When is it appropriate to address patients' alcohol consumption in health care—national survey of views of the general population in Sweden

The aim of this study was to investigate the Swedish population's beliefs and attitudes on when it is appropriate to address patients' alcohol in health care services and to identify the characteristics of those who are most supportive of this alcohol-preventive work. A cross-sectional study of 5981 nationally representative individuals (18–64 years) was done using confidential mail questionnaires. Alcohol consumption was assessed with AUDIT-C and respondents were classified into four levels of drinking status. Sociodemographic data were also collected. Thirty-four percent completely agreed that health care providers should routinely ask patients about their alcohol habits and 33% completely agreed that providers should ask but only if patients have consulted them with alcohol-related symptoms. There was limited support for a statement that alcohol conversations should be premised on the patient bringing up the issue and even less support for the notion that alcohol habits are people's own business and not something that health care providers should address. Thirty-four percent believed that people did not answer honestly when asked about their alcohol habits in health care. There appears to be considerable support in the general population for alcohol prevention in Swedish health care services that involves questions being asked routinely about alcohol. This should be helpful in ongoing efforts to improve the implementation of alcohol screening and brief interventions in Sweden. Further studies on the views of hazardous and excessive drinkers appear particularly important.

► There is considerable support for routine questions about alcohol in health care.
► Support was lower among excessive and hazardous drinkers.
► Support was also lower among those who were younger or less educated.
► Our findings contrast with providers’ concerns of addressing alcohol.
► Alcohol appears to have become less of a sensitive issue in Sweden.