Liberal alcohol legislation: does it amplify the effects among Swiss men of person-related risk factors on heavy alcohol use?

Aim: To estimate the statistical interactions between alcohol policy strength and the person-related risk factors of sensation-seeking, antisocial personality disorder and attention-deficit/hyperactivity disorder related to heavy alcohol use.

Design: Cross-sectional survey.

Setting: Young Swiss men living within 21 jurisdictions across Switzerland.

Participants: A total of 5701 Swiss men (mean age 20 years) participating in the Cohort Study on Substance Use Risk Factors (C-SURF).

Measurements: Outcome measures were alcohol use disorder (AUD) as defined in the DSM-5 and risky single-occasion drinking (RSOD). Independent variables were sensation-seeking, antisocial personality disorder (ASPD), attention-deficit/hyperactivity disorder (ADHD) and an index of alcohol policy strength.

Findings: Alcohol policy strength was protective against RSOD [odds ratio (OR) = 0.91 (0.84-0.99)], while sensation-seeking and ASPD were risk factors for both RSOD [OR = 1.90 (1.77-2.04); OR = 1.69 (1.44-1.97)] and AUD [OR = 1.58 (1.47-1.71); OR = 2.69 (2.30-3.14)] and ADHD was a risk factor for AUD [OR = 1.08 (1.06-1.10)]. Significant interactions between alcohol policy strength and sensation-seeking were identified for RSOD [OR = 1.06 (1.01-1.12)] and AUD [OR = 1.06 (1.01-1.12)], as well as between alcohol policy strength and ASPD for both RSOD [OR = 1.17 (1.03-1.31)] and AUD [OR = 1.15 (1.02-1.29)]. These interactions indicated that the protective effects of alcohol policy strength on RSOD and AUD were lost in men with high levels of sensation-seeking or an ASPD. No interactions were detected between alcohol policy strength and ADHD.

Conclusion: Stronger alcohol legislation protects against heavy alcohol use in young Swiss men, but this protective effect is lost in individuals with high levels of sensation-seeking or having an antisocial personality disorder.