Background: Patterns of alcohol use often start developing during adolescence and are associated with alcohol use and dependence during adulthood. The aims of the study were to describe trends in the prevalence of monthly alcohol use from 2003 to 2015 and to analyze the associations between alcohol use and family-related and school-related factors, risk behavioral factors and perceived alcohol availability in Estonia, Latvia, Lithuania, Finland, and Sweden.
Methods: The study used nationally representative data of 15–16-year-old adolescents from the European School Survey Project on Alcohol and Other Drugs (ESPAD). Data from Estonia, Latvia, Lithuania, Finland, and Sweden collected in 2003, 2007, 2011, and 2015 were utilized (n=57,779). The prevalence of monthly alcohol use and light and strong alcohol use was calculated for each study year in all countries. A chi-square test for trend was used to evaluate statistically significant changes in alcohol use over the study period. Logistic regression analysis was performed to analyze the association between alcohol use and different factors. Fully adjusted odds ratios with 95% confidence intervals were calculated.
Results: Monthly alcohol use decreased significantly among 15–16-year-old boys and girls in Estonia, Latvia, Lithuania, Finland, and Sweden from 2003 to 2015. In 2015, the prevalence of monthly alcohol use among boys was 36.1% in Estonia, 44.3% in Latvia, 32.4% in Lithuania, 32.3% in Finland, and 22.4% in Sweden, and among girls, it was 39.1%, 45.9%, 35.6%, 31.8%, and 29.1%, respectively. In Estonia, Latvia, Lithuania, and Sweden, girls had higher odds of monthly alcohol use than boys. In all countries, higher odds of monthly alcohol use were observed among adolescents who skipped school, smoked cigarettes, used cannabis, perceived alcohol to be easy to access and had parents who did not know always/often about their child’s whereabouts on Saturday nights.
Conclusion: From 2003 to 2015, monthly alcohol use decreased in Estonia as well as in neighboring countries such as Latvia, Lithuania, Finland, and Sweden. The factors related to alcohol use in all five countries were generally similar. Based on the study results, health promotion and alcohol policy interventions could be improved to decrease and prevent alcohol use among adolescents.