Association between genetic risk of alcohol consumption and alcohol‐related morbidity and mortality under different alcohol policy conditions: Evidence from the Finnish alcohol price reduction of 2004

Abstract

Aims Harmful alcohol consumption is influenced by both genetic susceptibility and the price of alcohol. Many previous studies have observed that genetic susceptibility to consumption of alcohol is more predictive in less restrictive drinking conditions. We assess whether such a pattern applies when the prices of alcoholic beverages are decreased. Design Data consist of genetically informed population‐representative surveys (FINRISK 1992, 1997, 2002 and Health 2000) linked to administrative registers. We analysed the interaction between a polygenic score (PGS) for alcoholic drinks per week consumed and price reduction in predicting the incidence of alcohol‐related hospitalizations and deaths in difference‐in‐difference and interrupted time‐series frameworks. Setting Individuals in Finland were followed quarter‐yearly from 1 March 2000 to 31 May 2008. Participants A total of 22 152 individuals (607 132‐person quarter‐years, 1399 outcome events) aged 30–79 years. Intervention A natural experiment stemming from the alcohol tax reduction in March 2004 and import deregulation in May 2004. Measurements Outcome was quarter‐yearly‐measured alcohol‐related death or hospitalization. The independent variables of main interest were PGS and a price reform indicator. We adjusted for gender, age, age squared, season, 10 first principal components of the genome, data collection round and genotyping batch. Findings Both alcohol price reduction and one standard deviation change in PGS were associated with alcohol‐related health outcomes; odds ratios (ORs) were 1.32, 95% confidence interval (CI) = 1.13, 1.53 and 1.26, 95% CI = 1.12, 1.42 in the 8‐year follow‐up, respectively. The association between PGS and alcohol‐related morbidity was similar before and after the alcohol price reform (PGS × price reform interaction OR = 0.96, 95% CI = 0.81, 1.14). These results were robust across different follow‐up periods and measurement and analysis strategies. Conclusions Although the decrease of alcohol price in Finland in 2004 substantially increased overall alcohol‐related morbidity and mortality, the genetic susceptibility to alcohol consumption did not become more manifest in predicting them.

Genetic and Environmental Factors Underlying Parallel Changes in Body Mass Index and Alcohol Consumption: A 36-Year Longitudinal Study of Adult Twins

“…Our study drew strength from the 36-year follow-up time in the Finnish Twin Cohort study. Modeling the trajectory of alcohol consumption using growth factors allowed us to capture the effects associated with Finnish policies on alcohol consumption, such as those initiated in the second half of the 1980s [60] , also visible in Table 1 , and those in the early 2000s [61] . These relatively abrupt changes in alcohol consumption provided an opportunity to detect associations between changes in alcohol consumption and weight gain at both population and individual levels.…”

“…Results: The baseline heritabilities were similar in men (BMI: h 2 = 79% [95% confidence interval: 74, 83]; alcohol consumption: h 2 = 49% [32,67]) and women (h 2 = 77% [73, 81]; h 2 = 45% [29,61]). Heritabilities of BMI change were similar in men (h 2 = 52% [42,61]) and women (h 2 = 57% [50,63]), but the heritability of change in alcohol consumption was significantly higher (p = 0.03) in men (h 2 = 45% [34,54]) than in women (h 2 = 31% [22,38]). Significant additive genetic correlations between BMI at baseline and change in alcohol consumption were observed in both men (rA = −0.17 [−0.29, −0.04]) and women (rA = −0.18 [−0.31, −0.06]).…”

“…growth factors were then decomposed into genetic and environmental components. Results: The baseline heritabilities were similar in men (BMI: h 2 = 79% [95% confidence interval: 74, 83]; alcohol consumption: h 2 = 49% [32,67]) and women (h 2 = 77% [73, 81]; h 2 = 45% [29,61]). Heritabilities of BMI change were similar in men (h 2 = 52% [42,61]) and women (h 2 = 57% [50,63]), but the heritability of change in alcohol consumption was significantly higher (p = 0.03) in men (h 2 = 45% [34,54]) than in women (h 2 = 31% [22,38]).…”

A novel correction method for modelling parameter-driven autocorrelated time series with count outcome

“…Many studies evaluating interventions rely on annual or monthly data with only a few dozen or even several time points available [ 27 , 28 ]. However, our study highlights that the type I error rate is far from being controlled under a small sample size.…”