how long do alcoholics live

Acta Psychiatr Scand. 2022 Apr; 131(four): 297–306.

Mortality and life expectancy of people with alcohol use disorder in Denmark, Republic of finland and Sweden

J Westman,^{ane, 2} K Wahlbeck,^{2, iii} T M Laursen,^four One thousand Gissler,^{2, 3} M Nordentoft,⁵ J Hällgren,¹ Thousand Arffman,ⁱⁱⁱ and U Ösby^{one, 6}

J Westman

ⁱCentre for Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden

²Nordic Inquiry University in Mental Health, Nordic School of Public Wellness, Gothenburg, Sweden

M Wahlbeck

²Nordic Research Academy in Mental Wellness, Nordic Schoolhouse of Public Health, Gothenburg, Sweden

³THL National Institute for Health and Welfare, Helsinki, Finland

T M Laursen

⁴National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark

1000 Gissler

²Nordic Research Academy in Mental Health, Nordic School of Public Wellness, Gothenburg, Sweden

^threeTHL National Institute for Wellness and Welfare, Helsinki, Finland

M Nordentoft

⁵Mental Health Eye Copenhagen, University of Copenhagen, Kinesthesia of Health Sciences, Copenhagen, Denmark

J Hällgren

¹Centre for Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden

Thou Arffman

^threeTHL National Institute for Health and Welfare, Helsinki, Finland

U Ösby

¹Eye for Family Medicine, Department of Neurobiology, Care Sciences and Club, Karolinska Institutet, Stockholm, Sweden

^viMiddle for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden

Abstract

Objective

To analyse bloodshed and life expectancy in people with alcohol utilise disorder in Denmark, Finland and Sweden.

Method

A population-based annals written report including all patients admitted to hospital diagnosed with alcohol utilise disorder (1 158 486 person-years) from 1987 to 2006 in Denmark, Finland and Sweden.

Results

Life expectancy was 24–28 years shorter in people with alcohol utilise disorder than in the general population. From 1987 to 2006, the difference in life expectancy betwixt patients with alcohol use disorder and the general population increased in men (Kingdom of denmark, 1.eight years; Republic of finland, 2.6 years; Sweden, 1.0 years); in women, the difference in life expectancy increased in Kingdom of denmark (0.3 years) but decreased in Finland (−0.8 years) and Sweden (−i.8 years). People with alcohol use disorder had college bloodshed from all causes of expiry (mortality rate ratio, 3.0–v.2), all diseases and medical conditions (2.3–4.eight), and suicide (nine.iii–35.9).

Conclusion

People hospitalized with alcohol apply disorder have an boilerplate life expectancy of 47–53 years (men) and 50–58 years (women) and die 24–28 years earlier than people in the general population.

Keywords: alcoholism, mortality, epidemiology, Scandinavia

Significant outcomes

• People with booze use disorder have 24–28 years shorter life expectancy than the general population in the Nordic countries.

• Alcohol use disorder is a major public health problem that causes many years of lost life, even in countries with restrictive alcohol consumption policies.

Limitations

• A major limitation of the present written report was the inclusion only of patients with alcohol use disorder from inpatient care, which may have caused selection bias of patients with the near severe health problems.

• The study was register-based and lacked clinical data well-nigh treatment and adherence.

• Alcohol consumption per capita was determined from amass data and not from alcohol exposure for individuals.

Introduction

Booze use disorder (AUD) is a major cause of morbidity and mortality (1). People with AUD take among the highest all-cause mortality of all people who receive handling for mental disorders (2, 3). A meta-analysis that included 81 observational studies from many countries showed that people with AUD take three-fold college mortality in men and 4-fold college bloodshed in women than the general population (4). In all people who have AUD, mortality is relatively college in women, younger people and people in treatment for habit (4). Notwithstanding, comprehensive mortality information over time of patients with AUD are not bachelor from Nordic countries.

Increased alcohol consumption is associated with increased disease burden, accidents, and social problems (4, 5). In response to these effects, booze policies were created in Nordic countries (Sweden, Norway, Kingdom of denmark, Finland and Iceland) to promote a decrease in alcohol consumption and restrict booze availability. The governments of all Nordic countries except Denmark have a monopoly of alcohol retail. However, later on joining the European Matrimony in 1995, Finland and Sweden shifted from a highly restrictive to a more liberal alcohol policy. The price of alcohol was reduced by tax reduction on alcoholic beverages in Denmark and Finland, abolition of quantitative quotas on alcoholic beverages in Sweden and Finland, and more generous opening hours of alcohol retailers in Sweden. These changes made alcohol more accessible to the public in these countries since 2003. The booze control policies of the countries were associated with total alcohol consumption (half-dozen, vii); Sweden has the most restrictive, and Denmark has the least restrictive alcohol policies. Frequency of heavy alcohol drinkers and alcohol-related problems are often assumed to depend on the level of alcohol consumption in the general population (7–9).

The reliable nationwide health intendance registers in Denmark, Finland and Sweden provide a unique opportunity to report mortality in people diagnosed with AUD.

Aims of the study

The purpose of this study was to evaluate mortality and life expectancy in people who had AUD in Denmark, Finland and Sweden between 1987 and 2006.

Material and methods

Study populations

National health registers from Denmark, Finland and Sweden were used to follow the entire population, approximately 20 meg people, aged 15 years or above, in these 3 countries and identify all people who were admitted to hospital considering of AUD as the primary or secondary diagnosis during xx years (January 1, 1987 to December 31, 2006). Data near patients were retrieved from the national infirmary discharge registers in each country. In Denmark, the data about patients were retrieved from the Psychiatric Care Register and the Hospital Discharge Register for medical intendance. In Finland and Sweden, the Infirmary Discharge Registers, which independent information well-nigh medical and psychiatric care, were used. The hospital register information was linked to the national registers about causes of death in each state to retrieve data about date and cause of death. Data most alcohol consumption per capita were nerveless from an international database (6). Follow-upward started on the date of first hospital access for AUD. Each person was followed from the twenty-four hours of first hospital admission until expiry or the stop of a 5-year period to estimate time trends with a sufficient number of deaths; therefore, a person could exist counted in more than i time period if readmitted during a unlike period. For analysis of fourth dimension trends, the 20-year ascertainment menstruum was divided into 5-twelvemonth periods: 1987–1991, 1992–1996, 1997–2001 and 2002–2006. Ethical approval was obtained from the regional ethics committee in Gothenburg. The data-keeping authorities from each country gave permission to use wellness register data in this study.

Definitions

The diagnosis of AUD (mental and behavioural disorders due to alcohol use) was defined according to the World Health System nomenclature organisation (International Classification of Diseases [ICD]): ICD-8, codes 291, 303; ICD-9, codes 291, 303, 305A; ICD-ten, codes F10.0 to F10.9 (10–12). Causes of decease were divers co-ordinate to the classification as (1) all-cause mortality (ICD-viii, codes 001 to E999; ICD-9, codes 001 to E999; ICD-ten, codes A00 to Y98); (2) death from diseases and medical conditions (ICD-eight, codes 001 to 796; ICD-9, codes 001 to 799; ICD-10, codes A00 to R99); (3) suicide (ICD-viii, codes E950 to E959; ICD-9, codes E950 to E959; ICD-10, codes X60 to 84); and (4) external causes of death other than suicide (ICD-8, codes E800 to E999, excluding codes E950 to E959; ICD-9, codes E800 to E999, excluding codes E950 to E959; ICD-10, codes V01 to Y98, excluding codes X60 to 84) (10–12).

Alcohol consumption was divers equally the national average of registered amount of alcohol consumed (litres of pure booze) per capita aged ≥xv years during a calendar twelvemonth. The aggregate indicator from revenue enhancement information included consumption for the unabridged population based on production, import, export and sales (6).

Statistical analysis

The report population for each country was stratified into 5 historic period groups (xv–29 years; 30–44 years; 45–59 years; 60–74 years; ≥75 years), and frequency of mortality was calculated for each group. Person-years and number of deaths were adamant for each age grouping and 5-yr period. Standardized mortality per 100 000 person-years was calculated for each state and standardized using Nordic population data for the year 2000 (13). Bloodshed rate ratios were calculated by taking standardized bloodshed rate in people with AUD divided by standardized mortality rate in general population. Nosotros calculated life expectancy for people with AUD aged ≥15 years, stratified by sexual activity, using Wiesler method with 1-year age stratification (xiv). Life expectancy for each of the v-year periods was determined. Population life expectancy information for each country, calculated and published by the World Health Organisation (half dozen), were used for population comparisons. The difference in life expectancy was calculated past taking life expectancy in full general population minus life expectancy in people with AUD. Data from national registers in the Nordic countries include all individuals and are not samples. Therefore, confidence intervals (CI) are non relevant.

Results

Alcohol employ disorder: incidence and associated mortality

In Denmark, the number of men and women hospitalized because of AUD was similar for the v-yr periods from 1987 to 2001 but increased for 2002 to 2006 (Table ​ ane). In Finland, the number of men and women with AUD increased from 1987 to 2001 and remained unchanged for 2002 to 2006. In Sweden, the number of men with AUD decreased and the number of women with AUD increased from 1987 to 2006 (Table ​ 1).

Table 1

Alcohol employ disorder and associated mortality in Denmark, Finland and Sweden from 1987 to 2006

Study period	Kingdom of denmark				Finland				Sweden
	1987–1991	1992–1996	1997–2001	2002–2006	1987–1991	1992–1996	1997–2001	2002–2006	1987–1991	1992–1996	1997–2001	2002–2006
Men
People with AUD
No. of people	32 368	29 818	31 646	39 163	27 845	32 232	41 748	40 489	51 411	49 097	43 715	46 840
No. of deaths	4866	5042	5041	6997	3229	3465	5355	5458	7338	6705	5497	6313
Person-years	84 192	76 142	75 011	93 981	63 452	67 223	95 952	90 994	143 990	134 416	114 017	119 116
Mortality per 100 000 person-years	5780	6622	6720	7445	5082	5154	5581	5998	5096	4988	4821	5300
Standardized mortality per 100 000 person-years	7591	8142	7838	7720	6327	6476	6196	6067	5855	5459	5245	5119
General population
Standardized mortality per 100 000 person-years	1888	1867	1704	1576	1977	2011	2045	2009	1660	1524	1413	1294
Women
People with AUD
No. of people	xiii 542	xiii 168	14 188	17 658	5428	7446	12 235	12 999	14 366	14 978	16 939	nineteen 926
No. of deaths	1673	1827	1804	2579	435	523	976	1128	1305	1331	1327	1585
Person-years	36 070	33 464	35 090	43 735	12 098	14 844	28 136	29 502	39 488	39 879	43 150	49 649
Mortality per 100 000 person-years	4638	5460	5141	5897	3596	3523	3469	3824	3305	3338	3075	3192
Standardized mortality per 100 000 person-years	5379	5764	5249	5746	4614	4381	4152	4134	4352	4040	3788	3779
General population
Standardized mortality per 100 000 person-years	1223	1242	1164	1097	1162	1197	1190	1142	1046	979	934	891

Bloodshed was college in Kingdom of denmark than Republic of finland or Sweden (Table ​ 1, Figs ​ 1 and ​ 2). Standardized mortality per 100 000 increased during the entire written report period in men and women with AUD in Denmark (Table ​ ane). In Finland and Sweden, the standardized mortality per 100 000 decreased in men and women with AUD during the entire study menses (Table ​ one).

Alcohol Use Disorder (AUD) and associated mortality in Denmark, Finland and Sweden from 1987 to 2006. Standardized mortality per 100 000 person-years. Men.

Alcohol utilise disorder (AUD) and associated bloodshed in Kingdom of denmark, Finland and Sweden from 1987 to 2006. Standardized mortality per 100 000 person-years. Women.

Life expectancy

Life expectancy in people with AUD was lowest in Kingdom of denmark and highest in Sweden (Table ​ 2, Figs ​ 3 and ​ four). In all three countries, life expectancy was longer for women than men, both for people with AUD and the general population (Tabular array ​ 2). In men and women in Denmark, life expectancy for people with AUD and the general population increased during the entire study, and the departure in life expectancy betwixt people with AUD and the general population increased more for men than women (Table ​ 2). In Finland, life expectancy for people with AUD increased more for women than men, and the difference in life expectancy betwixt people with AUD and the general population increased for men but decreased for women during the entire written report (Tabular array ​ ii). In Sweden, life expectancy for people with AUD and the full general population increased in men and women, and the departure in life expectancy between people with AUD and the general population increased in men but decreased in women during the entire written report (Tabular array ​ ii).

Table 2

Life expectancy of people with booze utilize disorder and people in the general population in Denmark, Finland and Sweden from 1987 to 2006

Life expectancy (years)	Kingdom of denmark				Finland				Sweden
Study period	1987–1991	1992–1996	1997–2001	2002–2006	1987–1991	1992–1996	1997–2001	2002–2006	1987–1991	1992–1996	1997–2001	2002–2006
Men
People with AUD	46.vi	46.ane	46.7	47.5	46.8	46.iv	46.8	48.3	50.iii	51.4	52.1	52.7
General population	72.three	72.8	74.0	75.0	71.vii	73.1	74.5	75.8	75.0	76.2	77.3	78.iv
Difference†	25.7	26.vii	27.three	27.5	24.9	26.7	27.vii	27.5	24.7	24.eight	25.2	25.7
Women
People with AUD	49.8	49.5	51.4	51.ii	52.seven	52.4	54.3	56.4	54.8	56.5	57.7	58.6
General population	77.9	77.ix	78.7	79.half dozen	79.7	eighty.7	81.7	82.six	80.7	81.4	82.ane	82.7
Difference†	28.ane	28.4	27.3	28.4	27.0	28.3	27.4	26.2	25.ix	24.9	24.4	24.one

Life expectancy of people with alcohol utilise disorder (AUD) and people in the full general population in Denmark, Republic of finland and Sweden from 1987 to 2006. Men.

Life expectancy of people with booze apply disorder (AUD) and people in the general population in Kingdom of denmark, Finland and Sweden from 1987 to 2006. Women.

Historic period

In all 3 countries, mortality rate ratios in people with AUD were higher in immature age groups. In Denmark, mortality rate ratios increased during the entire study in men and women for most historic period groups, especially ages 30–59 years (Table ​ 3). In Finland, bloodshed charge per unit ratios increased during the entire study flow in men and women anile 30–44 years. In Sweden, mortality charge per unit ratios increased during the unabridged report period in men aged 30–74 years and women anile 45–74 years (Table ​ 3).

Tabular array 3

Mortality charge per unit ratio for people with booze employ disorder compared with people in the general population in Denmark, Republic of finland and Sweden from 1987 to 2006

Bloodshed rate ratio*	Kingdom of denmark				Finland				Sweden
Written report menses	1987–1991	1992–1996	1997–2001	2002–2006	1987–1991	1992–1996	1997–2001	2002–2006	1987–1991	1992–1996	1997–2001	2002–2006
Men
Historic period (years)
15–29	nine.5	9.1	8.7	vii.v	fifteen.ane	21.seven	eighteen.8	16.8	9.6	xi.v	9.2	10.3
xxx–44	14.2	sixteen.4	nineteen.6	19.3	12.seven	13.5	17.6	20.seven	14.7	15.5	xviii.5	18.7
45–59	viii.8	11	11.vi	xiii.1	six.9	seven.0	six.6	vi.7	8.four	nine.4	ten.iii	11.four
60–74	5.0	v.3	v.8	6.3	3.1	three.three	3.3	3.6	4.ii	iv.three	4.vi	5.three
≥75	2.0	2.2	2.2	2.4	1.v	i.viii	1.iii	one.3	2.0	2.0	2.0	2.i
Cause of death
All causes	4.0	four.4	4.6	4.9	three.ii	three.2	iii.0	3.0	3.5	three.6	3.vii	iv.0
All diseases and medical conditions†	3.vii	iv.0	4.2	4.half dozen	2.3	two.3	2.3	ii.three	iii.one	3.ane	3.2	3.4
Suicide	xi.iii	11.6	thirteen.2	ten.7	12.0	13.three	12.ix	12.3	nine.seven	9.iii	12.vi	12.iii
Other external causes‡	8.half dozen	9.3	9.5	xi.5	12.3	13.5	10.0	11.0	x.2	xi.4	xi.0	12.0
Women
Historic period (years)
15–29	19.2	11.0	7.eight	11.vii	32.4	41.4	37.0	26.3	eighteen.two	16.7	12.4	12.3
30–44	21.7	24.3	24.7	28.4	23.9	25.9	26.1	30.9	19.5	xviii.6	19.7	19.ii
45–59	10.2	13.0	13.iii	15.half-dozen	13.ix	12.9	10.1	10.7	10.8	11.8	12.iii	11.9
60–74	five.6	6.1	5.eight	6.nine	4.nine	4.7	five.5	6.four	5.9	half dozen.three	6.5	7.4
≥75	two.0	1.9	1.ix	ii.4	1.five	one.five	1.5	one.iv	2.2	ii.ane	ii.0	2.1
Cause of death
All causes	4.4	four.6	4.5	5.ii	4.0	three.seven	3.5	3.6	4.2	4.1	iv.one	4.2
All diseases and medical conditions†	three.vii	four.ane	iv.0	4.8	3.0	ii.6	2.6	2.viii	3.6	3.half dozen	3.5	3.6
Suicide	21.4	22.4	20.4	24.9	22	35.5	35.nine	27.3	xv.ix	23.5	26.8	28.5
Other external causes‡	13.5	13.four	13.one	15.0	23.8	xx.2	sixteen.nine	sixteen.3	17.2	15.ane	15.5	15.6

Cause of death

In all 3 countries, people with AUD had higher mortality from all causes of death (Figs ​ 5 and ​ 6), all diseases and medical weather, and suicide, than people in the full general population (Table ​ iii). In Denmark, mortality rate ratios in people with AUD increased from 1987 to 2006 from all diseases and medical weather; mortality rate ratio from suicide was increased only in women during 2002 to 2006 (Table ​ 3). In Republic of finland, mortality charge per unit ratios from all causes of death decreased during the entire study in both men and women; mortality rate ratios from all diseases and medical atmospheric condition were unchanged during the entire study for men and women, and mortality rate ratios from suicide increased in women but not men (Table ​ 3). In Sweden, bloodshed rate ratios from all causes of death increased in men but was unchanged in women during the entire study; mortality rate ratio from suicide increased in both men and women (Table ​ 3).

Mortality rate ratio for people with booze use disorder compared with people in the full general population in Denmark, Finland and Sweden from 1987 to 2006. Men.

Mortality charge per unit ratio for people with alcohol use disorder compared with people in the full general population in Denmark, Finland and Sweden from 1987 to 2006. Women.

Alcohol consumption

During the unabridged study, registered booze consumption per capita was highest in Denmark and everyman in Sweden (Fig.​ 7). In Denmark, registered alcohol consumption per capita decreased slightly after the year 2002. In Finland, registered booze consumption per capita peaked in the time catamenia 2002–2006 in connection with an alcohol tax reduction. In Sweden, registered alcohol consumption per capita decreased slightly in the 90s and increased thereafter.

Registered total alcohol consumption in litres pure booze per capita in Denmark, Finland and Sweden from 1987 to 2006.

Discussion

Main findings

In this report, our master finding was a 24- to 28-yr shorter life expectancy in people with AUD compared with the general population. Mortality associated with AUD was sex-dependent; men with AUD in all iii countries had over time an increased difference in life expectancy, but women with AUD in Republic of finland and Sweden (non Kingdom of denmark) had a decreased difference in life expectancy. The changes in mortality and life expectancy during the study were about negative in Denmark and to the lowest degree negative in Sweden.

Strengths and limitations

A major strength of this written report was the comparison of life expectancy and bloodshed in all people who had AUD diagnosed in three Nordic countries with different alcohol policies and patterns of booze consumption. The availability of nationwide health registers enabled us to follow the entire report population. The large population size (all people treated for AUD from three countries) provided highly reliable data. Much time and try was invested in quality assurance of statistical analytical techniques, which made the data comparable between the different countries.

A major limitation of this study was the inclusion of patients from inpatient intendance simply, which may take caused selection bias towards AUD patients with the most severe health issues. Patients with AUD who had only outpatient care were not included. The report was annals-based and lacked clinical data near the blazon of treatment and adherence. In addition to illness prevalence in the population, patterns of hospitalization data including clinical diagnoses may be affected by other factors that were not analysed, such as changes in the number of hospital beds bachelor, changes in hospital remuneration policies, and differences in clinical indications for infirmary treatment. A common shortcoming in annals studies is that they rarely can provide satisfactory answers on why the mortality is loftier or whether its decrease is due to policy changes, improved intendance or merely authoritative decisions (15), although they can hint at the answer and provide directions (fifteen, sixteen).

Another written report limitation was that booze consumption per capita was determined from aggregate information and not from alcohol exposure for individuals. Even so, the Globe Health Arrangement data used in this study were supported by similar results from population surveys in Denmark, Finland and Sweden (17–xix). In the aggregate data, neither age- nor sex-specific alcohol consumption data were bachelor. The results based on aggregated data were exploratory and may not exist used to describe definitive causative conclusions. In improver, data about illegal alcohol production and private cross-border import were not included in the national statistics (6) and could not be evaluated in this study.

Life expectancy and bloodshed

The divergence in life expectancy betwixt people with AUD and the full general population during the study increased in men in all three countries, decreased in women in Finland and Sweden, and was unchanged in women in Denmark (Table ​ 2). However, the number of women hospitalized because of AUD increased during the study in all three countries (Tabular array ​ one), consistent with documented increment in booze consumption in women (13). In addition, there has been a decrease in the perceived stigma associated with seeking handling for AUD (20, 21). Therefore, diagnosis and treatment of AUD may be more mutual in women currently than xx years ago. Notwithstanding, only 1 in three people with AUD seek handling (21).

This study showed that people with AUD had a 4-fold greater risk of premature expiry than people in the general population, and people with AUD died on boilerplate 24–28 years before than people in the general population. Previous studies showed the mortality risk to be two- to six-fold greater in people with AUD (4, 22). In this study, people with AUD had a greater take a chance of death from all diseases and medical conditions, suicide, and other external causes of decease, than people in the general population, consistent with findings from previous studies (2–4, 22, 23).

In men, the departure in mortality between patients with AUD and the general population increased more in Kingdom of denmark and Finland than Sweden. These differences may be associated with the overall level of alcohol consumption, which is highest in Kingdom of denmark and lowest in Sweden. The divergence in mortality betwixt people with AUD and the general population was smaller for both men and women in all study periods in Sweden than Kingdom of denmark or Finland (Table ​ 2). The number of deaths amid women increased in all three countries during the study menses, due to increasing numbers of women diagnosed with AUD in all countries, although standard morality ratios did non increase. The alcohol control policies of the countries are associated with total booze consumption; Sweden had the most restrictive, and Denmark had the least restrictive alcohol policies. Other studies have shown that the negative furnishings of the increased availability of alcohol in Finland mainly occurred in people with AUD (24–27). For example, in Republic of finland, deaths from liver disease increased by 30% and alcohol-related sudden deaths increased by 17% after changes in alcohol regulations in 2004 (27–29).

Clinical implications

Findings from the present written report testify that AUD in the Nordic countries is associated with substantially increased mortality, even though booze command policies are restrictive compared with other countries. What might be important to add to the general restrictive booze policies would be selective efforts aimed at loftier alcohol consumers, to achieve preventive effects in terms of reducing the rate of high consumers converting to AUD. In this field, a wider focus is necessary including testing new preventive efforts, with the aim of reducing alcohol-related damage in people with AUD. In improver the somatic care of people with AUD should exist substantially improved.

In summary, the present study of the entire populations of Kingdom of denmark, Republic of finland and Sweden showed that people hospitalized with AUD had an boilerplate life expectancy of 47–53 years for men and 50–58 years for women. People hospitalized with AUD had a 24- to 28-twelvemonth shorter life expectancy than the general population. During the written report, the difference in life expectancy betwixt people with AUD and the full general population increased in men but not in women. Bloodshed and life expectancy were associated with total alcohol consumption in the three countries. Furthermore, the comprehensive population data confirmed that AUD is a major public health problem that causes many years of lost life, also in countries with restrictive alcohol consumption policies.

Acknowledgments

This study was supported by a grant (no. 2008-0885) from the Swedish Quango for Social and Working Life Enquiry and a projection grant (no. 20 120 263) from Stockholm County Council. The sponsors had no role in the design, conduct or reporting of the research. The statistical analyses were performed past TML, JH, MA at their institutions. The protocol can be obtained from es.ik@namtsew.ettenaej.

Declarations of interest

Jeanette Westman, Kristian Wahlbeck, Thomas Munk Laursen, Mika Gissler, Merete Nordentoft, Jonas Hällgren, Martti Arffman, and Urban Ösby have no connections (direct or indirect) with the alcohol or pharmaceutical industries.

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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4402015/

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