Adolescent alcohol use: a reflection of national drinking patterns and policy?

Addiction. 2014 Nov;109(11):1857-68. doi: 10.1111/add.12681. Epub 2014 Aug 5.


Aims: To analyse how adolescent drunkenness and frequency of drinking were associated with adult drinking patterns and alcohol control policies.

Design, setting and participants: Cross-sectional survey data on 13- and 15-year-olds in 37 countries who participated in the Health Behaviour in School-Aged Children (HBSC) Study in 2010 (n = 144 788) were linked to national-level indicators on alcohol control policies and adult drinking patterns.

Measurements: Outcome measures were self-reported weekly drinking and life-time drunkenness (drunk once or more). Data were analysed using multi-level logistic regression models.

Findings: In the mutually adjusted models, adolescent drunkenness was associated significantly with high adult alcohol consumption [odds ratio (OR) = 3.15 among boys, 95% confidence interval (CI) = 2.13-4.64, OR girls = 2.44, CI = 1.57-3.80] and risky drinking patterns in the adult population (OR boys = 2.02, CI = 1.33-3.05, OR girls = 1.61, CI = 1.18-2.18). The level of abstainers in the adult population was also associated significantly with girls' drunkenness; a 10% increase in the number of abstainers in a country reduced the odds of drunkenness with 21% (OR = 0.79, CI = 0.68-0.90). Weekly drinking was associated significantly with weak restrictions on availability (OR boys = 2.82, CI = 1.74-4.54, OR girls = 2.00, CI = 1.15-3.46) and advertising (OR boys = 1.56, CI = 1.02-2.40, OR girls = 1.79, CI = 1.10-2.94).

Conclusions: Comparing data cross-nationally, high levels of adult alcohol consumption and limited alcohol control policies are associated with high levels of alcohol use among adolescents.

Keywords: Adolescents; alcohol control policies; alcohol use; country-level predictors; cross-national studies; minimum purchasing age.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adolescent Behavior*
  • Adult
  • Alcohol Drinking / epidemiology
  • Alcohol Drinking / psychology*
  • Alcoholic Intoxication / epidemiology
  • Cross-Sectional Studies
  • Europe / epidemiology
  • Female
  • Humans
  • Male
  • Public Policy*