About this Journal

Article Abstract

Online ISSN: 1099-176X    Print ISSN: 1091-4358
The Journal of Mental Health Policy and Economics
Volume 25, Issue 2, 2022. Pages: 53-60
Published Online: 1 June 2022

Copyright © 2022 ICMPE.


Effects of Alcohol Policy on Depression, Thoughts of Self-Harm, and Suicide Attempts in European Adolescent

Jonathan K. Noel*

PhD, MPH, Associate Professor, Department of Health Science, Johnson & Wales University, Providence, RI, USA

* Correspondence to: Jonathan K. Noel, Johnson & Wales University, Department of Health Science, 8 Abbott Park Place, Providence, RI 02903, USA.
E-mail: jknoel@hotmail.com

Source of Funding: None declared


Background: Depression is highly prevalent in the European Region and is a major risk factor for self-harm and suicide. Efforts to decrease the disease burden attributable to depression and other mental illnesses has largely emphasized health care system changes and have ignored important behavioral risk factors, such as alcohol use, which is often associated with mental illness.

Aims of the Study: The current study sought to determine if alcohol control policies were associated with depression symptoms, thoughts of self-harm, and suicide attempts in a sample of European adolescents.

Methods: Data were available for n=46,561 16-year old adolescents from 15 European countries via the European School Survey Project on Alcohol and Other Drugs and the World Health Organization's Global Information System on Alcohol and Health. The independent variable was alcohol policy effectiveness score, and the dependent variables were depression symptoms, thoughts of self-harm, and suicide attempts. Fixed-effect linear (for depression symptoms) and logistic (for thoughts of self-harm and suicide attempts) regression models were used. Models were adjusted for participant's gender, ever drinking status and relative family wealth, and country Human Development Index and Pattern of Drinking Score.

Results: Strong warning label (p < 0.001) and marketing (p=0.003) policies were negatively associated with depression symptoms. Warning label (OR[95% CI] = 0.78 [0.73, 0.84]) and availability (OR[95% CI] = 0.99 [0.98, 0.99]) policies were negatively associated with thoughts of self-harm. There was no significant effect on suicide attempts.

Discussion: The findings suggest that warning labels on alcoholic beverages may be associated with decreased depression symptoms and thoughts of self-harm among adolescents. Restricting alcohol marketing may be associated with decreased depression symptoms, and limiting alcohol availability may be associated with decreased thoughts of self-harm. Alcohol control policies were not associated with adolescent attempted suicides. Study limitations include the cross-sectional nature of the data, participants that were of a single age, and the lack of information on policy implementation and enforcement.

Implications for Health Policies: The findings suggest an indirect and additional benefit of implementing strong alcohol control policies, particularly increasing the use of warning labels, restricting alcohol marketing, and decreasing availability. Regulators should consider these benefits when discussing the implementation of alcohol control measures, and when creating roadmaps to decrease the disease burden of depression and other mental illnesses.

Implications for Further Research: Current longitudinal studies examining the effect of policy on alcohol consumption should consider adding questions that measure symptoms of depression and other mental illnesses.

Received 2 September 2021; accepted 5 May 2022

Copyright 2022 ICMPE