ArticleLiterature Review

Adolescents drink less: How, who and why? A review of the recent research literature: Adolescents drink less-a literature review

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Abstract

Issues Today’s teenagers have been described as a sober generation and we asked: ‘What is known about the recent decline in youth drinking?’ Approach A literature review (2005–2017). Key Findings Research from wealthier parts of the world provides solid evidence of less alcohol use by youth since the millennium shift. Some studies show that this is reflected at all levels of consumption, but there are also indications that the heaviest drinkers have not reduced their drinking. The decrease is predominately seen in underage youth, and has been larger for boys than for girls in several countries. Teenagers across social strata drink less, but some disadvantaged subgroups have not followed the downward trend. Underage drinkers have apparently not become a more deviant group as the prevalence of drinking has dropped, indicating no hardening of the group. The major gap in the literature pertains to the issue of underlying driving forces. We found no evidence in support of the widespread assumption that the digital revolution has been of importance. A decline in parenting practices that are conductive to underage drinking has occurred in several countries, but studies examining whether these changes have contributed to less alcohol use by youth are almost non‐existent. Implications To inform alcohol policy and prevention, it is imperative to find out why teenage drinking has decreased in a fairly consistent way across numerous countries. Conclusion Future research into the issue of falling prevalence rates of youth drinking should focus on possible explanatory factors at the population level rather than at the individual level.

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... Despite some gaps in these data series, there is enough evidence to conclude that the decline in youth crime is a common experience in Western developed societies. Additionally, it is worth mentioning that other forms of problem or risk behavior such as marijuana use and binge drinking also showed a decline in many countries (Moss et al., 2019;Pape et al., 2018;Pennay et al., 2018). ...
... Some of these attempts to explain the general crime drop were implicitly or explicitly targeted at criminal behavior in young age groups or at causal mechanisms that impact child and adolescent development, such as lead poisoning or cohort size. In addition, and specifically addressing the decline in youth crime, it has been argued that it may be a consequence of changes in parental monitoring (Arnett, 2018), changes in young people's future orientation and attitudes toward school (Balvig, 2011), and more negative attitudes toward crime (Griffiths & Norris, 2020;Pape et al., 2018). Several scholars have discussed changes in daily routines as explanation for the decline in youth crime, in particular, an increase in time spent online and a corresponding decrease of offline activities (Arnett, 2018;Berghuis & De Waard, 2017;Moss et al., 2019;Twenge & Park, 2019;Twenge & Spitzberg, 2020;Weerman, 2017). ...
... In the Netherlands, it has been pointed out that a rise in disapproving attitudes toward crime has had an inhibiting effect on the propensity to commit crime (Berghuis & de Waard, 2017). Pape et al. (2018) reviewed the existing evidence for changing attitudes of adolescents toward alcohol consumption that is seen as an explanation of reductions in actual consumption patterns (see also below). Attitudes toward social norms are often addressed as morality, a set of convictions about right or wrong behavior. ...
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This study examines the declining crime trend among Swedish adolescents between 1999 and 2017 using data from eight repeated cross‐sectional waves of a nationally representative school survey (N = ca. 49,000). We examined to what extent changes in parental monitoring, school bonds, attitudes toward crime, routine activities, and binge drinking were related to the noticeable decline in youth crime. Multilevel modeling was employed for the analysis of temporal trends. We found strong empirical support for our hypotheses, that is, that changes in social bonds, attitudes toward crime, and routine activities were all associated with the decline in youth crime. Routine activities had the strongest explanatory power, and all predictors combined accounted for most of the variance attributed to the decline in youth crime. This study moves research on the crime drop closer to the analysis of social mechanisms by demonstrating that micro‐level associations between theoretically relevant, proximal variables, and delinquency account for macro‐level change.
... This development is not isolated to Sweden; similar trends have been observed from several countries such as Australia, Finland and Norway, to name a few [3,4]. Despite an increasing amount of research in recent years, there is currently no explanation for why youth drinking is declining [5][6][7]. Studies from the US, Australia and Sweden have shown a marked increase in the age of onset of alcohol use [8][9][10], indicating that youth today do start to drink but initiate drinking at older ages. ...
... There are also reports of changes in the parent-child relationship, with youth nowadays spending more time with parents and conforming to their parents' lifestyle [23]. One of the key theories put forward by researchers to explain this decline is that it represents a broader shift of 'delayed adolescence' or 'prolonged adolescence' [6,24,25]. Few alcohol researchers have, however, explicitly examined this question across a broad range of alcohol use indicators, i.e., beyond simple measures of abstinence or drinking volume. ...
... Our results show that the declines in drinking observed among Swedish youth have caused a displacement of drinking, so 17-18-year-olds in 2018 drink in a similar manner as 15-16 year-olds did twelve years prior. This would fit with the notion of a 'prolonged adolescence', where youth today start with adult behaviours at an older age [6,24]. ...
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To examine and compare trends in drinking prevalence in nationally representative samples of Swedish 9th and 11th grade students between 2000 and 2018. A further aim is to compare drinking behaviours in the two age groups during years with similar drinking prevalence. Data were drawn from annual surveys of a nationally representative sample of students in year 9 (15–16 years old) and year 11 (17–18 years old). The data covered 19 years for year 9 and 16 years for year 11. Two reference years where the prevalence of drinking was similar were extracted for further comparison, 2018 for year 11 (n = 4878) and 2005 for year 9 (n = 5423). The reference years were compared with regard to the volume of drinking, heavy episodic drinking, having had an accident and quarrelling while drunk. The prevalence of drinking declined in both age groups during the study period. The rate of decline was somewhat higher among year 9 students. In 2018, the prevalence of drinking was the same for year 11 students as it was for year 9 students in 2005. The volume of drinking was lower among year 11 students in 2018 than year 9 students in 2005. No differences were observed for heavy episodic drinking. The decline in drinking has caused a displacement of consumption so that today’s 17–18-year-olds have a similar drinking behaviour to what 15–16-year-olds had in 2005.
... A dolescent alcohol consumption has declined for the last two decades in many countries. [1][2][3][4] In Europe, ESPAD data showed an overall decrease in lifetime alcohol use from 90% in 2003 to 81% in 2015. 1 However, trends vary between countries, whereby decreases combine with periods of stability and even increases. In a recent study on past-month drinking, Vashishtha et al. 5 found that results varied markedly across countries, with Northern countries showing the earliest and steepest declines (the British Isles countries also showed large reductions), whereas the Eastern and Southern countries showed the shallowest declines. ...
... Previous studies suggested factors related to adolescents, their families and society. 2,[25][26][27] The most robust evidence seems to be associated with shifts in parental practices 27 and in unorganized leisure time with peers, 28 whereas the widespread assumption relating the rise of new technologies with reductions in adolescent drinking has not been supported by research. 2,28 Regarding alcohol control policies (i.e. ...
... 2,[25][26][27] The most robust evidence seems to be associated with shifts in parental practices 27 and in unorganized leisure time with peers, 28 whereas the widespread assumption relating the rise of new technologies with reductions in adolescent drinking has not been supported by research. 2,28 Regarding alcohol control policies (i.e. imposing a minimum legal drinking age, restricting availability, regulating advertising, providing information and education), there is a lack of strong agreement on their effects on alcohol-related behaviours. ...
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Background Adolescent alcohol consumption is a major public health concern that should be continuously monitored. This study aims (i) to analyze country-level trends in weekly alcohol consumption, drunkenness and early initiation in alcohol consumption and drunkenness among 15-year-old adolescents from 39 countries and regions across Europe and North America between 2002 and 2014 and (ii) to examine the geographical patterns in adolescent alcohol-related behaviours. Methods The sample was composed of 250 161 adolescents aged 15 from 39 countries and regions from Europe and North America. Survey years were 2002, 2006, 2010 and 2014. The alcohol consumption and drunkenness items of the HBSC questionnaire were employed. Prevalence ratios and 95% confidence intervals were estimated using Poisson regression models with robust variance. Results Data show a general decrease in all four alcohol variables between 2002 and 2014 except for some countries. However, there is variability both within a country (depending on the alcohol-related behaviour under study) and across countries (in the beginning and shape of trends). Some countries have not reduced or even increased their levels in some variables. Although some particularities have persisted over time, there are no robust patterns by regions. Conclusions Despite an overall decrease in adolescent alcohol consumption, special attention should be paid to those countries where declines are not present, or despite decreasing, rates are still high. Further research is needed to clarify factors associated with adolescent drinking, to better understand country specificities and to implement effective policies.
... 1,2 The association between alcohol use and aggression is well documented. 3,4 While recent studies provide solid evidence for a decline in alcohol use and heavy episodic drinking among adolescents in the Nordic countries and several other countries since the turn of the century, [5][6][7][8][9][10][11][12] several questions concerning the explanations for-and the impact of-this change, remain unanswered. Two of these questions are as follows: is the decline in adolescents' heavy episodic drinking accompanied by a decline in the prevalence of alcoholrelated violence, and furthermore:-has the decline in heavy episodic drinking been accompanied by a change in the magnitude of the association between alcohol use and alcohol-related violence? ...
... Along with the secular decline in adolescents' alcohol consumption in the 2000s, HED prevalence has decreased in several countries, including the Nordic countries in our study. 6 For this reason, one could expect that the prevalence of alcohol-related violence among adolescents declined as well. On the other hand, the vast majority of HED occasions do not result in violent behaviour. ...
... 25 While the proportion of individuals with such characteristics, or traits, are likely quite stable over time, in part due to their genetic underpinning, 26 the proportion of young people with problem behaviours, including aggressive behaviours and HED, typically vary over time. 6,27 This suggests that trait characteristics like impulsivity and low self-control will contribute more to the occurrence of HED in time periods when HED is rare as compared to periods when HED is common. 28 Figure 1 illustrates this point. ...
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Background: Since 2000, adolescents' alcohol use and heavy episodic drinking (HED) have declined in the Nordic countries. However, little is known about corresponding trends in alcohol-related harm and possible changes in the alcohol-harm association. The aims are to examine (i) whether the decline in HED was accompanied by a decline in alcohol-related violence (AV) and (ii) whether the strength of the HED-AV association changed concomitant with the decline. Methods: Analysis of data from the European School Survey Project on Alcohol and Other Drugs (ESPAD), conducted among 15-16-year-olds in Iceland, Norway and Sweden in 2007 and 2015 (n = 17 027). Changes in proportions of AV and alcohol use past 12 months, and mean frequency of HED past 30 days were examined using Pearsons χ2-test and F-test, respectively. The HED-AV associations were estimated using logistic regression analysis. Results: HED and AV proportions decreased from 2007 to 2015 in all countries. Among current drinkers (n = 8927), both HED frequency and AV proportion decreased in Norway (P < 0.001) and remained stable in Iceland. In Sweden, AV decreased (P < 0.001) whereas HED remained stable. The magnitude of the HED-AV association increased in Norway (Beta2015-2007 = 0.145, 95% CI 0.054-0.236), remained the same in Iceland and decreased in Sweden (Beta2015-2007 = -0.082, 95% CI -0.158 to -0.005). Conclusions: Among youth in Iceland, Norway and Sweden, heavy episodic drinking and alcohol-related violence declined from 2007 to 2015. Among drinkers, the strength of the alcohol-violence association was moderated by the extent of heavy episodic drinking.
... Most studies on the association between age at first alcohol use and HED have been conducted in developed countries where alcohol use and binge drinking have decreased since the early 2000s [24][25][26][27][28]. This trend is less obvious in developing countries [24]. ...
... Most studies on the association between age at first alcohol use and HED have been conducted in developed countries where alcohol use and binge drinking have decreased since the early 2000s [24][25][26][27][28]. This trend is less obvious in developing countries [24]. In Thailand, the prevalence of current drinkers among individuals aged 15-19 years has slightly increased from 11.0% in 2001 to 13.6% in 2017 [14]. ...
... This difference in the prevalence and trend of youth drinking between developed countries and developing countries may reflect the difference in contextual factors that are associated with the trend of youth drinking [24,28,31] and the relationship between age at first alcohol use and HED [16]. The association between age at first alcohol use and HED in developing countries may differ from what is observed in developed countries. ...
Article
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According to evidence from developed countries, age at first alcohol use has been identified as a determinant of heavy episodic drinking (HED). This study aimed to investigate the association between age at first alcohol use and HED using data from the Smoking and Drinking Behavior Survey 2017, a Thai nationally representative survey. Binary logistic regression was used to examine the association. This study used data from 23,073 current drinkers in the survey. The survey participants were chosen to represent the Thai population aged 15 years and older. The prevalence of HED and frequent HED among Thai drinkers was 18.6% and 10.1%, respectively. Age at first drinking <20 years was associated with higher odds of HED (adjusted OR, 1.43; 95% CI, 1.26–1.62) and frequent HED (adjusted OR, 1.31; 95% CI, 1.12–1.53) relative to age at first drinking ≥25 years. Regular drinking, drinking at home, and exposure to alcohol advertising increased the odds of HED. Drinking at home was associated with frequent HED. There was a significant interaction between the effect of age at first alcohol use and sex on HED and frequent HED with a stronger effect of age at first alcohol use observed in females. This study provides evidence from a developing country that early onset of alcohol use is associated with HED. Effective measures such as tax and pricing policy should be enforced to delay the onset of drinking.
... Over the past two decades, there have been marked declines in youth drinking across a wide range of countries [5][6][7]. The decline began in the USA followed by Nordic countries and then Western Europe [8]. ...
... This development has puzzled researchers and the trends are still largely unexplained [9,10]. Hypothesised explanations include increased use of internet-based technologies, changed parenting, greater health consciousness, migration from abstemious cultures and better enforcement of laws related to underage drinking [5]. ...
... Given the international scope of the trends, there have been calls for comparative studies across countries to help understand this development [17,18]. The European School survey Project on Alcohol and Other Drugs (ESPAD) has been identified as a rich and important source of information in this regard [5], since it uses a standardised data collection procedure and produces comparable estimates on drinking and use of other substances among 15-to 16-year-olds across many European countries over a long period of time. In 2015, the results showed that the prevalence of drinking declined between 2011 and 2015 in all countries included in the study. ...
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Youth drinking has declined in many high‐income countries for two decades. This development is still largely unexplained. Developing evidence and extending our understanding as to the mechanisms behind these changes is imperative for advising governments and policy makers on how to support and maintain the trends. Given the international scope of the trends, comparative studies have been suggested for improving our understanding of the development. In this commentary, we explore the patterns observed across several waves of the European School Survey Project on Alcohol and Other Drugs between 1999 and 2019, and how these match‐up with the World Values Survey. We found that the declines in youth drinking are limited to a smaller number of countries and that in Europe these are all found in two groups from the World Values Survey, protestant Europe and English‐speaking countries. If the declines in youth drinking are systematic and limited to a smaller number of countries, this challenges some of the hypothesised drivers of this development, but can also help guide future research.
... The data used in the two previous Swedish studies are also qualitative or based on regional samples and thus have limited generalisability. Furthermore, given the decline in adolescent (predominately aged 11-18 years) drinking in recent years (EMCDDA/ESPAD, 2016;Looze et al., 2015;Pape et al., 2018;Raninen et al., 2014; The Public Health Agency of Sweden, 2019; The Swedish Council for Information on Alcohol and Other Drugs, 2018b) there is a need for updated studies on drinking motives among adolescents. Moreover, neither of the previous Swedish studies used the Four-Factor Model (Cooper, 1994) or the five-factor version (Grant et al., 2007) to enable international comparisons. ...
... In previous studies, moderation by sex has foremost been found regarding enhancement and coping motives (Kuntsche et al., 2014;Lammers et al., 2013;Magid et al., 2007). These differences in results may relate to the reduced popularity of alcohol among adolescents (predominately aged 11-18 years) in Sweden -what was once a majority behaviour has now become relatively uncommon (EMCDDA/ESPAD, 2016;Looze et al., 2015;Pape et al., 2018;Raninen et al., 2014; The Public Health Agency of Sweden, 2019; The Swedish Council for Information on Alcohol and Other Drugs, 2018b). Drinking has also declined more among boys than among girls in Sweden and nowadays there are no apparent sex differences in drinking in this age group (15-16 years old) (The Swedish Council for Information on Alcohol and Other Drugs, 2020a), which may have altered the links between motives and drinking and the differences in these associations between the sexes. ...
... Our findings are important since drinking motives also seem to operate in the same way in the Nordic countries where drinking frequency usually is low, but heavy drinking is relatively common in comparison to other European countries . Adolescent drinking has furthermore declined sharply over the last two decades, warranting a contemporary study of drinking motives and their association with drinking (EMCDDA/ESPAD, 2016; Looze et al., 2015;Pape et al., 2018;Raninen et al., 2014; The Public Health Agency of Sweden, 2019; The Swedish Council for Information on Alcohol and Other Drugs, 2018b), but this study indicates that drinking motives and their associations with drinking remain stable and essentially follow a similar pattern as was summarised 15 years ago (Kuntsche et al., 2005). ...
Article
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Aims Previous studies have shown a close association between drinking motives and drinking behaviour among adolescents. However, there is a lack of evidence from the Nordic countries since few studies covering this topic have been carried out in this context. The present study among Swedish adolescents aims to examine (1) the prevalence of different drinking motives, (2) how drinking motives are associated with drinking frequency and heavy drinking frequency, and (3) whether the associations are moderated by sex. Methods A nationally representative sample ( n = 5,549) of Swedish adolescents (aged 15–16 years) answered a questionnaire in school. Of these, 2,076 were drinkers and were included in our study. Eighteen items from the Modified Drinking Motives Questionnaire-Revised (Modified DMQ-R) were used. Bivariate relationships between motives and drinking were examined with correlations. Linear regression models were used to assess the links between motives and drinking. Moderating effects of sex were examined with interactions. Results Most common were social motives, followed by enhancement, coping-anxiety, coping-depression, and conformity motives. Coping-depression motives were slightly more common among girls. Conformity motives were associated with a lower frequency of drinking and heavy drinking while enhancement, social and coping-depression motives were associated with a higher frequency of both outcomes. No associations were found for coping-anxiety motives. No moderation effect of sex was found. Conclusions Approach motives (social/enhancement) are the most prevalent drinking motives among Swedish adolescents. These also have the strongest association for both frequency of drinking and frequency of heavy drinking. This shows that Swedish adolescents drink to achieve something positive, rather than to avoid something negative, raising implications for prevention and intervention.
... In recent years, a vast body of research has searched for explanations that indicate the trends of declining alcohol consumption among youths. No single explanation is sufficient to understand why such a large share of youths in high-income countries today choose to abstain from alcohol compared to previous generations [1,2]. Earlier, there has been a close link between drinking to intoxication among 15-year-olds and the general patterns of drinking to intoxication in the older population [3]. ...
... Despite similar developments in young people's alcohol consumption in high-income countries, the decline in risky drinking among 18-to 24-year-olds has continued in Australia, whereas in Sweden the decrease primarily took place before 2010 [18]. To understand how young people's alcohol habits are related to overall societal changes and changes in young people's everyday life practices, concerns, and lifestyles [19], more qualitative research is needed [1]. Longitudinal qualitative research has the potential to be a powerful approach to understand the complexities of youth alcohol consumption across time [20]: including relationships with peers and family, the experience of intoxication, the influence of leisure time activities, health, school, and work opportunities. ...
Article
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In recent years, a vast body of research has investigated trends of declining alcohol consumption among youths. However, the extent to which restrictive-youth approaches towards drinking are maintained into adulthood is unclear. The aim of this study is to explore how young people’s relation to alcohol changes over time. Our data are based on longitudinal qualitative in-depth interviews with 28 participants aged 15 to 23 conducted over the course of three years (2017–2019). The study draws on assemblage thinking by analysing to what kinds of heterogeneous elements young people’s drinking and abstinence are related and what kinds of transformations they undergo when they get older. Five trajectories were identified as influential. Alcohol was transformed from unsafe to safe assemblages, from illegal to legal drinking assemblages, from performance-orientated to enjoyment-orientated assemblages, and from immature to mature assemblages. These trajectories moved alcohol consumption towards moderate drinking. Moreover, abstinence was transformed from authoritarian assemblages into self-reflexive assemblages. Self-control, responsibility, and performance orientation were important mediators in all five trajectories. As the sober generation grows older, they will likely start to drink at more moderate levels than previous generations.
... Declining trends in young people's drinking since the turn of the millennium have prompted numerous theories and hypotheses (see Bhattacharya 2016;Pape et al. 2018;Vashishtha et al. 2020). One popular hypothesis relates to the increased uptake and centrality of digital technologies in young people's lives (Pennay et al. 2015;Larm et al. 2019;Room et al. 2020;Ng Fat et al. 2021). ...
... Early hypotheses on declining drinking trends suggested technology use might be understood as 'screen time' substituting in-person interactionsthat is, leading young people to spend more time at home than out drinking with friends (Pennay et al. 2015;Pape et al. 2018). Increased time spent watching streaming services and playing video games might also contribute to this displacement or substitution effect . ...
Article
Changes in technology use and increased uptake of new forms of digital technology have been hypothesised as one of the key drivers for declining drinking among young people. Although some research has attempted to draw links between technology and young people’s drinking, little work has unpacked this complex relationship with reference to the multitude of ways technology has become a central component of young people’s lives. In this article, we suggest that the embeddedness of technologies can shape young people’s relationships with alcohol in dynamic ways that go beyond previous research, which has largely focused on deterministic relationships and associations. We discuss the multitude of effects digital technologies have on drinking practices at the micro (how young people do identity work), meso (their social practices and relationships) and macro level (the cultural norms and imperatives around alcohol). At all of these levels, digital technologies are implicated in increasing, reducing, destabilising, and transforming young people’s drinking. We suggest several ways forward for research using more theoretically informed approaches. Given these different layers – micro, macro and meso – need to be acknowledged as important mediators, a more nuanced approach to the various configurations of drinking and non-drinking practices digital technologies afford is essential in the design of future research.
... In recent years, increasing rates of non-drinkers have been observed in many countries, especially among youth [1][2][3] but also in the adult population [4]. Most crosssectional differences in population drinking between countries and regions in the world also stem from differences in rates of non-drinkers [5]. ...
... This could then lead to a reduction in the barriers of diffusion and increase the possibility of mutual influence of the groups on each other. The sharp increases in non-drinking observed among young people over the last couple of decades [1,26] might also have implications for the interpretation and implications of our findings, as these historically dry cohorts are now ageing into adulthood. Cohort effects have previously been observed for drinking behaviours [27][28][29] so it is reasonable to assume that these dry cohorts, with high rates of non-drinkers, can impact the total per capita consumption and also impact the drinking part of the population. ...
Article
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Introduction: Understanding how the mean consumption per drinker and rates of non-drinking interplay to form overall per capita alcohol consumption is imperative for our understanding of population drinking. The aim of the present study is to examine the association between rates of non-drinkers and per drinker mean alcohol consumption in the Swedish adult population and for different percentiles of drinkers. Methods: Data came from a monthly telephone survey of drinking habits in the Swedish adult population between 2002 and 2013. Alcohol consumption and non-drinking during the last 30 days were measured by beverage-specific quantity-frequency questions. Regression models estimated the association between the rate of non-drinkers and per drinker volume on annual data. Auto-regressive integrated moving average time-series models estimated the association on monthly data. Results: A significant (P < 0.01) negative association (-0.849) was found between the rate of non-drinkers and per drinker mean volume on annual data. A unit increase in non-drinking was associated with a decline of 0.85 cl of pure alcohol among drinkers. This finding was mirrored across all percentiles of consumption. The semi-log models found that a 1% unit increase in the rate of non-drinkers was followed by a 2% reduction in per drinker mean consumption. Auto-regressive integrated moving average time-series models verified these results. Discussion and conclusions: There is a significant association between the proportion of non-drinkers and the amount of drinking among drinkers. The theory of collectivity of drinking cultures should also include the non-drinking part of the population.
... Since 2013, when the prevalence of drinking dropped to 47 per cent, drinking is no longer the majority behaviour among Swedish ninth graders. Similar trends have been observed in most western countries [19][20][21][22]. Against this background with trends of declining drinking and increase of non-drinkers that has been so marked that it has also led to a shift in the majority behaviour, there is a need to assess what the changing social status of drinking implies for our understanding of non-drinking in adolescence. ...
... The trends in youth drinking are still unexplained and we do not know what is behind the decrease in drinking and the rise of non-drinking [20,22,30]. Maybe one reason for the lack of convincing explanations is that researchers are still thinking of not drinking as a minority behaviour whilst if we are to go looking for explanations for 'normal' youth behaviour we need other approaches, much like the case of understanding illicit drug use in Britain during the 1990s [24]. ...
Article
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Alcohol consumption is a major contributor to the disease burden among adolescents. The adolescent alcohol abstainer is still often depicted as problematic in the research literature and in prominent theoretical frameworks. However, over the past two decades, there has been a marked trend of declining youth drinking in Sweden. The declining trend has led to a shift in the majority behaviour of youth, from drinking to non-drinking. It is plausible that this trend has also shifted the position of non-drinkers. This paper examines the position of non-drinkers in a nationally representative sample of Swedish adolescents. A survey was carried out in 2017 in 500 randomly selected schools. A total of 5549 respondents (15–16-year-olds) agreed to participate and answered the questionnaire. A minority (42.8%) had consumed alcohol during their lifetime. The results show that non-drinkers had better health and school performance when compared to drinkers. The results also showed that there were no differences in the social position between non-drinkers and drinkers. These findings are new and indicate a changed position of non-drinkers among Swedish adolescents. With non-drinking being the majority behaviour among Swedish adolescents this seems to have shifted the position of non-drinkers. There is a need for research on the long-term importance of not drinking during adolescence.
... Alcohol consumption is no exception, with an enduring 'imperative to intoxication' (Griffin et al., 2009: 463) normalising heavy drinking and regular attendance at bars, pubs and clubs. Yet in the UK and more widely, drinking rates continue to decline, particularly among young people (Pape et al., 2018). Recent years have also seen a proliferation of online communities celebrating sobriety as a positive 'lifestyle choice' tied into wider discourses around wellness and self-improvement. ...
... Examples include the development of the UK-based mindful drinking movement 'Club Soda', the rise of online blogs, communities and social media accounts celebrating sobriety (often managed by women) and the growth in short-term abstinence initiatives such as 'dry months' (Yeomans, 2019). With 21% of the UK's female population reported as not having drunk during the last year in 2017 (Osborne and Cooper, 2018) and declining drinking rates among young people (Pape et al., 2018), we may be seeing something of a cultural shift in relation to drinking and sobriety. ...
Article
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Former drinkers in the UK are required to negotiate sobriety in a society that positions consumption (of alcohol but also more widely) as an important part of identity formation. A refusal to consume risks positioning the self outside of the established neoliberal order, particularly as traditional models of sobriety and ‘recovery’ position the non-drinker as diseased or flawed. As drinking rates decline across western contexts and new movements celebrating sobriety as a positive ‘lifestyle choice’ proliferate, this article will highlight ways in which sober women rework elements of traditional recovery models in order to construct an ‘enterprising self’ who remains a good consumer-citizen despite – or indeed because of – their refusal to drink. In doing so, this article enhances our understandings of the ways in which neoliberal notions of a successful, enterprising self can be incorporated into (re)constructions of the self and identity by ‘anti-consumers’ more widely.
... Major changes in adolescent alcohol use have taken place after the turn of the century. In many Western countries, it is now far less common for adolescents to drink alcohol compared to 20 years ago (Halkjelsvik et al., 2020;Inchley et al., 2020;Pape et al., 2018). This development may have been accompanied by a change in what constitutes important risk factors for adolescent alcohol use. ...
... A common explanation for the reported positive association between sports and alcohol use in previous studies is that sports involve socialization with peers who can motivate drinking and provide access to alcohol (Kwan et al., 2014;Wichstrøm & Wichstrøm, 2009). In the past two decades, there has been a marked decline in the prevalence of adolescent drinking in many Western countries, including Norway (Pape et al., 2018), and there is evidence that nondrinking has become normalized among Norwegian adolescents (Scheffels et al., 2020). The effect of socializing into alcohol use through sports may not be as common today as it was 10 or 20 years ago. ...
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Introduction: Recent developments in health behavior among adolescents may have been accompanied by changes in risk factors for alcohol use. Focusing on postmillennial cohorts of adolescents, we revisit the question of whether sports participation is a risk factor for alcohol use. Method: This study analyses data from four waves (2017-2020) of the MyLife longitudinal study. Participants were 3425 (45% boys) Norwegian adolescents attending middle school in 2017 (age range: 12-15 years). Annual questionnaire assessments included questions about frequency of sports practice, frequency of alcohol use/heavy episodic drinking, parental cohabitation, unstructured leisure time, sensation-seeking, and behavioral problems. We employed growth curve models (N = 2682) and fixed effects models (N = 3131). Results: Overall, we did not find systematic differences in initial alcohol use or development over time according to sports practice frequency at the first assessment. However, adolescents with the highest initial sports frequency had slightly lower initial alcohol use and a steeper increase (initial use: b = -0.06, p = .351; linear slope: b = -0.12, p = .218; quadratic curvature: b = 0.09, p = .004). There was no, or only a weak negative, association between change in sports practice and change in alcohol use after adjusting for potential time-varying confounders, b = -0.03, p = .065. Conclusion: Contrary to most previous research, we found little evidence for an association between sports participation and alcohol use among Norwegian adolescents born after 2000. Sports activities might not require particular attention in the prevention of alcohol use.
... Recent studies have proposed multiple explanations for the decline of youth drinking (Pape et al., 2018;Törrönen et al., 2019). Some studies indicate that parents today are more concerned about their children's drinking and have developed more restrictive parenting styles (Carlson, 2019;Raitasalo et al., 2021). ...
... Moreover, in line with the existing research, our results confirm that there are multiple master narratives that may act as powerful counter or alternative narratives against heavy drinking and contribute to the decline in youth drinking. In our data these master narratives are related to neoliberal performance culture, individualization, health, gender, competing activities, fitness and sports, political values, temperance ideology, religion, and parental relations (Pape et al., 2018;Kraus et al., 2020). ...
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This study analyzes how emerging adults negotiate their relation to alcohol in the context of declining youth drinking and how this relationship changes over time. The sample consists of longitudinal qualitative interview data (N = 28) with 9 boys and 19 girls aged 15 to 21. The participants were recruited through schools, social media, and non-governmental organizations from mainly the Stockholm region and smaller towns in central Sweden to reach a heterogeneous sample in terms of sociodemographic factors and drinking practices. We interviewed the participants in-depth three times between 2017 and 2019. Thematic coding of the whole data with NVivo helped us select four cases for more detailed analysis, as they represented the typical trajectories and showed the variation in the material. We used the master narrative framework and Bamberg’s narrative positioning analysis to examine the data. The analysis demonstrates what kinds of narrative alignments in identity development encourage heavy drinking, moderate alcohol consumption, and fuel abstinence. The results suggest that the decline in youth drinking is produced by a co-effect of multiple master narratives that intersect and guide the identity development away from heavy drinking.
... Youth drinking has declined in Sweden and in many other developed countries during the last 20 years and researchers have not been able to clarify the reasons for this development (Raninen & Livingston, 2018). As such knowledge has important implications for policy and prevention (Pape et al., 2018), it is vital to find out what factors have caused young people to drink less. A recent review of studies seeking to explain this decline in youth drinking concluded that changes in parenting had the most robust and consistent evidence (Vashishtha et al., 2020). ...
... Although there is some evidence for changes in parenting as one explanation for the decline in youth drinking, it is still warranted to replicate these findings with other approaches (Pape et al., 2018;Pennay et al., 2015). One suggested approach is to compare changes in parenting in countries with different trends in youth drinking (Pennay et al., 2015). ...
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Introduction: The aim of this study was to replicate earlier studies suggesting that changes in parenting have contributed to the recent decline in youth drinking by comparing parenting in a country experiencing a sharp decline in youth drinking (Sweden) with a country with only a small decline (Denmark). Data and analysis: Data stem from self-reported information from 15–16-year-old children in the Swedish and Danish subsamples of ESPAD. Youth drinking was measured by prevalence and frequency of drinking over the past year. Parenting was measured in terms of the extent the child reported that: (1) parents’ attitudes towards offspring drinking are restrictive, (2) parents set up general rules for what their children are allowed to do, and (3) parents have high level of knowledge about where and with whom their children spend time. The association between these indicators of parenting and youth drinking was first estimated with logistic regressions. Second, changes in parenting between 1999 and 2015 were compared between Denmark and Sweden across the study period. Results: Restrictive parental attitudes were associated with a lower likelihood of past-year drinking and frequent drinking in both Sweden and Denmark. This attitude was more common in Sweden, where it also became more prevalent between 2003 and 2015 in contrast to in Denmark. The association between strict parental rule-setting and youth drinking was weak in both countries. A high parental knowledge of the child's whereabouts was linked to a lower likelihood of past-year drinking in Sweden and a lower frequency of drinking in both countries. Parental knowledge of offspring's whereabouts did not develop differently in Sweden and Denmark, with a high and stable proportion in both countries. Conclusion: More restrictive parental attitudes towards youth drinking may have contributed to the decline in youth drinking, whereas the importance of general parental rule-setting and parental knowledge of offspring's whereabouts was not supported.
... The international and long-term nature of the trend, and its consistency across population subgroups, also suggest it is unlikely to be transient, as these characteristics imply it is driven by largescale, longterm structural and cultural shifts . These shifts may include increased economic insecurity among young people, the influence of new internet-based technologies, widespread shifts in relationships between parents and children, immigration from countries with more abstemious drinking cultures, and new health practices tied to notions of wellness and healthism ( Pape et al., 2018 ;Rogne et al., 2019 ;Room et al., 2020 ;Törrönen et al., 2019 ;. Concurrent trends showing major shifts in a wide range of adolescent behaviours support this perspective. ...
... In particular, the risk from higher levels of alcohol consumption is markedly greater for women and those in disadvantaged groups Holmes et al., 2016 ). Studies to date suggest the downturn in drinking is present across the youth population, but may be smaller among girls, those of lower socioeconomic position and people who drink heavily ( Pape et al., 2018 ), although evidence is mixed for the last two groups ( Hallgren et al., 2012 ;Livingston, 2014 ;Oldham et al., 2020 ;Oldham et al., 2021 ;Raninen et al., 2013 ;Raninen et al., 2014 ;Zeebari et al., 2017 ). Third, a decline in alcohol-related harm concentrated within this lighter drinking generation would rebalance the age distribution of harm away from younger people and further concentrate harms among those in middleand older-age. ...
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Youth drinking has declined across most high-income countries in the last 20 years. Although researchers and commentators have explored the nature and drivers of decline, they have paid less attention to its implications. This matters because of the potential impact on contemporary and future public health, as well as on alcohol policy-making. This commentary therefore considers how youth drinking trends may develop in future, what this would mean for public health, and what it might mean for alcohol policy and debate. We argue that the decline in youth drinking is well-established and unlikely to reverse, despite smaller declines and stabilising trends in recent years. Young people also appear to be carrying their lighter drinking into adulthood in at least some countries. This suggests we should expect large short- and long-term public health benefits. The latter may however be obscured in population-level data by increased harm arising from earlier, heavier drinking generations moving through the highest risk points in the life course. The likely impact of the decline in youth drinking on public and policy debate is less clear. We explore the possibilities using two model scenarios, the reinforcement and withdrawal models. In the reinforcement model, a ‘virtuous’ circle of falling alcohol consumption, increasing public support for alcohol control policies and apparent policy successes facilitates progressive strengthening of policy, akin to that seen in the tobacco experience. In the withdrawal model, policy-makers turn their attention to other problems, public health advocates struggle to justify proposed interventions and existing policies erode over time as industry actors reassert and strengthen their partnerships with government around alcohol policy. We argue that disconnects between the tobacco experience and the reinforcement model make the withdrawal model a more plausible scenario. We conclude by suggesting some tentative ways forward for public health actors working in this space.
... The international and long-term nature of the trend, and its consistency across population subgroups, also suggest it is unlikely to be transient, as these characteristics imply it is driven by largescale, longterm structural and cultural shifts . These shifts may include increased economic insecurity among young people, the influence of new internet-based technologies, widespread shifts in relationships between parents and children, immigration from countries with more abstemious drinking cultures, and new health practices tied to notions of wellness and healthism ( Pape et al., 2018 ;Rogne et al., 2019 ;Room et al., 2020 ;Törrönen et al., 2019 ;. Concurrent trends showing major shifts in a wide range of adolescent behaviours support this perspective. ...
... In particular, the risk from higher levels of alcohol consumption is markedly greater for women and those in disadvantaged groups Holmes et al., 2016 ). Studies to date suggest the downturn in drinking is present across the youth population, but may be smaller among girls, those of lower socioeconomic position and people who drink heavily ( Pape et al., 2018 ), although evidence is mixed for the last two groups ( Hallgren et al., 2012 ;Livingston, 2014 ;Oldham et al., 2020 ;Oldham et al., 2021 ;Raninen et al., 2013 ;Raninen et al., 2014 ;Zeebari et al., 2017 ). Third, a decline in alcohol-related harm concentrated within this lighter drinking generation would rebalance the age distribution of harm away from younger people and further concentrate harms among those in middleand older-age. ...
Article
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Youth drinking has declined across most high-income countries in the last 20 years. Although researchers and commentators have explored the nature and drivers of decline, they have paid less attention to its implications. This matters because of the potential impact on contemporary and future public health, as well as on alcohol policy-making. This commentary therefore considers how youth drinking trends may develop in future, what this would mean for public health, and what it might mean for alcohol policy and debate. We argue that the decline in youth drinking is well-established and unlikely to reverse, despite smaller declines and stabilising trends in recent years. Young people also appear to be carrying their lighter drinking into adulthood in at least some countries. This suggests we should expect large short- and long-term public health benefits. The latter may however be obscured in population-level data by increased harm arising from earlier, heavier drinking generations moving through the highest risk points in the life course. The likely impact of the decline in youth drinking on public and policy debate is less clear. We explore the possibilities using two model scenarios, the reinforcement and withdrawal models. In the reinforcement model, a ‘virtuous’ circle of falling alcohol consumption, increasing public support for alcohol control policies and apparent policy successes facilitates progressive strengthening of policy, akin to that seen in the tobacco experience. In the withdrawal model, policy-makers turn their attention to other problems, public health advocates struggle to justify proposed interventions and existing policies erode over time as industry actors reassert and strengthen their partnerships with government around alcohol policy. We argue that disconnects between the tobacco experience and the reinforcement model make the withdrawal model a more plausible scenario. We conclude by suggesting some tentative ways forward for public health actors working in this space.
... All rights reserved Discussion Adolescent ATOD is a significant public health problem in SSA and rates of ATOD use and associated harms among adolescents continue to be high across the continent. Despite signs of minor reductions in HED among adolescents in SSA [2] that have also been observed globally [86], interventions to reduce ATOD use and mitigate harms during this developmental period are urgently needed. Effective interventions may be delivered in varied settings (including schools, communities, family and health care sectors [70]), but in reality they seldom are. ...
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Alcohol, tobacco and other drug (ATOD) use by adolescents are major contributors to death and disability in sub-Saharan Africa (SSA). This paper reviews the extent of adolescents' ATOD use, risk and protective factors, and studies evaluating prevention interventions in this population in SSA. We also describe the harms associated with adolescents' ATOD use in SSA, which include mainly interpersonal violence, sexual risk behaviours (leading to HIV and other sexually transmitted infections, and unintended pregnancies) and negative academic outcomes. We use the socio-ecological model as our framework for understanding ATOD use risk and protective factors at individual, interpersonal, peer/school and societal/structural levels. We adopted two strategies to find literature evaluating ATOD interventions for adolescents in SSA: (a) we sought systematic reviews of adolescent ATOD interventions in SSA covering the period 2000-2020; and (b) we used a comprehensive evidence review strategy and searched for studies that had evaluated ATOD interventions in all SSA countries between 2000 and 2020. Only two community interventions (a brief intervention and an HIV prevention intervention), out of four that were identified, were partially effective in reducing adolescent substance use. Furthermore, only one school-based intervention (HealthWise), out of six that we uncovered, had any effect on substance use among adolescents. Many studies that were identified had methodological limitations. The scale of ATOD and related problems is disproportionate to the number of evaluated interventions to address them in SSA. More ATOD interventions need to be developed and evaluated in well-powered and well-designed studies.
... Many publications confirm substantial declines in adolescent alcohol use, drug use and other risk behaviour across high income countries since the late 1990s (see e.g. Pape et al., 2018). Local and national prevention activities are indeed likely to have had an influence on these trends. ...
... There is evidence for decreasing approval from parents toward adolescent drinking. Changes in parental attitudes toward alcohol, including reduced supply of alcohol to children, increased monitoring and setting alcohol norms have been linked to declines in adolescent drinking in quantitative studies [74,75]. As indicated earlier, some countries have observed a significant decrease in parental supply of alcohol and increase in parental restrictiveness toward adolescent drinking [64,65,76]. ...
Article
Background In the early 2000s, alcohol use among young people began to decline in many western countries, especially among adolescents (aged between 12-17 years old). These declines have continued steadily over the past two decades, against the backdrop of much smaller declines among the general population. Argument Hypotheses examining individual factors fail adequately to provide the necessary ‘big picture’ thinking needed to understand declines in adolescent drinking. We use the normalisation thesis to argue that there is strong international evidence for both processes of denormalisation of drinking and normalisation of non-drinking occurring for adolescents in many western countries. Conclusions Research on declining adolescent drinking provides evidence of both denormalisation of alcohol consumption and normalisation of non-drinking. This has implications for enabling policy environments more amenable to regulation and increasing the acceptability of non-drinking in social contexts. Normalisation theory (and its various interpretations) provides a useful multi-dimensional tool for understanding declines in adolescent drinking.
... Young individuals visit public drinking venues more often than older individuals and are consequently more exposed to situations that may cause harm. Additionally, the declining trend in youth drinking observed in the Nordic countries since the millennium shift (Pape et al., 2018) may have resulted in more restrictive attitudes among young individuals and therefore a lower threshold of reporting harm from others' drinking (Scheffels et al., 2019;Simonen et al., 2019). While one previous study found that those with higher educational level experienced more harm from others' drinking (Rossow & Hauge, 2004), a more recent study showed that those with low educational level experienced more of such harm . ...
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Background In order to curb alcohol’s harm to others, it is important to identify the contexts where people experience such harm. Objectives: To examine whether frequency of drinking in four different locations was associated with increased likelihood of experiencing harm from others’ drinking. Methods: Data stem from surveys conducted in the five Nordic countries in 2015 (N = 7065, aged 18–64 years) as part of the European Union’s Joint Action on Reducing Alcohol Related Harm (RARHA). Three types of harm from others’ drinking in the past 12 months were measured: verbally abused by, harmed physically by, and experienced a serious argument with someone who had been drinking. Respondents also reported frequency of drinking in their own home, in others’ homes, in a pub/bar/club/restaurant, and outdoors the past 12 months. Results: Country-pooled adjusted analyses showed that higher frequency of drinking in pubs/bars/clubs/restaurants, outdoors and in someone else’s home was associated with increased likelihood of experiencing all three harms. Frequent drinking in one’s own home was weakly associated with experience of harm. Women, young individuals, respondents without tertiary level of education and individuals who reported drinking almost daily were at increased risk of experiencing harm from others’ drinking. Conclusions: Frequent drinking on licensed premises and outdoors was most clearly associated with experiencing harm from others’ drinking, suggesting that these are important arenas for preventive efforts. Women, young individuals, those with low educational level and the most frequent drinkers are important target groups for preventive efforts.
... One type of critique on Skog's theory has arisen from the observation that population subgroups have moved in different directions in their alcohol use-that is, not collectively. These include the recent decline in adolescent drinking in various countries concurrent with stable or increasing overall consumption (Pape et al., 2018), the divergent trends in drinking of the Black and White populations of the United States, and the diverging trends in alcohol consumption in northern and southern Sweden (Room & Livingston, 2017). However, Skog's theory predicts that when there are barriers for the diffusion of drinking habits, for instance because of little drinking-related social interaction across subgroups of the population, exceptions from the overall pattern may result (Skog, 2001). ...
Article
Objective: Alcohol per capita consumption (APC) is used for monitoring harmful alcohol exposure in populations and assessing progress with goals set internationally and nationally. Recently, the alcohol industry challenged the use of this indicator. Here, we assessed the validity of APC as an indicator for reducing alcohol-related harm. Method: We conducted a narrative review of association between population-level drinking and harm rates, and the underlying mechanisms of this association. Results: A substantial literature demonstrates quite consistently close associations between APC and population harm levels for various types of health and social harms. Across populations with different total consumption, the distribution of consumption displays a fairly fixed shape, with no clear distinction between heavy drinkers and other drinkers. The mean consumption in a population is closely associated with the prevalence of heavy drinking; an increase in APC arises from a change in the whole distribution, heavy drinkers included. Although risk of harms from drinking increases with consumption, it seems that for many harm types the majority of drinkers, who do not drink heavily, account for a large proportion of harms from alcohol. Conclusions: By reducing APC, decreases in drinking among heavy drinkers as well as among ordinary drinkers will lead to fewer alcohol-related harms. The evidence strongly suggests public health gains from universal policies targeting APC. Reducing APC is furthermore an investment in future public health, as it is likely an efficient way of preventing people from becoming very heavy drinkers, who may cause themselves and others severe health and social problems.
... In line with other countries from wealthier parts of the world, the Netherlands shows clear trends of less alcohol use and less binge drinking by youth since the millennium shift. 1 Contrary to these trends, the number of underage patients who are admitted to a hospital with alcohol intoxication characteristics is an ongoing and stable health concern in the country. 2 Knowledge about what time of day patients are brought into the hospital is important for the development of efficient prevention policies. The primary aim of this repeated cross-sectional study was to investigate how time of day variation (morning, afternoon, evening and night) was associated with patient and intoxication characteristics in Dutch adolescents admitted for alcohol intoxication. ...
... Adolescent drinking has declined in several Western countries in the past two decades [1,2]. However, alcohol consumption, particularly the consumption of large amounts of alcohol on the same occasion, is associated with a range of detrimental consequences and health problems for young people [3][4][5]. ...
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Introduction No previous studies have examined the cross-sectional association between fear of missing out (FOMO) and binge-drinking among adolescents. The aim of the present study was: (i) to estimate the magnitude of this association; (ii) to assess the impact of potential confounders (i.e. sensation-seeking, symptoms of depression and self-regulation); and (iii) determine if it is uniform across all levels of these characteristics. Methods Cross-sectional study of adolescents from 33 middle schools in Norway, stratified according to geographic location, urban and rural locations, and standard of living. Participants were a nation-wide sample of N = 2646 adolescents (mean age 16.2 years, 43% boys). Self-report data were collected on binge-drinking, FOMO, sensation-seeking, symptoms of depression and self-regulation. Results Overall, 21% reported binge-drinking ≤ once per month in the past 12 months, while 9% reported binge-drinking more than once per month. Multinomial logistic regression showed that the crude effect, where greater FOMO was associated with greater risk of binge-drinking, was substantial (relative-risk ratio = 1.50 [1.35, 1.66], P < 0.001), but somewhat attenuated after including all potential confounders (relative-risk ratio = 1.28 [1.14, 1.43], P < 0.001). Effect modification analyses showed that the effect of FOMO on binge-drinking ≤ once per month was stronger for adolescents with low symptom levels of depression and weaker for adolescents at high levels of depression. Discussion and Conclusion Norwegian adolescents with higher FOMO have greater risk of binge-drinking.
... However, adolescent drinking is being challenged by young people who choose not to drink (Pavlidis et al., 2019). Underage drinking is less common today than it was 10-15 years ago, both in Nordic countries and globally (de Looze et al., 2015;Kraus et al., 2020;Pape et al., 2018). ...
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Initiation of alcohol use often takes place in adolescence. This longitudinal study explores adolescents’ alcohol use by highlighting mediators in their network that either hinder or facilitate alcohol consumption. Qualitative individual interviews were conducted with 75 adolescents (age 15–16) during their final year of lower secondary school (LSS), and their first year of upper secondary school (USS) (age 16–17), amounting to 150 interviews in total. Three drinking practices were identified during the transition from LSS to USS. The abstainers did not drink either in LSS or USS. They emphasized negative effects of alcohol and ascribed their non-drinking to the mediating role of parental expectations, sports and school achievements, and weak social ties. The initiators started to drink in USS and described increased acceptance, availability, peer pressure and social benefits as mediators for alcohol use initiation. The drinkers drank alcohol in both LSS and USS, and the mediators for drinking ranged from curiosity and social lifestyles to personal vulnerability traits. This study identified hindering and facilitating mediators for drinking, but also highlighted blurred boundaries between drinking and non-drinking: non-drinkers recognized social benefits associated with drinking, and drinkers highlighted control and responsible drinking alongside the pleasure and social benefits of drinking.
... En rekke nyere studier har vist at viktige risikofaktorer for villet egenskade blant ungdom er betydelig endret i løpet av de siste 10-20 årene. Unge jenter rapporterer mer depresjonssymptomer enn tidligere (Collishaw, 2015;Twenge et al., 2018), mens alkoholbruk blant ungdom har gått ned (Pape et al., 2018 tivene «Ja» eller «Nei», og vi sammenliknet andelen som svarte «Ja, for mindre enn ett år siden» på spørsmålet i UiN 2002 med andelen som svarte «Ja» på spørsmålet i UngData i 2017 og 2018. Videre ble følgende risikofaktorer for selvskading som var identiske eller svaert like mellom UiN og Ungdata inkludert i analysene: depressive symptomer, antisosial atferd, alkoholberuselse, det å ha en kjaereste, familieøkonomi, og eksponering for voldelige trusler eller handlinger. ...
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Selvskade er vanlig hos ungdommer, og er assosiert med psykiske helseproblemer og negative livshendelser.Denne artikkelen beskriver resultatene fra en ny studie om endringer i forekomsten av selvskade blant ungdomsskoleelever i Norge og diskuterer implikasjoner av funnene. To kryss-seksjonelle undersøkelser blant ungdommer i ungdomsskolen (8.–10. klasse) ble benyttet for å analysereendring i forekomsten av selvskade: Ung i Norge-undersøkelsen fra 2002 (N = 5 842) og Ungdata-undersøkelsen fra 2017 og 2018 (N = 29 063). Fra undersøkelsene hentet vi forekomst av selvskade siste år og kjente risikofaktorer for selvskade hos ungdom. Vi analyserte endring i forekomst av selvskade blant ungdomsskoleelever fra 2002 til 2017/2018, og undersøkte i hvilken grad den observerte endringen kunne forklares av samtidig endring i underliggende risikofaktorer. Forekomsten av selvskade siste år økte fra 4,1 % i 2002 til 16,2 % i 2017/2018. Blant risikofaktorene økte forekomsten av depressive symptomer, mens forekomsten av antisosial atferd, eksponering for vold og alkoholberuselse sank. Økningen av depressive symptomer forklarte en liten del av økningen i selvskade, men hadde liten betydning når alle risikofaktorer ble tatt i betraktning. Vi fant at forekomsten av selvskade siste år hos ungdom firedoblet seg i løpet av 15 år. Etablerte risikofaktorer forklarer ikke hele den observerte økningen. Det er behov for mer forskning for å forstå det komplekse samspillet mellom faktorer som kan påvirke forekomstenav selvskade hos ungdom.
... Other authors also reported a decrease in occasional BD from 48.8% in 2014 to 44.0% in 2017 in 17 year olds in France and a decrease in frequent BD from 21.8 to 16.4% during the same period (Spilka et al., 2017). This downward trend was found in adolescents in other European countries according to a literature review and also among young adults (Ng Fat et al., 2018;Pape et al., 2018).This decrease could be explained by two new laws in France aimed at reinforcing the protection of young people regarding alcohol use during this period (Jager et al., 2015). In 2009, the legal age to purchase alcohol increased from 16 to 18 years (French law. ...
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The objective of this study is to evaluate tobacco smoking, cannabis use, and binge drinking among university students from different curricula in France between 2009 and 2016 and the associated factors. Six repeated cross-sectional studies with self-administered anonymous questionnaires were performed among university students. Data collected included age, gender, curriculum, tobacco smoking, cannabis use, and binge drinking over the previous 12 months. From 2009 to 2016, 4755 students filled out the questionnaire. Mean age of students was 20.1 years (standard deviation = 1.8) and sex-ratio (M:F) was 0.54. During the study period, 21.4% of university students were tobacco smokers, 28.4% were cannabis users and 54.6% were binge drinkers. The logistic regression showed no significant change for tobacco smoking for cannabis use during the period and a significant decrease for binge drinking only in 2016. Male gender, living in rented accommodation and job holder status were positively associated and grant holder status was negatively associated with these consumptions. Students from the engineering schools’ and healthcare group were found more at risk of binge drinking, compared to the mixed discipline university group. Binge drinking remains a concern among university students in France. This trend could be deserved to be confirmed in a few years. Our results also showed differences within those risks according to curriculum and socio-demographic characteristics, which could lead to targeted prevention.
... However, for both last year and last month drinking, this downward trajectory has stalled, and an increase was evident between 2015 and 2019, with last year drinking increasing from 63% to 65% and last month drinking increasing from 36% to 41% in the same period [10, 42,43]. [9] A decline in alcohol use among young people has been noted internationally since the early 2000's with various possible explanations proposed [44][45][46]. An increased focus on personal health, home, school and family life and a decrease in peer pressure to drink has been suggested as potential reasons for this reduction [47,48]. ...
... Doch das «Binge-Drinking» -das traurige Relikt des archaischen Gelages -gilt zunehmend als uncool (vgl. Pape et al. 2018). Und in TV-Talk-Shows bekommen die Gäste inzwischen Wasser vorgesetzt. ...
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Alkohol im Wandel des Zeitgeists --- siehe Auszug unten!
... We found a higher burden among countries classified in the high-middle SDI, and large differences in PAR between men and women, and in younger age groups in comparison with older. Important variations in alcohol PAR were also observed for specific causes of road injuries, with motorcy- (Pape et al., 2018;White et al., 2018). Globally, substantial resources have been invested in developing publicity and campaigns for antidrunk driving, generally aimed at encouraging young people to rethink their decision to drive under the influence (Fell, 2019). ...
Article
Background Alcohol consumption is one of the main risk factors for death by road injuries, but little is known about the global distribution of the population-attributable risk (PAR) of alcohol use for death by road injuries. Methods We used publicly available data from the 2019 Global Burden of Disease Study (GBD) to estimate the PAR of alcohol use for 5 types of road injury, globally and individually for available countries, by socio-demographic index (SDI), and by age, sex, and year from 1990 to 2019. Results 6.6% of all road injuries in 2019 were attributable to alcohol consumption, with large variations worldwide; the highest burden was in Europe and among countries classified in the high–middle SDI. PAR was higher in men than in women, and among younger individuals. Important variations in PAR of alcohol were also observed by road injury type, with motorcyclist road injuries having the highest PAR. Overall, PAR showed a small increase during 1990–2019; younger (<39 years old) men showed an increasing trend during this period, while older women had a decreasing trend in PAR. Conclusions PAR for alcohol and road injuries is not homogenous. Large PAR for alcohol and road deaths was found in Europe, among men, young adults, and motorcyclists. These results could help public health agencies, law enforcement, and the public guide efforts to reduce these deaths.
... While the last decade has seen reductions in alcohol consumption overall, including among youth, the heaviest drinkers have shown no such reduction (Chan et. al, 2016;Pape, Rossow, & Brunborg, 2018). Hazardous drinking occurs most frequently among young people, and alcohol use disorders are most common in late adolescence/young adulthood (18 -29 years;Connor, Haber, & Hall, 2016;Kuntsche, Rehm, & Gmel, 2004). ...
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High impulsivity predisposes young adults to engage in hazardous alcohol use. Experimental research has shown that reward-related impulsivity is causally-related to heavier drinking. Correlational studies suggest that positive alcohol outcome expectancies mediate this effect, but causation has yet to be established. This study sought to clarify this relationship by: 1) developing a new, individualized procedure for inducing reward-related impulsivity with high generalizability; 2) experimentally manipulating positive alcohol expectancies to determine its mechanistic role in reward-related impulsivity risk for drinking. Eighty-seven young adults (67% female; Mage = 19.19, SD = 2.01) received either a covert manipulation to reduce positive alcohol expectancies (n = 43) or control (n = 44) after being administered the Individualized Reward-Seeking Induction Schedule (IRIS). The primary outcome was self-reported confidence in the ability to refuse alcohol in cued situations (drinking refusal self-efficacy). Results showed that IRIS increased reward-related impulsivity (p < .001, drm = 0.48) and reduced drinking refusal self-efficacy (p = .029, η²P = .055, ωp² = .043). Experimentally diminishing positive alcohol expectancies had a marginal effect on the reward-seeking induction when controlling for covariates (p = .057, η²P = .044). Findings provide preliminary validation of IRIS as a new methodology for investigating the causal role of reward-related impulsivity in alcohol-related cognition and youth drinking.
... Andere Merkmale wie das Bildungsniveau und der Migrationshintergrund, die in Zusammenhang mit dem Rauschtrinken stehen können, werden nicht berücksichtigt. Internationale Studien zeigen aber, dass es sich lohnen kann, die Trends nach weiteren sozialen Merkmalen aufzuschlüsseln [27]. Wenn sich auch für Deutschland Teilgruppen nach weiteren sozialen Merkmalen finden lassen, in denen sich das Rauschtrinken unterschiedlich verändert, könnte ein solcher Befund Hinweise dafür liefern, wie Maßnahmen zur Förderung eines verantwortungsvollen Umgangs mit Alkohol noch zielgruppengerechter auszugestalten sind. ...
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Zusammenfassung Hintergrund Studien zeigen, dass die Verbreitung des Rauschtrinkens unter jungen Menschen in Deutschland insgesamt rückläufig ist. Diese Veränderung wird in der Regel in Abhängigkeit von Alter und Geschlecht näher untersucht. Dieser Beitrag vertieft diese Analysen und untersucht, ob sich der Rückgang des Rauschtrinkens junger Menschen in Abhängigkeit von Bildungsniveau und Migrationshintergrund unterscheidet. Methoden Auf Grundlage von Repräsentativbefragungen der Bundeszentrale für gesundheitliche Aufklärung (BZgA) wurden für den Zeitraum 2008 bis 2019 für männliche und weibliche 12- bis 17-jährige Jugendliche und 18- bis 25-jährige junge Erwachsene die 30-Tage-Prävalenzen des Rauschtrinkens ermittelt. Mit logistischen Regressionsanalysen wurden Trendverläufe für den Zeitraum 2008 bis 2019 geschätzt. Dies erfolgte auch in Abhängigkeit von Bildungsniveau und Migrationshintergrund. Ergebnisse In einen Alkoholrausch trinken sich, über alle Befragungen gesehen, mehr junge Erwachsene als Jugendliche, mehr männliche als weibliche junge Menschen und mehr junge Menschen ohne einen Migrationshintergrund. Im Zeitraum 2008 bis 2019 ging die 30-Tage-Prävalenz des Rauschtrinkens bei Jugendlichen (männlich: von 23,0 % auf 16,4 %; weiblich: von 17,7 % auf 10,7 %) sowie jungen Männern (von 53,0 % auf 43,9 %) insgesamt gesehen zurück, bei jungen Frauen veränderte sie sich statistisch nicht signifikant (2008: 28,1 %; 2019: 24,5 %). Die Trendanalysen in Abhängigkeit von Bildungsniveau und Migrationshintergrund zeigen, dass zumindest bei jungen Frauen ohne (Fach‑)Abitur ein Rückgang des Rauschtrinkens erfolgt. Diskussion Der Rückgang des Rauschtrinkens kann sich in Abhängigkeit von sozialen Merkmalen unterscheiden. Solche Unterschiede sollten in der Prävention des Rauschtrinkens berücksichtigt werden. Insbesondere junge Frauen mit höherem Bildungsniveau müssen mit Präventionsangeboten erreicht werden.
... However, the harm reduction and safety messages communicated repeatedly by parents, alongside implementation of a range of parental monitoring techniques and disapproving attitudes, reflect evidence of more restrictive alcoholrelated parenting and less tolerant views in the study sample, which supports published evidence. For instance, studies have suggested a shift to more restrictive alcoholrelated parenting behaviour and lower tolerance to adolescent drinking; and changes in parental permissiveness and practice has been suggested to be one possible explanation of the decline in adolescent drinking [45][46][47]. In this way, our findings lend support to reduced tolerance and increased boundary setting as implicated in the downward trends observed. ...
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Background Parental alcohol consumption and alcohol-related behaviour play a critical role in shaping adolescent alcohol use, but comparatively little is known about the perspectives of parents regarding adolescent alcohol use from qualitative studies in England. This study aimed to explore parental views and attitudes towards alcohol use during adolescence, among their offspring and among young people in general. Methods Twenty-three parents (21 mothers, 2 fathers) of children aged 13–18 years were recruited via schools, workplaces and community settings, predominantly in the West of England ( n = 19) between 2017 and 2018. Data were collected via in-depth one-to-one interviews and analysed thematically, using an inductive, constructionist approach. Results Five major themes were identified in the data: (1) the parental alcohol environment, (2) balance and acceptance, (3) influences of the parental approach, (4) boundaries and parental monitoring, and (5) wider influences shaping young people’s behaviour. Overall, parents were aware of the risks and consequences of alcohol use and the wide range of influences shaping drinking behaviour, and expressed broad disapproval of alcohol use among young people. However, adolescent alcohol use was viewed as inevitable, and set within a context of a tolerant drinking culture. Many parents therefore chose a balanced and reluctantly accepting approach. This approach was determined by weighing disapproval of drinking against consistency with wider culture and parental behaviour, support for autonomy of the child, and avoidance of social sanctions. Parents’ responses were also determined by a desire to protect the parent–child relationship, maintain an open, communicative and trusting relationship, and ultimately limit risk and minimise harm. Various boundaries and strategies were employed to this end, including care around role modelling, gradual introductions to alcohol, boundaried provision, clear risk reduction messaging and parental monitoring. Conclusions Parents employ a range of mechanisms to reduce alcohol-related risk and to balance harms of alcohol use among their offspring against adolescent behavioural norms. A downward shift in community consumption and changing socio-cultural norms could alter the accepting context in which parents are required to navigate adolescent alcohol use.
... Nevertheless, in the US cannabis has become the first psychoactive substance that adolescents start using [60]. In contrast, the alcohol use in youth is steadily declining in the USA but also in other countries [61,62]. ...
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Introduction: Debates about the legalization of illegal substances (e.g., cannabis) continue around the globe. A key consideration in these debates is the adequate protection of young people, which could be informed by current prevalence and age-of-onset patterns. For Switzerland, such information is limited, which is particularly true for women, despite advanced political efforts to legalize cannabis. The objective of the current study was to investigate substance use prevalence rates and ages of onset in a community-representative sample of female and male young adults in Switzerland. Methods: Data came from the Zurich Project on the Social Development from Childhood to Adulthood (z-proso). In 2018, participants (N = 1,180, 50.8% females) were ∼20 years old. Lifetime and past-year use of alcohol, tobacco, cannabinoids, stimulants, hallucinogens, opioids, and benzodiazepines were assessed with an extensive substance use questionnaire. Additionally, ages of onsets of the respective substances were estimated by averaging participants' self-reported ages of onsets from ages 13 to 20 (max. 4 assessments). Results: 57% of 20-year-olds had used cannabinoids, 16% stimulants, 15% opioids (mostly codeine), and 8% hallucinogens in the past year. Males had higher prevalence than females for most drugs; nevertheless, females' prevalence rates were notably high. Legal substance use was typically initiated 1.3-2.7 years before legal selling age. Thus, almost half of the sample had consumed alcohol and tobacco by age 14. More than 40% of the total sample had smoked cannabis by age 16. Males initiated use of legal substances and cannabis earlier than females. Discussion: Our recent community-representative data suggested unexpectedly high levels and early onsets of substance use compared to a previous Swiss surveys and also the European average. Drug policy debates should consider urban substance use patterns when considering legalization efforts.
... There is evidence that it is affecting all strata of society, while concerns have also been raised that some disadvantaged subgroups are not following this trend. The decline in alcohol consumption seems to be limited to adolescents (aged 18 and under), whereas young adults and adults in many regions did not reduce their consumption [10]. This is exactly what can be observed in Austria, where student data indicate a sharp decline since 2003 [11], although data from the alcohol industry only suggest a minor change in overall per capita consumption over the last two decades [12]. ...
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Background: Adolescents and young adults are a crucial target group for preventing harm related to substance use. Recently, declining alcohol and tobacco consumption in young people has been observed in many countries. Based on survey data from 2004 to 2020, we describe time trends for several subgroups of adolescents and young adults (based on consumption levels and socioeconomic variables) and analyze associations between the level of alcohol per capita consumption or daily smoking and socioeconomic variables. Methods: Time trends for males and females are analyzed by a two-way ANOVA and predictors of use by using multivariate regression and logistic regression. Results: Alcohol per capita consumption decreased significantly for both sexes in the 16-year period, with male and female consumption levels converging. Daily smoking was equally prevalent for young males and females and decreased to a similar degree for both sexes. Being male and living in rural areas are associated with a higher level of alcohol consumption. Daily smoking is associated with a low level of education and is more prevalent among young adults who have already started to work. Conclusions: The decline in alcohol use and daily smoking among adolescents and young adults is taking place simultaneously. However, higher levels of alcohol consumption and daily smoking occur in different groups of adolescents and young adults, which should be considered in prevention strategies.
Article
Introduction Adolescent drinking has been declining in Australia over the past two decades, but this trend may be part of a broader shift towards healthier lifestyles for adolescents. We examined trends in the prevalence of multiple risky health‐ and school‐related behaviours and outcomes to test whether this was the case. Methods Data on multiple behaviours and outcomes were collated from Australian government agencies and other relevant sources for 10–19‐year‐olds from the year 2000 onward. Trends were examined descriptively. Results Rates of substance use, youth offending and injuries due to underage driving declined over the study period. Some health‐related behaviours (physical activity and diet) worsened between 2001 and 2017; however, obesity rates remained stable. Risky sexual behaviours increased in terms of early initiation of lifetime sexual intercourse and decreased condom use. However, sexual health outcomes improved with a reduction in teenage pregnancies and there was a recent decline in sexually transmitted infection rates from 2011 onward. Suicide rates and rates of major depressive disorders increased. School attendance and engagement in full‐time work or study remained stable. Discussion and Conclusions The decline in adolescent drinking does not appear to correspond with increased engagement in healthier behaviours; however, it may be related to a more risk‐averse way of living. Future work could be directed towards identifying which social, economic, policy and environmental factors have impacted positive changes in risky behaviours. Public health efforts can then be directed towards behaviours or outcomes, which have not yet improved.
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Purpose This study examined whether national trends in unstructured in-person socializing with peers (i.e., socializing without goals or supervision) among adolescents could help explain recent declines in adolescent risk behaviors (e.g., substance use, fighting, theft). Methods The sample contained of 44,842 U.S. 12th-grade students (aged 17–18 years) from the Monitoring the Future survey (years 1999–2017). Analyses examined (1) prevalence trends, (2) latent factor structure of risk behaviors and unstructured in-person socializing, and (3) whether trends in the unstructured in-person socializing factor accounted for the relationship between time (i.e., survey year) and the risk behavior factor. Results Adolescent risk behaviors and unstructured in-person socializing declined by approximately 30% in the U.S., and both formed coherent latent factors. After adjusting for sociodemographics, declines in unstructured in-person socializing accounted for approximately 86% of declines in risk behaviors. Conclusions The prevalence of risk behaviors and unstructured in-person socializing behaviors declined among U.S. 12th graders from 1999 to 2017. It is unknown whether such effects are directly causal and/or influenced by unmeasured variables. However, the results provide evidence that national declines in unstructured in-person socializing are a likely component of the explanation for national declines in adolescent risk behaviors.
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Academic dissertation for the degree of Doctor in Medical Science, University of Helsinki
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El programa Servicio Responsable cuenta con una larga experiencia en el ámbito de la formación a profesionales del sector del ocio nocturno. A pesar de que es un programa totalmente implementado desconocemos fehacientemente cuales son sus niveles de calidad, eficacia, eficiencia y efectividad. La ausencia de una evaluación robusta, en cierta medida una característica compartida con multitud de programas preventivos que se ejecutan en España representa un hándicap para su diseño, fiabilidad, y en última instancia, continuidad. Los programas preventivos, sean de la naturaleza que sean, deben acreditar unos niveles de calidad para continuar con su labor, es decir, no puede haber atisbo de duda de que «funcionan» y son netamente preventivos. El objetivo del presente programa «Diseño de evaluación del sistema de calidad del programa Servicio Responsable» ejecutado por «Episteme. Investigación e intervención Social» es establecer los puntos cardinales de la metodología de evaluación. El objetivo a medio plazo es convertir el programa Servicio Responsable en un corpus preventivo de calidad, efectivo, eficaz y eficiente. Solo la evaluación nos permitirá alcanzar tal objetivo.
Since 2000, adolescent alcohol use has declined substantially in many high-income countries, particularly in Northern Europe. This study examined whether birth cohorts in Norway who experienced different levels of alcohol consumption in mid-adolescence differed in drinking behaviour when they reached young adulthood. We analysed data from annual population surveys in Norway (2012–2021). The analytic sample comprised data from respondents aged 20–29 years (N = 5266), and we applied four birth cohorts (i.e., 1983–1987, 1988–1992, 1993–1996 and 1997–2001). We applied age categories with two- and five-year intervals and tested whether drinking frequency, heavy episodic drinking (HED) and usual number of drinks per drinking occasion during the past 12 months differed by birth cohort in age-specific strata. Possible cohort differences within age groups were tested using Pearson’s Chi square. There were no statistically significant differences between cohorts with respect to drinking frequency or HED frequency. However, the youngest cohort had fewer drinks per occasion when in their early 20s compared to older cohorts. This study showed that birth cohorts who differed substantially in levels of alcohol consumption in mid-adolescence, only to a little extent differed in drinking behaviour in young adulthood.
Article
Aim We examine age-related trends in past-year cannabis use in a series of nationally representative surveys in Australia. Methods We analysed data from the largest nationally representative survey in Australia collected between 2001 and 2019 (National Drug Strategy Household Survey [NDSHS]; N = 157,151). Prevalence of past-year daily/occasional (non-daily)/non-use of cannabis use were estimated using weighted multinomial logistic regression and predicted marginal probabilities. Difference-in-difference analysis was used to examine if trends of cannabis use across age groups were different. Results The youngest age group (14-17s) witnessed the largest increase in past-year abstinence rate from 79% to 92% from 2001 to 2019 (p < .003); the increase in abstinent rate among the 18-24 and 25-39 were relatively moderate (from 68 to 76% and from 81% to 84% respectively; p < .003). The abstinent rate among the 40-54s and 55-74s decreased significantly from 93% to 90% and from 99% to 95% respectively (p < .003). There were similar diverging trends in occasional and daily cannabis use, with decreases in both patterns of use observed among the younger age group (14-17s and 18-25s) but increases among the older age group (40-54s and 55-74s). Conclusion There is a diverging trend in cannabis use among younger and older age groups in Australia between 2001 and 2019. Cannabis use substantially decreased among the youngest age group (14-17s) but modestly increased among older people (55-74s).
Article
Background: Alcohol use and alcohol-related harm (ARH) among adolescents places a substantial burden on health, and public services more generally. To date, attempts to intervene at a universal level have yielded results varying from iatrogenic to null, although some skill-enhancing universal interventions have successfully impacted drinking behaviors. One such intervention is SHAHRP. The present study is a secondary analysis of data from the STAMPP Trial, providing new, and more nuanced findings. Methods: A total of 13,914 adolescents (41.7% female) participated in this cRCT where schools were randomly assigned to a control or intervention group. Growth mixture modelling was used to identify trajectory classes from baseline through third follow-up (+33 months) of adolescents on heavy episodic drinking (HED) and ARH. Extracted classes were related to school intervention participation using multinomial logistic regression. Results: Five trajectory classes of the HED and ARH composite were identified: Low (62%), Late Onset (16%), Early Onset (13%), Delayed Onset (7%), and Unstable (3%). The intervention was most strongly related to Late Onset (OR = 0.50, 95%CI [0.25, 1.01]) and Delayed Onset (OR = 0.55, 95%CI [0.26, 1.16]), although not statistically significant. With classes constructed with ARH only, the Delayed Onset class was significantly related to the intervention (OR = 0.60, 95%CI [0.43, 0.84]). Conclusions: These results support those previously reported on the STAMPP Trial and provide a more nuanced insight into the effects of the intervention.
Article
Introduction The emergence of low-cost smartphone technology has coincided with major declines in adolescent smoking and other risk behaviours. This study explores the relationship between internet use and smoking in adolescents and investigates whether rising internet use contributed to the decline in smoking between 2012 and 2018. Methods Data were drawn from a nationally representative New Zealand survey of students aged 14–15 (N = 11 299), conducted biennially between 2012 and 2018. We used logistic regression to explore the association between internet use and smoking and test whether increasing time on the internet was associated with declining adolescent smoking over the study period. Results The proportion of students spending 5+ hours per day online increased from 15% to 35%. Heavy internet use was not a protective factor for smoking at the individual level. In 2016/2018, some types of past week internet use were associated with decreased risk of smoking (e.g. doing schoolwork, finding out about news), some were associated with increased risk (e.g. social media use) and others appeared to have no association with smoking (e.g. gaming, online shopping). The relative risk of smoking was lower in 2018 relative to 2012 (relative risk 0.68, 95% confidence interval 0.51, 0.90, after adjustment for demographic factors). Adding internet use to the model did not help to account for smoking decline. Discussion and Conclusions We found no evidence that increasing time spent on the internet during the 2012–2018 period (during which smartphones became ubiquitous) contributed to the decline in adolescent smoking.
Article
The aim of this study was to examine trends in cannabis use among Spanish students from 2006 to 2018 by sex, age, and sex and age combined. Data showed a global decrease both in a lifetime and frequent cannabis use between 2006 and 2018 but four-year comparisons revealed more variability within the specific sex-age groups. No change was found in lifetime use between 2014 and 2018 for all groups. The results emphasize the need for ongoing monitoring of trends in cannabis use and the importance of implementing preventive measures to avoid a change in tendency and to work with high-risk groups, especially 17–18-old boys.
Article
Introduction Adolescent alcohol consumption has been declining in many high-income countries since the turn of this century. Research investigating the plausible explanations for these declines has been mostly based on individual-level studies, which are largely inconclusive. Changes in leisure time internet use and computer gaming (referred to in this article as ‘computer activities’) have been hypothesised to play a role in declining adolescent alcohol consumption at a country-level. The aim of this study was to examine the association between country-level changes over time in computer activities and adolescent drinking in 33 European countries. Methods This is a multi-level repeated cross-national study examining the role of changes over time in country-level and individual-level computer activities on regular drinking. We utilised four waves of the European School Survey Project on Alcohol and Drugs (ESPAD) from 2003, 2007, 2011 and 2015. At an individual-level the primary exposure of interest was daily engagement in computer activities and aggregated means were used to measure country-level daily computer activities in each included country. Data were analysed using three-level hierarchical linear probability methods. Results In the fully adjusted model, for between individual effects, we found significant positive association between daily computer activities and regular drinking (β = 0.043, p-value <0.001 and 95% CI = 0.033–0.054). However, at a country-level, we did not find any association between within-country changes in daily computer activities and regular drinking (β = 0.031, p-value = 0.652 and 95% CI = -0.103–0.164. Conclusion Findings from this study suggest that broad cultural shifts towards increased computer-based activities among adolescents has played a little or no role in declining adolescent drinking. Future research should be directed towards examining other high-level cultural changes which may have influenced cross-national reductions in adolescent drinking.
Article
Background and Aims There is significant debate about whether or not changes in per-capita alcohol consumption occur collectively across the entire distribution of drinking. This study used data from a decade of declining drinking in Australia to test the collectivity of drinking trends. Design Repeated cross-sectional surveys (2010, 2013, 2016, 2019), analysed with quantile regression techniques assessing trends in drinking for 20 quantile groups. Setting Australia Participants A general population sample (total n= 85,891; males =39,182, females = 46,709) aged 14 and over. Measurements Past year volume of alcohol consumed was measured using standard graduated frequency survey questions. Models were stratified by sex and age group. Findings Across the whole population, alcohol consumption had declined in all percentile groups, with the largest proportional declines evident for light and moderate drinkers (e.g. drinkers at in 25th percentile declined by 33%; 95% confidence interval (CI) 22%-42% per wave). Broadly collective declines were also found for younger men and women with significant declines in every percentile group, but older groups showed some evidence of polarisation. For example, women aged 45-64 significantly increased their consumption (3% per wave, 95%CI: 0.3%-6%), while consumption for those for the 25th percentile fell significantly (17%, 95%CI: 4%-28%). Conclusions The declines in Australian drinking since 2010 have included important deviations from the collectivity predicted by Skog’s influential theory of collectivity of drinking, with markedly different patterns evident across different demographic groups.
Article
The article aims to make understandable a significant change that has taken place in the adolescent drinking habits: throughout the world, the teens are drinking much less than previous generations. Previous research has approached this phenomenon through survey research methodology, trying to identify the variables that correlate with individuals’ alcohol consumption level, thereby explaining the phenomenon. The impact of social media use on drinking habits has been identified as one possible explanation, but the results have been contradictory. The article hypothesizes that the rise of social media created an institutional change in young people’s conditions for and patterns of socializing. Using qualitative interviews with Finnish teenagers as empirical data, the article concludes that since socializing with peers and initiating romantic relationships takes place primarily in virtual contexts, there are less occasions in which alcohol would serve as a social lubricant. Consequently, compared with previous generations, alcoholic beverages play a smaller role in young people’s lives. The current living conditions molded by the social media concern everyone, which is why individual-level correlations between social media use and alcohol consumption level do not capture the aggregate effect that the changed living conditions have brought about.
Article
Background Changes in adolescents’ attitudes towards school are a potential explanation for recent declines in young people’s alcohol consumption. However, this has not been tested using multi-national survey data, which would permit stronger causal inferences by ruling out other country-specific explanations. This study, therefore, uses an international survey of schoolchildren to examine the associations between changing attitudes towards school and adolescent alcohol consumption. Methods We used data from 247 325 15-year-olds across 37 countries participating in four waves of the Health Behaviour in School-aged Children study (2001/02–2013/14). Attitudes towards school were assessed using two measures—self-reported pressure from schoolwork and whether respondents like school. Outcome measures were weekly alcohol consumption and having been drunk twice in one’s lifetime. We used whole population and gender-specific hierarchical linear probability models to assess the relationship between attitudes and alcohol outcomes within countries over time. Results Country-level changes over time in liking school were not associated with changes in alcohol consumption. However, a 10% increase in feeling pressured by schoolwork was associated with a 1.8% decline in drunkenness [95% confidence interval (CI): −3.2% to −0.3%] and weakly associated with a 1.7% decline in weekly drinking (95% CI: −3.6% to 0.2%). Among girls only, increases in feeling pressured by schoolwork were associated with a 2.1% decline in weekly drinking (95% CI: −3.7% to −0.6%) and a 2.4% decline in drunkenness (95% CI: −3.8% to −1.1%). Conclusion Changes in attitudes towards school may have played a minor role in the decline in alcohol consumption among adolescent girls only.
Article
There has been a dramatic decline in alcohol consumption among younger people, including an increase of conscious moderation and abstinence. Change has a generational character, with different cohorts' drinking changing over time from the heavy, embedded pattern among post‐war ‘boomers’ to the more selective habits initiated by ‘millennials’. This is a surprising development in historical terms and has been cast as indicating the emergence of a moderating ‘generation sensible’. It is also coincident with more negative trends, such as young adults worsening mental health. Informed by the perspective of individualization, we consider the decline in youth drinking in the context of generational changes in the lifecourse. We focus upon how recent generations of young people experience greater choice, pressure and a prolonged adolescence, characterized by more limited autonomy. Explored with conscious young moderators through a survey (N = 517) and focus groups (N = 13), these themes resonated with our sample who appear a self‐conscious generation with significant and open‐ended focus upon maintaining their wellbeing and control. Further, they appear more disembedded from pressure to conform but under greater pressure to perform. The same forces of individualization encouraging moderate drinking may also weigh down upon young people who feel under pressure not only to transform their own lives but feel a burden of responsibility for a damaged, unjust world. The article's originality lies in applying individualization to both generational change and consumption, suggesting this can be usefully done through a focus upon freedom/choice and pressure/performance. It also considers what is regarded as the positive trend of drinking decline alongside, and as related to, negative trends such as greater loneliness and less autonomy among young adults.
Article
Background and aims Adolescent drinking in Australia (and many other countries) has declined substantially since the early 2000s. This study aimed to test whether these declines have been maintained into adulthood and whether they are consistent across sub-groups defined by sex and socio-economic status. Design Quasi-cohorts were constructed from seven repeated waves of cross-sectional household survey data (2001-2019) Setting Australia Participants 20,733 respondents aged between 14 and 24 (male: 9,492; female: 11,241) Measurements Participants were grouped into five cohorts based on their birth year (from 1979-83 to 1999-2003). Three measures of drinking were assessed: any past-year consumption (yes/no), past-year regular risky drinking (12 or more drinking episodes of > 40g of pure alcohol, yes/no) and total volume of alcohol consumed in the past year (in Australian standard drinks, 10g of alcohol). Socio-economic status was measured based on neighbourhood of residence. Findings Drinking declines were consistent across socio-economic groups on all measures and trends were broadly similar for women and men. More recent birth cohorts had significantly lower levels of drinking across all three measures (odds ratios between 0.31 and 0.70 for drinking and risky drinking, coefficients between -0.28 and -0.80 for drinking volume). There were significant interactions between birth cohort and age for past-year drinking and past-year regular risky drinking, with cohort differences diminishing as age increased. Conclusions Lighter drinking adolescent cohorts appear to partly ‘catch up’ to previous cohorts by early adulthood but maintain lower levels of drinking and risky drinking up to the age of 24. These ongoing reductions in drinking are spread evenly across socio-economic groups.
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Most research on trends in physical aggression has shown declining levels among adolescents during the past two decades. However, few studies have attempted to explain such time trends. Based on two representative cross-sectional surveys of students in the final year of high school in 2007 (N = 6631; 58.8% girls) and 2015 (N = 4145; 60.3% girls), this study reports a substantial decline in physical aggression among Norwegian adolescents. Moreover, mediation analyses show that declining levels in problematic alcohol use and family violence during the same period are plausible explanations for some of this reduction. The results are discussed in light of contemporary changes in socialization of adolescents, and implications for violence prevention are presented.
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Introduction: Over the past two decades, alcohol consumption of Icelandic adolescents has decreased dramatically. The aim of this study was to quantify the extent of this reduction and compare it with the trend in cannabis use over a 20 year period and to identify possible explanations. Methods: We used data from the Icelandic participants to the European School Survey Project on Alcohol and Other Drugs study (collected via paper-and-pencil questionnaires in classrooms). The sample included all students in the 10th grade (54-89% response rate). Results: The percentage of participants who had never used alcohol during their lifetime rose from 20.8% in 1995 to 65.5% in 2015. Similarly, there was a decline in the proportion of students who had consumed alcohol 40 times or more, from 13.7% to 2.8%. During the same period, the number of students who had never used cannabis rose from 90.2% to 92.0%. In contrast, we found a small, but statistically significant, increase in the prevalence of those who had used cannabis 40 times or more, from 0.7% in 1995 to 2.3% in 2015. Parental monitoring increased markedly between 1995 and 2015, but availability of alcohol decreased. Perceived access to cannabis and youth attitudes towards substance use remained unchanged. Discussion: Although Iceland has enjoyed success in lowering alcohol use among adolescents over the past decades, and somewhat fewer claim to have ever tried cannabis, there has been a threefold increase among heavy users of cannabis. Increased parental monitoring and decreased availability of alcohol explain some of the changes seen. [Arnarsson A, Kristofersson GK, Bjarnason T. Adolescent alcohol and cannabis use in Iceland 1995-2015. Drug Alcohol Rev 2017;00:000-000].
Article
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Background Existing research on parental supply of alcohol analyses the effects of self-reported parental supply on adolescent drinking using individual level data. This study examined the contextual effect of parental supply of alcohol on adolescent alcohol use by examining the association between the prevalence of parental supply in each Australian state and adolescent alcohol use using a multilevel analytic framework. Methods Adolescent samples (Age: 12–17) were drawn from the four National Drug Strategy Household Surveys (2004, 2007, 2010 and 2013; N = 6803). The prevalence of parental supply of alcohol, defined as the weighted percentage of sample who reported obtaining alcohol from their parents, was estimated in each state and territory across the four surveys. Three multilevel logistic regressions were used to examine the contextual effects of parental supply prevalence on adolescents’ alcohol use in the past 12 months, weekly drinking and heavy drinking. Results Overall, adolescents’ rates of past 12 months alcohol use, heavy drinking and weekly drinking between 2004 and 2013 were 40.1, 14.4 and 6.4% respectively. The prevalence of parental supply was significantly associated with past 12 months alcohol use (OR = 1.06, p < .001) and heavy drinking (OR = 1.04, p < .001) but not with weekly drinking (OR = 1.03, p = .189). The results were adjusted for gender, age, socio-economic index for area, place of birth, survey year and prevalence of peer supply. Conclusion A high prevalence of parental supply in a region was associated with heavier adolescent drinking, regardless of whether adolescents primarily obtained their alcohol from their own parents.
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Background and objectives: Scientific understanding of the forces involved in the decades-long decline of adolescent alcohol use in the United States is limited. This study examines specific changes in US adolescent frequent binge drinking (FBD) by age (variation due to maturation), period (variation across time that does not covary across age), and cohort (variation common to adolescents born around the same time). Methods: We analyzed nationally representative, multicohort data from 8th, 10th, and 12th grade students sampled between 1991 and 2015 from Monitoring the Future (n = 1 065 022) to estimate age, period, and cohort effects on adolescents' FBD (defined as ≥2 occasions of ≥5 drinks in a row during the past 2 weeks). Age-Period-Cohort analyses were stratified by sex, race/ethnicity, and socioeconomic status (SES). Trends in the associations between demographics and FBD across historical time were examined. Results: Decreases in FBD during adolescence were attributable to period and cohort effects independent of age variations. Birth cohorts between 1985 and 1990 showed the greatest decline in FBD. The Age-Period-Cohort results were consistent across sex, race/ethnicity, and SES, with the exception of slower declines seen among African American adolescents compared with white adolescents since 2007. We also found convergence in FBD by sex and divergence by SES. Conclusions: Recent declines in adolescent FBD have been driven by period and cohort effects. Attention is warranted for the slower declines in FBD seen among African American adolescents since 2007, a narrowing difference by sex, and a growing gap by SES.
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Background: Many Western countries have reported declines in adolescent alcohol use. This study examined changes in adolescent alcohol use in New Zealand between 2007 and 2012 and explored variations across socio-demographic strata. Methods: Data from two nationally-representative, cross-sectional high school surveys conducted in 2007 (n = 7,709) and 2012 (n = 7,266) were examined. Changes in the prevalence of drinking in the past 4 weeks were examined among the total sample, as well as the frequency of drinking in the past 4 weeks and typical drinking-occasion quantity among drinkers. Only students residing in urban areas were included. Variation in changes were investigated across four demographic groups characterized by age (<16yrs, ≥16yrs) and sex. Interactions with household- and neighborhood-level socio-economic position (SEP) identified any differential changes between socio-economic strata. Results: From 2007 to 2012, significantly fewer students consumed alcohol in the past 4 weeks. Interaction analyses demonstrated that, among young females (<16years), declines were significantly greater among those of high household SEP when compared to those of low household SEP. Among drinkers, reductions in the frequency of drinking were found among all demographic groups and SEP strata. Interaction analyses revealed that only young males (<16 years) showed significantly reduced typical drinking-occasion quantities. Among young females, significant interactions revealed a shift towards increasing typical drinking-occasion quantities among those of low household and neighborhood SEP, whilst their more advantaged counterparts showed no significant change over time. Conclusions: Fewer drinking occasions characterized the major declines in adolescent drinking between 2007 and 2012. Whilst young males showed reductions in the typical quantity consumed, young females of low household and neighborhood SEP progressed towards higher typical quantities. To address the uneven distribution of alcohol-related harm and improve the targeting of harm reduction initiatives, it remains imperative to examine changes in both the overall shift and shape of the distribution curve.
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Objectives: To analyze selected indicators of alcohol use (lifetime use, initiation of drinking at ≤13 years of age, weekly use, beverage preferences, initiation of drunkenness at ≤13 years of age and lifetime drunkenness) in adolescents in Slovakia from 2006 to 2014. Study design: The Health Behaviour in School Aged Children (HBSC) study is a cross-sectional questionnaire study. Methods: A standardized uniform questionnaire was used in representative samples of 11-, 13- and 15-year-old adolescents. In Slovakia, the HBSC study was undertaken in 2006 (n = 3972), 2010 (n = 5089) and 2014 (n = 4369). Results: Over the study period, decreases were observed in weekly drinking (from 34.3% to 21.0% in 15-year-old boys and from 22.1% to 11.9% in 15-year-old girls), lifetime drinking and initiation of drinking at ≤13 years of age. In terms of beverage preferences, the reduction in beer consumption was most notable. Approximately one-third of respondents got drunk for the first time at ≤13 years of age, and this remained consistent throughout the study period. Conclusions: The declining trend in alcohol use among adolescents in Slovakia may reflect a progressive change in the social environment and is attributable, at least in part, to policy improvements such as pricing and stricter legislation and enforcement.
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Aims: Unlike adults, abstaining has increased and regular use of alcohol has decreased among 12-16-year-olds over the past two decades. The paper studies whether these developments will be continued as the adolescent cohorts come of age. Methods: The Adolescent Health and Lifestyle Survey is a nationally representative monitoring system of the health habits of 12-, 14-, 16-, and 18-year-old Finns, conducted biannually between 1981 and 2013. The prevalence of alcohol use and drunkenness were measured for each 5-year cohort born in 1967-1995. Age-by-cohort trajectories and hierarchical age-period-cohort (APC) modeling were used to assess effects of age, period, and birth cohort. Results: Cohorts differentiate for underage drinking, but not at the age of 18. The younger cohorts postpone their drinking debut compared with older cohorts and thus age profiles are steeper than before. The most recent cohorts born in the 1990s, and the oldest cohorts born in 1967-71, have the highest prevalence in abstinence but drinking has been more prevalent for cohorts born in 1973-1989. APC modeling confirms significant cohort effects, but no significant decrease in drinking or drunkenness at the age of 18 years. Some of the changes can also be attributed to period effects. Conclusions: Despite the decrease in underage drinking in Finland, 18-year-olds continue to drink similarly from cohort to another. Postponing the onset of drinking has a preventive effect on alcohol-related harms, but a reduction in drinking among adult cohorts is not evident in the future.
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OBJECTIVE This study depicts the current situation (2015) and 30-year trends (1984–2015) in smoking, alcohol, and drug use among 16 year-old high school pupils in Greece. METHOD The data are derived from the “Greek Nationwide School Population Survey on Substance Use and other Addictive Behaviours”, a cross-sectional survey conducted quadrennially on representative samples of high-school pupils. Logistic regression analysis was used to assess recent and long-term trends (linear and quadratic) over the 30-year period 1984–2015. RESULTS In 2015, 39.2% of 16 year-old high school pupils nationwide had smoked conventional cigarettes at least once in their lifetime. About 11.1% and 2.9% were regular and heavy smokers, respectively, with a higher proportion among males than females. In addition, 19.1% reported experimentation with e-cigarettes, mostly males and smokers of conventional cigarettes. About 66.2% had consumed alcohol in the past month, 7.6% 10 times or more, nearly twice as many boys as girls. Heavy episodic drinking in the past month was reported by 38.3% of the sample, in a higher proportion by males, and 27.6% reported drunkenness in the past 12 months. About 10.6% had tried an illicit drug, half (5.8%) at least 3 times. A higher proportion of males than females reported use of “any illicit drug”. Cannabis was the most commonly used drug (9.1%), with almost half of “ever” cannabis users (4.1%) reporting use within the past month, and 2.5% reported use of “new psychoactive substances” (including synthetic cannabinoids). The lifetime prevalence of use of any of the other illicit drugs did not exceed 2.0%. Short-term trends suggest a decrease in smoking and in current and frequent alcohol consumption in 2015 compared with 2011 or 2007. A decrease was also observed in heavy episodic drinking, but only between 2011 and 2015 and only in males. No significant change was observed in lifetime use of “any illicit drug” or cannabis in the period 2007–2015. The 30-year trends (1984–2015) suggest a decrease in lifetime and current smoking, similar between genders, and a decrease in heavy smoking after 1999 in females and 2003 in males, and in regular smoking after 1999 in males. A linear decrease was also observed in alcohol use, with decreases in frequent alcohol use and heavy episodic drinking observed after 2011. Following linear increases between 1984 and 1999, the rates of illicit drug use levelled off from 2003 onwards. CONCLUSIONS Despite recent decreases in substance use among 16 year-olds in Greece, interventions need to be sustained and focus more towards preventing heavy episodic drinking and the use of novel substances, such as e-cigarettes and “new psychoactive drugs”.
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Alcohol content is frequently displayed on social media through both user-generated posts and advertisements. Previous work supports that alcohol content on social media is influential and often associated with offline behaviors for adolescents and young adults. Social media may have a role in future alcohol intervention efforts including identifying those at risk or providing timely prevention messages. Future intervention efforts may benefit from an affordance approach rather than focusing on a single platform.
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Aims: In this study we look at (1) changes in parenting practices related to adolescents’ alcohol use in Finland from 2006 to 2012 and (2) whether parents’ own drinking behaviour is related to the parenting practices. Methods: Two surveys of parents with children were conducted in 2006 (n = 2864) and 2012 (n = 2965). The data were analysed using χ2-test and multivariate regression analysis. Findings: Alcohol-related parenting practices had become stricter between the study years in all sociodemographic groups. The frequency and volume of the parent’s own drinking in the presence of their children were the strongest predictors of permissive parenting practices related to the children’s alcohol use. Conclusions: The study indicates that, as preventive policies can influence parental practices in a positive way in the majority of families, special attention needs to be paid to families with heavy parental alcohol use.
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Parental time with children leads to posive child outcomes. Some studies have reported a posive educational gradient: More educated parents devote more time to children than other parents. Furthermore, some research finds that parental child care increased over time. Less certain is whether more educated parents increased their time more than less educated ones did, whether parenting trends for mothers and fathers are the same, and whether observed patterns characterize all Western countries or only some. Hypotheses inspired by theories of social diffusion, class differentiation, and ideologies of child rearing are tested with time-use data for 11 Western countries between 1965 and 2012. For both mothers and fathers, results indicated a widespread educational gradient and an increase in child-care time. In a number of countries, the posive educational gradient increased; nowhere was it dished. Thus, the advantages of intensive parenting continued to accrue to the well-educated elite.
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Background Most adolescents begin alcohol consumption during adolescence, heavy alcohol use by adolescents is common, and alcohol-related harm amongst adolescents is a major public health burden. Parents are a common source of alcohol amongst adolescents, but little is known about how parental supply of alcohol has changed over recent years. This study examines national trends in parental supply of alcohol to adolescent children in Australia since 1998. Methods Six Australian National Drug Strategy Household Surveys (1998–2013) yielded rates of parental supply of current and first ever alcohol consumed. Lifetime and current alcohol use were also estimated. The surveys were conducted for households across all Australian states and territories. Surveyed adolescents were aged 14–17 years (N = 7357, 47.6 % male). Measures included the reported source of currently consumed alcohol and first ever alcoholic beverage (parents/friends/others), lifetime alcohol use, number of standard alcohol units consumed on drinking days, and frequency of alcohol use. Corrected Pearson chi-squared tests were used to compare survey years. Results There was a significant drop in parental supply of current alcohol use from 21.3 % in 2004 to 11.79 % in 2013 (p < .001). The lower prevalence of parental supply coincided with legislative changes on parental supply of alcohol to adolescents, but causality cannot be established because of the variation in the timing and reach of parental supply legislation, and small samples in some states. There were downward trends in adolescent experimentation, quantity and frequency of alcohol use across years, with the largest drop in alcohol use in 2010 and 2013. Conclusions In Australia, there has been a substantial reduction in parental supply of alcohol to adolescents from 2010, and this factor may partially account for reductions in adolescent alcohol use.
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Bullying among children and adolescents is a public health concern; victimization is associated with psychological and physical health problems. The purpose of this study is to examine temporal trends in bullying victimization among school-aged children in Europe and North America. Data were obtained from cross-sectional self-report surveys collected as part of the Health Behaviour in School-aged Children (HBSC) study from nationally representative samples of 11-, 13- and 15-year-olds, from 33 countries and regions which participated in the 2001-02, 2005-06 and 2009-10 surveys. Responses from 581 838 children were included in the analyses. Binary logistic regression was used for the data analyses. The binary logistic regression models showed significant decreasing trends in occasional and chronic victimization between 2001-02 and 2009-10 across both genders in a third of participating countries. One country reported significant increasing trends for both occasional and chronic victimization. Gender differences in trends were evident across many countries. Overall, while still common in many countries, bullying victimization is decreasing. The differences between countries highlight the need to further investigate measures undertaken in countries demonstrating a downward trend. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
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The quality of communication with parents is a determinant of health and well-being during adolescence, being predictive of self-esteem, self-rated health and the ability to navigate health risk behaviours. This article describes trends in adolescent's (aged 11, 13 and 15 years) perception of communication with mothers and fathers by gender across 32 European and North American countries from 2002 to 2010. Analyses were performed on 425 699 records employing a General Linear Model (MANOVA). In most countries, significant increases in the prevalence of ease of communication with both mothers and fathers were observed, with the greatest positive changes over time in Estonia, Denmark and Wales. In some countries, the opposite trend was found with the greatest negative changes occurring in France, Slovenia and Poland. Across the pooled dataset, a significant positive trend was observed for ease of communication with father, for both boys and girls and for ease of communication with mother for boys only. The temporal trends demonstrated an increase in a positive health asset for many young people, that of family communication. Positive trends may be a feature of the economic boom over the past decade coupled with cultural changes in attitudes to parenting, especially fathering. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.