Alcohol consumption patterns among adolescents are related to family structure and exposure to drunkenness within the family: results from the SEYLE project

Sports participation moderates the risk of family-specific negative life events on alcohol use among adolescents: Evidence from the longitudinal MyLife study

Negative life events (NLE) have been associated with increased alcohol use (AU) during adolescence. However, whether this risk association may be modified by leisure activities such as sports participation (SP) remains poorly understood. This study examined whether accumulated family-specific NLE in particular were associated with greater AU, and if so, whether SP moderated this association to reduce AU among high-NLE adolescents. We examined five annual assessments from a nationwide cohort of 3,422 Norwegian adolescents (13-15 year-olds; 55.3 % girls at baseline) who participated in the MyLife study. At each assessment, adolescents reported their AU on the Alcohol Use Disorders Identification Test-Concise (AUDIT-C), the number of family-specific NLE in the past 12 months, SP days in the past 30 days, and multiple sociodemographic and individual-level characteristics (covariates). Changes over time in AU as a function of NLE, SP, and their interaction (NLExSP) were examined with a set of partially nested growth curve models. AU increased non-linearly over time in all models. The fully adjusted best-fitting model showed significant NLExSP interactions (estimate = -0.013, 95% CI [-0.02, -0.006]), such that the initial AUDIT-C scores were lower for high-NLE adolescents with high SP and greater for high-NLE adolescents with low SP. Further, linear increases in AU over time were marginally steeper for high-NLE adolescents with high SP (NLExSPxTime estimate = 0.034, 95% CI [-0.0002, 0.007]). Thus, SP appeared to have a protective role in reducing AU for high-NLE youth primarily during middle school years. Prevention efforts thus may utilize organized sports for youth facing family-specific NLE as a resource early on.

Investigating the relationship between high-risk behaviors and mental health in adolescents in Rabor city, Iran

OBJECTIVES

High-risk behaviors (HRBs) represent significant health threats for adolescents and significantly affect adolescents' mental health. Adolescents often engage in risky behaviors. The present study was conducted to investigate the relationship between high-risk behaviors (HRBs) and mental health in adolescents in Rabor.

CONTENT

The present study was a cross-sectional analytical study that was performed on 334 girl and boy students aged 12-18 years in Rabor city in 2021. In this study, adolescents answered high risk behaviors and mental health questionnaires. Data were analyzed using SPSS-26 software and the spearman correlation coefficient and linear regression analysis (univariate and multivariate analysis) were used to analyze the data.

SUMMARY AND OUTLOOK

In this study, the mean age was 15.25 ± 1.78. The findings indicate that smoking and hookah use were higher in boys than girls. Among the demographic variables, age and level of education had a positive and significant relationship with HRBs and mental health (p<0.05). The mean score of total mental health for all subjects was 12.83 ± 10.82. The variables of age, sex, marital status of parents, the number of children in the family, educational level, smoking, hookah, and alcohol have been determined as influential and facilitating factors in HRBs of adolescents. Father's literacy was considered as a facilitator and age variables, alcohol consumption and parents' marital status were considered as deterrents to mental health. The present study showed that the male gender is one of the risk factors for alcohol, smoking and other substances, the tendency to high-risk sexual behaviors, depression, and suicide in adolescents. Among the determinants of the tendency to HRBs in adolescents, psychological variables are of particular importance at the individual, social, and family levels. Good mental health can improve quality of life, while poor mental health can make it worse.

Family Structure, Unstructured Socializing, and Heavy Substance Use among Adolescents

Background: Psychoactive substance use is a transient behavior among many adolescents and diminishes as they mature, but some engage in heavy forms of substance use, which increases their risk of health and behavioral challenges. A consistent predictor of substance use among youth is family structure, with adolescents living in single-parent, stepparent, or no-parent families at higher risk than others of several forms of substance use. The objective of this research was to investigate whether unstructured socializing mediated the association between family structure and heavy alcohol or substance use. Methods: Data from 30 nations (n = 65,737) were used to test the hypothesis using a generalized structural equation model and tests of mediation. Results: The analysis furnished clear support for a mediation effect among adolescents living with a single parent but less support among those living with a stepparent or neither parent. Conclusion: The association between living in a single-parent household and heavy alcohol or other substance use was mediated largely by time spent outside the home with friends in unsupervised activities. Additional research that uses longitudinal data and more nuanced measures of family structure is needed to validate this finding.

Is Adolescent Risk Behavior Associated With Cross-Household Family Complexity? An Analysis of Post-separation Families in 42 Countries

We examine whether complex cross-household structures of post-separation families are associated with higher risk-taking behavior in adolescence (substance use, bullying, early sexual onset) and whether the proportion, and thus statistical normality, of complex family types in a certain country is a potential moderator of this association. Drawing on representative data from 42 countries and regions from the Health Behavior in School-aged Children (HBSC) study in 2001, 2006, and 2010 (N = 506,977), we provide detailed analyses on adolescent risk behavior even for very rare family types, thereby accounting for the complex cross-household structure present in many post-separation families. We combine logistic and count regression models to analyze risk incidence and intensity. Controlling for relevant child and family characteristics, our results reveal a gradient along which adolescent risk-taking increases with family complexity: The incidence and intensity of risk-taking among adolescents is lowest in two-biological-parent and highest in two-household families with stepparents in both households. The association decreases with a higher proportion of the respective family type in a country. However, the differences between family types, other than the two-biological parent family, are not as pronounced as expected.

Current alcohol consumption and associated factors among school adolescents and youths in Ethiopia: A systematic review and meta-analysis

BACKGROUND

The use of alcohol is an alarmingly growing public health concern worldwide, and it has an impact on younger generations. There are a few large scale and comprehensive nation-wise surveys conducted on the subject matter and study groups. Hence, the purpose of this study was to render strong evidence for policymakers and researchers on the prevalence of alcohol consumption and its associated factors among school adolescents and youths in Ethiopia.

METHODS

Systematic searching was conducted using electronic (Medline, EMBASE, PubMed, CINAHL, Web of Science, Scopus, PsycINFO, and Science direct), and grey literature sources. Cross-sectional studies conducted among adolescents and youths (12-24 years old) were included. Joanna Briggs Institute critical appraisal tool was used to assess the quality of studies. Heterogeneity was examined by using forest plot and I2 heterogeneity tests. Publication bias was also assessed by inspecting the funnel plot and Egger's regression test. Stata/M16.0 for windows was used for the analysis.

RESULTS

A total of 26 studies were included in the final analysis with a total of 17,880 participants. The pooled prevalence of current alcohol consumption was 27.0% (95% CI = 22.0-32.0). In the subgroups, the prevalence of current alcohol consumption among high school, college, and university students was 23%, 27%, and 29%, respectively. The pooled data revealed that being a male (odds ratio = 1.93; 95% CI = 1.24-2.99), khat chewing (odds ratio = 6.65; 95% CI = 2.52-17.52), family members alcohol consumption behavior (odds ratio = 3.20; 95% CI = 2.08-5.17), and peer pressure (odds ratio = 3.79; 95% CI = 2.64-5.42) were significantly associated with alcohol consumption.

CONCLUSION

The pooled analysis of 26 studies indicate that over a quarter of school adolescents and youths consume alcohol in Ethiopia. Hence, we recommend designing and implementing community and school-based intervention programs to tackle the growing problems of alcohol consumption and its multifaceted impacts.

Factors associated with different forms of alcohol use behaviors among college students in Bhutan: a cross-sectional study

Background

Alcohol use has impacts on several dimensions of health, including physical health and mental health, particularly in college-age populations. Therefore, this study aimed to estimate the prevalence and to determine factors associated with alcohol use behaviors among college students in Bhutan.

Methods

A cross-sectional design was applied to collect data from the participants. A simple random method was used to select the participants from the lists of students who were attending the four selected colleges in Bhutan in the academic year of 2019. A questionnaire was developed, and validity and reliability were verified before use. Descriptive statistics were applied to describe the general characteristics of participants, while logistic regression was used to detect the associations between variables at the significance level of α = 0.05.

Results

A total of 432 college students were recruited into the study, of whom 62.0% were females. The average age was 20.0 years, 40.7% were the third-year students, and 79.9% lived in college dormitories. The prevalence of current drinking was 51.6% and that of binge drinking was 19.4%. After controlling for all potential confounder factors, three variables were found to be associated with current drinking: students who had low income were more likely to be current drinkers than those who had high income (AOR = 2.59, 95% CI = 1.29–5.21); students who did not use tobacco were more likely to be current drinkers than those students who used tobacco (AOR = 6.99, 95% CI = 2.90–16.81); and students who had close friends who did not use alcohol were more likely to be current drinkers than those who had close friends who used alcohol (AOR = 5.14, 95% CI = 3.04–8.69). Four factors were found to be associated with binge drinking after controlling for all possible confounder factors: students who had high income were more likely to be binge drinkers than those who had low income (AOR = 3.03, 95% CI = 1.72–5.31); students who used tobacco were more likely to be binge drinkers than those students who did not use tobacco (AOR = 2.28, 95% CI = 1.35–3.87); students whose parents used alcohol were more likely to be binge drinkers than those students whose parents did not use alcohol (AOR = 1.75, 95% CI = 1.02–3.01); and students whose close friends used alcohol were more likely to be binge drinkers than those who had close friends who did not use alcohol (AOR = 2.26, 95% CI = 1.05–4.87).

Conclusions

There is a high prevalence in alcohol use among the college students in Bhutan. Effective health promotion programs should be implemented by focusing on reducing the alcohol consumption among college students.

Family structure and alcohol use disorder: a register-based cohort study among offspring with and without parental alcohol use disorder

AIMS

To assess whether parental alcohol use disorder (AUD) is associated with higher risks of living in a non-intact family and assess whether non-intact family structure is associated with higher risks of AUD in the offspring.

DESIGN

Prospective cohort study.

SETTING

Danish nation-wide registries.

PARTICIPANTS

A total of 9948 parental AUD offspring and 98 136 reference offspring from the Danish population.

MEASUREMENTS

Family structure assessed at birth and at each birthday until age 15 as intact or non-intact (with mother only, father only or neither parent); years lived in an intact family defined as total number of years lived with both parents from birth until the 15th birthday; AUD defined as registration in medical, treatment and cause of death registries. Data were analyzed by Cox regression.

FINDINGS

At birth, 30.9% [95% confidence interval (CI) = 29.1-32.6] of parental AUD offspring and 10.7% (95% CI = 10.3-11.0) of reference offspring lived in a non-intact family. At age 15, the numbers were 84.6% (95% CI = 83.9-85.3) and 38.4% (95% CI = 38.1-38.7). Parental AUD was associated with a higher risk of offspring AUD [hazard ratio (HR) = 1.88, 95% CI = 1.74-2.02]. Offspring were at lower risk of AUD if they lived 15 years in an intact family compared with offspring who never lived in an intact family (HR = 0.67, 95% CI = 0.52-0.87 for those with parental AUD, and HR = 0.53, 95% CI = 0.48-0.59 for those whose parents did not have AUD). Findings were inconclusive as to whether or not an association was present between family structure and AUD among offspring with parental AUD and reference offspring.

CONCLUSIONS

The prevalence of non-intact family structure appears to be higher in offspring of parents with alcohol use disorder (AUD) than among offspring from the general population. Parental AUD appears to be associated with increased risk of offspring AUD, and non-intact family structure appears to be associated with increased risk of offspring AUD regardless of parental AUD.

Associations between Harmful Experiences from Alcohol Use of Others and Mental Health in Korean Adolescents

This study assessed alcohol-induced harm to those not drinking and investigated its association with mental health in Korean adolescents. The 14th Korea Youth Risk Behavior Survey (2018) was used and 60,040 adolescents were analyzed. Harm from others’ alcohol consumption was assessed by four criteria: teasing in public places, being scared in public places, sleep problems, and unsafety of public places due to people drinking alcohol. Mental health included stress, depressive symptoms, suicidal ideation, and attempted suicide. Harm reported due to the alcohol use of others was 5.8% for teasing in public places, 33.6% for being scared in public places, 5.6% for sleep problems, and 40.2% for unsafety of public places among total study participants. Experiences of teasing in public places due to people who drank alcohol were associated with an increased risk of stress, depressive symptoms, suicidal ideation, and suicide attempts. Similarly, experiences of being scared in public places, sleep problems, and unsafety of public places due to people who drank alcohol were associated with poor mental health. In the stratified analysis, alcohol-induced harm was associated with poor mental health in both non-drinkers and drinkers. Harmful experiences from others’ alcohol consumption were associated with poor mental health among Korean adolescents.

Understanding adolescent binge drinking in Spain: how school information campaigns moderate the role of perceived parental and peer consumption

Despite its potentially harmful effects, adolescent binge drinking is becoming increasingly common worldwide. To enable the design of more effective school information campaigns, the underlying factors of heavy alcohol use must be carefully analysed. This study investigated how individual, social and contextual factors relate to adolescent binge drinking. It also explored whether adolescents' exposure to information campaigns at school moderates the relationships between perceived parental and peer alcohol consumption and adolescent binge drinking. We used data from a Spanish nationwide representative sample of 47 803 students aged 14-18 years, of whom 25 576 had engaged in binge drinking behaviours. Data were collected every 2 years between 2006 and 2012. For the multilevel estimation in 2012, the sample comprised 10 577 students. Whilst perceived problems associated with binge drinking and perceived difficulty in accessing alcohol were associated with low levels of binge drinking, adolescents' perceptions of parental and peer consumption were associated, to a greater degree, with high levels of binge drinking. School information campaigns moderated the relationship between parental consumption and adolescent binge drinking but not the relationship between peer consumption and adolescent binge drinking. We conclude by highlighting implications for policymakers and offering possible directions for future research.

Health and health risk behaviour of adolescents-Differences according to family structure. Results of the German KiGGS cohort study

Objective

This study’s aim was to investigate the association between family structure and different health-related outcomes in adolescence (self-rated health, emotional and behavioural problems, health-related quality of life, regular smoking, and heavy episodic drinking). Furthermore, we analysed the extent to which socio-economic status, family cohesion and the pre-transition health status explain family structure-related health disparities.

Methods

We used longitudinal data from the first two waves of the German KiGGS cohort study carried out by the Robert Koch Institute (baseline: 2003–2006, follow-up: 2009–2012). The sample comprised 4,692 respondents aged 11 to 17 years. Using data from both waves, effects of family structure on health status at follow-up were calculated applying linear and logistic regression models.

Results

We found that adolescents continuously living with both birth parents were in good health. Adolescents whose parents separated after the baseline survey, reported poorer health and were more likely to smoke. The transition from stepfamily to single parent family was also associated with a higher risk of regular smoking. Lower health-related quality of life as well as higher scores for emotional and behavioural problems occurred in almost all non-nuclear family structures, although not all effects were statistically significant. No significant effects of family structure on heavy episodic drinking were found. While family cohesion mediated the effects of family structure on adolescents’ health, the mediating effect of socio-economic status was small. After controlling for pre-transition health, the effects were even lower.

Conclusions

Because the direct effects of family structure on adolescents’ health were small and family cohesion was found to be an important mediator in the association between family structure and adolescents’ health, prevention programmes and interventions should be directed towards the parent–adolescent relationship rather than just the family structure, in order to minimize the psychosocial stress of adolescents during the period of family transition.

Factors associated with different smoking status in European adolescents: results of the SEYLE study

Early onset and long-term smoking are associated with physical and psychological health problems. The aim of the presented analysis was to investigate risk and influencing factors for different smoking status in a big sample of European adolescents. In the context of the "saving and empowering young lives in Europe" (SEYLE) study we surveyed 12,328 adolescents at the age of 13-17 from 11 countries. The survey took place in a school-based context using a questionnaire. Overall 58% reported the onset of ever-smoking under the age of 14 and 30.9% smoke on a daily basis. Multinomial logistic regression model showed significant positive associations between adolescent smoking and internalizing problems (suicidal behavior, direct self-injurious behavior, anxiety), externalizing problems (conduct problems, hyperactivity, substance consumption) and family problems (parental substance consumption, broken home). Our data show that smoking among adolescents is still a major public health problem and adolescents who smoke are at higher risk for mental problems. Further, adolescent smoking is associated with broken home families and parental behaviors. Therefore, early preventive measures are necessary not only for adolescents, but also for their parents.

Comparison between alcohol- and hepatitis C virus-related hepatocellular carcinoma: clinical presentation, treatment and outcome

BACKGROUND

Hepatitis C virus (HCV) and alcohol abuse are the main risk factors for hepatocellular carcinoma (HCC) in Western countries.

AIM

To investigate the role of alcoholic aetiology on clinical presentation, treatment and outcome of HCC as well as on each Barcelona Clinic Liver Cancer (BCLC) stage, as compared to HCV-related HCCs.

METHODS

A total of 1642 HCV and 573 alcoholic patients from the Italian Liver Cancer (ITA.LI.CA) database, diagnosed with HCC between January 2000 and December 2012 were compared for age, gender, type of diagnosis, tumour burden, portal vein thrombosis (PVT), oesophageal varices, liver function tests, alpha-fetoprotein, BCLC, treatment and survival. Aetiology was tested as predictor of survival in multivariate Cox regression models and according to HCC stages.

RESULTS

Cirrhosis was present in 96% of cases in both groups. Alcoholic patients were younger, more likely male, with HCC diagnosed outside surveillance, in intermediate/terminal BCLC stage and had worse liver function. After adjustment for the lead-time, median (95% CI) overall survival (OS) was 27.4 months (21.5-33.2) in alcoholic and 33.6 months (30.7-36.5) in HCV patients (P = 0.021). The prognostic role of aetiology disappeared when survival was assessed in each BCLC stage and in the Cox regression multivariate models.

CONCLUSIONS

Alcoholic aetiology affects survival of HCC patients through its negative effects on secondary prevention and cancer presentation but not through a greater cancer aggressiveness or worse treatment result. In fact, survival adjusted for confounding factors was similar in alcoholic and HCV patients.

Internet Use and Adolescent Binge Drinking: Findings from the Monitoring the Future Study

OBJECTIVE

To investigate the relation between Internet use and binge drinking during early and middle adolescence.

METHODS

This is a cross-sectional study of a sub-sample of 8^th and 10^th graders from the Monitoring the Future (MtF) study, which annually surveys a nationally representative sample of U.S. youth on their attitudes, behaviors, and values. This study includes data from 21,170 8^th and 24,362 10^th graders who participated between 2007 and 2012 and were asked questions about Internet use and binge drinking.

RESULTS

In fully adjusted models, we found a dose response relation between hours of recreational Internet use (i.e. outside work or school) and binge drinking which was stronger for 8^th than 10^th graders. Compared to <1 h of Internet use per week, odds ratios estimates for 1-5 h/week, 6-19 h/week, and 20 or more h/week were 1.24 (99% CI: 0.85, 1.82), 1.83 (1.28, 2.61), and 2.78 (1.99, 3.87) for 8^th graders, respectively. For 10^th graders, this same association was attenuated [estimated OR=1.06 (99% CI: 0.96, 1.16); 1.20 (1.03, 1.40); and 1.30 (1.07, 1.58), respectively].

CONCLUSIONS

Drawing on a nationally representative sample of U.S. youth, we find a significant, dose-response relation between Internet use and binge drinking. This relation was stronger in 8^th graders versus 10^th graders. Given that alcohol is the most abused substance among adolescents and binge drinking confers many health risks, longitudinal studies designed to examine the mediators of this relation are necessary to inform binge drinking prevention strategies, which may have greater impact if targeted at younger adolescents.

Alcohol-related emergency department admissions among adolescents in the Ghent and Sint-Niklaas areas

Alcohol abuse is a major health concern. The aim of this retrospective study was to analyse the alcohol-related emergency department (ED) admissions among adolescents in all hospitals of distinct areas during a 1-year period. In each hospital, all ED patients with a blood alcohol concentration (BAC) of at least 0.5 g/l were surveyed in a standardised way. Of the 3918 included patients, only 146 (3.7%) were < 18  years. The male-to-female ratio was 1.5:1. There was a strong preponderance of weekend and night time admissions. Most of the patients were transported by ambulance (77% of 138 patients with information on this item). The main reason for ED admittance was depressed level of consciousness (64%), trauma (12%), vomiting and/or abdominal pain (12%), agitation or aggression (4%), syncope (4%) and psychological problems (4%). The context of the alcohol intoxication was related to some kind of festivity in 85%, mental problems in 14% and chronic abuse in 1%. Median BAC values (and range) were 2.08 g/l (0.73-3.70 g/l) for boys and 1.51 g/l (0.73-2.90 g/l) for girls. Most patients (87%) could be discharged home within 24  hours. Our study confirms that problematic alcohol use leading to ED admissions starts in adolescence. Although the numbers of cases below 18 years are low when compared to adults, the phenomenon is alarming as it is associated with substantial health problems. Therefore, Belgium urgently needs a global national alcohol plan, with youngsters being one of the target groups.

Gender-Specific Analyses of the Prevalence and Factors Associated with Substance Use and Misuse among Bosniak Adolescents

Ethnicity and religion are known to be important factors associated with substance use and misuse (SUM). Ethnic Bosniaks, Muslims by religion, are the third largest ethnic group in the territory of the former Yugoslavia, but no study has examined SUM patterns among them. The aim of this study was to explore the prevalence of SUM and to examine scholastic-, familial- and sport-factors associated with SUM in adolescent Bosniaks from Bosnia-and-Herzegovina. The sample comprised 970 17-to-18-year-old adolescents (48% boys). Testing was performed using an previously validated questionnaire investigating socio-demographic-factors, scholastic-variables, and sport-factors, cigarette smoking, alcohol drinking, simultaneous smoking and drinking (multiple SUM), and the consumption of other drugs. The 30% of boys and 32% of girls smoke (OR = 1.13; 95% CI = 0.86–1.49), 41% of boys and 27% of girls are defined as harmful alcohol drinkers (OR = 1.94; 95% CI = 1.48–2.54), multiple SUM is prevalent in 17% of boys and 15% of girls (OR = 1.11; 95% CI = 0.79–1.56), while the consumption of other drugs, including sedatives, is higher in girls (6% and 15% for boys and girls, respectively; OR = 2.98; 95% CI = 1.89–4.70). Scholastic achievement is negatively associated with SUM. SUM is more prevalent in those girls who report higher income, and boys who report a worse familial financial situation. The study revealed more negative than positive associations between sport participation and SUM, especially among girls. Results can help public health authorities to develop more effective prevention campaign against SUM in adolescence.