Alcohol use in adolescents and adult psychopathology and social outcomes: Findings from a 35-year cohort study

Paternal and maternal psychological distress and adolescent health risk behaviors: The role of sensitive periods

INTRODUCTION

Adolescent health risk behaviors are linked to poor physical and mental health outcomes. While past research shows that maternal psychological distress predicts those behaviors, we know less about the role of paternal psychological distress and the role of sensitive periods.

METHODS

Using 11,128 data from families (50.5% female children) from the UK's Millennium Cohort Study, we examined the role of timing of exposure to paternal and maternal psychological distress in engagement in health risk behaviors (smoking, alcohol use, binge drinking, and sexual activity) at age 14. Paternal and maternal psychological distress, measured with the Kessler-6 scale, were assessed at child ages 3, 7, and 11. We performed path analysis, adjusting for key covariates, modeling maternal distress parallel to paternal, and allowing for autoregressive paths.

RESULTS

Paternal distress experienced at age 11 predicted a higher likelihood of smoking at age 14. Maternal distress at age 7 also predicted a higher likelihood of smoking, alcohol use, and binge drinking, but only for boys. Moreover, maternal distress at age 3 was associated with a lower risk for alcohol use. Effects were not replicated in the sensitivity analysis we performed, including only families with resident biological fathers across the study period. Instead, maternal and paternal distress at age 11 raised girls' risk for binge drinking and sexual activity, respectively.

CONCLUSIONS

Parental distress in early childhood does not predict adolescent health risk behaviors. In late childhood, however, both paternal and maternal distress seem to influence the likelihood of engagement in such behaviors.

The application of target trials with longitudinal targeted maximum likelihood estimation to assess the effect of alcohol consumption in adolescence on depressive symptoms in adulthood

Time-varying confounding is a common challenge for causal inference in observational studies with time-varying treatments, long follow-up periods, and participant dropout. Confounder adjustment using traditional approaches can be limited by data sparsity, weight instability, and computational issues. The Nicotine Dependence in Teens Study is a prospective cohort study, and we used data from 21 data collection cycles carried out from 1999 to 2008 among 1294 students recruited from 10 high schools in Montreal, Quebec, Canada, including follow-up into adulthood. Our aim in this study was to estimate associations of timing of alcohol initiation and cumulative duration of alcohol use with depression symptoms in adulthood. Based on the target trials framework, we defined intention-to-treat and as-treated parameters in a marginal structural model with sex as a potential effect-modifier. We then used the observational data to emulate the trials. For estimation, we used pooled longitudinal target maximum likelihood estimation, a plug-in estimator with double-robust and local efficiency properties. We describe strategies for dealing with high-dimensional potential drinking patterns and practical positivity violations due to a long follow-up time, including modifying the effect of interest by removing sparsely observed drinking patterns from the loss function and applying longitudinal modified treatment policies to represent the effect of discouraging drinking.

Global Trends in the Prevalence of Alcohol Consumption Among School-Going Adolescents Aged 12-15 Years

PURPOSE

Adolescent alcohol consumption is detrimental to multiple facets of health. However, there is a scarcity of data available on time trends in adolescents' alcohol consumption particularly from non-Western countries and low- and middle-income countries. Thus, we examined the temporal trend of alcohol use in a large representative sample of school-going adolescents aged 12-15 years from 22 countries in Africa, Asia, and the Americas.

METHODS

Data from the Global School-based Student Health Survey were analyzed. Alcohol consumption referred to consuming alcohol on at least one day in the past 30 days. Crude linear trends of past 30-day alcohol consumption by country were assessed by linear regression models.

RESULTS

Data on 135,426 adolescents aged 12-15 years were analyzed [mean (standard deviation) age 13.8 (1.0) years; 52.0% females]. The overall mean prevalence of past 30-day alcohol consumption was 14.1%. Of the 22 countries included in the study, increasing, decreasing, and stable trends were observed in 3, 8, and 11 countries, respectively. Specifically, significant increases were observed in Benin between 2009 (16.1%) and 2016 (38.6%), Myanmar between 2007 (0.9%) and 2016 (3.6%), and Vanuatu between 2011 (7.6%) and 2016 (12.2%). The most drastic decrease was observed in Samoa between 2011 (34.5%) and 2017 (9.8%), but the rate of decrease was modest in most countries.

DISCUSSION

Among school-going adolescents, decreasing trends in alcohol consumption were more common than increasing trends, but the rate of decrease was limited in most countries, suggesting that more global action is required to curb adolescent alcohol consumption.

Adolescent alcohol and cannabis use and early adulthood educational attainment in the 1986 Northern Finland birth cohort study

BACKGROUND

Heavy alcohol and cannabis use during adolescence have been previously described as risk factors not only for morbidity in adulthood, but also social problems including adversities in educational attainment. Attempts to consider overlapping risk factors and confounders for these associations are needed.

METHODS

Using weighted multivariable models, we examined prospective associations between age at first drink (AFD), age at first intoxication (AFI), frequency of alcohol intoxication, as well as self-reported alcohol tolerance (i.e., number of drinks needed for the subjective experience of intoxication), and lifetime cannabis use at age 15/16 years with subsequent educational attainment obtained from comprehensive registers until age 33 in the Northern Finland Birth Cohort 1986 (6,564 individuals, 49.1% male). Confounding variables including sex, family structure (intact vs. non-intact), maternal and paternal education level, behavioural/emotional problems in school at age 7/8 years, having a history of illicit substance use in adolescence, having any psychiatric diagnosis before age 16, and parental psychiatric diagnoses, were adjusted for.

RESULTS

In this large birth cohort study with a 17-year follow-up, younger age at first intoxication, higher frequency of alcohol intoxication, and high self-reported alcohol tolerance at age 15/16 years were associated with poorer educational outcomes by the age of 33 years. These associations were evident regardless of potential confounders, including parental education and childhood behavioural/emotional problems. The association between adolescent cannabis use and educational attainment in adulthood was no longer statistically significant after adjusting for confounders including frequency of alcohol intoxication at age 15/16.

CONCLUSIONS

Assessments of age of first alcohol intoxication, high self-reported alcohol tolerance and frequency of intoxication during adolescence should be included when implementing screening strategies aimed at identifying adolescents at risk for subsequent social problems.

Patterns of alcohol and alcohol-flavoured non-alcoholic beverage advertisements over Japanese free-to-air television networks

Background

Alcohol use is a serious public health challenge worldwide. Japan has no government regulations or legal penalties against advertising alcoholic beverages on television (TV). Instead, advertisements depend on the Japanese alcohol industry’s self-regulation on airtime (no advertisements from 5 am to 6 pm) and the content of alcoholic beverages, which must not tempt minors. However, many adolescents (10 to 19 years old) watch TV from 6 pm to 11 pm. The aim of this study was to describe the pattern in the advertising of alcoholic beverages and alcohol-flavoured non-alcoholic beverages (AFNAB) in Japan during the popular TV viewing time for adolescents.

Methods

A secondary analysis of advertising airtime data from five free-to-air Japanese TV networks in the Greater Tokyo area that aired between 12 August and 3 November 2019, was performed.

Results

During the study period, 5215 advertisements for alcoholic beverages and AFNABs aired (1451.75 min). In total, 2303 advertisements (44.2%) were beer, low-malt beer, or beer-taste beverages, 277 (5.3%) were whisky, 2334 (44.8%) were local alcoholic beverages (shochu and seishu), and 301 (5.8%) were AFNAB. On average, more advertisements aired on weekends (67.6 advertisements) than on weekdays (59.3 advertisements) per day. Approximately 30% of advertisements for AFNABs were aired during the time restricted for alcohol advertising, although AFNABs are considered alcohol according to industry guidelines. During the popular television viewing time for young adolescents, about two to three times more advertisements were aired per hour than during the rest of the day, on both weekdays and weekends (p < 0.001).

Conclusion

The number of alcohol advertisements aired at times when adolescents often watch TV is 2 to 3.2 times higher than that at other times of the day. Furthermore, despite the industry’s self-imposed regulations, some alcoholic beverages are still advertised. Therefore, other methods to protect children and adolescents from exposure to advertisements for alcoholic beverages should be investigated and implemented.

Exploring the relationships between adolescent alcohol misuse and later life health outcomes

BACKGROUND

We sought to clarify the impact of adolescent alcohol misuse on adult physical health and subjective well-being. To do so, we investigated both the direct associations between adolescent alcohol misuse and early midlife physical health and life satisfaction and the indirect effects on these outcomes attributable to subsequent alcohol problems.

METHOD

The sample included 2733 twin pairs (32% monozygotic; 52% female) from the FinnTwin16 study. Adolescent alcohol misuse was a composite of frequency of drunkenness, frequency of alcohol use, and alcohol problems at ages 16, 17, and 18.5. The early midlife outcomes included somatic symptoms, self-rated health, and life satisfaction at age 34. The mediators examined as part of the indirect effect analyses included alcohol problems from the Rutgers Alcohol Problem Index at ages 24 and 34. Serial mediation and co-twin comparison models were applied and included covariates from adolescence and early midlife.

RESULTS

There were weak direct associations between adolescent alcohol misuse and early midlife physical health and life satisfaction. However, there was stronger evidence for indirect effects, whereby young adult and early midlife alcohol problems serially mediated the relationship between adolescent alcohol misuse and early midlife somatic symptoms (β = 0.03, 95% CI [0.03, 0.04]), self-rated health (β = -0.02, 95% CI [-0.03, -0.01]), and life satisfaction (β = -0.03, CI [-0.04, -0.02]). These serial mediation effects were robust in co-twin comparison analyses.

CONCLUSIONS

These results provide evidence that alcohol problems are a primary driver linking adolescent alcohol misuse and poor health outcomes across the lifespan.

Underage drinking in Brazil: findings from a community household survey

Objectives:

Previous studies have estimated the 30-day prevalence of alcohol use to be approximately 21% among youth in Brazil, despite the legal drinking age of 18 years. The present study aimed to determine the prevalence of underage drinking and its associated factors among adolescents in Brazil.

Methods:

The 3rd National Survey on Drug Use by the Brazilian Population (III Levantamento Nacional sobre o Uso de Drogas pela População Brasileira) is a nationwide, multi-stage, probability-sample household survey. Herein, youth between the ages of 12-17 years were included. Lifetime and 12-month alcohol use prevalence were estimated. Factors associated with 12-month alcohol use were evaluated through multivariate analysis considering survey weights and design.

Results:

Overall, 628 youth were interviewed. Estimated lifetime and 12-month alcohol use were 34.3% (standard error [SE] = 1.9) and 22.2% (SE = 1.7), respectively. Factors associated with 12-month drinking were: other/no religion vs. Christianity; living in rural vs. urban areas; self-reported diagnosis of depression vs. no self-reported depression; lifetime tobacco use vs. no history of tobacco use; and any illicit drug use vs. no history of illicit drug use.

Conclusion:

Considering that alcohol use is a major risk factor for early death among Brazilian youth, our findings highlight the importance of preventative measures to reduce underage drinking.

Clustering of South Korean Adolescents' Health-Related Behaviors by Gender: Using a Latent Class Analysis

Background: Health-related behaviors during adolescence could influence adolescents’ health outcomes, leading to either advantageous or deteriorative conditions. Clustering of adolescents’ health-related behaviors by gender identifies the target groups for intervention and informs the strategies to be implemented for behavioral changes. Methods: Data from 1807 adolescents in grades 7 and 10 in a city in South Korea were used. Health-related behaviors including eating habits, physical activity, hand washing, brushing teeth, drinking alcohol, smoking, and Internet use were examined. Latent class analysis (LCA) was used to identify subgroups of adolescents with regard to their health-related behaviors. Results: A four-class model was the most adequate grouping classification across genders: adolescents with (1) healthy behaviors, (2) neither health-promoting nor health-risk behaviors, (3) good hygiene behaviors, and (4) unhealthy behaviors. The majority of both male and female adolescents were classified into the healthy group. Male adolescents belonging to the healthy group were more likely to engage in vigorous physical activities, while vigorous physical activity was not important for female adolescents. The smallest group was the unhealthy group, regardless of gender; however, the proportion of boys in the unhealthy group was almost twice that of girls. Only female adolescents engaged in excessive Internet use, especially the group with neither health-promoting nor health-risk behaviors. Conclusion: To improve adolescents’ health-related behaviors, it would be more effective to develop tailored interventions considering the behavioral profiles of the target groups.

The Association between Gender Role Attitudes and Alcohol Use among Early Adolescents in Shanghai, China

Adolescent alcohol use was a major social and public health concern given its negative impacts. Previous studies indicated gender role attitudes (GRA) were associated with alcohol use; however, few studies focused on early adolescents (10 to 14 years) and similar researches were not found in China. Objective: This study sought to explore the association between GRA and alcohol use among early adolescents. Methods: A cross-sectional study was conducted among students in grades six to eight across three public secondary schools in Shanghai, China. Data were collected by Computer-Assisted Self-Interview (CASI) questionnaire on mobile tablets. Alcohol use was measured by self-report, and six items with 5-point Likert-type options assessed the attitude toward traditional gender roles. The logistic regression model was adopted to examine the associations between GAR and alcohol use. Results: Totally 1,631 adolescents aged 10 to 14 years with 50.33% of boys included in this study. The mean score of GRA in drinkers was significantly higher than nondrinkers among boys (3.03 vs. 2.78, p < 0.001) but not girls (2.15 vs. 2.18, p = 0.499). After controlling the covariates of age, depression, peers' substance use, social cohesion, etc., we found that more traditional GRA was associated with a higher risk of alcohol use among boys (OR = 1.39, 95%CI: 1.11-1.75), whereas the association was not significant among girls (OR = 0.96, 95%CI: 0.74-1.24). Conclusions: Traditional GRA may increase the risk of alcohol use among early adolescent boys, suggesting that altering traditional GRA among this population group may help to prevent alcohol use.