a n d w h ol es ale. T h e r et ail s al es m o n o p ol y o n s pirits a n d wi n es w as r et ai n e d, w h ere as li g ht er b e v er a g es c o ul d b e s ol d offpr e mis es i n gr o c er y s h o ps, ki os ks a n d p etr ol st ati o ns. Al c o h ol l a w c h a n g es ar e k n o w n t o i nfl u e n c e p o p ul ati o n t ot al c o ns u m pti o n ( B a b or et al., 2 0 0 3; Br u u n et al., 1 9 7 5). I n Fi nl a n d, t h e 1 9 9 5 l a w c h a n g e r es ult e d i n a n i n cr e as e i n t ot al p o p ul ati o n c o ns u m pti o n ( N ati o n al I nstit ut e f or H e alt h a n d W elfar e, 2 0 1 8) as w ell as a m o n g a d ol esc e nts ( Li nt o n e n, K arlss o n, N e v al ai n e n, & K o n u, 2 0 1 3). Strict alc o h ol p oli ci es ha ve b ee n s h o w n t o c orr el at e ne g ati v el y w it h p o p ul ati o n al c o h ol c o ns u m pti o n i n O E C D c o u ntri es ( Br a n d, Sais a n a, R y n n, Pe n n o ni, & L o w e nfels, 2 0 0 7) as well as less alc o h ol dri n ki n g a m o n g 1 5 t o 1 7y e arol d a d ol es c e nts ( P as c h all, Gr u b e, & K y pri, 2 0 0 9). As i n m ost W est er n c o u ntri es, s elli n g al c o h oli c b e v er a g es t o a d ol es c e nts u n d er t h e a g e of 1 8 y e ars is pr o hi bit e d i n Fi nla n d. T h e alc o h ol p oli c y c h a n g es si n c e t he Alc o h ol Act ( 1 1 3 4/ 1 9 9 4) u p t o 2 0 1 7 h a ve pred o mi na ntl y be e n ai me d at de cre asi n g t otal c o ns u m pti o n a n d r estricti n g u n d era g e alc o h ol us e ( Li nt o ne n, A hti n e n, & K o n u, 2 0 1 8). T he alc oh ol l a w was c ha n g e d at t h e be gi n ni n g of 2 0 1 8 ( Mi nistr y of S ocial Affairs a n d H ealt h, 2 0 1 8). T h e m ost n ot a bl e c h a n g e was a n i n cre as e i n all o w e d et h a n ol c o nt e nt i n b e v er a g es s ol d t hr o u g h gr oc er y st or es fr o m 4. 7% t o 5. 5% ; t he n u m ber of p oi nts of s al e of str o n g be er, str o n g ci d er a n d str o n g al c o p o ps i n cr e as e d 1 5-f ol d ( M a¨ k el a¨ & O ¨ster b er g, 2 0 1 7). I n a d diti o n, t he l a w c h a n g e r e m o v e d r estri cti o ns o n t h e s ales of al c o p o ps a n d a b olis h e d or r e d u c e d s e v er al ot h er r estri cti o ns o n t h e s al es of al c o h oli c b e v er a g es ( Mi nistr y of S o ci al Aff airs a n d H ealt h, 2 0 1 8). T h e Fi n nis h I nstit ute f or H ealt h a n d Welfare esti m at e d t hat t h e la w c h a n g e w o ul d i n cr e as e p o p ul ati o n-l e v el al c o h ol c o ns u m pti o n d u e t o i n cr e as e d a v ail a bilit y, d e cr e as e d pri c e a n d i n cr e as e d m ar k eti n g ( M a¨ k el a¨ & O ¨st er b er g, 2 0 1 7). St at e m e nts o n t h e l a w c h a n g e hi g hli g hte d t h e n e gati v e i m p a ct t h e l a w c h a n g e ha d o n a d oles ce nt alc o h ol us e ( S T M 0 7 5: 0 0/ 2 0 1 1, 2 0 1 7). E x p ert or ga nisati o ns as well as or ga nis ati o ns s p e ci alisi n g i n al c o h ol tr e at m e nt st at e d t h at t h e c h a n g es h a v e a si g nifi c a nt n e g ati v e i m p act o n t he wellb ei n g of c hil dr e n, a d olesce nts a n d f a milies. A n e w t a x o n str o n g alc op o ps w as s u g g este d t o b al a nc e t he i ncreasi n g a v aila bilit y a n d e x p ecte d d ecr easi n g pri ce; t his w o ul d h el p t o c o ntr ol t h e f ores ee n i n crease i n h ar m t o a d ol es c e nts. D u e t o t his s e v er e 2 Nor dic St u dies o n Alco h ol a n d Dr ugs criti cis m, a d ecisi o n w as m a d e t o c o u nt er act s o me of t he e x p ecte d ris e i n h ar m b y i ncre asi n g alc o h ol t a xes si m ult a ne o usl y t o t he n e w alc o h ol la w ta ki n g effe ct ( H E 1 6 9/ 2 0 1 7, 2 0 1 7). At t he p o p ulati o n l e v el, t h e t otal c o ns u m pti o n of alc o h olic b e vera g es i n 1 0 0% et ha n ol p er ca pita a g e d 1 5 y ears a n d o ver i n Fi nla n d w as 1 0. 3 litres i n 2 0 1 7 ( N ati o n al I nstit ute f or H ealt h a n d W elf ar e, 2 0 1 8). R e c or d e d c o ns u m pti o n (t otal c o ns u m pti o n mi n us esti m at e d p ass e n g er i m p orts, c o ns u m pti o n a br o a d, ille g al distillati o n a n d s m u g gli n g, a n d h o me bre wi n g a n d distill ati o n) fi g ur es f or 1 0 0% et h a n ol w er e 8. 4 litr es per c a pita a ge d 1 5 ye ars or ol d er b ot h i n 2 0 1 7 a n d 2 0 1 8 ( V al vira Nati o n al S u p er vis or y A ut h orit y f or W elfar e a n d He alt h, 2 0 1 9). C o ns u m pti o n statisti cs s h o we d t h at i n t h e p eri o d fr o m J a n u ar y t o A pril 2 0 1 9, re c or d e d c o ns u m pti o n h a d d e cr e as e d 0. 6% ( V al vir a N ati o n al S u p er vis or y A ut h orit y f or W elfar e a n d He alt h, 2 0 1 9). Alt h o u g h littl e c h a n g e w as s e e n i n re c or d e d c o ns u m pti o n, r et ails sales i n gr oc er y st ores a n d ot her p oi nts of sale, e xcl u di n g t he alc o h ol m o n o p ol y ( Al k o I n c.) st or es, i n cre ase d b y 4. 6 % i n 2 0 1 8 c o m pare d wit h 2 0 1 7. T h e l a w c h a n ge t h us s hifte d alc o h ol p ur c hases fr o m t h e m o n o p ol y st or es t o gr oc er y st or es. T h e pr eferre d be v er a g e i n Fi nla n d h as tr a diti o n all y b e e n m e di u m-str e n gt h be er, w hic h has ac c o u nte d f or al m ost half of t h e t otal c o ns u m pti o n ( Ti gerste dt, K arlss o n, & Ha¨r k o¨ ne n, 2 0 1 8). T his c h a n g e d t o war ds str o n g er be er after t h e l a w t o o k eff e ct: str o n g b e er a c c o u nt e d f or 4. 0 % of et h a n ol i m bi b e d i n t h e f or m of be er i n 2 0 1 7 b ut 1 2. 3% i n 2 0 1 8 ( V al vir a Nati o n al S u p er vis or y A ut h orit y f or W elfar e a n d He alt h, 2 0 1 9). A m ore n ota ble c h a n g e w as s e e n i n t h e s h are of str o n g alc o p o ps ( o v er 4. 7% alc o h ol) of all al c o p o ps (r e a d ym a d e mi xt ur es of s oft dri n ks a n d al c o h ol): t h e s h ar e of 3 2. 7 % i n 2 0 1 7 i n cr e as e d t o 7 0. 6 % i n 2 0 1 8 ( V al vir a N ati o n al S u p er vis or y A ut h orit y f or W elf ar e a n d H e alt h, 2 0 1 9). S o m e c h a n g e w as s e e n wit hi n ci ders ( 1. 1 % t o 5. 0% ). T he s ales of wi n e s ol d e x cl usi v el y i n Al k o m o n o p ol y st or es de cre ase d b y 1. 8 % fr o m 2 0 1 7 t o 2 0 1 8, a n d t he sales of str o n g alc o h olic b e v era g es d e cr eas e d b y 3. 3 % ( V al vira Nati o n al S u p er vis or y A ut h orit y f or W elfar e a n d H e alt h, 2 0 1 9). Alc o h olic b e v era g es h a ve si g nific a ntl y diff eri n g a v ail a biliti es i n Fi nl a n d. L o walc o h ol b e v er a g es ( b eer, ci d er, alc o p o ps) ca n b e p urc h ase d fr o m e ver y gr oc er y st or e, ki os k a n d s ervi c e st ati o n. B ef or e t h e 2 0 1 8 l a w c h a n g e, str o n g er b e v era g es s u c h as str o n g b e er, wi n e a n d s pirits w ere o nl y a v ail a bl e t hr o u g h st ate m o n o p ol y st or es, w hic h are k n o w n t o e x c el i n e nf orc e m e nt of alc o h ol sales a g e-li mits c o mp ar e d wit h gr o c er y st or es a n d es p e ci all y s m all er b usi n ess es s u c h as s er vi c e st ati o ns ( War pe ni us, H ol mila, & R aitasal o, 2 0 1 2). T h e l a w c h a n g e t h us e as e d u n d era g e a c c ess t o str o n g er alc o h ol. As i n m a n y i n d ustrialis e d c o u ntries w orl dwi d e ( d e L o o z e et al., 2 0 1 5; Kra us et al., 2 0 1 8), Fi n nis h u n der-a ge d a d olesc e nts d ecr eas e d t heir dri n ki n g ( Ki n n u n e n et al., 2 0 1 9) aft er t h e t ur n of t h e mille n ni u m. R es e ar c h o n b e vera g e prefere n ces a m o n g Fi n nis h a d oles ce nts has s h o w n t h at l o w-alc o h ol be v er a g es a cc o u nt f or m ost of t h e alc o h ol c o ns u me d b y t he u n d era ge d ( Li nt o n e n & K o n u, 2 0 0 1). I n 1 9 9 9, alc o h ol i n t h e f or m of be er, ci d er a n d alc o p o ps a m o u nte d t o 6 3 % of all alc o h ol c o ns u me d. I n 2 0 1 7, t his pr op orti o n w as u n c ha n g e d at 6 2 % ( Li nt o n e n et al., 2 0 1 8). B eer h as be e n t h e fa v o urite a m o n g b o ys b ut b e v er a g e c h oi c es a m o n g girls h a v e b e e n m or e mi x e d wit h ci d er a n d str o n g b e v er a g es o n t h e t o p of t h e list ( Li nt o n e n et al., 2 0 1 8; Li nt o n e n & K o n u, 2 0 0 1). D uri n g t he b e gi n ni n g of t he mille n ni u m, alc o p o ps m or e t h a n d o u ble d t h eir s h are of 1 0 0% et ha n ol c o ns u m e d b y 1 4 a n d 1 6 y e ar ol ds, b ut t he p o p ularit y of str o n g b e v er a g es als o i n cr e as e d ( Li nt o n e n et al., 2 0 1 8). T h e pr o p orti o n of 1 4y earol d a d ol es c e nts w h o di d n ot dri n k al c o h oli c b e v er a g es w as 7 8 % i n 2 0 1 7 a n d 7 6% i n 2 0 1 9 ( Ki n n u n e n et al., 2 0 1 9). T h e c orr es p o n di n g pr o p orti o ns a m o n g 1 6 y e ar ol ds w er e 4 2 % i n 2 0 1 7 a n d 3 7 % i n 2 0 1 9. I n li g ht of t h e 2 0 1 8 alc o h ol la w c h a n ge ma ki n g it e asier f or t h e u n der-a ge d t o a c c es s str o n g er al c o h oli c b e v er a g es t h a n bef or e, o ur p ur p ose is t o e x a mi ne t h e c h a n ges Li nto ne n et al. 3 i n al c o h oli c b e v er a g e pr ef er e n c es a m o n g 1 4 a n d 1 6 y e ar ol ds i n Fi nl a n d fr o m t h e y e ar 2 0 1 7 t o 2 0 1 9. I n a d diti o n, we will a nal ys e t h e effects of a ge, g e n d er a n d dr u n k e n ness se verit y o n b e v era g e pref er e n c e; fr o m al c o h ol p oli c y a n d h ar m c o ntr ol p oi nts of vie w, it is i m p ort a nt t o st u d y be vera g e pref er e n c e a m o n g dr u n k e nness s u b gr o u ps. M et h o ds T h e A d ol es c e nt H e alt h a n d Lifest yle S ur v e y ( A H L S), h as b ee n c o n d ucte d si nc e 1 9 7 7 wit h data c oll ecti o ns i n 2 0 1 7 a n d 2 0 1 9 ( Ki n n u n e n et al., 2 0 1 9). D at a w er e c olle cte d usi n g s elfa d mi nist er e d q u esti o n n air es b y m ail fr o m Fe br uar y t o J u n e. T hr ee re-i n q uiries were s e nt t o n o n-res p o n d e nts. I n a d diti o n t o a 1 2p a g e pa per q uesti o n n air e, a di git al v ersi o n w as a v aila ble o n t he i nter net. T h e s a m ples w ere m ut uall y i n d e pe n d e nt, nati o n all y re pres e ntati ve s a m ples of 1 2, 1 4, 1 6 a n d 1 8 ye ar ol ds a n d w ere o btai ne d fr o m t h e N ati o n al P o p ulati o n Re gister C e ntr e base d o n p artic ular dates of birt h. T h e a nal ys es c o n ce ntr ate o n d at a f or 1 4 a n d 1 6 y ear ol ds. T h e pr o c e d ur es p erf or m e d w ere i n a c c orda nc e wit h t he et hic al sta n d ar ds of t he i nstit uti o n al rese arc h c o m mitte es, a n d wit h t h e 1 9 6 4 Helsi n ki Declar ati o n a n d its later a me n d me nts or c o m p ara ble et hic al sta n d ar ds ( W orl d Me dical Ass o ciati o n, 1 9 6 4). T h e st u d y pla n a n d data c oll ecti o n pr oce d ur e w er e re vi e we d b y et hi cs c o m mitte es. T h e Et hics C o m mitte e of t h e T a mpere R e gi o n ( Fi nla n d) a p pr o v e d t h e st u d y pr ot o c ol. Filli n g i n t h e q u esti o n n air e w as c o nsi d er e d as a d oles ce nts’ c o ns e nt t o parti cipate a n d n o p are ntal c o nse nt w as re q uire d. I n case t h e r es p o n de nt’s pare nts wis h e d t o i ns p e ct t h e q u esti o n n air e, t h e res p o n d e nt w as i nstr ucte d t o pres e nt t h e q u esti o n nair e t o his/ h er pare nts bef or e a ns weri n g. I n 2 0 1 7, 7 2 3 1 4ye arol d a n d 6 9 7 1 6ye arol d girls r es p o n de d, a n d t h e n u m bers f or b o ys were 5 7 2 ( 1 4 ye ar ol ds) a n d 4 5 9 ( 1 6 y ear ol ds). T h e res p o ns e r ates w ere 5 4 % a n d 5 3 % a m o n g girls, a n d 4 1 % ( 1 4 y) a n d 3 3% ( 1 6 y) a m o n g b o ys. I n 2 0 1 9, 5 8 0 1 4y e arol d a n d 6 3 0 1 6y e arol d girls r es p o n d e d; t h e c orr es p o n di n g n u m b ers f or b o ys w er e 5 0 3 a n d 4 0 6. T h e r es p o ns e r ates w er e 4 4% a m o n g 1 4y earol d a n d 4 7 % a m o n g 1 6y e arol d girls a n d 3 7 % ( 1 4ye arol d b o ys) a n d 3 1% ( 1 6ye arol d b o ys). T h e m e a n a g e of t h e 1 4ye arol d res p o n d e nts was 1 4. 6 y ears; t h e 1 6 y ear ol ds were, o n a vera g e, 1 6. 6 ye ars ol d. T h e pr o p orti o n of 1 4 a n d 1 6y e arol d girls r e p orti n g dri n ki n g al c o h ol was 4 1 % i n 2 0 1 7 a n d 4 5% i n 2 0 1 9. T h e c orres p o n di n g pr o p orti o ns a m o n g b o ys were 3 9% i n 2 0 1 7 a n d 4 3 % i n 2 0 1 9. T h e fre q u e n c y of alc o h ol us e w as i n v estigate d wit h t h e q u esti o n “ H o w ofte n d o y o u us e alc o h ol? Tr y t o i n cl u d e als o t h ose ti mes y o u c o ns u me d o nl y s mall a m o u nts of alc o h ol”. T he res p o ns e c h oic es wer e “ dail y”, “ a f e w ti m es a we e k”, “ o n c e a w ee k ”, “ a fe w ti m es a m o nt h”, “a b o ut o n c e a m o nt h ”, “ a b o ut o n c e i n t w o m o nt hs ”, “ 3 – 4 ti m es a y ear”, “ o n ce a y ear or less fr e q u e ntl y ”, “I d o n ot us e alc o h ol”. Dr u nke n n ess w as m e as ure d wit h t he q u esti o n “ H o w oft e n d o y o u us e alc o h ol u ntil y o u are r eall y dr u n k ? ” T h e r es p o ns e c h oi c es w er e “ o n c e a we e k or m or e ofte n ”, “ o n ce or t wic e a m o nt h”, “l ess fr e q u e ntl y ”, “ n e v er ”. T h e m eas ur es f or dr u n k e n n ess ha ve be e n f o u n d t o be r eas o n a bl y r eli a bl e a n d v ali d ( Li nt o n e n, A hlstr o¨ m, & M ets o, 2 0 0 4; Li nt o n e n & Ri m p el a ¨, 2 0 0 1). A ns weri n g cate g ories w er e c o m bi n e d f or m o delli n g. A n i n dic at or l a b ell e d “ dri n ki n g st yl e” was c o nstr u cte d b y c o m bi ni n g r es p o ns es t o t he q u esti o ns d es cri b e d a b o v e t o f or m m ut u all y e x cl u di n g c ate g ories “ dr u n k w ee kl y ”, “ dr u n k m o nt hl y”, “ dr u n k o ccasi o n all y ” a n d “ dri n ks b ut n ot u ntil dr u n k ”. T h e q ualities a n d q ua ntiti es of al c o h oli c b e v er a g es c o ns u m e d o n t h e l at est dri n ki n g o cc asi o n wer e i n q uir e d after wit h t h e q u esti o n: “ T hi n k b ac k o n y o ur latest dri n ki n g o cc asi o n a n d d es cri b e i n y o ur o w n w or ds as ac c ur at el y as y o u ca n w h at y o u dr a n k a n d h o w m u c h? (If y o u s hare d dri n ks wit h ot h er pe o ple ple ase tr y t o tell us h o w m uc h y o u p ers o n all y dr a n k)” ( Hi bell et al., 1 9 9 7). T h e rates of vali d r es p o ns es t o t his q u esti o n a m o n g eli gi bl e res p o n d e nts (i. e., t h os e re p orti n g alc o h ol dri n ki n g) w ere 7 9% a m o n g 1 4 ye ar ol ds a n d 8 3 % 4 Nor dic St u dies o n Alco h ol a n d Dr ugs a m o n g 1 6 y ear ol ds i n 2 0 1 7, a n d 7 8 % ( 1 4 y) a n d 8 0 % ( 1 6 y) i n 2 0 1 9. T h e o p e ne n d e d a ns w ers wer e c o d e d i nt o b e v er a g e-t y p e c ateg ori es a n d t he a m o u nt of alc o h ol i n p ure et h an ol. T h e c ases w here t h e a m o u nt o n a si n gle oc casi o n e xc e e de d 3 0 c e ntilitr es of p ur e et h a n ol were r e m o v e d fr o m t h e d ata sets ( 1 3 c ases i n 2 0 1 7, 1 1 c ases i n 2 0 1 9) as t h e y w ere d ee m e d i n vali d. T he a nal yses ha ve bee n a dj uste d f or r es p o nde nt’s a ge b y calc ulati n g t he fi g ures first s e p aratel y f or t h e a ge gr o u ps a n d t he n calc ulati n g t he a vera ge of t h ose fi g ures t o re prese nt b ot h 1 4 a n d 1 6 y ear ol ds. Differe n ces b et w ee n t h e gr o u ps ha ve bee n t este d usi n g c hi-s q uare d tests f or cat eg ori cal a n d A N O V A f or c o nti n u o us vari a bles wit h p - val ue of . 0 5 as t he criteri o n f or statistical si g nifi ca nc e. I n a nal yses prese nt e d i n Fi g ure 1, t he gr o u ps were d efi ne d b y st u d y year a n d s pecific alc o h olic be vera ges. I n t he a nal yses prese nte d i n Fi g ur e 2, t h e gr o u ps w er e b ase d o n t he differe nt dri n ki n g st yles a n d alc o h olic b e vera ge t y p es. Differe nces bet w ee n t he a ge gr o u ps were st u di e d usi n g l o gistic re gressi o n m o delli n g. A se nsiti vit y a nal ysis ill ustr ati n g t he effect of differe nt ass u m pti o ns i n alc o h ol per ce nta ge of alc o p o ps, beer or ci d er was perf or m e d i n 2 0 1 9. T he r es p o nses w here t he alc o h ol c o nte nt of t he be vera ge was n ot e x pli citl y state d were first c alc ul ate d f or b eer a n d ci d er as 4. 7 % a n d alc o p o ps as 5. 5% , c orres p o n di n g t o t heir d o mi na nc e i n t he s ales statistics ( V al vir a N ati o n al S u p er vis or y A ut h orit y f or Welf are a n d He alt h, 2 0 1 9). T o test f or s e nsiti vit y t o ass u m pti o ns o n et ha n ol c o nte nt i n cases w here t he r es p o n de nt h a d n ot e x plicitl y state d t he stre n gt h, b eer a n d ci der were c ha n g e d t o 5. 5% a n d alc o p o ps t o 4. 7 % . M o d elli n g is use d i n or der t o f urt her i d e ntif y t h e s u b gr o u ps, a c c o u nti n g f or ot h er f a ct ors, w h ere be vera g e pr efere n ce h as c h a n g e d. L o gistic r e gr essi o n m o dels pre dicti n g s p ecific be vera g e us e o n t h e latest dri n ki n g oc c asi o n w er e e x ec ute d s e p aratel y f or t he fi ve b e vera g e t y p e c at e g ori es: b e er, ci d er, al c o p o ps, wi n e a n d str o n g alc o h oli c b e v era g es. Pr e dict ors e nter e d i n t h e m o d els si m ult a ne o usl y w ere st u d y year, r es p o n d e nt a g e a n d g e n d er, al c o h ol us e fr eq u e nc y a n d dri n ki n g st yle. R es ults T h e t otal p ur e et ha n ol q u a ntities re p orte d o n t h e m ost re ce nt dri n ki n g o ccasi o n w er e o n a v era g e 2. 3 0 cl a m o n g 1 4yearol d a n d 4. 2 4 cl a m o n g 1 6ye arol d girls i n 2 0 1 7, a n d 2. 4 8 cl ( 1 4ye arol d girls) a n d 4. 4 5 cl ( 1 6y e arol d girls) i n 2 0 1 9. F or b o ys, t h e a v er a g e q u a ntiti es w er e 1. 9 7 cl ( 1 4 y) a n d 5. 5 7 cl ( 1 6 y) i n 2 0 1 7, a n d 2. 4 0 cl ( 1 4 y) a n d 6. 0 4 cl ( 1 6 y) i n 2 0 1 9. A m o n g t h e girls, t h e a m o u nt of et h a n ol i m bi be d i n t h e f or m of alc o p o ps (r ea d ym a de mi xt ur es of s oft dri n ks a n d alc o h ol) was, o n a v er a g e, 0. 9 1 cl i n 2 0 1 7 a n d 1. 2 9 cl i n 2 0 1 9 (p ¼ . 0 2). I n 2 0 1 7, alc o p o ps c o nstit ute d 2 4% a n d i n 2 0 1 9, 3 7 % of t he t otal et h a n ol c o ns u m pti o n re p ort e d b y girls ( Fi g ure 1). N o c ha n g e w as o bs er v e d i n t h e a v er a g e a m o u nt of ci d er Fi g u r e 1. T h e distri b uti o n of 1 0 0 % et ha n ol by alc o h olic b ev erag e ty p e r e p ort e d o n lat est dri n ki ng occasi o n a m o ng 1 4 a n d 1 6y earol d girls a n d b o ys i n 2 0 1 7 a n d 2 0 1 9. Li nto ne n et al. 5 c o ns u me d a m o n g girls ( p > . 0 5). T he s h are of be er a m o n g girls w as 1 1 % i n 2 0 1 7 a n d 1 7% i n 2 0 1 9, b ut t h ere w as n o statisti call y si g nific a nt c h a n ge i n t he a m o u nt ( p > . 0 5). A si g nifica nt de cre ase i n a m o u nt of et h a n ol i m bi be d i n t h e f or m of wi ne was o bser ve d b et w ee n 2 0 1 7 a n d 2 0 1 9 ( p < . 0 1). N o c ha n g e i n a v er a g e a m o u nt of str o n g b e vera g es c o ns u me d was o bs er v e d (p > . 0 5). All i n all, mil d b e vera g es, be er, ci der a n d alc o p o ps, a cc o u nte d f or 5 5 % ( 2 0 1 7) a n d 7 5% ( 2 0 1 9; p ¼ . 0 2) of alc o h ol c o ns u me d i n ter ms of 1 0 0 % et ha n ol ( Fi g ure 1). Fi g u r e 2. T h e distri b uti o n of 1 0 0 % et ha n ol by b ev erag e ty p e r e p ort e d o n lat est dri n ki ng occasi o n a m o ng 1 4 a n d 1 6-y earol d girls (l eft) a n d b oys (rig ht) by dri n ki ng styl e i n 2 0 1 7 a n d 2 0 1 9. 6 Nor dic St u dies o n Alco h ol a n d Dr ugs A m o n g t h e b o ys, b eer w as b y f ar t h e m ost p o p ul ar s o ur c e of et h a n ol b ot h i n 2 0 1 7 a n d 2 0 1 9 ( Fi g ur e 1). Str o n g be v er a g es w ere t h e s eco n d m ost p o p ular be v era ge gr o u p i n 2 0 1 7, b ut alc o p o ps a p p ear e d t o h a v e t a ke n t h eir p ositi o n i n 2 0 1 9. N o st atisti c all y si g nifi c a nt c h a n g es fr o m 2 0 1 7 t o 2 0 1 9 w er e o bs er v e d i n t h e a m o u nts of et ha n ol i m bi be d b y b e vera g e t y p e a m o n g b o ys ( p > . 0 5). A m o n g b o ys, mil d be ver a ges a cc o u nte d f or 6 9 % of alc o h ol c o ns u me d i n 2 0 1 7 a n d 7 6% i n 2 0 1 9, b ut t his c h a n g e was n ot statisti call y si g nifica nt ( p > . 0 5). T h e pr o p orti o n of girls r e p orti n g w e e kl y dr u n k e n n ess was u n d er 1 % b ot h i n 2 0 1 7 a n d 2 0 1 9. T h e c h oi c e of alc o h olic b e v er a g e t y p e c o ns u m e d o n t h e l at est dri n ki n g o c c asi o n a m o n g girls t h at w ere dr u n k we e kl y w as differe nt i n 2 0 1 9 c o m p ar e d wit h 2 0 1 7 ( Fi g ur e 2, p < . 0 1). M o nt hl y dr u n k e n n ess w as r e p orte d b y 6 % of t h e girls i n 2 0 1 7 a n d 4 % i n 2 0 1 9, a n d be vera g e c h oices i n t his gr o u p di d n ot c h a n ge (p > . 0 5). Girls r e p orti n g o ccasi o nal dr u n ke nn ess f a v o ur e d al c o p o ps i n 2 0 1 9 i nst e a d of str o n g be v era ges i n 2 0 1 7 (p ¼ . 0 1). Girls w h o r e p ort e d dri n ki n g al c o h oli c b e v er a g es, b ut ne ver u ntil dr u n k, f a v o ur e d ci der a n d alc o p o ps i n 2 0 1 9 i nstea d of ci d er a n d str o n g b e vera g es (p < . 0 1). T h e pr o p orti o ns of b o ys r e p orti n g w ee kl y dr u n k e n n ess wer e u n der 1 % b ot h i n 2 0 1 7 a n d 2 0 1 9, a n d t h e y all dr a n k b e er o n t h e l at est dri n ki n g o c casi o n ( Fi g ure 2). M o nt hl y dr u n k e nness was re p orte d b y 5 % b ot h i n 2 0 1 7 a n d 2 0 1 9. Fa v o ure d b e vera g e c h a n g e d i n t his gr o u p fr o m str o n g b e v er a g es i n 2 0 1 7 t o b e er i n 2 0 1 9 (p < . 0 1). T h er e w as n o c h a n g e i n b e v er a g e c h oic e a m o n g b o ys dri n ki n g oc casi o n all y u ntil dr u n k ( p ¼ . 0 6). Alt h o u g h beer a p p ear e d t o be re pla ce d b y alc o p o ps as t h e n u m ber o ne c h oic e a m o n g b o ys n e ver dri n ki n g u ntil dr u n k, n o statisti c all y si g nifi c a nt c h a n g e w as d et e ct e d (p ¼ . 1 5). A l o gisti c re gr essi o n m o d el pr e dicti n g b eer us e o n t h e l at est dri n ki n g o c casi o n s h o w e d t h at b o ys pref erre d it m or e ofte n t h a n girls; t h os e dri n ki n g u ntil dr u n k pr ef err e d it m or e t h a n t h os e dri n ki n g o nl y s m all a m o u nts; t h os e dri n ki n g m or e fre q u e ntl y als o pref err e d b eer ( T a ble 1, c ol u m n 1). Ci ders wer e f a v o ure d b y 1 6 ye ar ol ds c o m pare d wit h 1 4 y e ar ol ds, a n d b y girls r at h er t ha n b o ys ( T a ble 1, c ol u m n 2). T he l o gisti c re gr essi o n m o dels s h o w e d t h at t he o nl y be vera g e t y p e cate g or y t h at i n cre ase d i n p o p ularit y fr o m 2 0 1 7 t o 2 0 1 9 was al c o p o ps ( T a ble 1, r o w “ Y e ar ”). I n a d diti o n t o b e c o mi n g m or e p o p ular, alc o p o ps were f a v o ur e d b y t he ol d er a g egr o u p, girls c o m p are d wit h b o ys a n d t h ose dri n ki n g u ntil dr u n k ( T a ble 1, c ol u m n 3). Girls were li k el y t o dri n k wi ne m ore oft e n t h a n b o ys, t h os e dri n ki n g m or e fre q u e ntl y pref err e d wi n e, a n d wi n e w as f a v o ure d b y a d oles ce nts n e v er dri n ki n g u ntil dr u n k ( T a bl e 1, c ol u m n 4). Str o n g alc o h olic be vera g es w ere c h os e n m ore oft e n b y t h os e dri n ki n g u ntil dr u n k ( T a ble 1, c ol u m n 5). Si xtee n y ear ol ds f a v o ur e d ci d er a n d alc op o ps m or e t h a n 1 4 y e ar ol ds ( T a bl e 1, r o w “ A g e ”). B e er w as cl e arl y f a v o ur e d b y b o ys w hil e ci d er, alc o p o ps a n d wi n e w er e us e d m ore ofte n a m o n g girls (a dj usti n g f or st u d y y e ar, a g e, dri n ki n g fr e q u e nc y a n d dri n ki n g st yle). Be er, al c o p o ps a n d str o n g al c o h oli c b e v er a g es w er e c h os e n b y t h os e dri n ki n g i n a m or e dr u n k e n n ess-relate d dri n ki n g st yle. B eer was a m or e li k el y c h oi c e a m o n g fr e q u e nt dri n k ers w hil e wi ne w as m ore p o p ular a m o n g i nfre q u e nt a n d m o d erate dri n k ers. T h e se nsiti vit y a nal ysis ill ustr ati n g t he eff ect of diff ere nt ass u m pti o ns i n alc o h ol per ce nta g e i n alc o p o ps, b e er or ci der s h o w e d t hat w hile t he or der of p o p ularit y was r o b ust a m o n g girls i n 2 0 1 9 ( Fi g ur e 1), t h e p erce nta ge of et h a n ol fr o m t h e differ e nt t y p es of be v era g es c ha n ge sli g htl y: al c o p o ps 3 2 % , ci d er 2 3% a n d b e er 2 0 % . A m o n g b o ys, m ost of t h e et h a n ol c a me fr o m be er i n 2 0 1 9 ( 5 2 % , s e nsiti vit y a nal ysis: 5 7% ) f oll o w e d b y alc o p o ps ( 2 1% , se nsiti vit y a nal ysis: 1 7% ) a n d str o n g be v era g es ( 1 9% , se nsiti vit y a n al ysis: 1 8% ). Dis c ussi o n After al m ost t w o de ca d es of d ecr easi n g u n dera g e dri n ki n g, t h e pr o p orti o n of 1 4 a n d 1 6ye arLi nto ne n et al. 7 ol d Fi n ns re p orti n g alc o h ol dri n ki n g d uri n g t he past 1 2 m o nt hs s ee m e d t o h a ve i n cr e as e d fr o m ye ar 2 0 1 7 t o 2 0 1 9, b ut t he a p pare nt c h a n g e w as n ot st atisti c all y si g nifi ca nt ( Ki n n u n e n et al., 2 0 1 9). T h e a m o u nt of alc o h ol i m bi be d o n t h e l atest dri n ki n g o cc asi o n als o s ee me d t o h a v e i n cre ase d, b ut t h e c h a n g es were n ot statisticall y si g nifica nt i n a n y of t he a g e/ ge n d er gr o u ps. It is s af e t o s a y t h at t h e l o n g-t er m tre n d s h o wi n g de cre asi n g dri n ki n g has be e n halte d. A si milar halt t o a l o n g d ecre as e h as als o b e e n o bs er v e d i n alc o h ol dri n ki n g a m o n g 1 5 y ear ol ds i n S we de n ( E n gl u n d, 2 0 1 9). A m o n g dri n kers, t he a m o u nt of alc o h ol i m bi b e d i n t h e f or m of alc o p o ps h a d i n cre ase d a m o n g girls w hile wi ne dri n ki n g h a d d e cr e as e d a m o n g girls. R e gressi o n m o d elli n g t a ki n g i nt o a cc o u nt a g e, ge n d er a n d dri n ki n g p atter ns s h o w e d t h at alc o p o ps w er e t h e o nl y be vera g e gr o u p t hat h a d i n cr e ase d i n p o p ularit y. T h e 2 0 1 8 alc o h ol la w c ha n g e i ncrease d t h e alc o h ol c o nte nt of alc o p o ps a vaila ble t hr o u g h gr oc er y st or es – a n d t hes e be v er a ges b ec a m e m ore p o p ular a m o n g t h e u n der-a ge d. T h e alc o h ol l a w c h a n g e t hat t o o k effect at t h e b e gi n ni n g of 2 0 1 8 i ncrease d t he a v aila bilit y of str o n g b e er, ci d er a n d es p eci all y alc o p o ps ( Fi nl e x 1 1 0 2/ 2 0 1 7, 2 0 1 7; Mi nistr y of S o cial Affairs a n d H ealt h, 2 0 1 8). E ve n b ef ore t h e la w w as p ass e d, r es e ar c h ers p oi nt e d o ut t h at t h e c h a n ge w as li kel y t o h alt t he tre n d of decreasi n g u n d er-a g e dri n ki n g – or e v e n ca use u n d era ge dri n ki n g l e v els t o i n cr e as e ( Li nt o n e n et al., 2 0 1 8; M a¨ k el a¨ & O ¨st er b er g, 2 0 1 7; S T M 0 7 5: 0 0/ 2 0 1 1, 2 0 1 7). T h e r e as o ni n g b e hi n d t his state m e nt was t h e pr o p ose d i ncrease i n et h a n ol c o nt e nt i n b e v er a g es s ol d t hr o u g h gr o c er y st ores fr o m 4. 7% t o 5. 5% . T he i n cre ase i n alc op o ps w as s e e n as a parti c ul ar c o n c er n si n c e t h ese dri n ks ar e k n o w n t o a p p eal es p eciall y t o y o u n g p e o ple ( G ale et al., 2 0 1 5). It se e ms t hat b ot h t h es e c o n c er ns h a v e m aterialis e d: y o ut h al c o h ol us e h as st o p p e d d e cr e asi n g or e v e n t ur ne d t o war ds a n i n cr e as e, a n d alc o p o ps h a ve be c o m e a si g nific a nt s o urce of alc o h ol a m o n g t h e u n d era g e d. A c a us al relati o ns hi p b et w ee n a l a w c h a n g e a n d c h a n g es i n dri n ki n g p att er ns a n d b e vera g e pref ere n ces c a n n ot be s h o w n, as T a bl e 1. Fi v e l ogistic r egr essi o n m o d els (c ol u m ns: b e er, ci d er, alc o p o ps, wi n e, str o ng b ev erag es) pr e dicti ng t h e c o ns u m pti o n of s p ecific alc o h olic b ev erag es o n t h e lat est dri n ki ng occasi o n a m o ng 1 4 a n d 1 6 y ear ol ds. All pr e dict ors (ag e, g e n d er, st u d y y ear, dri n ki ng styl e, dri n ki ng fr e q u e nc y) e nt er e d i n t h e m o d el si m ulta n e o usly. Pr e dict or O R f or b e er ( Cl 9 5 %) O R f or ci d er ( Cl 9 5 %) O R f or al c o p o ps ( Cl 9 5 %) O R f or wi n e ( Cl 9 5 %) O R f or str o ng b e v erag es ( Cl 9 5 %) Ag e 1 6 (r ef. 1 4) 1. 1 9 ( 0. 9 0 – 1. 5 8) 1. 5 8 ( 1. 1 7 – 2. 1 3)** 1. 3 5 ( 1. 0 3 – 1. 7 7)* 0. 9 0 ( 0. 6 9 – 1. 1 8) 0. 9 7 ( 0. 7 4 – 1. 2 7) S e x girls (r ef. b oys) 0. 1 9 ( 0. 1 5 – 0. 2 4)*** 4. 6 0 ( 3. 3 2 – 6. 3 8)*** 1. 3 3 ( 1. 0 5 – 1. 6 9)* 2. 1 3 ( 1. 6 2 – 2. 8 0)*** 1. 0 9 ( 0. 8 6 – 1. 3 8) Y ear 2 0 1 9 (r ef. 2 0 1 7) 0. 9 7 ( 0. 7 7 – 1. 2 3) 0. 8 7 ( 0. 6 8 – 1. 1 2) 1. 3 0 ( 1. 0 3 – 1. 6 2)* 0. 9 0 ( 0. 7 0 – 1. 1 5) 1. 0 6 ( 0. 8 4 – 1. 3 3) H o w oft e n d o y o u us e alc o h ol u ntil y o u ar e r eally dr u n k? (r ef. dri n ks b ut n ot u ntil dr u n k) Dr u n k w e e kly 4. 4 7 ( 1. 2 3 – 1 6. 2 3)* 0. 3 7 ( 0. 0 4 – 3. 2 8) 3. 7 6 ( 1. 0 0 – 1 4. 1 5) 0. 3 2 ( 0. 0 6 – 1. 6 2) 4. 1 7 ( 1. 2 0 – 1 4. 5 0)* Dr u n k m o nt hly 1. 9 2 ( 1. 2 2 – 3. 0 3)** 0. 6 4 ( 0. 3 7 – 1. 1 0) 2. 4 0 ( 1. 5 4 – 3. 7 6)*** 0. 4 1 ( 0. 2 3 – 0. 7 3)** 4. 3 5 ( 2. 8 2 – 6. 7 0)*** Dr u n k occasi o nally 1. 7 8 ( 1. 3 3 – 2. 3 8)*** 0. 8 1 ( 0. 5 9 – 1. 1 2) 2. 2 9 ( 1. 7 2 – 3. 0 4)*** 0. 5 0 ( 0. 3 6 – 0. 6 8)*** 2. 3 6 ( 1. 7 5 – 3. 1 7)*** H o w oft e n d o y o u us e alc o h ol? (r ef. 3 – 4 ti m es i n y ear or l ess) Dri n ks w e e kly or m or e 2. 3 5 ( 1. 3 6 – 4. 0 6)** 0. 8 3 ( 0. 3 9 – 1. 7 3) 0. 6 5 ( 0. 3 6 – 1. 1 8) 1. 9 2 ( 1. 0 3 – 3. 5 9)* 1. 0 7 ( 0. 6 2 – 1. 8 5) Dri n ks o nc e i n t w o m o nt hs or m o nt hly 1. 5 6 ( 1. 1 7 – 2. 0 8)** 1. 1 1 ( 0. 8 1 – 1. 5 1) 1. 0 3 ( 0. 7 8 – 1. 3 6) 0. 9 4 ( 0. 6 9 – 1. 2 7) 1. 1 5 ( 0. 8 6 – 1. 5 4) *p < . 0 5. ** p < . 0 1. *** p < . 0 0 1. 8 Nor dic St u dies o n Alco h ol a n d Dr ugs e x p eri m e nt al desi g ns i n p o p ul ati o ns ar e n ot p ossi ble. Vari o us ot her de v el o p me nts ma y h a v e i nfl ue nc e d a d olesc e nts’ c h oic es. H o w e v er, t heories o n p o p ulati o n alc o h ol dri n ki n g s u p p ort t h e r ole of a vaila bilit y i n c o ntr olli n g alc o h ol c o ns u m pti o n ( B a b or et al., 2 0 0 3; Br u u n et al., 1 9 7 5). B e er s e e ms t o b e a m as c uli n e b e v er a g e c h oic e, at l east i n Fi nla n d, b ot h a m o n g a d ults ( Ti g erste dt et al., 2 0 1 8) a n d a d olesc e nts j u dgi n g fr o m t h e res ults pres e nte d i n t his a n al ysis. T h e fa v o urit es a m o n g girls wer e al c o p o ps a n d ci d er. S o m e w h at s ur prisi n gl y, t h os e dri n ki n g u ntil dr u n k fa v o ur e d mil d b e v er a g es as well, al c o p o ps a m o n g girls a n d b e er a m o n g b o ys, i nste a d of str o n g b e v era g es. T his ma y b e p artl y e x plai ne d b y differ e nc es i n a g e-li mit e nf or c eme nt. R es e ar c h h as s h o we d t h at Fi n nis h al c o h ol m o n o p ol y Al k o st or es ar e s u p eri or i n a g e restricti o n e nf or ce me nt c o m p are d wit h gr oc er y st or es ( W ar p e ni us et al., 2 0 1 2). It is hi g hl y li k el y t hat easier a v aila bilit y of b e er, al c o p o ps a n d ci d er r es ulti n g fr o m t h e ne w alc o h ol l a w ( Mi nistr y of S ocial Affairs a n d He alt h, 2 0 1 8) has affe ct e d a d oles ce nt b e v era g e c h oic es: alc oh oli c be vera g es o nl y a v aila ble t hr o u g h m o n op ol y st or es ( wi n e a n d str o n g b e vera ges) ha v e d e cr e as e d i n p o p ul arit y a m o n g t h e u n d era g e d. T h e s h are of al c o h ol c o ns u m e d i n t h e f or m of b e er, al c o p o ps a n d ci d er i n cr e as e d a m o n g girls fr o m 5 5 % i n 2 0 1 7 t o 7 5% i n 2 0 1 9, b ut t h e a p p are nt i n cre as e a m o n g b o ys fr o m 6 9% i n 2 0 1 7 t o 7 6% i n 2 0 1 9 w as n ot statisti call y si g nific a nt. T his is a c o nsi d era bl y hi g h er i n cre ase t h a n t he o n e o bs er v e d i n p o p ul ati o n t ot al al c o h ol c o ns u m pti o n ( V al vir a N ati o n al S u p er vis or y A ut h orit y f or W elf ar e a n d H e alt h, 2 0 1 9); u n d era g e d a d ol es c e nts were aff ecte d m or e b y t he alc o h ol l a w c ha n g e t h a n a d ults. At t h e p o p ul ati o n l e v el, t h e p eri o d fr o m 2 0 1 7 t o 2 0 1 9 wit n ess e d little c h a n g e i n t ot al c o ns u m pti o n, 2 1 2 % i n cr e as e i n str o n g al c op o ps, 2 0 6 % i n cre ase i n str o n g b e er a n d 3 0 0% i n cre ase i n str o n g ci der – a n d d ecr eas es i n all ot h er be vera g e gr o u ps ( V al vir a Nati o n al S u pervis or y A ut h orit y f or Welfare a n d He alt h, 2 0 1 9). T his pict ur e is m ostl y refl ecte d i n t he b e vera g e t y p e pr ef er e n c es a m o n g u n d era g e d a d ol esc e nts: t h e o nl y e x c e pti o n w as t h at b o ys d e cr e as e d t h eir c o ns u m pti o n of ci d er. T h e e x pl a n ati o n s e e ms t o li e i n t h e w ellk n o w n eff e ct of b e v er a g e a v ail a bilit y ( B a b or et al., 2 0 0 3): t h e la w c h a n g e t hat ma de it p ossi ble t o sell str o n g alc o p o ps, be er a n d ci d er i n gr o cer y st ores i n crease d t h eir c o ns u m pti o n. I n t h e N or dic c o nte xt, Fi nla n d a n d N or w a y ar e b eer t errit or y, w hile wi ne is t h e m ost p o p ular b e ver a ge i n De n mar k a n d S w e de n ( Ti gerste dt et al., 2 0 1 8; Nati o n al I nstit ute f or H ealt h a n d W elfar e, 2 0 1 8). Fi nla n d has be e n c h ar a cterise d b y hi g h c o ns u m pti o n of s pirits, b ut t he c o ns u m pti o n of str o n g b e vera g es has d ecr eas e d i n p o p ularit y b ot h a m o n g t h e a d ult ( N ati o n al I nstit ut e f or H e alt h a n d W elf ar e, 2 0 1 8) a n d u n d er-a g e d a d oles c e nt p o p ulati o n. I n a n a nal ysis of b e vera g e c h oic e c h a n g e a m o n g a d olesc e nts b et w e e n 1 9 9 9 a n d 2 0 1 7, a s hift fr o m b eer t o w ar ds wi n e w as wit n ess e d. T h e l atest res ults pres e nte d i n t his article s h o w t hat b ot h wi n e a n d str o n g b e vera g es h a v e de cr eas e d i n p o p ularit y. It s ee ms t hat Fi nla n d is n ot m o vi n g t o w ar ds t h e wi n ec e ntr e d dri n ki n g c ult ur e s ee n i n S w e de n a n d D e n mar k. T h e alc o h ol l a w c ha n g e, a n d es p eciall y t h e c h a n gi n g stat us of alc o p o ps, r e c ei v e d a l ar ge a m o u nt of p u bli cit y d uri n g 2 0 1 7. T h e m e di a dis c uss e d alc o p o ps e xte nsi v el y as p art of t h e pr oc ess le a di n g t o l e gislati o n c h a n g e a n d t his ma y h a ve w or ke d as a “ pr o m oti o n ca m p ai g n ” f or al c o p o ps. Al c o p o ps h a v e b e e n f o u n d t o a p p eal m ore t o y o u n g p e o ple t h at t he p o p ulati o n as a w h ole: i n A ustr alia, alc o p o ps w er e t he m ost p o p ular alc o h olic b e v er a g e t y p e a m o n g a d ol es c e nts a g e d 1 2 t o 1 7 y e ars ( A ustr ali a n I nstit ute of H ealt h a n d Welf are, 2 0 1 7). Alc op o ps a p p e al t o a d ol esc e nts n ot o nl y be c a us e of t h eir t aste, b ut als o t h eir stre n gt h a n d c ost (J o n es & R eis, 2 0 1 2). I n li ne wit h t h e tr e n d of de cre asi n g r es p o nse rates t o s ur ve ys, t h e A H L S r ates h a ve d ecr eas e d fr o m ar o u n d 9 0% i n t he 1 9 7 0s t o 4 5% i n 2 0 1 7 a n d 4 0 % i n 2 0 1 9. T his m a y h a ve de cre ase d t h e r e pr es e ntati v e n ess of t h e r es p o n de nt data s et, Li nto ne n et al. 9