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

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=144788) 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.