Work- and family-related stressors and risk of hazardous alcohol use: the role of social support. A cohort study in Sweden.

Aims: To investigate whether work- and family-related stressors increase the risk of hazardous alcohol use among low-risk drinkers, and to examine the role of sex and social support.

Methods: Overall, 4046 individuals aged 25-55 years, living and working in Stockholm, without a history of hazardous alcohol use, who completed the Mental Health, Work and Social Relations study questionnaire on work- and family-related stressors (exposures) during 1998-2000 and 2001-03, were included. This cohort was followed until 2010 for hazardous alcohol use (outcome) assessed by the Alcohol Use Disorder Identification Test. Weights for selective attrition were calculated, and crude and multivariate (adjusting for sociodemographic, health-, and baseline stress-related factors) logistic regression models, yielding odds ratios (ORs) with 95% confidence intervals (CIs), were used to estimate the exposure-outcome associations. The analyses were stratified by sex and social support.

Results: The crude OR for hazardous alcohol use was 1.28 (95% CI: .88-1.88) and 1.48 (95% CI: 1.05-2.08) among individuals with work-related and family-related stressors, respectively, when compared with those without these exposures. The association between family-related stressors and hazardous alcohol use was slightly more pronounced among women (crude OR, 95% CI: 1.66, 1.02-2.71) and those with low social support (crude OR, 95% CI: 2.06, 1.17-3.62). Adjusting for the history of previous work- and family-related stressors explained most of the associations.

Conclusions: In this population-based longitudinal study of individuals without a history of hazardous alcohol use, we found greater vulnerability to transitioning into hazardous alcohol use among those who experienced family-related stressors, particularly women and individuals with low social support.