What shapes local alcohol, narcotics, and tobacco policy in Sweden?

Abstract Swedish municipalities vary significantly in their commitment to preventing alcohol, narcotics, and tobacco related (ANT) problems. This study investigates the drivers of local policy development, focusing on the salience of ANT‐related problems, municipal economic resources, and the political orientation of local governments. We analyzed pooled time‐series cross‐sectional data from 109 of Sweden's 290 municipalities between 2011 and 2021. Local prevention efforts were measured using a composite Alcohol, Narcotics, and Tobacco Prevention Index. Key independent variables included indicators of problem salience (e.g., alcohol‐related morbidity), municipal economic capacity, and the political orientation of the ruling coalition. We applied first‐difference models with panel‐corrected standard errors and panel‐specific autoregressive terms to account for unobserved heterogeneity, temporal dynamics, and spatial dependence. Political orientation was the only statistically significant predictor of changes in local ANT‐prevention efforts. A shift to left‐wing governance was associated with a 4.2% increase in the ANT‐index. Neither the salience of ANT‐related harms nor municipal economic capacity had a significant effect. Our findings suggest that variation in local ANT‐policy is less driven by problem burden or economic resources, but rather by political orientation.