From Age 4 to 8, Children Become Increasingly Aware About Normative Situations for Adults to Consume Alcohol

The potential adverse effects of minors' exposure to alcohol-related stimuli via licenced venues: A narrative review

ISSUES

Young people are particularly impressionable when it comes to forming expectations and attitudes around alcohol consumption. Any stimuli that normalise and foster positive expectations around alcohol use may increase the risk of underage alcohol consumption. Alcohol venues that market themselves as being appropriate 'family friendly' establishments for children risk exposing minors to environments that are saturated with alcohol-related stimuli. However, research examining how exposure to licenced venues affects underage people is very limited. The aim of this narrative review was to identify and synthesise relevant evidence to better understand how attending these venues might affect minors.

APPROACH

A narrative review of research published between January 2016 and November 2022 was conducted to investigate the potential effects on underage people of exposure to licenced venues and stimuli encountered in/around these venues. Examined stimuli included alcohol advertising, people consuming alcohol and alcohol outlets.

KEY FINDINGS

The reviewed literature indicates that the risk of alcohol-related harm among minors is likely to increase with greater exposure to alcohol venues due to the associated exposure to alcohol advertising, exposure to others consuming alcohol and higher outlet density. In combination, these factors are likely to normalise alcohol consumption for minors and create positive alcohol expectancies.

IMPLICATIONS AND CONCLUSION

Venues serving alcohol should be discouraged from targeting families and parents should be warned about the risks associated with taking minors to venues where alcohol is sold and consumed.

All alcohol exposure counts - testing parental, older sibling, best friend and peer exposure on young adolescent drinking in a seven-wave longitudinal study

AIMS

Role models around the adolescent, including parents, peers, best friends and older siblings, all act in ways to socialize the adolescent into alcohol use. This study aims to examine the effect of exposure to siblings' drinking alongside the more traditionally examined role models on alcohol use among adolescents.

DESIGN

A longitudinal study followed adolescents (45.6% male) who completed a questionnaire every 6 months over 3 years (seven in total).

SETTING

Netherlands PARTICIPANTS: This resulted in 5112 observations clustered in 765 participants aged between 10 and 16 years.

MEASUREMENTS

We examined three alcohol use measures: alcohol use in the last 6 months, in the last 4 weeks and binge drinking in the last 4 weeks-both cross-sectionally at each time-point and their change from one time-point to the next in a series of multi-level logistic regression models.

FINDINGS

Results revealed a non-significant difference in any of the exposure or alcohol use variables between those with or without older siblings. Higher exposure to sibling drinking was significantly associated with all alcohol use outcomes: use in the last 6 months, odds ratio (OR) = 1.54, 95% confidence interval (CI) = 1.25-1.91; last 4 weeks, OR = 2.04, 95% CI = 1.60-2.60; and binge drinking, OR = 2.35, 95% CI = 1.82-3.05. When adding the other role models (i.e. peers, mothers, fathers and best friends), the significant association between siblings' exposure and adolescents' alcohol use remains.

CONCLUSIONS

It would appear that, after adjustment for the effect of role models, adolescents who are exposed to more sibling drinking are more likely to have drunk alcohol during the past 6 months and past 4 weeks and also to binge drink.

Effects of exposure to mother's and father's alcohol use on young children's normative perceptions of alcohol

BACKGROUND

While consumption of alcohol does not often begin until early adolescence, young children are highly capable of internalizing normative information through observational learning. We used a longitudinal multiple-informant family study to examine the impact of exposure to mothers' and fathers' drinking on young children's normative perceptions of who drinks alcohol.

METHODS

Three hundred twenty-nine children (4 to 6 years old at baseline [M_age 4.78 (SD = 0.725)], 51% girls) completed the Dutch electronic appropriate beverage task [eABT] where they attributed alcoholic beverages to a variety of persons depicted in an illustrated scenario. Their parents completed an online survey that included information on alcohol use and exposure.

RESULTS

Children more frequently exposed to their mothers' drinking provided females shown in the eABT illustrations with alcohol significantly more often than children less frequently exposed to mothers' drinking. There was no effect of mother's exposure on providing males in the eABT with alcoholic beverages. Similarly, children more frequently exposed to their fathers' drinking provided fathers with alcoholic beverages significantly more often than children less frequently exposed to their fathers' drinking. There was no effect of father's exposure on providing the females with alcoholic beverages, nor was there an effect of father's exposure on providing "other males" with alcohol. These patterns held after adjusting for age and sex.

CONCLUSIONS

This study demonstrates that there are gender-specific effects of exposure to parents' (particularly mothers') drinking on young children's perceptions of person-specific drinking norms. The findings provide unique evidence in a young population group of effects on an understudied dimension of alcohol-related perceptions with implications for future drinking behavior.

Exposure to Parental Alcohol Use Is Associated with Adolescent Drinking Even When Accounting for Alcohol Exposure of Best Friend and Peers

AIMS

To further disentangle the role of exposure to drinking of role models (parents, peers, best friends) in the development of young adolescent alcohol use, the current study examined (a) whether parent's alcohol use exposure was associated with alcohol use outcomes among adolescents and (b) whether this association remained significant when including best friend and peer drinking exposure.

METHODS

A longitudinal study followed 765 adolescents from the Netherlands over 3 years. Adolescents (45.6% male, Mage = 11.78, standard deviation = 0.49 at baseline) completed questionnaires every 6 months, resulting in seven measurement waves. Adolescents reported their own alcohol use and exposure to parental, best friend and peers drinking.

RESULTS

Multilevel regression analyses indicated that parental alcohol use exposure was positively associated with a higher likelihood of adolescent alcohol use in the past 6 months, drinking in the last month and binge drinking in the last month. These associations remained significant when including exposure to peer and best friend's alcohol use, also when controlling for alcohol use at the previous timepoint (i.e. change in drinking). These associations were also consistent for boys and girls.

CONCLUSIONS

Throughout early adolescence, parental alcohol exposure matters for their offspring's alcohol use, independently of whether peers or their best friend expose them to alcohol or not. Parental alcohol exposure should be considered in prevention efforts to further decrease the number of adolescents that engage in early alcohol use and binge drinking.

'They're like little police': Australian parents' perceptions of their children's awareness of drinking during COVID-19

INTRODUCTION

As a result of COVID-19 and associated lockdown restrictions, children may have been exposed to more home-based alcohol consumption and parents' drinking practices. This paper explores Australian parents' perceptions of their children's awareness of drinking and their reflections on the impact of COVID-19 on children's exposure and acquisition of alcohol-related knowledge.

METHODS

In-depth interviews were undertaken with 30 parents and carers of children aged four to 12 years from across Australia. Participants described their family lives, the role of alcohol, any changes in alcohol and family dynamics experienced because of COVID-19 and their children's exposure and knowledge of alcohol before and during their experience of COVID-19. Using social learning theory as a guiding framework, transcripts were analysed to identify relevant themes.

RESULTS

Pre-COVID-19 children were commonly thought to be aware of behavioural changes owing to alcohol consumption, made associations between people, beverages and activities and recognised boundaries around consumption. COVID-19 was suggested to have impacted the environments in which children were exposed and the types of modelling and practices they were exposed to. It was more common for participants to describe COVID-19 affecting other children's learning and knowledge of alcohol, rather than their own.

DISCUSSION AND CONCLUSIONS

Participants were mindful of children's knowledge and the role they played in modelling consumption practices prior to and during the COVID-19 lockdowns. There may be scope to use the insights provided here to support parents in modelling approaches and engaging with children about alcohol in ways that challenge or disrupt its prominence or acceptability.

Levels of Parental Drinking in the Presence of Children: An Exploration of Attitudinal Correlates

Aims

This study aimed to examine perceived social norms, the effect of parental drinking on these norms, alcohol use in front of children, and how norms and consumption vary based on child age and gender of the parent.

Methods

A cross-sectional online panel survey was undertaken with n = 1000 Australian adults (including 670 parents) aged 18–59 years. The survey assessed: alcohol consumption in front of children; normative attitudes towards drinking in the presence of children; and perceived social norms.

Results

Overall, 33.9% of parents reported drinking a glass of alcohol each day or a couple of times a week, 18.2% reported getting slightly drunk and 7.8% indicated getting visibly drunk each day or a couple of times a week with their children present. In total, 37.5% reported drinking in front of their children at least weekly. Fathers were more likely to drink in front of children than mothers. Most parents deemed drinking small amounts of alcohol in front of children as acceptable but did not accept drunkenness. Respondents were less concerned about a father drinking one or two drinks in front of their children than a mother. Social expectations were not related to child age, but norms related to others’ perceived behaviour were.

Conclusions

Many parents, particularly fathers consume alcohol in front of their children. There is a need to target health promotion strategies to adults and parents consuming in excess of health guidelines, and to the many parents who are consuming alcohol at higher levels in front of their children.

Beverage-specific situational norms: Evidence from the Dutch electronic appropriate beverage task

INTRODUCTION AND AIMS

By the time young adolescents initiate alcohol consumption they have firmly established attitudes, expectations and beliefs about alcohol and its effects. To further unravel the origins of this knowledge in childhood, we aim to address Dutch children's knowledge of the types of alcoholic beverages adults typically consume in certain situational contexts (i.e. their knowledge of beverage-specific situational norms).

DESIGN AND METHODS

A total of 329 children (4-8 years old) completed the Dutch electronic Appropriate Beverage Task at three-time points (2015, 2016, 2017). Three-level regression models were estimated examining whether children's beverage-specific situational norms depend on the gender of the person displayed in the task, sex of the participant and whether there were any beverage-specific changes over time.

RESULTS

Beverage-specific findings seem to be robust across the appropriateness of the situation. Beer was the most frequently attributed alcoholic beverage overall and across the common drinking situations. White wine was attributed significantly more to females in the task. Beer, red wine and champagne were attributed significantly more to males. Attributions of individual alcoholic beverages did not change significantly over time. There were no significant differences between the participating boys and girls.

DISCUSSION AND CONCLUSIONS

Results suggest that 4-8-year olds are yet to form knowledge of beverage-specific situational norms. Independent of the situation, time and participants' sex, the gender of the person displayed in the task seemed to be more salient to children than situational or environmental indicators in determining consumption.

Do different drinks make you feel different emotions? Examination of young adolescents' beverage-specific alcohol expectancies using the Alcohol Expectancy Task

The aim of this paper is to explore whether in the eyes of young adolescents the consumption of different alcoholic beverages is associated with different alcohol expectancies, namely beliefs on what emotional outcomes take place when alcohol is consumed. 283 nine to 12-year olds from Switzerland completed the Alcohol Expectancy Task (AET). Participants were asked to assign one of 12 beverages (four alcoholic, eight non-alcoholic) to 16 adults depicting four emotional states (happy, angry, relaxed, sad). General linear modelling was used to examine beverage attributions across the four different emotional states. Beer was the most commonly attributed beverage across all 16 adults depicted. Happy and angry persons were most commonly attributed beer. Gender variations were found for relaxed persons, with females predominantly attributed champagne and males predominantly attributed beer. Young adolescents predominantly gave white wine to sad persons. Findings reveal a level of nuanced knowledge existing among young adolescents with minimal drinking experience, in that they hold very different expectancies for different beverages, prompting for future investigations to examine beverage-specific expectancies. Furthermore, findings showing beverage-specific expectancies among young adolescents may have implications for researchers' considerations of how alcohol-related knowledge and expectancies develop throughout childhood.