Resea ch epo
Changes in Finnish
adolescen s’ alcoholic be e age
p e e ences 1999–2017
Tomi Lin onen
Finnish Founda ion o Alcohol S udies, Helsinki, Finland
Su i Ah inen
Finnish Founda ion o Alcohol S udies, Helsinki, Finland
Anne Konu
Facul y o Social Sciences, Heal h Sciences, Uni e si y o Tampe e, Finland
Abs ac
Aims: The pu pose was o examine he changes in alcoholic be e age p e e ences among 14- and
16-yea -olds in Finland om he yea 1999 o 2017. In addi ion, he e ec s o age, gende and d inking
s yle on be e age p e e ence was s udied. Me hods: Na ionally ep esen a i e su eys o adolescen
heal h beha iou s in Finland om 1999 (n¼4943) and 2017 (n¼2451) among 14- and 16-yea -olds
we e analysed using c oss- abula ions and logis ic eg ession modelling. Be e age da a we e coded
om an open-ended ques ion conce ning he la es d inking occasion. Resul s: While he p e alence
o 14- and 16-yea -old adolescen s’ alcohol d inking was mo e han hal ed be ween 1999 and 2017, he
popula i ies o di e en be e ages did no change equally. D inking bee , cide and s ong be e ages
mi o ed he o al dec ease, as did he d inking o se e al di e en be e age ypes a a ime. Wine
d inking dec easedonly a li leand alcopops ac ually inc easedin popula i y. Taking he amoun so pu e
e hanol in he be e ages in o accoun , he p opo ion o alcohol d unk in he o ms o bee and cide
dec easedno ably,andin he o mo winei dec easeda li le. S ong be e ages inc eased hei sha e o
alcohol d unk, bu he mos no able inc ease was seen in he sha e o alcopops, which mo e han
doubled hei sha e o he pu e e hanol d unk. Conclusions: Inc eased popula i y o alcopops among
he unde -aged oge he wi h he ecen alcohol law change inc easing he a ailabili y o alcopops in
Finland call o a en ion o be paid bo h o ma ke ing and he con ol o age limi s o hese p oduc s.
Submi ed: 3 May 2018; accep ed: 4 June 2018
Co esponding au ho :
Tomi Lin onen, Finnish Founda ion o Alcohol S udies, PO Box 30, FI-00271 Helsinki, Finland.
Email: [email p o ec ed]
No dic S udies on Alcohol and D ugs
2018, Vol. 35(4) 304–317
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Keywo ds
adolescen , alcohol, alcopop, be e age ype
Adolescen alcohol use has dec eased conside -
ably in mos de eloped coun ies since he u n
o he millennium (Bha acha ya, 2016; de
Looze e al., 2015; K aus e al., 2018). This
de elopmen has been ma kedly mo e p o-
nounced han he sligh dec eases obse ed in
popula ion o al alcohol consump ion in he
same coun ies (Yea book o Alcohol and D ug
S a is ics 2017, 2018). Recen ly, p ocesses,
explana ions and eason behind declining ado-
lescen d inking ha e been called o (e.g., Pen-
nay, Li ings on, & MacLean, 2015) and
a emp s o analyse hem ha e been p esen ed
(Lin onen & Ne alainen, 2017; Rai asalo,
Simonen, Tige s ed , Ma¨kela¨, & Tapanainen,
2018). Thus a , esea ch is undecisi e on he
de ails o his de elopmen .
The alcohol policy changes in Finland om
he yea 1999 o 2017 we e p edominan ly aim-
ing a dec easing o al consump ion and
es ic ing unde -aged alcohol use. The Second
Eu opean Alcohol Ac ion Plan (20002005)
was adop ed by he WHO in 1999 (Eu opean
Alcohol Ac ion Plan,2000),and heWHO-
EURO and he Eu opean Commission adop ed
he Decla a ion on Young People and Alcohol
in 2001 wi h he pu pose o p o ec ing adoles-
cen s om ha m caused by alcohol (The
Decla a ion on Young People and Alcohol,
2001). In line wi h hese WHO ac ions, he
Finnish go e nmen issued a na ional alcohol
policy p og amme and, o example, he age
limi o 18 yea s was ex ended o co e sales
o be e ages con aining e en small amoun s o
alcohol (Yea book o Alcohol and D ug S a is-
ics 2017, 2018). In 2001, a na ional adap a ion
o he Eu opean ac ion plan was app o ed.
Wo king agains hese goals, quo as on ax-
ee alcohol impo s o pe sonal use by passen-
ge s om o he EU coun ies we e abolished in
2004 (Yea book o Alcohol and D ug S a is ics
2017, 2018) and, as a coun e -measu e agains
p edic ed inc ease in ou is impo s o Finland,
alcohol axes we e lowe ed in Ma ch 2004 o
p epa e o Es onia joining he EU in May
2004. Go e nmen esolu ion on alcohol policy
was announced in 2003 ollowed by a na ional
Alcohol P og amme 2004–2007, la e ex ended
o 2011, and ans o med in 2015 in o an Ac ion
Plan on Subs ance Abuse P e en ion (Yea book
o Alcohol and D ug S a is ics 2017, 2018). In
line wi h he p og ammes, he go e nmen
decided ha he e ail sales o alcohol should
no commence ea lie han 9 o’clock in he
mo ning and la e , bulk discoun s o alcoholic
be e ages we e p ohibi ed and ad e ising on
TV and in cinemas was es ic ed. Taxes on
alcoholic be e ages we e aised in 2008 by
15%on spi i s and 10%on bee and wine. In
2009, axes on alcoholic be e ages we e aised
again wice. Also, he legisla ion on alcohol
o ences was amended enabling mo e e ec i e
in e en ions in, o example, possession o
alcohol by unde -aged people and alcohol ma -
ke ing o unde -aged people.
Du ing he pe iod om 1999 o 2017, he
popula ion o al consump ion (including un ec-
o ded consump ion; es ima ed using in e iew
s udies) i s inc eased om 10.8 li es o pu e
alcohol o 12.7 li es in 2007, a e which i
dec eased o 10.3 li es in 2017 (Yea book o
Alcohol and D ug S a is ics 2017, 2018). The
p e e ed be e age has been medium-s eng h
bee , which accoun s o almos hal o he o al
consump ion (Ka lsson, Ha¨ ko¨nen, & Tige -
s ed , 2018). Be ween 1999 and 2016, he con-
sump ion o s ong bee has been s eady a
a ound 3%o he o al consump ion, while he
popula i y o cide has been bo h small and on a
sligh decline, and he consump ion o alco-
pops, eady-made mix u es o spi i s and so
d inks, has inc eased om a ound 3% o a ound
5%. Wine inc eased in popula i y du ing he
pe iod s udied, while consump ion o spi i s
Lin onen e al. 305
i s inc eased un il 2007, a e which i
dec eased apidly. All in all, he pe iod om
1999 o 2017 wi nessed li le change in o al
consump ion, dec eases in he consump ion o
cide and spi i s, and inc eases in he consump-
ion o alcopops and wine, and li le change in
he consump ion o ei he medium-s eng h o
s ong bee (Ka lsson e al., 2018).
As in many indus ialised coun ies wo ld-
wide, Finnish unde -aged adolescen s dec eased
hei d inking om 1999 o 2017. The Adoles-
cen Heal h and Li es yle Su ey showed ha he
p opo ions o 14-yea -olds d inking alcoholic
be e ages a leas once a mon h we e 34%in
1999 and 6%in 2017, and among 16-yea -
olds, he igu es we e 58%in 1999 and 25%in
2017 (Kinnunen e al., 2017). The su ey se ies
was conduc ed bi-annually and illus a ed a con-
inually dec easing end un il he yea 2015,
a e which he decline came o a hal . The Eu -
opean School Su ey P ojec on Alcohol and
O he D ugs epo ed ha he p opo ion o 15-
o 16-yea -olds ha ing d unk alcoholic be -
e ages du ing he 30 days p io o da a collec ion
was 60%in 1999 and 32%in 2015 (Rai asalo,
Huh anen, & Miekkala, 2015). Bee had been
consumed by 43%in 1999 bu was down o
23%in 2015. The co esponding igu es o
cide we e 49%in 1999 and 17%in 2015, o
alcopops 29%in 1999 and 22%in 2015, wine
29%in 1999 and 13%in 2015, and spi i s 42%
in 1999 and 21%in 2015 (Rai asalo e al., 2015).
Resea ch on he be e age p e e ences among
Finnish adolescen s has shown ha low-alcohol
be e ages accoun o mos o he alcohol con-
sumed by he unde -aged (Lin onen & Konu,
2001). In 1999, bee was he a ou i e among
boys and accoun ed o 44%o 14- and
16-yea -olds’ consump ion. In he same yea ,
cide was he gi ls’ choice, and accoun ed o
28%o o al alcohol consump ion. All in all,
alcohol in he o m o bee , cide and alcopops
amoun ed o 63%o all alcohol consumed by 14-
and 16-yea -olds (Lin onen & Konu, 2001).
Among adolescen s, di e en be e age
ypes ha e been shown o be associa ed wi h
ha ms o a di e en deg ee and in di e en
ways. Consequen ly, imp o ed moni o ing o
alcoholic be e age p e e ence among you h has
been called o in o de o o m e ec i e poli-
cies in ela ion o adolescen alcohol use (The
ESPAD G oup, 2016). Indeed, s udies om
Finland, Swi ze land and he USA poin ou ha
bee and s ong be e ages a e p e e ed by ado-
lescen s wi h iskie d inking pa e ns and o he
isky heal h beha iou s (Dey, Gmel, S ude ,
De mo a, & Mohle -Kuo, 2014; Lin onen &
Konu, 2001, 2003; Siegel, Naimi, C emeens,
& Nelson, 2011). Thus, om alcohol policy
poin o iew, i is impo an o s udy be e age
p e e ence among d unkenness subg oups.
Alcohol be e age ypes ha e d ama ically
di e ing a ailabili ies in Finland. Low-alcohol
be e ages (bee , cide , alcopops) can be pu -
chased om e e y g oce y s o e, kiosk and se -
ice s a ion. S onge be e ages such as s ong
bee , wine and spi i s a e only a ailable h ough
s a e monopoly s o es. The s a e monopoly
s o es excel in en o cemen o alcohol sales age
limi s compa ed wi h g oce y s o es, especially
smalle businesses such as se ice s a ions (Wa -
penius, Holmila, & Rai asalo, 2012). A he u n
o he yea 2017 o 2018, a law change inc eased
he alcohol con en limi o be e ages sold in
g oce y s o es om 4.7% o 5.5%, expanded he
sales o alcopops, and educed se e al o he
es ic ions on he sales o alcoholic be e ages
(Comp ehensi e e o m o alcohol ac , 2018;
Finlex 1102/2017 Alkoholilaki, 2017).
In ligh o di e ing ends in alcohol con-
sump ion among unde -aged adolescen s in
compa ison wi h adul s and he di e en impac
o changes in a ailabili y o speci ic be e ages
among adolescen s, ou pu pose is o examine
he changes in alcoholic be e age p e e ences
among 14- and 16-yea -olds in Finland om he
yea 1999 o 2017. In addi ion, we will analyse
he e ec s o age, gende and d unkenness
se e i y on be e age p e e ence.
Me hods
The s udy da a we e de i ed om a bi-annual
na ionwide moni o ing sys em o adolescen
306 No dic S udies on Alcohol and D ugs 35(4)
heal h beha iou s in Finland, he Adolescen
Heal h and Li es yle Su ey (AHLS), which has
been conduc ed since 1977 (Kinnunen e al.,
2017). The ques ions on alcohol use u ilised in
his s udy we e p esen ed in he yea s 1999 and
2017. Da a we e collec ed om Feb ua y o
May. Sel -adminis e ed ques ionnai es we e
mailed o mu ually independen , na ionally ep-
esen a i e samples o 12-, 14-, 16- and 18-yea -
olds; he cu en analysis concen a es on da a on
14- and 16-yea -olds. Two e-inqui ies we e sen
o non- esponden s in 1999, and h ee in 2017. In
addi ion o a 12-page pape ques ionnai e, a digi-
al e sion was a ailable on he in e ne in 2017.
Samples we e ob ained om he Na ional Popu-
la ion Regis e Cen e and we e based on pa ic-
ula da es o bi h, so ha all Finns bo n on he
sample days we e included.
The p ocedu es pe o med we e in acco -
dance wi h he e hical s anda ds o he ins i u-
ional esea ch commi ees and wi h he 1964
Helsinki decla a ion and i s la e amendmen s
o compa able e hical s anda ds. The s udy plan
and da a collec ion p ocedu e we e e iewed
by e hics commi ees. In 1999, he E hics
Commi ees o he Pi kanmaa Hospi al Dis ic
(Finland) and in 2017 he E hics Commi ee o
he Tampe e Region (Finland) app o ed he
s udy p o ocol. Filling in he ques ionnai e was
conside ed as adolescen s’ consen o pa ici-
pa e and no pa en al consen was equi ed. In
case he esponden ’s pa en s wished o inspec
he ques ionnai e, he esponden was ins uc ed
o p esen he ques ionnai e o his/he pa en s
be o e answe ing.
In 1999, 1315 14-yea -old and 1332 16-yea -
old gi ls esponded; he co esponding numbe s
o boys we e 1186 and 1110. The esponse
a es we e 85%among bo h 14- and 16-yea -
old gi ls and 74%(14-yea -old boys) and 68%
(16-yea -old boys). In 2017, 723 14-yea -old
and 697 16-yea -old gi ls esponded, and he
numbe s o boys we e 572 (14-yea -olds) and
459 (16-yea -olds). The esponse a es we e
54%and 53%among gi ls, and 41%(14-yea -
olds) and 33%(16-yea -olds) among boys. The
mean age o he 14-yea -old esponden s was
14.6 yea s; he 16-yea -olds we e, on a e age,
16.6 yea s old.
The equency o alcohol use was in es i-
ga ed wi h he ques ion “How o en do you use
alcohol? T y o include also hose imes you
consumed only small amoun s o alcohol”. The
answe choices we e “daily”, “a ew imes a
week”, “once a week”, “a ew imes a mon h”,
“abou once a mon h”, “abou once in wo
mon hs”, “3–4 imes a yea ”, “once a yea o
less equen ly”, “I do no use alcohol”. D un-
kenness was measu ed wi h he ques ion “How
o en do you use alcohol un il you a e eally
d unk?” The al e na i es we e “once a week
o mo e o en”, “once o wice a mon h”, “less
equen ly”, “ne e ”. The measu es o d un-
kenness ha e been ound o be easonably eli-
able and alid (Lin onen, Ahls o¨m, & Me so,
2004; Lin onen & Rimpela¨, 2001). Ca ego ies
we e combined o modelling. An indica o
labelled “d inking s yle” was cons uc ed by
combining esponses o he ques ions desc ibed
abo e o o m mu ually excluding ca ego ies
“d unk weekly”, “d unk mon hly”, “d unk
occasionally” and “d inks bu no un il d unk”.
The quali ies and quan i ies o alcoholic be -
e ages consumed on he la es d inking occa-
sion we e inqui ed abou wi h he ques ion
(Hibell e al., 1997): “Think back on you la es
d inking occasion and desc ibe in you own
wo ds as accu a ely as you can wha you d ank
and how much? (I you sha ed d inks wi h o he
people please y o ell us how much you pe -
sonally d ank)”. The a es o alid esponses o
his ques ion among eligible esponden s (i.e.,
hose epo ing alcohol d inking) we e 73%
among 14-yea -olds and 85%among 16-yea -
olds in 1999, and 79%(14-yea -olds) and 83%
(16-yea -olds) in 2017. The open-ended
answe s we e coded in o be e age ype ca e-
go ies and he amoun o alcohol in pu e
e hanol.
The analyses ha e been adjus ed o espon-
den s’ ages by calcula ing he igu es i s sep-
a a ely o he age g oups and hen calcula ing
he a e age o hose igu es o ep esen bo h
14- and 16-yea -olds. Di e ences be ween he
Lin onen e al. 307
age g oups a e s udied using logis ic eg ession
modelling.
Di e ences be ween he g oups ha e been
es ed using a chi-squa ed es wi h p- alue o
.05 as he c i e ion o s a is ical signi icance. In
analyses p esen ed in Figu es 1 and 2, he
g oups we e de ined by s udy yea and speci ic
alcoholic be e ages. In he analyses p esen ed
in Figu es 3 and 4, he g oups we e based on he
di e en d inking s yles and alcoholic be e age
ypes. Tes s ha e been pe o med o gi ls and
boys aged 14–16-yea s-olds.
Logis ic eg ession models p edic ing spe-
ci ic be e age use on he la es d inking occa-
sion we e execu ed sepa a ely o he i e
be e age ype ca ego ies: bee , cide , alcopops,
wine and s ong alcoholic be e ages. P edic o s
en e edin hemodelssimul aneously we e:
s udy yea , esponden age and gende ,
alcohol-use equency and d inking s yle.
Resul s
The mos no able change in 14- o 16-yea -old
adolescen s’ d inking om he yea 1999 o
2017 was he inc ease (p< .05) o hose who
do no d ink alcoholic be e ages (Figu e 1). In
2017, 64%o gi ls and 67%o boys epo ed
ha hey did no d ink alcohol. Among he gi ls,
dec eases we e g ea es o cide and bee
(p< .05); no ably, alcopops ( eady-made mix-
u es o so d inks and alcohol) emained
almos as popula as in 1999 (no signi ican ).
Among he boys, d inking cide became a e
(2%;p< .05), bu alcopops we e men ioned
mo e o en han in 1999 (p< .05). D inking
mo e han one alcoholic be e age on he same
occasion became no ably less popula among
bo h gende s in he yea 2017 compa ed wi h
1999 (p< .05).
A clea gende di e ence in be e age ype
choice is seen when analysing he amoun o
100%e hanol consumed by 14- and 16-yea -
olds (Figu e 2). The mos popula sou ces o
e hanol we e s ong be e ages (spi i s, o i ied
wines, liqueu s) among gi ls (33%in 2017) and
bee among boys (41%in 2017). Among he
gi ls, bee and cide showed dec eases in popu-
la i y (p< .05), and he mos no able inc ease
was seen in alcopops ( om 10%in 1999 o 23%
in 2017; p< .05). Cide became no ably less
popula among boys (p< .05), while alcopops
doubled hei sha e o e hanol om 8% o 16%
(p< .05).
The choice o alcoholic be e age ype
consumed on he la es d inking occasion was
ela ed o esponden s’ d inking s yles bo h in
he yea 1999 and 2017 (Figu e 3 and Figu e 4;
p< .05). Among 14- and 16-yea -old gi ls,
hose who epo ed d inking un il d unk once
a week o mo e o en a ou ed bee in 1999, bu
s ong alcoholic be e ages in 2017 (Figu e 3).
Gi ls who epo ed d inking alcoholic be -
e ages, bu ne e un il d unk, a ou ed cide
bo h in 1999 and 2017. In 2017, howe e , hose
d inking bu no un il d unk consumed almos
as la ge a p opo ion o absolu e alcohol in he
o m o s ong alcoholic be e ages (Figu e 3).
Boys who epo ed d inking un il d unk
a ou ed bee on he la es d inking occasion
bo h in 1999 and 2017 (Figu e 4). The e we e
e y ew boys who epo ed weekly d unken-
ness in 2017; when he g oups epo ing d un-
kenness weekly and mon hly we e combined,
he a ou i e among boys in 2017 was s ong
be e ages (50%o o al e hanol e sus 38%in
he o m o bee ). Wi h his excep ion, bee was
he a ou i e among boys ega dless o hei
d inking s yle bo h in 1999 and 2017. Cide ,
alcopops and wine we e mo e popula among
boys d inking in mode a ion, bu e en in his
g oup o d inke s, bee accoun ed o 40%o
he e hanol consumed.
A logis ic eg ession model p edic ing bee
use on he la es d inking occasion showed ha
bee was p e e ed less in he yea 2017 com-
pa ed wi h 1999, and ha boys p e e ed i mo e
o en han gi ls (Table 1, column 1). D inking
bee was also mo e common among hose
d inking alcohol mo e o en, and among hose
d inking mo e o en un il d unk.
The model p edic ing cide use showed ha
i was a ou ed by gi ls a he han boys, and
signi ican ly less in he yea 2017 compa ed
308 No dic S udies on Alcohol and D ugs 35(4)

wi h 1999 (Table 1, column 2). D inking cide
was as common among weekly d inke s as i
was among hose d inking only a ew imes a
yea . Howe e , hose d inking alcohol a leas
once in wo mon hs bu no weekly a ou ed
cide mo e han hose d inking less o en.
Alcopops we e mo e common on he la es
d inking occasion in he yea 2017 han in 1999
(Table 1, column 3). Gi ls d ank alcopops mo e
o en han boys. The e we e no di e ences in
alcopop use by d inking equency. Howe e ,
alcopops we e p e e ed by hose d inking un il
0% 10% 20% 30% 40% 50% 60% 70%
Does no d ink
Bee
Cide
Alcopop
Wine
S ong be e ages
Mo e han one ype
2017 1999
gi ls
0% 10% 20% 30% 40% 50% 60% 70%
Does no d ink
Bee
Cide
Alcopop
Wine
S ong be e ages
Mo e han one ype
2017 1999
boys
Figu e 1. The dis ibu ion o alcoholic be e age ype names epo ed on la es d inking occasion among
14- and 16-yea -old gi ls (abo e) and boys (below) in 1999 and 2017.
Lin onen e al. 309
d unk in equen ly when compa ed wi h hose
ne e d inking un il d unk.
D inking wine was mo e common among
gi ls han boys, and among 14-yea -olds han
16-yea -olds (Table 1, column 4). Wine was
a ou ed by hose ne e d inking un il d unk and
hose d inking alcohol a leas once in wo
mon hs compa ed wi h hose d inking less o en.
No change in he popula i y o s ong alco-
holic be e ages was seen be ween he yea s
0% 5% 10% 15% 20% 25% 30% 35% 40% 45%
Bee
Cide
Alcopop
Wine
S ong be e ages
2017 1999
gi ls
0% 5% 10% 15% 20% 25% 30% 35% 40% 45%
Bee
Cide
Alcopop
Wine
S ong be e ages
2017 1999
boys
Figu e 2. The dis ibu ion o 100% e hanol by alcoholic be e age ype epo ed on la es d inking occasion
among 14- and 16-yea -old gi ls (abo e) and boys (below) in 1999 and 2017.
310 No dic S udies on Alcohol and D ugs 35(4)
1999 and 2017 (Table 1, column 5). Gi ls
epo ed mo e s ong be e age use han boys,
and 16-yea -olds mo e han 14-yea -olds. D ink-
ing mo e o en inc eased he odds o d inking
s ong be e ages, as did d inking un il d unk.
The eg ession models showed ha he only
be e age ype ca ego y ha inc eased in popu-
la i y om he yea 1999 o 2017 was alcopops
(Table 1). S ong be e ages we e mo e popula
among 16-yea -olds han among 14-yea -olds
0% 10% 20% 30% 40% 50% 60% 70%
Bee
Cide
Alcopop
Wine
S ong be e ages
D inks bu no unl d unk D unk occasionally D unk mon hly D unk weekly
gi ls 1999
0% 10% 20% 30% 40% 50% 60% 70%
Bee
Cide
Alcopop
Wine
S ong be e ages
D inks bu no unl d unk D unk occasionally D unk mon hly D unk weekly
gi ls 2017
Figu e 3. The dis ibu ion o 100% e hanol by alcoholic be e age ype epo ed on la es d inking occasion
among 14- and 16-yea -old gi ls by d inking s yle in 1999 (abo e) and 2017 (below).
Lin onen e al. 311
while wine was mo e popula among 14-yea -
olds. Bee was clea ly a ou ed by boys while
all o he be e ages we e used mo e o en
among gi ls (adjus ing o s udy yea , age,
d inking equency and d inking s yle). Bee
and s ong alcoholic be e ages we e chosen
by hose d inking mo e equen ly and in a
mo e d unkenness-o ien ed d inking s yle.
Wine was mo e popula among in equen and
mode a e d inke s.
0% 10% 20% 30% 40% 50% 60% 70%
Bee
Cide
Alcopop
Wine
S ong be e ages
D inks bu no unl d unk D unk occasionally D unk mon hly D unk weekly
boys 1999
0% 10% 20% 30% 40% 50% 60% 70%
Bee
Cide
Alcopop
Wine
S ong be e ages
D inks bu no unl d unk D unk occasionally D unk mon hly D unk weekly
100%
boys 2017
Figu e 4. The dis ibu ion o 100% e hanol by alcoholic be e age ype epo ed on la es d inking occasion
among 14- and 16-yea -old boys by d inking s yle in 1999 (abo e) and 2017 (below).
312 No dic S udies on Alcohol and D ugs 35(4)