Mind the gap! Gender differences in alcohol consumption among Swedish ninth graders 1989-2021

INTRODUCTION

To examine gender differences in drinking habits among Swedish ninth graders over the period 1989-2021.

METHODS

Annual school surveys with nationally representative samples of ninth-grade students in Sweden covering the period 1989-2021, total sample of 180,538 students. Drinking habits were measured with self-reports of frequency and quantity of use and frequency of heavy episodic drinking. Differences between genders were compared annually and differences were tested using logistic and ordinary least square regression models with cluster robust standard errors.

RESULTS

Small gender differences in the prevalence of alcohol use during the first part of the study period were followed by an increasing gap over the past decade with girls being more likely to drink alcohol than boys. Boys consumed larger amounts of alcohol than girls during the first three decades of the studied period but no gender differences were found in later years. Binge drinking was more prevalent among boys during 1989 to 2000 but no systematic gender difference was found during the past 15 years.

DISCUSSION AND CONCLUSIONS

There used to be clear gender differences in drinking habits among ninth graders in Sweden with boys drinking more than girls. This gap has narrowed over the past three decades and among contemporary adolescents, no gender differences are found neither in binge drinking nor volume of drinking and the prevalence of drinking is even higher among girls.

Examining the association between psychological distress and alcohol use in Australian adolescents over a period of declining consumption

INTRODUCTION

Youth drinking rates have declined over the past 15 years while self-reported psychological distress has increased, despite a well-recognised positive relationship between the two. The current study aimed to identify changes in the relationship between psychological distress and alcohol use in adolescents from 2007 to 2019.

METHODS

This study used survey responses from 6543 Australians aged 14-19 years who completed the National Drug Strategy Household Survey in 2007, 2010, 2013, 2016 or 2019. Logistic and multivariable linear regressions with interactions (psychological distress × survey wave) predicted any alcohol consumption, short-term risk and average quantity of standard drinks consumed per day.

RESULTS

Psychological distress was a positive predictor of alcohol use and this association remained stable across survey waves as alcohol consumption decreased.

DISCUSSION AND CONCLUSIONS

The relationship between distress and alcohol consumption remained relatively steady, even as youth drinking declined and distress increased. The proportion of drinkers experiencing distress did not increase as consumption rates dropped, suggesting that the decline in youth drinking is occurring independently of the increase in self-reported and diagnosed mental health issues.

Adolescent binge drinking in the West of Ireland: associated risk and protective factors

BACKGROUND

Alcohol is a leading cause of morbidity and mortality worldwide. Adolescence is when alcohol use typically begins. Harmful patterns of alcohol consumption, such as binge drinking, may emerge during adolescence and become established. This study aimed to examine potential risk and protective factors for binge drinking among 15-16-year-old adolescents in the West of Ireland.

METHODS

This was a cross-sectional secondary analysis of 4473 participants from the Planet Youth 2020 Survey. The outcome was ever binge drinking, defined as ever consumption of five or more drinks in a two-hour period or less. Independent variables were selected a priori following review of peer-reviewed literature and were grouped as individual, parents and family, peer group, school, leisure time and local community factors. Statistical analysis was completed using SPSS version 27. Differences in medians and means for continuous variables were examined using the Mann-Whitney U test and Independent Samples t-test respectively. Multivariable logistic regression was used to examine independent associations between potential risk and protective factors and ever binge drinking. A p-value of < 0.05 was deemed statistically significant.

RESULTS

The prevalence of ever binge drinking was 34.1%. Self-rated 'bad/very bad' mental health (adjusted Odds Ratio (aOR) 1.61, 95% CI 1.26-2.06, p < 0.001), current cigarette use (aOR 4.06, 95% CI 3.01-5.47, p < 0.001) and current cannabis use (aOR 2.79, 95% CI 1.80-4.31, p < 0.001) increased odds of ever binge drinking. Parental supervision (aOR 0.80, 95% CI 0.73-0.88, p < 0.001) and negative parental reaction to adolescent drunkenness (aOR 0.51, 95% CI 0.42-0.61, p < 0.001) reduced odds of ever binge drinking. Getting alcohol from parents increased odds of ever binge drinking (aOR 1.79, 95% CI 1.42-2.25, p < 0.001). Adolescents with friends who drink alcohol had almost five times higher odds of ever binge drinking (aOR 4.59, 95% CI 2.65-7.94, p < 0.001). Participating in team/club sports also increased odds of ever binge drinking (aOR 1.30, 95% CI 1.07-1.57, p = 0.008 for 1-4 times/week, aOR 1.52, 95% CI 1.07-2.16, p = 0.020 for ≥ 5 times/week).

CONCLUSION

This study identifies individual and social environment factors associated with adolescent binge drinking in the West of Ireland. This can inform intersectoral action to protect adolescents from alcohol-related harm.

Alcohol consumption and well-being among 25,000 Danish high school students

Excessive alcohol consumption among young people is an international public health concern, as alcohol is associated with a range of adverse short- and long-term consequences. Furthermore, alcohol consumption has been associated with well-being in young people, but the association depends on the chosen measure of well-being. The objective of this study was to assess how weekly alcohol consumption was associated with poor well-being (poor school enjoyment, social inclusion in school, mental well-being, life satisfaction, self-esteem, and self-efficacy, and experiencing loneliness). Cross-sectional data from the Danish National Youth Study 2019 was used (a total of 25,910 students aged 15-25 years). For most outcomes, there was a U-shaped association between weekly alcohol consumption and poor well-being e.g. students who never drank, students who only drank occasionally, and students who drank a lot (22 units of alcohol or more a week) had higher odds of poor well-being, compared to the reference group (1-7 units a week). This was the case for measures such as low school enjoyment (only females), poor mental well-being, low life satisfaction, low self-esteem (only females) and low self-efficacy (only males). Among females, odds of low self-efficacy was higher with higher weekly alcohol consumption. Higher weekly alcohol consumption was associated with lower odds of low social inclusion in school, experiencing loneliness often, and (among males) low self-esteem. Conclusively, well-being in general was lowest among never-, occasional- and heavy drinking students. Understanding these associations can help to decrease alcohol consumption and promote well-being among young students.

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.

The Interactions of Media Use, Obesity, and Suboptimal Health Status: A Nationwide Time-Trend Study in China

Obesity and suboptimal health status (SHS) have been global public health concerns in recent decades. A growing number of works have explored the relationships between media use and obesity, as well as SHS. This study aimed to examine the time trend of the associations between media use (including traditional media and new media) and obesity, as well as SHS. The data were derived from three national random samples of the Chinese General Social Survey (CGSS), which was separately conducted in 2013, 2015, and 2017. In total, 34,468 respondents were included in this study, consisting of 16,624 males and 17,844 females, and the average age was 49.95 years old (SD = 16.72). It found that broadcast use and television use were positively associated with obesity and showed an increasing trend over time. Cellphone use emerged as a risk factor for obesity in 2017 and showed an increasing trend. By contrast, newspaper use, television use, and internet use were negatively associated with SHS, and television use showed a decreasing trend in the association with SHS, while internet and newspaper use showed an increasing trend. In conclusion, media use was positively associated with obesity while negatively associated with SHS. It showed a decreasing trend in the associations between traditional media use and obesity, while revealing an increasing trend in the associations between new media use and obesity, as well as SHS. The practical implications of the findings are discussed.

Longitudinal within- and between-person associations of substance use, social influences, and loneliness among adolescents and emerging adults who use drugs

Loneliness is a public health problem causing morbidity and mortality. Individuals with substance use problems are often lonelier than the general population. We evaluate the longitudinal associations between social influences, substance use, and loneliness among adolescents and young adults recruited from an urban Emergency Department (ED). We use secondary data from a natural history study of N=599 youth (ages 14-24) who used drugs at baseline and completed biannual assessments for 24 months; 58% presented to the ED for an assault-related injury and a comparison group comprised 42% presenting for other reasons. Measures assessed cannabis use, alcohol use, and loneliness. Using GEE models, we evaluated the relationships between social influences (peers, parents), substance use, and loneliness via longitudinal data, de-coupling within- and between-person effects. Men reported lower loneliness over time. At the between-person level, individuals with greater alcohol and cannabis use severity and negative peer influences had greater loneliness; positive parental influences were associated with less loneliness. At the within-person level, greater alcohol use severity, negative peer influences, and parental substance use corresponded to increases in loneliness; positive parental influences corresponded to decreases in loneliness. Youth with more severe alcohol and cannabis use had greater loneliness over time. Within individuals, peer and parental social influences were particularly salient markers of loneliness. An ED visit provides an opportunity for linkage to personalized, supportive interventions to curtail negative outcomes of substance use and loneliness.

Trends in alcohol intoxication among native and immigrant youth in Sweden, 1999-2017: A comparison across family structure and parental employment status

BACKGROUND

Developing a better understanding of drinking patterns across immigrant generations and how these change over time is important for the development of effective alcohol polices. This study investigates the direction and rate of change in youth alcohol intoxication over time, based on immigrant status, and by family structure and parental employment status.

METHOD

The study is based on eight nationally representative school surveys conducted by the Swedish National Council for Crime Prevention between 1999 and 2017, with a combined sample of 50,657 adolescents. Group by time interactions were examined to compare rates of change of alcohol intoxication over time across immigrant generations.

RESULTS

The results show a decreasing trend in alcohol intoxication among both first and second generation immigrant youth, and also among immigrant youth across different family structures and parental employment statuses. The results also show that the decrease in alcohol intoxication over time is greater for youths born abroad and for youths with two immigrant parents than for native Swedes, and that the decrease over time is greater for youths from intact families than for native Swedish youths from non-intact families and youths with one immigrant parent.

CONCLUSION

Native and first- and second-generation immigrant youth may differ substantially from one another in many ways, and may therefore manifest different patterns of drinking behaviours. From a policy and prevention perspective, the data in this study imply that native youths and youths with one immigrant parent should be a central target group for alcohol prevention policy in Sweden.

Change in prevalence of self-harm from 2002 to 2018 among Norwegian adolescents

Background

Self-harm is prevalent among adolescents and associated with mental health problems and negative life-events. Few studies have examined changes in its prevalence related to these factors. This study explored whether changes in prevalence of self-harm among adolescents had occurred, and to what extent changes in associated factors may have contributed.

Methods

Two cross-sectional school-based surveys among adolescents (grades 8–10) in Norway were conducted in 2002 (N = 5842) and in 2017/18 (N = 29 063). Past year prevalence of self-harm and identical variables on risk factors was analyzed in hierarchical logistic regression to examine whether and to what extent changes in self-harm correlates could explain periodical change in prevalence of self-harm.

Results

An increase from 4.1% to 16.2% in self-harm prevalence was observed from 2002 to 2017/18. The increase was relatively larger among girls compared to boys and among 8th graders compared to 10th graders. Among the assessed risk factors for self-harm, depressive symptoms increased, while anti-social behavior, exposure to violent acts and drinking to intoxication decreased. The increase in depressive symptoms contributed to explain increase in self-harm. This contribution was outweighed by the decrease in other risk factors.

Conclusions

Self-harm prevalence increased 4-fold among Norwegian adolescents over a 15-year period. While exposure to several risk factors for self-harm changed substantially in this period, these risk factors could in sum not explain any of the increase in self-harm.

The associations of comorbid substance use disorders and psychiatric conditions with adolescent brain structure and function: A review

Adolescence is a period of rapid neural and behavioral development that often precipitates substance use, substance use disorders (SUDs), and other psychopathology. While externalizing disorders have been closely linked to SUD epidemiologically, the comorbidity of internalizing disorders and SUD is less well understood. Neuroimaging studies can be used to measure structural and functional developments in the brain that mediate the relationship between psychopathology and SUD in adolescence. Externalizing disorders and SUD are both associated with structural and functional changes in the basal ganglia and prefrontal cortex in adolescence. The neural mechanisms underlying internalizing disorders and SUD are less clear, but evidence points to involvement of the amygdala and prefrontal cortex. We also highlight independent contributions of SUD, which may vary in certain ways by the substances assessed. A deeper understanding of the neural basis of the relationship between psychopathology and SUD will allow for more informed interventions in this critical developmental stage.

Trends in the psychosocial characteristics of 11-15-year-olds who still drink, smoke, take drugs and engage in poly-substance use in England

INTRODUCTION AND AIMS

Youth substance use is declining in many high-income countries. As adolescent substance use becomes less common, it may concentrate in higher-risk groups. This paper aims to examine how the psychosocial characteristics of young substance users in England have changed over time.

DESIGN AND METHODS

Annual cross-sectional data from the 2001-2014 Smoking, Drinking and Drug Use Among Young People in England survey are analysed (n = 112 792, age: 11-15). Logistic and Poisson regression analyses are used to test whether the sex, socioeconomic status (SES) and prevalence of truancy and exclusion from school of those who drink alcohol, smoke cigarettes, take cannabis, take other drugs and engage in poly-substance use changed across the study period.

RESULTS

Use of all substances decreased and there were shifts in the psychosocial characteristics of young smokers, illicit drug users and poly-substance users. The proportion of current smokers and ever-users of cannabis of low SES and who had been excluded increased significantly between 2001/2003-2014. The proportion of last month drug users who had been excluded from school also increased significantly and there were increases in the proportion of polysubstance-users who had truanted and been excluded. The proportion of low SES alcohol users who had been excluded also increased significantly, but this change was very small. There was no evidence of substance use becoming more or less concentrated in one gender.

DISCUSSION AND CONCLUSIONS

There is some evidence that smoking, illicit drug use and poly-substance use are becoming more concentrated in potentially at risk populations. There is limited evidence of concentration amongst young drinkers.

Less adolescent alcohol and cannabis use: More deviant user groups?

INTRODUCTION AND AIMS

Adolescent drinking and cannabis use in Norway declined in the 2000s, and we tested the assumption that psychosocial problems were more strongly related to substance use when the prevalence was quite low (2012/2013) than when it was considerably higher (2002).

DESIGN AND METHODS

Data stemmed from school surveys of almost 20 000 students aged 14-17 years in 2002 and 2012/2013 in the four largest cities in Norway. We assessed how various deviant behaviours and depressive mood were related to past-year measures on any alcohol intoxication, frequent intoxication (6+ times) and any cannabis use, and tested whether the associations varied significantly by survey year.

RESULTS

The prevalence of any intoxication episodes dropped markedly from 2002 (50%) to 2012/2013 (28%), as did the prevalence of frequent intoxication (29% vs. 10%) and any cannabis use (15% vs. 7%). Deviant behaviours and depressive mood were either more closely related to the drinking outcomes in 2012/2013 than in 2002, or the associations showed no temporal change. None of the associations with cannabis use varied significantly by survey year.

DISCUSSION AND CONCLUSION

The assumption that psychosocial problems correlated more strongly with alcohol and cannabis use in a low-prevalence period (2012/2013) as compared to a high-prevalence period (2002) was partly supported, but only with respect to drinking. The strength of the associations with cannabis use was stable, which may reflect that the proportion reporting any use of the drug was low even in the relatively 'high-prevalence' period.

The Decline in Alcohol Consumption in Russia from 2006 to 2017: Do Birth Cohorts Matter?

AIM

Previous studies on youth drinking showed opposite trends for high-income and low-income countries. In Russia, a recent decline was observed in the prevalence of alcohol use, particularly among younger cohorts. This study aims at disentangling age and birth cohort effects to better understand the dynamics of abstinence and the volume of alcohol consumption.

METHODS

Data were collected from annual nationally representative panel surveys from 2006 to 2017. Data included 34,514 individuals aged 14-80. We estimated mixed-effects binary-choice models for percentage of abstainers and mixed-effects linear models with Heckman correction for alcohol volume. Integer variables of age and age-squared were used. Period was defined with a dummy variable using 2012 as the dividing line associated with a new Russian alcohol policy. Birth cohorts were defined as 13 groups from 1930-1939 to 2000-2003. Controls were per capita income, education, marital status, composition of households, body weight, ethnicity, residence type, regional per capita income and regional climate.

RESULTS

In both genders, percentage of abstainers increased and drinking volumes declined. Age for both genders showed u-shaped trend for abstinence and inverse u-shaped trend for alcohol volume. Controlling for age effects, cohorts born after 1990 demonstrated the strongest increase in abstinence for both genders and the strongest decrease in alcohol volume for males. The period of 2012-2017 had the effect of increasing the abstinence and decreasing the alcohol volume.

CONCLUSION

Downward trend in alcohol consumption in Russia is partially attributable to increased abstinence and reduced alcohol volume among younger cohorts.

Alcohol Use, Binge Drinking, and Drunkenness Experience in Adolescence: Complex Associations with Family, Peers, Social Context, and Risk Perceptions

Background: A number of correlates to adolescent substance use have been shown, yet their unique predictive influence is unclear. We investigated the incremental validity of demographics, family background, school variables, risk perception, parental alcohol attitudes, age of first alcohol use, peer group influence, and behavioral variables as they concurrently predicted last month alcohol use, binge drinking, and drunkenness experience frequency. Methods: Hierarchical multiple regression analyses in a sample of N = 743 adolescents (mean age = 15.01). Results: All predictors explained 26-40% of the total variance. Alcohol use was predicted by age, gender, having two working parents, academic family background, relationship to parents, relative risk perception, parental acceptance of alcohol use, age of first use, talking about positive aspects of alcohol, normality of alcohol use among peers, time spent with friends, and going out to clubs. Binge drinking was predicted by age, working parents, school problems, relative risk perception, parental alcohol acceptance, age of first use, talking about positive aspects of alcohol, time spent with friends, and going out to clubs. Drunkenness was predicted by age, relationship to parents, school problems, relative risk perception, age of first use, talking about positive aspects of alcohol, and going out to clubs. Conclusions: Researchers need to take the complexity of adolescent substance use into account when designing studies and interventions. Relative risk perception emerged as the strongest (positive) predictor, indicating that adolescents are able to rather accurately assess their own risk and risk awareness alone does not suffice to engage in protective behavior.

Immigration and the decline in adolescent binge drinking

BACKGROUND

Adolescent alcohol consumption has fallen in most Western countries over the past two decades, while immigrants and children of immigrants from low-consumption countries constitute a growing proportion of teenagers in many Western nations. We investigate the extent to which immigrants and children of immigrants have contributed to the decline in adolescent heavy episodic drinking in Oslo, the capital of Norway.

METHODS

We use repeated cross-sectional survey data on adolescents in grades 9-11 in Oslo (aged around 14-16, N = 54,474) from 1996 to 2018. We use data on heavy episodic drinking/intoxication in the past 12 months (dichotomized), immigrant background, sex and grade. We decompose the trend into components attributable to changes in the demographic composition of the adolescent population (by immigrant background, grade and sex), and to changes in drinking patterns within different groups. Confidence intervals (CIs) are obtained by bootstrap resampling.

RESULTS

The proportion of adolescents with immigrant backgrounds increased from 21% to 35% over the time span. The proportion reporting having been intoxicated fell from 42% to 25%. Most of the decline stems from reduced heavy episodic drinking in the majority population, accounting for 70.8% of the reduction (95% CI: 67.5-74.2). The increased proportion of adolescents with an immigrant background accounts for 21.4% of the decline (95% CI: 19.2-23.8).

CONCLUSIONS

An increasing proportion of immigrants and children of immigrants with low alcohol consumption explains one-fifth of the decline in the prevalence of adolescent heavy episodic drinking in Oslo.

Young cohorts of Russians drink less: age-period-cohort modelling of alcohol use prevalence 1994-2016

BACKGROUND AND AIMS

Young Russians have been drinking less alcohol, and fewer strong spirits in particular, in recent years. This study aimed to disentangle age, period and birth cohort effects for the first time in Russia to improve our understanding of these trends.

DESIGN

Age, period and cohort analysis of annual nationally representative repeated cross-sectional surveys [Russian Longitudinal Monitoring Survey- Higher School of Economics (RLMS-HSE)] using separate logistic models for each gender.

SETTING

Russia 1994-2016.

PARTICIPANTS

A total of 195 234 respondents aged 14-85 years.

MEASUREMENTS

Age (14 groups: 14-17 to 76+ years), period (21 years: 1994-2016) and birth cohorts (17 groups: 1920-24 to 2000-02). Outcome measures were 30-day overall and beverage-specific alcohol use prevalence accounting for vodka, moonshine, beer and wine. Controls were per capita income, education, marital status, ethnicity, residence type and regional climate.

FINDINGS

Controlling for age and period effects, the most recent cohorts had lower rates of participation than older cohorts. Findings were valid for females born in 1995-2002 (P = 0.000) and males born in 1990-94 (P = 0.002) and 1995-2002 (P = 0.000). The period effects were strong in 1994-2003 due to intensive substitution of beer in place of vodka. Period effects were also important in determining a decline of prevalence in 2008-15 due to restrictive alcohol policy. Age effects showed an inverse U-shaped trend in both genders, except for moonshine and wine. Overall, drinking profiles were beverage-specific. Models indicated diverse beverage-specific effects of income, ethnicity, education, marital status and residence on the prevalence of alcohol use.

CONCLUSION

The recent downward trend in alcohol use in Russia appears to be attributable to reduced participation rates among younger cohorts born after 1990.

Earlier Alcohol Use and Lower Neuropsychological Performance in Brazilian Adolescence: Is the School Environment Related to This?

OBJECTIVES

The aim of this study was to evaluate impulsivity, inhibitory control, and alcohol use in preadolescents and adolescents aged 10 to 16 from public and private schools.

METHODS

Participants were 190 adolescents selected from public and private schools in Brazil. Neuropsychological measures related to impulsivity (i.e., Barratt Impulsiveness Scale), inhibitory control (i.e., Go/No-go Task), and processing speed (i.e., Five Digits Test) were assessed.

RESULTS

60% of the sample had started drinking alcohol. Early alcohol consumption is not influenced by type of school, indicating that adolescents consume alcohol early, regardless of the type of education or income. Although there were significant differences in neuropsychological performance between types of schools, better neuropsychological performance was found in students from private schools.

CONCLUSIONS

When comparing consumption of alcohol among public and private school students, there were no significant differences, perhaps because the use of early alcohol can be a public health problem. Private school students may perform better in inhibitory control task because they have a good school environment, which serves as a protective factor.

Externalizing behavior problems are related to substance use in adolescents across six samples from Nordic countries

The aim of this study is to investigate associations between use of cigarettes, cannabis, and alcohol (CCA) and psychosocial problems among adolescents with different cultural backgrounds living in Nordic countries. Data from six questionnaire-based surveys conducted in Denmark, Norway, and Greenland, with participants from different cultural and religious backgrounds, were compared. A total of 2212 adolescents between 15 and 18 years of age participated in the study. The surveys were carried out nationally and in school settings. All adolescents answered a 12-item questionnaire (YouthMap12) with six questions identifying externalizing behavior problems and six questions identifying internalizing behavior problems, as well as four questions regarding childhood neglect and physical or sexual abuse, and questions about last month use of CCA. Externalizing behavior problems were strongly associated with all types of CCA use, while childhood history of abuse and neglect was associated with cigarette and cannabis use. The associations did not differ by sample. Despite differences between samples in use of CCA, national, cultural, and socioeconomic background, very similar associations were found between psychosocial problems and use of CCA. Our findings highlight the need to pay special attention to adolescents with externalizing behavior problems and experiences of neglect and assault in CCA prevention programs, across different ethnic and socioeconomic backgrounds.

Imaging the neuroimmune response to alcohol exposure in adolescent baboons: a TSPO PET study using 18 F-DPA-714

The effects of acute alcohol exposure to the central nervous system are hypothesized to involve the innate immune system. The neuroimmune response to an initial and acute alcohol exposure was investigated using translocator protein 18 kDa (TSPO) PET imaging, a non-invasive marker of glial activation, in adolescent baboons. Three different alcohol-naive adolescent baboons (3-4 years old, 9 to 14 kg) underwent ¹⁸ F-DPA-714 PET experiments before, during and 7-12 months after this initial alcohol exposure (0.7-1.0 g/l). The brain distribution of ¹⁸ F-DPA-714 (V_T ; in ml/cm³ ) was estimated in several brain regions using the Logan plot analysis and the metabolite-corrected arterial input function. Compared with alcohol-naive animals (V_Tbrain  = 3.7 ± 0.7 ml/cm³ ), the regional V_T s of ¹⁸ F-DPA-714 were significantly increased during alcohol exposure (V_Tbrain  = 7.2 ± 0.4 ml/cm³ ; p < 0.001). Regional V_T s estimated several months after alcohol exposure (V_Tbrain  = 5.7 ± 1.4 ml/cm³ ) were lower (p < 0.001) than those measured during alcohol exposure, but remained significantly higher (p < 0.001) than in alcohol-naive animals. The acute and long-term effects of ethanol exposure were observed globally across all brain regions. Acute alcohol exposure increased the binding of ¹⁸ F-DPA-714 to the brain in a non-human primate model of alcohol exposure that reflects the 'binge drinking' situation in adolescent individuals. The effect persisted for several months, suggesting a 'priming' of glial cell function after initial alcohol exposure.

15-year-old tobacco and alcohol abstainers in a drier generation: Characteristics and lifestyle factors in a Norwegian cross-sectional sample

Aims: Norwegian adolescents currently drink and smoke less on average than previous cohorts. Based on cross-sectional survey data, the individual and familial characteristics of 15-year-old non-users and users of alcohol and tobacco were compared to identify correlates to abstinence. Methods: The survey was approved by the Norwegian Social Science Service. The sample consisted of 3107 adolescents from a 2011 school-based survey, of which 848 (27.3%) did not drink alcohol nor use tobacco. Associations with leisure time activities, risk perceptions, parenting style and social factors were analysed by logistic regression. Results: Most of the non-drinkers were also non-users of tobacco. Abstainers (neither alcohol nor tobacco use) tended to have less unorganized and more hobby-related leisure time activities, higher risk perceptions for smoking, and monitoring or emotionally supportive parents. They more rarely reported close relationships with their best friend and were more likely to report lower occurrences of drinking and smoking among friends or siblings. Conclusions: Differences in perceived parenting styles and a lower degree of unorganized leisure in the abstainer group points to monitoring and closer emotional ties between parents and children as important factors in adolescent abstinence. An implication of these results is that promoting hobby-based activities might be a useful strategy for preventing alcohol and tobacco use in young people.

Researching the decline in adolescent drinking: The need for a global and generational approach

Adolescent alcohol consumption has been in decline across many high-income countries since the early to mid-2000s. This is a significant public health trend, with few documented examples from history where such a global downward shift in alcohol consumption has occurred primarily among the adolescent segment of the population. In this commentary we describe the nature and breadth of the trend; reflect on the environmental, social and policy factors that have been proffered; and argue that to adequately understand and support the maintenance of these trends, three important methodological considerations are needed for future research. Firstly, longitudinal panel and qualitative studies are needed to complement and inform continuing cross-sectional research. Secondly, a collaborative cross-cultural approach is needed to contextualise the international scale of the trend and thirdly, future research must be situated within a historical and generational perspective to understand declines in adolescent drinking in the context of a broader shift in adolescent behaviours.

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

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.

Changes in Smoking Rates Among Pregnant Women and the General Female Population in Australia, Finland, Norway, and Sweden

Introduction:

Smoking rates have dropped substantially in most developed countries in recent decades. This general trend has, however, not always been evident among women—particularly younger women. Smoking habits do, however, often change in connection with pregnancy and the aim of this study is to determine whether smoking during pregnancy follows general trends in smoking rates in the general female population in four countries with active anti-tobacco policies and decreasing population smoking rates.

Methods:

Changes in rates of persistent smoking, that is, smoking in late pregnancy or daily smoking among all women of childbearing age were described according to age groups. Data were retrieved from the Australian Household Drug Surveys during 2000–2013 and from registries and surveys in Finland, Norway, and Sweden between 1995 and 2014.

Results:

In general, persistent smoking has decreased and late-pregnancy smoking rates are lower than daily smoking rates among all women. However, younger women are more likely to be persistent smokers regardless of pregnancy status. In Norway and Finland, persistent smoking was most common among young pregnant women and in Sweden there was an increased polarization between age groups. In Australia, a steady decrease in smoking rates appears to have stalled in younger pregnant women.

Conclusion:

Although smoking has declined substantially in recent decades, there are groups lagging behind this general trend. Young pregnant women are of particular concern in this respect. The possibility that these findings reflect the changing characteristics of younger pregnant women is discussed.

Implications:

This study puts recent trends in maternal smoking into a broader context by relating developments to changes in smoking rates among women in general. By using similar data from four countries we were able to follow changes in smoking rates “within” groups of women within the four countries without being limited by methodological problems related to cross-country or inter-group comparisons. We were above all able to show that aggregate data disclose the strong age gradient in maternal smoking habits.

Nucleus Accumbens MC4-R Stimulation Reduces Food and Ethanol Intake in Adult Rats Regardless of Binge-Like Ethanol Exposure during Adolescence

The melanocortin (MC) system regulates feeding and ethanol consumption. Recent evidence shows that melanocortin 4 receptor (MC4-R) stimulation within the nucleus accumbens (NAc) elicits anorectic responses and reduces ethanol consumption and ethanol palatability in adult rats. Ethanol exposure during adolescence causes long-lasting changes in neural pathways critically involved in neurobehavioral responses to ethanol. In this regard, binge-like ethanol exposure during adolescence reduces basal alpha-melanocyte-stimulating hormone (α-MSH) and alters the levels of agouti-related peptide (AgRP) in hypothalamic and limbic areas. Given the protective role of MC against excessive ethanol consumption, disturbances in the MC system induced by binge-like ethanol exposure during adolescence might contribute to excessive ethanol consumption during adulthood. In the present study, we evaluated whether binge-like ethanol exposure during adolescence leads to elevated ethanol intake and/or eating disturbance during adulthood. Toward that aim, Sprague-Dawley rats were treated with ethanol (3 g/kg i.p.; BEP group) or saline (SP group) for 14 days (PND 25 to PND 38). On PND73, all the groups were given access to 20% ethanol on an intermittent schedule. Our results showed that adult rats given intermittent access (IAE) to 20% ethanol achieved high spontaneous ethanol intake that was not significantly enhanced by binge-like ethanol pretreatment during adolescence. However, BEP group exhibited an increase in food intake without a parallel increase in body weight (BW) relative to SP group suggesting caloric efficiency disturbance. Additionally, we evaluated whether binge-like ethanol exposure during adolescence alters the expected reduction in feeding and ethanol consumption following NAc shell administration of a selective MC4-R agonist in adult rats showing high rates of ethanol consumption. For that, animals in each pretreatment condition (SP and BEP) were divided into three subgroups and given bilateral NAc infusions of the selective MC4-R agonist cyclo(NH-CH₂-CH₂-CO-His-D-Phe-Arg-Trp-Glu)-NH₂ (0, 0.75 or 1.5 μg). Results revealed that MC4-R stimulation within the NAc reduced feeding and ethanol intake in high ethanol-drinking adult rats, regardless of previous binge-like ethanol exposure during adolescence, which adds new evidence regarding the dual ability of MC compounds to control excessive ethanol and food intake.

The direct and indirect effect of loneliness on the development of adolescent alcohol use in the United Kingdom

Alcohol use among adolescents in the United Kingdom (UK) remains relatively high compared to those in other European countries. The present study sought to examine both the direct and indirect effect of loneliness on drinking behavior. Participants were school children (mean age 13.5 years at Time 1) participating in a Randomized Controlled Trial in the UK, who completed a battery of questionnaires examining alcohol-use indicators, loneliness, self-efficacy and sensation seeking at Time 1 and at +12 months. Loneliness at Time 1 had a substantive, though largely indirect (i.e., via self-efficacy and sensation seeking covariates), impact on alcohol-related harm at +12 months. Furthermore, Loneliness interacted with gender in the prediction of context of alcohol use, where being female and experiencing loneliness put an individual at a greater risk of unsupervised drinking. Females experiencing loneliness were also 2.9 times as likely to have had a drink in the past 30 days, and around 2.5 times as likely to have ever consumed a full drink, when compared to their male peers. The current results indicate that loneliness is an important but complex factor in adolescent drinking. There are important implications for the development of interventions to prevent underage drinking, not least that it is not appropriate to consider all underage drinkers as socially marginalised. However, for those that are, the self-medication hypothesis is potentially relevant through emotional self-efficacy.

•

Data were gathered on loneliness, self-efficacy, sensation seeking and alcohol use.

•

Loneliness at Time 1 had an indirect impact on alcohol-related harm at + 12 months.

•

Loneliness interacted with gender in the prediction of context of alcohol use.

•

Being female and experiencing loneliness put an individual at a greater risk of unsupervised drinking.

Preserved Crossmodal Integration of Emotional Signals in Binge Drinking

Binge drinking is an alcohol consumption pattern with various psychological and cognitive consequences. As binge drinking showed qualitatively comparable cognitive impairments to those reported in alcohol-dependence, a continuum hypothesis suggests that this habit would be a first step toward alcohol-related disorders. Besides these cognitive impairments, alcohol-dependence is also characterized by large-scale deficits in emotional processing, particularly in crossmodal contexts, and these abilities have scarcely been explored in binge drinking. Emotional decoding, most often based on multiple modalities (e.g., facial expression, prosody or gesture), yet represents a crucial ability for efficient interpersonal communication and social integration. The present study is the first exploration of crossmodal emotional processing in binge drinking, in order to test whether binge drinkers already present the emotional impairments described among alcohol-dependent patients, in line with the continuum hypothesis. Twenty binge drinkers and 20 matched controls performed an experimental task requiring the identification of two emotions (happiness or anger) presented in two modalities (visual or auditory) within three conditions (unimodal, crossmodal congruent or crossmodal incongruent). In accordance with previous research in binge drinking and alcohol-dependence, this study was based on two main hypotheses. First, binge drinkers would present a reduced facilitation effect (i.e., classically indexed in healthy populations by faster reaction times when two congruent modalities are presented simultaneously). Second, binge drinkers would have higher difficulties to inhibit interference in incongruent modalities. Results showed no significant difference between groups in emotional decoding ability, whatever the modality or condition. Control participants, however, appeared slower than binge drinkers in recognizing facial expressions, also leading to a stronger facilitation effect when the two modalities were presented simultaneously. However, findings did not show a disrupted facilitation effect in binge drinkers, whom also presented preserved performance to inhibit incongruence during emotional decoding. The current results thus suggest that binge drinkers do not demonstrate a deficit for emotional processing, both in unimodal and crossmodal contexts. These results imply that binge drinking might not be characterized by impairments for the identification of primary emotions, which could also indicate that these emotional processing abilities are well-preserved at early stages of excessive alcohol consumption.

More Drinking, More Problems-Stable Association Between Alcohol Consumption and Harm Among Swedish Youth 1995-2012

Aims

Alcohol consumption among Swedish youth increased during the 1990s. In the following decade, levels declined coinciding with a reduction in the prevalence of self-reported alcohol-related harm. We examine how the trend in self-reported alcohol-related problems among young Swedish alcohol consumers has followed the trend in alcohol consumption during 1995-2012, and test whether the strength of the association between self-reported alcohol consumption and alcohol-related problems within individuals is inversely proportional to the overall level of consumption among youth.

Methods

The study was based on a representative survey on alcohol and drug habits among ninth-year students, consisting of current alcohol consumers (n = 68 863), 1995-2012. Negative binominal regression models were used to estimate the relationship between three consumption variables (average volume of consumption, binge drinking and heavy drinking) and self-reported alcohol-related problems.

Results

The prevalence of binge drinking showed a greater association with self-reported alcohol-related problems than did overall mean consumption. No noticeable variation in the strength of the individual-level alcohol and harm relationship was found over the study period. We found no significant interaction between the individual alcohol use measures and overall mean youth consumption.

Conclusion

We found no signs of normalization; on the contrary, young alcohol consumers suffer about the same number of self-reported negative consequences from their drinking, regardless of the level of overall youth consumption. The study also suggests that binge drinking rather than overall consumption is the main factor that influences the development of self-reported problems experienced among young alcohol consumers.

Short summary

Young alcohol consumers suffer about the same number of self-reported negative consequences from their drinking, regardless of the level of overall mean consumption in the youth population. Binge drinking consumption appears to be the main factor influencing the development of self-reported alcohol-related problems among young alcohol consumers.

Mapping risk factors for substance use: Introducing the YouthMap12

BACKGROUND

In adolescence, psychological problems and regular use of alcohol, cigarettes, cannabis and other drugs (AOD) tend to cluster together, strongly indicating that certain groups of young people are at elevated risk of developing a problematic use of AOD.

OBJECTIVE

The aim of the present study was to develop an easy-to-implement screening instrument to identify subgroups of young people with different psychological problems at risk of problem use of AOD.

METHOD

3589 randomly selected young Danes between 15 and 25years of age, from a national survey (n=2702) and a municipality survey (n=887), answered a 12-item questionnaire (YouthMap12) with 6 items identifying externalizing problems (EP6) and 6 items identifying internalizing problems (IP6). Latent class analysis (LCA) was used to characterize groups at risk, and associations were estimated between EP6 and IP6 and regular use of AOD, and between latent class membership and regular use of AOD.

RESULTS

LCA identified 6 classes with varying degrees of externalizing and internalizing problems: 70% of youth were in the low problem score class, and the remaining 30% were at various levels of risk. Regular use of cigarettes, cannabis and alcohol was strongly associated with classes characterized by externalizing problems, while over-the-counter and prescription medicine was strongly associated with classes characterized by internalizing problems.

CONCLUSIONS

Youth at risk of problem use of AOD can be identified using a simple and easily administered instrument.

Trends in binge drinking in Canada from 1996 to 2013: a repeated cross-sectional analysis

BACKGROUND

Heavy drinking is a major factor in morbidity and mortality worldwide. Little information is available on trends in Canada regarding alcohol abuse. We sought to estimate abstinence, binge drinking and alcohol intake exceeding low-risk drinking guidelines in the Canadian population from 1996 to 2013.

METHODS

The data sources for this analysis were a series of cross-sectional national health surveys of the Canadian population carried out by Statistics Canada between 1996 and 2013. These were cross-sectional files from the National Population Health Surveys of 1996 and 1998, plus the Canadian Community Health Surveys from 2000 to 2013. Respondents were aged 18 years and older.

RESULTS

The proportion of binge drinkers increased steadily from 13.7% (95% confidence interval [CI] 13.2%-14.2%) in 1996 to 19.7% (95% CI 19.1%-20.3%) in 2013. The corresponding proportions for men were 20.8% (95% CI 19.9%-21.7%) in 1996, and 25.7% (95% CI 24.7%-26.6%) in 2013; for women, these proportions were 6.9% (95% CI 6.4%-7.5%) in 1996, and 13.8% (95% CI 13.1%-14.5%) in 2013. No significant increases were seen in the proportion of people who exceeded low-risk drinking guidelines or of abstainers during the same period.

INTERPRETATION

The rate of self-reported binge drinking in Canada has increased from 1996 to 2013, relatively more so among women than among men. No evidence of an increase in the proportion of people exceeding low-risk drinking guidelines or of abstainers was seen during the same period. These results suggest that binge drinking is of particular concern regarding intervention strategies aimed at improvement of public health.

When is it OK to be drunk? Situational and cultural variations in the acceptability of visible intoxication in the UK and Norway

BACKGROUND

Research on norms regulating drunken behaviour has tended to focus on differences between different countries and cultures rather than variations within them. Here, we examine whether there are: (i) situation-specific differences in the acceptability of visible intoxication among students in the UK and Norway; (ii) whether there are situation-specific and overall differences in this regard between the two countries; and finally (iii) to what degree possible differences reflect individual characteristics such as use of alcohol, perceived harm of alcohol consumption, and broader value orientation.

METHODS

Students at one British (n=473) and one Norwegian (n=472) university responded to a survey including a battery of questions assessing the acceptability of visible intoxication in different situations, such as with friends, with work colleagues, with family members, and situations where children are present. Data were also collected regarding alcohol consumption, perceived harms of alcohol consumption, and value orientation. Analyses of covariance were performed to assess patterns in the acceptability of visible intoxication across different situations, and the relative contributions of country, alcohol consumption, perceived harm of alcohol consumption and human values.

RESULTS

In both countries, visible intoxication was rated as most acceptable in situations involving friends and colleagues. Students from both countries rated visible intoxication least acceptable in situations where children are present. However, both overall, and in situations where children or family members are present, acceptability of visible intoxication scores were higher in the UK than Norway. These differences persisted after control for other variables.

CONCLUSION

The study demonstrates large situational variation in acceptability of drunken behaviour, pointing to a fine-meshed set of norms regulating alcohol use and drunken behaviour within the two cultures, with the UK standing out as a more alcohol-liberal culture than Norway. Such differences underline how norms regulating drunken behaviour are culturally constituted.