Ludwig Kraus

Stockholm University | SU · Department for Public Health Science

Aims: To estimate temporal trends in adolescents' current cigarette, alcohol and cannabis use in Europe by gender and region, test for regional differences and evaluate regional convergence. Design and setting: Five waves of the European School Survey Project on Alcohol and Other Drugs (ESPAD) from 28 countries between 1999 and 2015. Countries w...

Background The consumption of alcohol increases the risk of drinkers harming others. The extent of alcohol’s morbidity and mortality harms to others in Germany in 2014 was estimated for (1) fetal alcohol syndrome (FAS) or fetal alcohol spectrum disorders (FASD) among newborns, (2) road traffic fatalities, and (3) interpersonal violence-related deat...

Background: There is growing evidence for recent declines in adolescent alcohol use in the Western world. While these changes have been subject to scientific debate, the reasons for this downward trend are not yet understood. Method: We consider broader theoretical framings that might be useful in understanding declines in youth drinking. In partic...

Background and aims: Sweden has experienced a substantial decrease in adolescent drinking over the past decades. Whether the reduction persists into early adulthood remains unclear. Using survey data, the present study aimed to determine whether reductions in indicators of alcohol use observed among adolescents remain in early adulthood and whethe...

While there is evidence for self-exclusion (SE) as an individual-level harm reduction intervention, its effects on reducing harm from gambling at the population level remain unclear. Based on a review of national legal frameworks and SE programs, including their utilization and enforcement in selected high-income societies, the present analysis aim...

Introduction: Smoking remains a significant global public health issue, leading to numerous preventable deaths and disabilities annually. Telephone counselling is a recommended intervention for smoking cessation, offering accessible support to a wide range of people who smoke. This study aimed to evaluate the long-term effectiveness of the German...

Introduction Individuals with gambling disorder (GD) harbor cognitive distortions and dysfunctional beliefs about gambling that may foster problematic gambling behaviour. Evidence on particularly detrimental attitudes and beliefs is however lacking. To close this knowledge gap, we analysed associations between gambling attitudes and beliefs (Gambli...

Introduction We aimed to assess: (i) trends in alcohol‐specific — that is, fully attributable — morbidity and mortality in the German adult population aged 15–69 between 2000 and 2021; and (ii) changes in alcohol‐attributable disease burden — that is, fully and partially alcohol‐attributable categories — for 2006, 2012, 2018 and 2021. Methods Morb...

Aims: Voluntary self-exclusion (VSE) programmes are intended to minimise gambling-related harm. They are considered effective for the individual but several weaknesses have been reported that deter individuals from enrolment. The present paper summarises opinions about and experiences with VSE strategies and assesses gaps and needs with regard to t...

Aims Our study aimed to a) describe the distribution of hospital discharges with primary and secondary alcohol‐specific diagnoses by sex and age group, and b) describe how the number of hospital discharges with primary and secondary alcohol‐specific diagnoses have changed across different diagnostic groups (categorized by primary International Clas...

Aim: Alcohol use is causing a considerable health burden for individuals and society in Germany. To reduce the burden from alcohol use, ensuring optimal treatment for those who are in need, is key. With this data-linkage study, we aim to provide a comprehensive description of healthcare service use among individuals with alcohol use disorders (AUD)...

Background Although many individuals with alcohol dependence (AD) are recognized in the German healthcare system, only a few utilize addiction-specific treatment services. Those who enter treatment are not well characterized regarding their prospective pathways through the highly fragmented German healthcare system. This paper aims to (1) identify...

Zusammenfassung Hintergrund Das Ziel der vorliegenden Arbeit war die Erfassung der Verbreitung des (problematischen) Konsums von Alkohol, Tabak und Cannabis sowie der (problematischen) Nutzung sozialer Medien, von E‑Produkten, Computerspielen und Glücksspielen unter Auszubildenden. Methode Querschnittliche Befragung von 4591 Auszubildenden an 17...

Background The objective of the present study was to examine the short-term effectiveness of the national German quitline for smoking cessation. Methods A parallel-group, two-arm, superiority, randomized controlled trial with data collection at baseline and post-intervention (three months from baseline) was conducted. Individuals were randomized t...

BACKGROUND AND AIMS OAT is a well developed and successful treatment strategy for opioid dependent patients in Europe. It has significantly contributed to the fight against the HIV and HCV pandemics, leading to an increased life expectancy in this population. Building on the OAT experiences in Austria, Germany, and Switzerland and their models of c...

b> Introduction: The aim of the present study was to examine for the first time the factorial, construct, and predictive validity of the motivation for treatment (MfT) scale in a cohort of patients undergoing inpatient-qualified alcohol withdrawal treatment with the goal of referring patients to further treatment. The MfT scale has previously been...

The paper analyses how the Covid-19 pandemic affected young people's alcohol-related assemblages, trajectories of becoming and identity claims in Sweden. The data is based on longitudinal qualitative interviews among heavy and moderate drinking young people (n = 23; age range 15-24 years). The participants were interviewed two to three times before...

Aims: To measure the current trends of cannabis use in Germany, measure trends in the proportion of heavy cannabis users and estimate future cannabis use rates. Design: Repeated waves of the Epidemiological Survey on Substance Abuse, a cross-sectional survey conducted between 1995 and 2021 with a two-stage participant selection strategy where re...

Zielsetzung: Ausgehend von der Veröffentlichung der dritten Ausgabe des Buchs „Alkohol: Kein gewöhnliches Konsumgut“ haben die Autor_innen die Umsetzung kosteneffektiver alkoholpolitischer Maßnahmen in Deutschland bewertet. Methodik: Aktuelle gesetzliche Regelungen und Praktiken zu Maßnahmen aus vier Bereichen wurden gesichtet: (1) Preispolitische...

Background and aims: Individuals with gambling disorder (GD) often suffer from psychiatric comorbidities. Previous studies demonstrated greater severity of GD among gamblers with psychiatric comorbidities. However, evidence on the association between psychiatric comorbidity and course of GD severity during and after outpatient treatment is sparse....

Young adult men who gamble frequently face an elevated risk of developing gambling-related problems. So far, little is known about how changing levels of perceived social support interact with the course of gambling behaviour and gambling-related problems in this population. Using data from a prospective single-arm cohort study (Munich Leisure Time...

Aims Germany is experiencing a decline in alcohol consumption but not for every alcoholic beverage type. Given the differential health impacts of alcoholic beverage type, it is important to understand the drivers of these trends. We investigated: (a) temporal trends in beverage preference and (b) the effects of age, period and cohort on these trend...

Background Given low utilization by individuals experiencing gambling problems the potential of self-exclusion (SE) might be not fully exploited in Germany. This paper aims to gain insight into different actors’ perceptions and reflections on the problems and difficulties in the process of self-exclusion to delineate which specific attitudes hamper...

Background In Germany, most individuals with alcohol dependence are recognized by the health care system and about 16% per year receive addiction-specific care. This paper aimed to analyze the prevalence and treatment utilization rate of people with alcohol dependence by type of addiction-specific care in the federal state of Bremen using routine a...

Vocational students are a risk group for problematic substance use and addictive behaviors. The study aim was to evaluate the effects of an app-based intervention on tobacco, e-cigarettes, alcohol, and cannabis use as well as gambling and digital media-related behaviors in the vocational school setting. A total of 277 classes with 4591 students (me...

Background To counteract the spread of new psychoactive substances (NPS) and to prevent the emergence of novel substances, specifically designed as a response to the legal control of individual substances, a new law was introduced in Germany in 2016: the New Psychoactive Substances Act (NpSG). The NpSG combines a generic approach with the waiver of...

Background The Covid-19 restrictions – as they made young people's practices in their everyday life visible for reflection and reformation – provide a productive opportunity to study how changing conditions affected young people's well-being and drinking practices. Methods The data is based on qualitative interviews with 18- to 24-year-old Swedes...

Einleitung: Suchthilfe im Sinne von Beratung von Personen mit substanzbezogenen Störungen trägt dazu bei, Belastungen durch den Konsum psychotroper Substanzen zu reduzieren. Für eine zielorientierte Schwerpunktsetzung in der Suchthilfeplanung ist es entscheidend, Trends bezüglich der Inanspruchnahme von Suchthilfeleistungen und ihre Einflussfaktore...

Hintergrund: Das Monitoring des Konsums psychoaktiver Substanzen sowie substanzbezogener Probleme in der Bevölkerung ermöglicht die Beurteilung der Verbreitung und der damit verbundenen gesundheitlichen und sozialen Folgen. Methode: Datenbasis ist der Epidemiologische Suchtsurvey (ESA) 2021 (n = 9 046, 18–64 Jahre). Es wurden Prävalenzwerte des Kon...

Hintergrund: Vor dem Hintergrund der Zunahme des Konsums von alternativen Tabakprodukten (Shishas [Wasserpfeifen], Tabakerhitzer) und Tabakalternativen (E-Zigaretten) wurde untersucht, wie sich der Konsum konventioneller Tabakprodukte und der entsprechenden Alternativen entwickelt hat. Methode: Zehn repräsentative Erhebungen des Epidemiologischen S...

Background Despite the decline in cigarette smoking prevalence during nearly the past two decades, tobacco use is still widespread in the German adult population, accounting for 125,000 deaths each year and causing tremendous social costs. To accelerate the reduction in tobacco smoking prevalence, evidence-based smoking cessation methods are pivota...

Background Owing to their pharmacological properties the use of opioid analgesics carries a risk of abuse and dependence, which are associated with a wide range of personal, social, and medical problems. Data-based approaches for identifying distinct patient subtypes at risk for prescription opioid use disorder in Germany are lacking. Objective Th...

Aims: Due to large inconsistencies in previous studies, it remains unclear how alcohol use is related to health care utilization. The aim of this study was to examine associations between alcohol drinking status with utilization of outpatient and inpatient health care services in Germany. Methodology: Survey data of the GEDA 2014/2015-EHIS study wi...

Zusammenfassung Hintergrund Einrichtungen der Aids- und Drogenhilfe bieten einen niedrigschwelligen Zugang für Menschen mit injizierendem und anderen Drogenkonsumformen und spielen somit eine zentrale Rolle für die Eindämmung von Hepatitis C Virus (HCV)-Infektionen in dieser Hochrisikogruppe. Ziel dieser Studie ist es, die Versorgungsleistungen sow...

Background Motives to gamble are important in the functional analysis of problematic gambling. This study examines the possibility of classifying young male gamblers based on their motives to gamble and compares the identified groups to validate the obtained classification. Method Based on a screening survey among 2,681 young men from Bavaria, n=1...

Background Abuse of non-opioid analgesics (NOA) is associated with serious health consequences. However, due to inconsistent definitions of NOA abuse, prevalence estimates for the German population are unclear. Objectives This study aimed to estimate the 12-month prevalence of NOA abuse among self-medicated users of these drugs in the general Germ...

Background Substance-related and addictive disorders are among the most common mental disorders in adolescence and young adulthood. Vocational school students are a risk group for problematic substance use and addictive behavior. However, the availability of evidence-based prevention concepts and programs is underdeveloped in the vocational school...

Background The aim of this study was to decompose independent effects of age, period, and cohort on trends in outpatient addiction care utilization resulting from alcohol (AUD) and illicit substances use disorders (ISUD). Decomposing trends in addiction care utilization into their independent effects by age, period, and cohort may lead to a better...

Background In the implementation of placement matching guidelines, feasibility has been concerned in previous research. Objectives of this process evaluation were to investigate whether the patient-centered matching guidelines (PCPM) are consistently applied in referral decision-making from an inpatient qualified withdrawal program to a level of ca...

Background: Substance-related and addictive disorders are among the most common mental disorders in adolescence and young adulthood. Vocational school students are a risk group for problematic substance use and addictive behavior. However, the availability of evidence-based prevention concepts and programs is underdeveloped in the vocational school...

Background Parental substance misuse is reported to endanger the health and psychological development of children and adolescents. The aim of the present study was to address conceptual and methodological problems in estimating the number of children affected by parental substance misuse (CaPSM) and offer a novel approach based on survey data. Met...

Background Bouldering-Psychotherapy (BPT) has proven to effectively reduce depressive symptoms, but evidence on its cost-effectiveness is lacking. Corresponding information is paramount to support health policy decision making on a potential implementation of BPT in routine care. Methods Using data from the German KuS trial BPT was compared with g...

This paper explores trends in beverage preference in adolescents, identifies related regional differences, and examines cluster differences in key drinking measures. Data were obtained from the European School Survey Project on Alcohol and Other Drugs (ESPAD), covering 24 European countries between 1999 and 2019. Trends in the distribution of alcoh...

Objective The present paper extends the scope of testing Skog’s theory on the ‘collectivity of drinking culture’ to adolescent alcohol use in 26 European countries. The aim was to 1) examine whether changes in adolescent alcohol use are consistent across different consumption levels, and 2) explore whether trends in heavy and light drinkers diverge...

Background and aim Evidence on the course of gambling disorder (GD) in clients seeking help from outpatient addiction care facilities is sparse. To close this knowledge gap, this longitudinal one-armed cohort study portrays the development of GD in help-seeking clients over a 3-year timeframe. Methods We investigated changes in severity of GD as w...

Background Older individuals are not only more sensitive to the impact of alcohol but also face significant health risks from alcohol–drug interactions. To alter current drinking patterns, it is crucial to understand the motives for abstention of adults in late middle age. Objectives We hypothesized that, for adults in late middle age, socio-demog...

Im Jahr 2020 ist der Absatz von Bier stärker zurückgegangen, als erwartet. Umfragedaten zeigen, dass sich der Alkoholkonsum bei etwa der Hälfte der Befragten verändert und vor allem bei denjenigen zugenommen hat, die bereits vor der Pandemie hohe Trinkmengen berichteten. Weiterhin haben sich (teil-)stationäre Behandlungszahlen insgesamt stark reduz...

The European School Survey Project on Alcohol and Other Drugs (ESPAD) has been collecting comparable data on risk behaviours and substance use among adolescent students for almost 25 years, in order to monitor trends in and between countries. The study is conducted in each participating country as a school survey for students reaching the age of 16...

IntroductionAccording to Skog’s collectivity of drinking cultures theory, changes in alcohol consumption in all groups and strata of the population take place as parallel displacement in the distribution of consumption. The aims of the present paper are (1) to illustrate temporal trends in risky drinking and episodic heavy drinking by age and gende...

Introduction: In recent years, beverage composition of total alcohol consumption has changed substantially in Sweden. As beverage choice is strongly associated with drinking practices, our paper aims to analyse trends in beverage composition of alcohol consumption by age, period and cohort. Methods: Age-period-cohort (APC) analysis was conducted...

Introduction The ageing of baby boomers is expected to confront addiction care with new challenges. This cohort had greater exposure to psychoactive substances in youth than earlier cohorts. In this study, we aimed to investigate whether Berlin addiction care is confronted with a sustained change in its clientele initiated by the baby boomers. Met...

Background and aims In recent decades, alcohol drinking in the European Union has been characterized by increasing homogenization of levels of drinking coupled with an overall decrease. This study examined whether we can still distinguish distinct practices of drinking by addressing two research questions: (1) Are drinking practices still character...

Objective The prospective naturalistic study ‘Katamnese‐Studie’ conducted between 2014 and 2019 gathers evidence on the course of gambling disorder in German routine outpatient addiction care. This study elucidates design and methodological advantages and caveats of the study. Methods Participants of the multi‐centre cohort received written questi...

Zusammenfassung Ziel Erfassung der Häufigkeit, mit der zentral in die Gesundheitsversorgung der Zielgruppe eingebundene Berufsgruppen auf problematischen Alkoholkonsum screenen. Die S3-Leitlinie „Screening, Diagnose und Behandlung alkoholbezogener Störungen“ empfiehlt „allen Patient/innen in allen Settings“ ein fragebogenbasiertes Screening anzubie...

The main purpose of the European School Survey Project on Alcohol and Other Drugs (ESPAD) is to collect comparable data on substance use and other forms of risk behaviour among 15- to 16-year-old students in order to monitor trends within, as well as between, countries. Between 1995 and 2019, seven waves of data collection were conducted across 49...

Zusammenfassung Ziel der Studie Die Art und Häufigkeit durchgeführter Diagnostik, Kurzintervention und Behandlung bei PatientInnen mit bekanntem problematischen Alkoholkonsum und Alkoholkonsumstörungen durch Berufsgruppen der Gesundheitsversorgung soll erfasst werden. Diese Informationen dienen der Bedarfsabschätzung zur Entwicklung von Strategien...

Background The aging of baby boomers is expected to confront addiction care with new challenges. This study aims to investigate if German addiction care is confronted with a sustained change in its clientele that was initiated by the baby boomers. Methods Using data from Berlin outpatient addiction care facilities, we contrasted type of primary su...

Background: Not much is known about the correlation between gaming problems and substance use across different countries. This paper presents cross-national analyses of different gaming indicators and their relationship to substance use. Methods: Based on data from the 2015 ESPAD study, differences in the relationship between gaming and substanc...