In this guest post Rakhi Vashishtha, a research officer at Centre for Alcohol Policy Research, Melbourne, Australia, explores the current evidence behind falls in youth drinking following publication of a recent systematic review.
For decades, alcohol consumption among young people has remained a huge concern for community, public health practitioners and policy advocates. Adolescent alcohol consumption is a well-established risk factor for range of negative health and social outcomes.
However, from around the turn of this century, dramatic declines have been observed for adolescent alcohol consumption from almost all high-income countries. The declines are consistent among all demographic and socio-economic groups for various drinking measures. For example, based on the UK based Health Behaviour in School-Aged Children (HBSC) survey, consistent declines have been observed for 15 year olds in England and Scotland beginning from 2001/02 until the latest survey reports 2013/14. Similar trends also started to appear for Ireland and Wales from 2005/06. These trends have also been reported in other surveys such as Smoking, Drinking and Drug Use Among Young People in England survey.
Despite these huge reductions in young people’s drinking across the globe, the explanations for these declines remain unknown. Numerous theories have been put forward to explain the reductions in young people’s drinking but scientific evidence to support these theories is lacking. It is imperative to understand the factors that are driving these declines so that the benefits arising from these reductions can be extended to other substance use problems or to communities which have not yet benefitted from these declining trends. In a recent systematic review, the authors summarised empirically tested factors to help try to explain the declines in adolescent alcohol consumption from all high income countries.
The study found the most robust evidence supporting the theory regarding change in parenting practices. There is moderate evidence suggesting that change in positive parenting practices - especially related to parental monitoring and alcohol-specific rule setting - have contributed to the decline in adolescent alcohol consumption in the last two decades. Many authors have also reported that parents of current generation of young people spend more time with their kids every day compared to parents of previous generation of young people. On similar lines, there are studies showing that parenting styles have changed from authoritarian to a more authoritative style where there is more open communication between parents and children along with clear rule settings. There is also substantial evidence showing there is marked reduction in parental alcohol supply practices, however, there is also more work needed in the area to understand why and how these parental practices have changed.
Another plausible explanation that has been very commonly suggested is the introduction of stricter and more restricted alcohol-related policies. The authors of the review found mixed results showing that some policies may have contributed in some way to the reduction in adolescent alcohol consumption in some countries. However, considering the global extent of these declines there are more complex mechanisms involved. There is only one study from Australia that has examined the change in televised alcohol advertising as the potential contributor to the decline in adolescent alcohol consumption and found some evidence to support their hypothesis. However, this study did not take into account other sources of advertisements such as social media or internet and hence, more evidence is needed in this area.
There were also speculations suggesting the role of economic crisis in reducing adolescent alcohol consumption, but the review found contrary results from studies which showed increase in adolescent alcohol consumption in the USA during the time of financial crisis of 2007. Considering the decline began prior to the global financial crisis, it seems that other driving forces contributed to these trends. Some studies examined the effect of change in drug preferences as a potential contributor to the declining trends and found that it seems unlikely that adolescents have changed their preferences in terms of drug use and are therefore not choosing to use other substances in lieu of alcohol. One study also examined if increase in immigration of non-drinking cultures could have resulted in decline in adolescent alcohol use but did not find an association between growth in non-drinking communities and adolescent alcohol use.
Overall, it seems that currently very limited scientific evidence exists to support any specific explanatory factors in relation to the decline in adolescent alcohol consumption in higher income countries. Extensive research work is needed to examine the effects of change in drinking attitudes and norms on adolescent alcohol consumption. Many young people have been reported to be adopting a healthier lifestyle, by turning vegan, being environmentally conscious, and so abstaining from substance use and reduction in alcohol consumption could just be a small part of the big positive change.
There is also lacking evidence in relation to the huge change in internet use that has taken place in the last two decades. The digital revolution is the biggest change that present generation of young people has encountered compared to previous generations. Advances in digital technology provides adolescents with alternative social opportunities that do not require alcohol and therefore may act as “distraction” and also increase awareness about alcohol related harms. Studies are therefore needed which examine multiple factors together to explore the complex dynamics in relation to declining alcohol use among young people. Fortunately some research programmes are underway, including the UK based ‘Youth Drinking In Decline’ (Y-DID) four year programme. In the meantime, much more research work is needed in this field before we can more confidently state the various probable explanatory factors behind these declining trends. Further, the most recent data may raise some cause for concern that these positive shifts could be coming to an end, at least in Scotland.
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