The Role of Parental Control and Support in Declining Adolescent Drinking: A Multi-Level Study Across 30 European Countries

Prevalence of parental supply of alcohol to minors: a systematic review

Parental supply of alcohol to minors (i.e. those under the legal drinking age) is often perceived by parents as protective against harms from drinking, despite evidence linking it with adverse alcohol-related outcomes. This systematic review describes the prevalence of parental supply of alcohol, as reported in the international literature. The review was registered with PROSPERO (CRD42020218754). We searched seven online databases (Medline, Embase, PsycINFO, CINAHL, Scopus, Web of Science and Public Health Database) and grey literature from January 2011 to December 2022 and assessed the risk of bias with the JBI Critical Appraisal Checklist. Among 58 articles included in narrative synthesis from 29 unique datasets, there was substantial variation in the definition and measurement of parental supply of alcohol. Overall prevalence rates ranged from 7.0 to 60.0% for minor-report samples, and from 24.0 to 48.0% for parent-report samples. Data indicate that parental supply prevalence is generally proportionately higher for older minors or later-stage students, for girls, and has increased over time among minors who report drinking. Literature on the prevalence of parental supply of alcohol is robust in quantity but inconsistent in quality and reported prevalence. Greater consistency in defining and measuring parental supply is needed to better inform health promotion initiatives aimed at increasing parents' awareness.

Generational shifts in attitudes and beliefs about alcohol: An age-period-cohort approach

INTRODUCTION AND AIMS

Population level alcohol consumption has declined markedly in Australia in the past two decades, with distinct generational patterns. The underlying reason for this shift remains unclear and there has been little work assessing how attitudes and beliefs about alcohol have shifted in population sub-groups.

DESIGN AND METHODS

Using seven waves of survey data spanning 19 years (2001-2019, n = 166,093 respondents aged 14 +), we assess age, time-period and birth cohort effects on trends in four measures of alcohol attitudes (disapproval of regular alcohol use, perceptions of safe drinking levels for men and women and perception that alcohol causes the most deaths of any drug in Australia).

RESULTS

There were steady increases in period effects for perceived safe drinking levels (especially for men) and belief that alcohol causes the most deaths. Disapproval of regular use has been stable at the population level, but there are marked cohort differences, with early and recent cohorts more likely than others to disapprove of regular alcohol use.

DISCUSSIONS AND CONCLUSIONS

These findings point to a broad lowering of perceived safe levels of drinking across the population alongside a sharp increase in disapproval of drinking for recent cohorts, potentially contributing to the reductions in drinking that have been reported in these cohorts.

The great decline in adolescent risk behaviours: Unitary trend, separate trends, or cascade?

In many high-income countries, the proportion of adolescents who smoke, drink, or engage in other risk behaviours has declined markedly over the past 25 years. We illustrate this behavioural shift by collating and presenting previously published data (1990-2019) on smoking, alcohol use, cannabis use, early sexual initiation and juvenile crime in Australia, England, the Netherlands, New Zealand, and the USA, also providing European averages where comparable data are available. Then we explore empirical evidence for and against hypothesised causes of these declines. Specifically, we explore whether the declines across risk behaviours can be considered 1) a 'unitary trend' caused by common underlying drivers; 2) separate trends with behaviour-specific causes; or 3) the result of a 'cascade' effect, with declines in one risk behaviour causing declines in others. We find the unitary trend hypothesis has theoretical and empirical support, and there is international evidence that decreasing unstructured face-to-face time with friends is a common underlying driver. Additionally, evidence suggests that behaviour-specific factors have played a role in the decline of tobacco smoking (e.g. decreasing adolescent approval of smoking, increasing strength of tobacco control policies) and drinking (e.g. more restrictive parental rules and attitudes toward adolescent drinking, decreasing ease of access to alcohol). Finally, declining tobacco and alcohol use may have suppressed adolescent cannabis use (and perhaps other risk behaviours), but evidence for such a cascade is equivocal. We conclude that the causal factors behind the great decline in adolescent risk behaviours are multiple. While broad contextual changes appear to have reduced the opportunities for risk behaviours in general, behaviour-specific factors have also played an important role in smoking and drinking declines, and 'knock-on' effect from these behavioural domains to others are possible. Many hypothesised explanations remain to be tested empirically.

The Declining Trend in Adolescent Drinking: Do Volume and Drinking Pattern Go Hand in Hand?

Traditionally, adolescent drinking cultures differed between Nordic and Mediterranean countries; the former being characterised by low volume and relatively frequent heavy episodic drinking (HED). Across these drinking cultures, we examined the associations between alcohol volume and HED with respect to (i) secular trends at the country level and (ii) individual-level associations over time. The data stem from the European School Survey Project on Alcohol and Other Drugs (ESPAD) conducted among 15–16-year-olds in Finland, Iceland, Norway, Sweden, France and Italy, employing six cross-sectional surveys from 1999 to 2019 (n = 126,126). Both consumption volume and HED frequency decreased in all Nordic countries and displayed a curvilinear trend in France and Italy. In all countries, consumption volume and HED correlated highly over time at the country level. At the individual level, the correlation was positive but with a varying magnitude over time and between countries. In 1999/2003, the alcohol volume–HED correlation was significantly higher in the Nordic compared to the Mediterranean countries but became significantly weaker in Finland, Norway and Sweden and remained stable in France, Iceland and Italy during the period. In conclusion, while trends in consumption volume and drinking patterns went hand in hand at the aggregate level, the association at the individual level weakened over time in several Nordic countries, along with the substantial decline in adolescent drinking since 2000.