This edition of NAFKAMs national survey was carried out by Norstat in November/ December 2022. The data were analyzed by Agnete E. Kristoffersen at NAFKAM, who also authored this report together with Ola Lillenes.
The 2022-survey provides knowledge about Norwegians' use of complementary and alternative medicine (CAM) and dietary supplements, as well as their perceived health status, based on 1,000 telephone interviews with residents aged 18 and over; consisting of 501 men (50,1%) and 499 women (49,9%).
According to Statistics Norway, the total population in this age group was by the end of 2022 4,316,747 people, consisting of 2,168,307 men (50,2%) and 2,148,440 women (49,8%). In our survey, the proportion of male respondents was thus slightly lower (50,1 %) than the actual proportion at population level; and the proportion of females correspondingly higher (49,9%).
Please note that the reported figures are not adjusted for possible cases of statistical outliers.
Definitions and more information about the methodology used in NAFKAMs national surveys can be read in the article Generelt om NAFKAMs befolkningsundersøkelse (in Norwegian).
- Total use of CAM in Norway in 2022
- CAM treatment from a provider in 2022
- Use of herbs/natural remedies in 2022
- Use of self-help techniques in 2022.
- Characteristics of users and non-users of CAM in 2022
- Use of dietary supplements in 2022
- Dialogue with the doctor, risk assessment and experiences with CAM and dietary supplements
- Expenditures for the public health service and conventional medical treatment.
- Corona medallions and the like
- Use of NAFKAM.no
1. Total use of CAM in 2022
Almost 4 of 10 used CAM: 383 (38,3%) of the 1,000 reported having used one or more of the following forms for CAM in 2022, for health-related purposes:
- CAM therapy from a provider (ie an acupuncturist, homeopath, reiki healer, etc), and/or
- herbs/ natural remedies (ie ginseng, garlic, ginger, etc), and/or
- self-help techniques (ie yoga, mindfulness, meditation, etc)
Most common among women: Use of CAM was more common among women (46,7% of the female respondents) than men (29,9% of the male respondents). The user group consisted of 61/39 women/men.
More than NOK 4,700 per user; most among men: The average cost per CAM user was NOK 4,718. With a difference of NOK 3,286 the average cost was almost twice as high (189%) among male users (NOK 6,968 per male user) than among female users (NOK 3,682 per woman who used).
Almost NOK 8 billion at population level: If we transfer the level of use and costs from this survey to the entire Norwegian population, this corresponded to 1.6 million Norwegians using CAM in 2022, at a total cost of NOK 7.799.000.
A closer look at the data shows the following:
2. CAM therapy from providers in 2022
1 in 4 saw a CAM provider: 24,9% reported that they had received one or more CAM therapies from a provider, inside or outside the public health system,
More women than men: Receiving CAM treatment from a provider was more common among women (30% of the female respondents) than men (20% of the male respondents). The user group consisted of 60/40 women/men.
Almost NOK 5,000 per user; most among women: The average cost per user was NOK 4,817.
With a difference of NOK 3,725 the average cost was significantly higher (243%) among female users (NOK 6,324 per female user) than among male users (NOK 2,599 per male user).
Over NOK 5 billion at population level: Transferred to the population, this corresponded to 1.075.000 Norwegians receiving CAM from providers in 2022, at a total cost of NOK 5.178.000 billion.
Table 2.1: Most commonly used CAM therapies in Norway, 2022
|Therapy||Proportion who used (from all respondents, N = 1,000)|
|Massage therapy 1)||17,4%|
|Psychotherapy (not from a psychologist/ psychiatrist)||2,8%|
|Other CAM therapy, not listed 3)||0,9%|
Notes re table 2.1:
- The differences in usage of the 9 predefined therapies were all minor, except for massage therapy, which also in 2022 constituted a significantly higher proportion than the others. You can read more about this in our general article on NAFKAM's population survey, and in the report from the 2014 survey.
- Until May 1, 2022, naprapathy and osteopathy were regulated as CAM in Norway. From then on, these therapies are considered public healthcare, delivered by authorized healthcare professionals (naprapaths and osteopaths). Respondents who stated having used these therapies, were not asked if their usage occurred before or after May 1, 2022. Thus, the total use of CAM and costs to it may be somewhat lower, due to these changes in regulation. Read more about this change in regulation in the article Naprapater og osteopater autoriseres i Norge (in Norwegian).
- The answers in the category "Other CAM therapy, not listed" have been adjusted by NAFKAM: any reported use of therapies not complying with the definition of CAM in §2 of the CAM Act have been removed.
3. Use of herbs/ natural remedies in 2022
Almost 14% used herbs: A total of 13,8% reported using herbs/natural remedies (eg ginseng, garlic, ginger or similar) for health-related purposes.
More women: Use of herbs/natural remedies was more common among women (17.6% of female respondents) than among men (10% of male respondents). The user group consisted of 64/36 women/men.
Almost NOK 3,400 per user; most among men: The average cost of herbs/natural remedies was NOK 3,386 per user.
With a difference of NOK 3,127 the average cost was significantly higher (239%) among male users (NOK 5,380 per male user) than among female users (NOK 2,253 per female user).
Over NOK 2 billion at population level: Transferred to the population level, this corresponded to 596,000 Norwegians using herbs/natural remedies as treatment in 2022, at a total cost of NOK 2.016.000.
4. Use of self-help techniques in 2022
2 in 10 used self-help techniques: A total of 18.1% of the 1,000 reported using self-help techniques (such as yoga, mindfulness, meditation or similar) for health-related purposes.
More women: Use of self-help techniques was more common among women (26.3% of female respondents) than among men (10% of male respondents). The user group consisted of 72/28 women/men.
Over NOK 1,500 per user; most among women: The average cost for self-help techniques was NOK 1,536 per user.
With a difference of NOK 1,394 the average cost was significantly higher (291%) among female users (NOK 1,921 per female user) than among men (NOK 527 per male user).
NOK 1.2 billion at population level: Transferred to the population level, this corresponded to 781,000 Norwegians using self-help techniques as treatment in 2022, at a total cost of NOK 1.199.000.
5. Characteristics of users and non-users of CAM in 2022
The 1,000 respondents were asked about their age, which part of the country they lived in, how they assessed their own state of health, and whether they had a long-term (chronic) illness or not. The table below presents this information broken down by all participants and by gender, as well as by users and non-users of CAM:
|Total||Those who used CAM||Those who didn't use CAM||Total||Those who used CAM||Those who didn't use CAM||Total||Those who used CAM||Those who didn't use CAM|
|All respondents||1 000||38,3%||61,7%||501||29,9%||70,1%||499||46,7%||53,3%|
|Average respondent's age||48,6 yrs||46,4 yrs||50,1 yrs||47,9 yrs||45,4 yrs||49,1 yrs||49,3 yrs||47,0 yrs||51,4 yrs|
|Respondents aged 18-39 yrs||37,0%||39,6%||35,3%||37,9%||42,2%||35,9%||36,1%||37,8%||34,5%|
|Respondents 40-59 yrs||33,9%||37,3%||31,6%||34,7%||33,5%||35,0%||33,1%||39,9%||26,8%|
|Respondents 60+ yrs||29,1%||23,1%||33,1%||27,3%||24,2%||29,0%||30,9%||22,3%||38,7%|
|Southern Norway incl Telemark||9,8%||9,8%||9,8%||9,6%||9,3%||9,7%||10,0%||10,1%||10,0%|
|Neither good nor bad||16,6%||18,3%||16,0%||15,0%||14,5%||15,0%||18,2%||20,9%||15,8%|
|Diagnosed with a chronic (long-term) illness or disease||34,6%||41,4%||30,0%||32,1%||37,3%||30,0%||37,1%||44,1%||31,0%|
Respondents' average age was 48.6 years. The men in the survey were generally a little younger (47.9 years) and the women a little older (49.3 years) than this.
Use of CAM occurred most often among respondents in the age group 40-59 years, and CAM users were generally slightly younger than non-users:
The average CAM user was 46.4 years; male users averaged 45.1 years old and female users 49.1 years old. The non-users were on average 50.1 years old. In terms of age, use of CAM was lowest among those in the 60+ age group.
Geographically, use of CAM was highest among respondents from northern Norway, and lowest in the western parts of Norway.
In terms of health, users of CAM generally rated themselves as having slightly worse health than non-users. Use of CAM was also higher among those with a chronic/long-term illness, than among those who did not report such a diagnosis.
6. Use of dietary supplements in 2022
NAFKAM does not consider ordinary use (in line with the enclosed declaration) of dietary supplements (vitamins, minerals, trace elements etc) to strengthen ones' health as CAM, but we measure the population's use of such based on a specific assignment from the health authorities.
Almost 3 out of 4 used supplements: 73,8% of the 1,000 respondents stated that they had used dietary supplements in 2022.
More common among women than men : Use of dietary supplements was more common among female respondents (77.8% of all women) than among male respondents (69.9% of all men). The user group consisted of 53/47 women/men.
On average NOK 1,100 per user, higher costs among women: The average cost of dietary supplements was NOK 1,095 per user.
With a difference of NOK 329, the average cost was significantly higher (136%) higher among female users (NOK 1,253 per female user) than among male users (NOK 924 per male user).
Almost NOK 3.5 billion at population level: Transferred to the population level, this corresponded to 3.2 million Norwegians using nutritional supplements in 2022, at a total cost of NOK 3.487.000.000.
7. Dialogue with MDs; considerations of risk and users' experiences with CAM and supplements
Those respondents who stated that they had used CAM and/or dietary supplements in 2022 were also asked if their doctor knew about their usage of such; if they were familiar with any known risks concerning what they had used; whether they had experienced any positive and/or negative health effects from it. Those who had experienced negative effects were further asked whether this was or should have been reported:
|Among all CAM users (% of 383)||Among all who received CAM from a provider (% of 249)||Among all who used herbs/ natural remedies (% of 138)||Among all who used self-help techniques (% of 181)||Among those who used dietary supplements (% of 738)|
|7.1.1 My MD is aware of what I used||49,1||48,5||26,8||37,6||47,3|
|7.1.2 I am familiar with risks associated with what I used||16,4||11,8||18,8||11,6||16,5|
|7.1.3 I experienced positive health effects||89,8||84,6||71,7||90,6||45,5|
|7.1.4 I experienced negative health effects||5,2||3,7||6,5||1,1||3,4|
|7.1.5 The negative experiences were reported**||40,0||40,0||33,3||50,0||52,0|
|7.1.6 The negative experiences should have been reported but were not**||20,0||40,0||0||0||16,0|
*= Note that ordinary use of dietary supplements is not considered CAM by NAFKAM, and is measured and calculated separately from figures concerning CAM.
**= % shares of those who stated having experienced negative effects in section 7.1.6
Just under half (49.1%) of all who used CAM in 2022 stated that their doctor was aware of this. This was most seldom among those who used herbs/natural remedies (26.8%) and most common among those who received CAM from a provider (48.5%). Among users of dietary supplements, just under half stated that the doctor knew about this (47.3%).
Almost nine out of ten (89.8%) of all who used CAM meant that they had positive health effects from this. The group with the greatest experience of such effects were those who had used self-help techniques (90.8%). Among users of dietary supplements, less than half (45.5%) experienced positive health effects.
5.2% reported having experienced negative effects (side effects, worsening or similar) of CAM. This occurred most often among users of herbs/natural remedies (6.5%). 3.4% of those who used dietary supplements had experienced negative effects from this.
A closer look at those who had experienced negative effects finds that on average, 40% of these said that this had been reported to a doctor or other health personnel. This occurred most often among users of self-help techniques (50%).
Among those users of CAM who experienced negative effects and had not reported them, 20% believed that they should have been reported anyway. Among the corresponding group that used dietary supplements, this figure was 16%.
8. Expenses to conventional treatment in/ from the public health care service
All respondents were also asked if they could estimate their total expenditure to consultation and medical treatment from the public health care service (such as their MD/ GP, emergency room, hospital, physiotherapist, chiropractor etc.) in the last 12 months prior to the survey:
|Among all||Among the men||Among the women||Among CAM users||Among non-CAM users|
|Yes, I can estimate this for 2022||86,8%||88,2%||85,4%||87,7%||86,2%|
|Average cost per user in this group (NOK)||2,199||2,165||2,233||2,595||1,930|
The average cost per respondent who could estimate this was NOK 2,199 per person, regardless of gender and whether they used CAM or not.
The cost was slightly higher among women than men, and clearly highest among those who used CAM. This tells us that those who use CAM also use conventional medicine/ the public healthcare system at relatively high costs.
9. Corona-medallions and the like
During the COVID pandemic, various self-help products appeared on the market; allegedly with ability to prevent against the coronavirus and help with COVID-19 disease. We asked all respondents how strongly they agreed or disagreed with four statements about such products, on a scale from 0 (completely disagree) to 5 (completely agree). They could also answer "don't know/don't want to answer". In table 9.1 below, answers from 0-2 are combined to "Disagree"; 3-5 to "Agree" and don't know/ don't want to answer combined to "Not answered":
|Statement||Among all respondents||Among the men||Among the women||Among CAM users||Among non-CAM users|
|9.1.1 "They can make someone feel better"||Agree||17,5%||18,2%||16,8%||20,4%||15,6%|
|9.1.2 "They should be more strictly regulated, or forbidden"||Agree||62,7%||62,5%||62,9%||56,1%||67,1%|
|9.1.3 "They bring a risk that patients skip important medical treatment "||Agree||65,4%||63,3%||67,5%||61,1%||68,2%|
|9.1.4 "They can affect your health, positively or negatively"||Agree||13,5%||13,6%||13,4%||14,4%||13,0%|
If considered represented by the survey's 1,000 respondents, the Norwegian population express a sober attitude towards products like this. You may note that the proportion who did not answer the question was higher here, than for other questions in the survey. Those who also reported to use CAM, consistently expressed a somewhat more positive attitude towards such products than those who did not use CAM.
10. Use of NAFKAM.no
We also asked all respondents whether they had visited NAFKAM's website nafkam.no during the 12 months prior to the survey. Table 10.1 shows this, broken down by everyone, gender and use/non-use of CAM:
|Among all respondents||Among the men||Among the women||Among CAM users||Among non-CAM users|
|Yes, have visited||0,8%||0,6%||1,0%||1,8%||0,2%|
|No, have not visited||99,0%||99,4%||98,6%||98,2%||99,5%|
|Unsure/ no answer given||0,2%||0,0%||0,4%||0,0%||0,3%|