Why can alcohol-related problems be high in Scandinavian countries despite relatively low total alcohol consumption?

In Scandinavian countries, the relatively high rate of alcohol-related problems, such as intoxication, is primarily attributed to specific drinking patterns rather than the total volume of alcohol consumed. Unlike cultures where alcohol is consumed daily or with meals, the prevailing pattern in Scandinavia involves very heavy drinking concentrated on weekends or special occasions.1

This episodic, high-intensity consumption is believed to be the primary driver of alcohol-connected issues, even though the overall per capita consumption remains relatively low compared to other nations. Furthermore, because these countries have strong temperance movements and large populations that abstain from alcohol entirely, the total consumption is likely distributed among a smaller number of active drinkers, which may exacerbate the social and health impacts within that specific subset of the population.1