Work- & family-related stress & the risk of hazardous alcohol use: role of sex and social support

Abstract Background There is a lack of longitudinal studies investigating the effect of individual stress factors on alcohol use behaviour, and how sex and social support may mitigate the effect of these stressors. We aimed to determine the association of work- and family-related stressors with developing hazardous alcohol use over time among habitual drinkers, and to examine the role of sex and social support in these associations. Methods A sample of 4,046 individuals, working and living in Stockholm, age 25-55 years, habitual drinkers, who answered the PART study (Swedish acronym for Mental Health, Work and Social Relations) questionnaire regarding work- and family-related stress (exposures) in 1998-2000 (wave1) and 2001-2003 (wave2) were followed until 2010 (wave3) regarding hazardous alcohol use (outcome) measured using Alcohol-Use-Disorder-Identification-Test (AUDIT) score ( > =8 in men, > =7 in women). Weights for selective attrition were calculated, and crude and multivariate (adjusting for sociodemographic, health- and previous stress-related factors) logistic regression models, yielding Odds Ratios (OR) with 95% Confidence Intervals (CI), were used to estimate the exposure-outcome associations. Analyses were stratified for sex and social support in general and at work. Results Job strain (a combination of high demand and low control) was not statistically significantly associated with hazardous alcohol use (OR, CI: 1.3, 0.9-1.9). Among those reporting any family-related stress, a significantly higher risk was observed (OR, CI: 1.5, 1.1-2.1), particularly among women (OR, CI: 1.7, 1.02-2.7) and those with low social support (OR, CI: 2.1, 1.2-3.6). These associations became non-significant after adjusting for previous family-related stress. Conclusions Public health measures aiming to prevent transitions from habitual to hazardous alcohol use should give special attention to individuals with family-related stress, especially among women and those with low social support. Key messages • While job stress was not significantly associated, those experiencing family-related stress had a higher risk of hazardous alcohol use, especially among women and those without social support. • Individuals experiencing family-related stress, particularly women and those lacking social support, require special attention in public health prevention strategies for risky alcohol consumption.