Childhood Alcohol Use Research Articles

Use of Tobacco Products and Suicide Attempts Among Elementary School–Aged Children

The use of tobacco products, including e-cigarettes and vaping, has rapidly increased among children. However, despite consistent associations found between smoking cigarettes and suicidal behaviors among adolescents and adults, there are limited data on associations between emerging tobacco products and suicidal behaviors, especially among preadolescent children. To examine whether the use of tobacco products is associated with nonsuicidal self-injury (NSSI), suicidal ideation (SI), and suicide attempts (SAs) among preadolescent children. This cohort study, conducted from September 1, 2022, to September 5, 2023, included participants in the Adolescent Brain Cognitive Development study, a population-based cohort of 11 868 US children enrolled at 9 and 10 years of age. The cross-sectional investigation focused on 3-year periods starting from the baseline to year 2 of follow-up. Statistical analysis was performed from October 1, 2022, to June 30, 2023. Children's use of tobacco products was assessed based on youth reports, including lifetime experiences of various nicotine-related products, supplemented with hair toxicologic tests. Main outcomes were children's lifetime experiences of NSSI, SI, and SAs, assessed using the K-SADS-5 (Kiddie Schedule for Affective Disorders and Schizophrenia for the DSM-5). Multivariate logistic regression was conducted to examine the associations of the use of tobacco products with NSSI, SI, and SAs among the study participants. Sociodemographic, familial, and children's behavioral, temperamental, and clinical outcomes were adjusted in the analyses. Of 8988 unrelated study participants (median age, 9.8 years [range, 8.9-11.0 years]; 4301 girls [47.9%]), 101 children (1.1%) and 151 children (1.7%) acknowledged lifetime use of tobacco products at baseline and at 18-month follow-up, respectively. After accounting for various suicide risk factors and potential confounders, children reporting use of tobacco products were at a 3 to 5 times increased risk of SAs (baseline: n = 153 [adjusted odds ratio (OR), 4.67; 95% CI, 2.35-9.28; false discovery rate (FDR)-corrected P < .001]; year 1: n = 227 [adjusted OR, 4.25; 95% CI, 2.33-7.74; FDR-corrected P < .001]; and year 2: n = 321 [adjusted OR, 2.85; 95% CI, 1.58-5.13; FDR-corrected P = .001]). Of all facets of impulsivity measures that were significant correlates of use of tobacco products, negative urgency was the only independent risk factor for SAs (adjusted OR, 1.52 [95% CI, 1.31-1.78]; FDR-corrected P < .001). In contrast, children's alcohol, cannabis, and prescription drug use were not associated with SAs. This study of US children suggests that the increased risk of SAs, consistently reported for adolescents and adults who smoke cigarettes, extends to a range of emerging tobacco products and manifests among elementary school-aged children. Further investigations are imperative to clarify the underlying mechanisms and to implement effective preventive policies for children.

Determinantes sociais do uso de álcool na infância e adolescência em territórios rurais

Abstract This paper analyzes the social determinants of alcohol use in childhood and adolescence in rural areas. This qualitative study was carried out in a small municipality of Rio Grande do Sul State, Brazil, with professionals from the psychosocial and intersectoral care network. Data were collected using the Empowerment Evaluation and analyzed by thematic analysis. The social determinants found show that alcohol use is a cultural aspect of the Pomeranian families and the religious rituals that mark the passage from youth to adulthood. In work-related aspects, alcohol use is a form of leisure in face of the responsibilities the youth assume in farming. Gender and violent situations also influence this factor: boys are encouraged to try alcohol, while girls are the biggest victims of physical aggression. Risk behaviors are observed in traffic accidents involving children and adolescents under alcohol the influence of alcohol. The social determinants broaden the scope of the topic, moving away from an exclusive conception of chemical and biological dependence to encompass multiple factors such as territories, cultures, work, and society.

Incipient Alcohol Use in Childhood: Early Alcohol Sipping and its Relations with Psychopathology and Personality - Corrigendum.

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Incipient alcohol use in childhood: Early alcohol sipping and its relations with psychopathology and personality.

Prior research has shown that sipping of alcohol begins to emerge during childhood and is potentially etiologically significant for later substance use problems. Using a large, community sample of 9- and 10-year-olds (N = 11,872; 53% female), we examined individual differences in precocious alcohol use in the form of alcohol sipping. We focused explicitly on features that are robust and well-demonstrated correlates of, and antecedents to, alcohol excess and related problems later in the lifespan, including youth- and parent-reported externalizing traits (i.e., impulsivity, behavioral inhibition and activation) and psychopathology. Seventeen percent of the sample reported sipping alcohol outside of a religiously sanctioned activity by age 9 or 10. Several aspects of psychopathology and personality emerged as small but reliable correlates of sipping. Nonreligious sipping was related to youth-reported impulsigenic traits, aspects of behavioral activation, prodromal psychotic-like symptoms, and mood disorder diagnoses, as well as parent-reported externalizing disorder diagnoses. Religious sipping was unexpectedly associated with certain aspects of impulsivity. Together, our findings point to the potential importance of impulsivity and other transdiagnostic indicators of psychopathology (e.g., emotion dysregulation, novelty seeking) in the earliest forms of drinking behavior.

Childhood Family Environment and Depression in Early Adulthood in Botswana

The childhood family environment is a determinant of mental health outcomes later in life. Yet, few studies have examined its role in outcomes such as depression in early adulthood, especially in low- and middle-income countries such as Botswana. This study explores the relationship between childhood family environmental factors and depression among young adults in Botswana. A sample of 351 students at the University of Botswana was surveyed through a self-administered questionnaire, which included various childhood environmental factors, the Beck Depression Inventory-II and socio-demographic items. Descriptive statistics, t-tests and regression models were used in the data analyses. About one in four young adults reported moderate to severe symptoms of depression with about one in ten in the severe category. Childhood alcohol use, parental drug and alcohol use, physical assault, and psychological aggression towards parents or guardians during childhood, all significantly predicted symptoms of depression in early adulthood. Altogether, the childhood family environmental factors and gender explained significant variance in depressive symptoms. Multiple adverse childhood environments constitute significant risk factors for depression in early adulthood and the next generation. Preventive and early intervention services for vulnerable children, evaluation of mental health, childhood family experiences, and creating awareness of the need for treatment are critical. Cognitive behavioural therapy and mindfulness training are possible strategies to reduce the life-course effects of adverse childhood family environmental factors on depression in young adults.

The relationship between parental attitudes and children's alcohol use: a systematic review and meta-analysis.

The main aim of this study was to assess the relationship between parental attitudes towards children's alcohol use and their child's alcohol use. Secondary aims included assessing the relationship between attitudes reported by parents and those perceived by children, and between perceived parental attitudes and children's alcohol use. Meta-analysis of studies reporting on the associations between parental attitudes towards children's alcohol use and children's self-reported alcohol use. Published, peer-reviewed cross-sectional and longitudinal studies were identified from the following databases up to April 2018: Medline, PsycINFO, EMBASE, Scopus and Web of Science. Quality assessment was performed by using guidelines developed by Hayden, Cote & Bombardier. Pooled effect sizes were calculated by using random-effects meta-analyses, if there were at least two studies that could be included per analysis. Of 7471 articles screened, 29 were included comprising data from 16 477 children and 15 229 parents. Less restrictive parental attitudes towards children's alcohol use were related to higher rates of alcohol use initiation [odds ratio (OR)=1.45, 95% confidence interval (CI)=1.17-1.80], alcohol use frequency (OR=1.52, 95% CI=1.24-1.86) and drunkenness (OR=1.58, 95% CI=1.35-1.85) among children. Less perceived restrictive parental attitudes were related to higher alcohol use frequency (OR=1.76, 95% CI=1.29-2.40). Perceived parental attitudes were not clearly related to alcohol use initiation. Parent-reported attitudes and perceived parental attitudes were weakly positively correlated (r=0.27, P=≤0.001). The strength of the relationship between parental attitudes and children's alcohol use frequency attenuated with children's age. Study design, sample size, study location and levels of alcohol use frequency did not have a detectable effect on the relationship. Less restrictive parental attitudes towards children's alcohol use are associated with increases in children's alcohol use onset, alcohol use frequency and drunkenness. Children's perception of less restrictive parental attitudes is associated with children's alcohol use.

Prediction of binge drinking in young adults: a cohort study over nine years

Which person characteristics and environmental factors predict binge drinking at age 21? A longitudinal observational study with a nine-year follow-up. A total of 5,176 adolescents from the German states Schleswig-Holstein and Saxony-Anhalt were surveyed in 2006 with paper-pencil questionnaires (mean age 12.6 years, SD = 0.6). A follow-up assessment was conducted in the year 2015. Baseline predictors were age, gender, school type, school performance, parenting style, early experience with alcohol, alcohol use of parents, alcohol use of friends, and sensation seeking. Primary outcome in 2015 was binge drinking at least once a month (six or more alcoholic drinks during one drinking occasion). A subsample of 1,087 (20.9 %) of the former students could be surveyed nine years after baseline (mean age 21.6 years, SD = 0.8). One out of four (25.4 %) reported binge drinking at least once in a month. A multiple regression model revealed three significant predictors of binge drinking: male gender, early experience with alcohol and frequency of parental alcohol use at baseline. Perceived frequency of parental alcohol use might be an important risk factor for children's alcohol use in early adulthood. Parents need to reflect their role as alcohol-specific socialization agents.

Associations of Father's Lifetime Cannabis Use Disorder with Child's Initiation of Cannabis Use, Alcohol Use, and Sexual Intercourse by Child Gender

ABSTRACTBackground: Early initiation of alcohol use, cannabis use, and sexual intercourse among adolescents is an important public health concern in the United States. Parents' history of substance use disorder is an important contributing factor for children's problem behaviors. Objectives: The associations of fathers' lifetime cannabis use disorder with children's initiation of cannabis use, alcohol use, and sexual intercourse were examined. In addition, child's gender was considered as a moderator of each association. Methods: Data from two companion longitudinal studies was utilized, the Rochester Youth Developmental Study and its intergenerational extension, the Rochester Intergenerational Study. Multiple linear regression analyses were conducted to examine the associations of the father's lifetime cannabis use disorder with the child's initiation of cannabis use, alcohol use, and sexual intercourse. To test gender differences in the associations, the study sample was stratified by child's gender. Results: The average age of first cannabis use (b = –3.71, p < .05), alcohol use (b = –3.65, p < .05), and sexual intercourse (b = –2.94, p < .05) among daughters of fathers with a lifetime cannabis use disorder was lower than that of their counterparts after adjusting for all other control variables, whereas no significant differences were detected in a father–son relationship. Conclusions: Homotypic continuity of cannabis use, as well as heterotypic continuity from the father's cannabis use to the child's alcohol use and sexual intercourse existed in a father–daughter relationship. These findings suggest that family-based interventions for female adolescents whose father has suffered from a cannabis use disorder be developed to prevent better adolescents' early substance use and sexual intercourse.

Parents' drinking motives and problem drinking predict their children's drinking motives, alcohol use and substance misuse

The aim of the current study was to test the direct and indirect influence of parents' drinking motives and problem drinking on their children's drinking motives, alcohol use and substance misuse. Cross-sectional analysis of parent and child drinking patterns and motives, derived from the nationally representative Drinkaware Monitor panel survey. The sample comprised a total of 148 couples of parents and child. Path analysis revealed that children's alcohol use and substance misuse were influenced by their own drinking motives and parents' problem drinking. Parents' conformity motives were linked to their children's conformity motives. Finally, parental drinking problems mediated the effect of their coping motives on their childrens' alcohol use and substance misuse. In conclusion, parental drinking styles relate to their children's alcohol use and substance misuse through problem drinking and drinking motives.

Media alcohol advertising with drinking behaviors among young adolescents in Taiwan

ObjectivesTo investigate potential effects of alcohol ads in six major marketing channels on drinking behaviors among young adolescents in Taiwan. MethodsThe data were derived from the Alcohol-Related Experiences among Children study. The baseline sample was comprised of 1926 seventh-eighth graders from 11 public middle schools in Taipei in 2010; follow-up was conducted one year later (follow-up rate=97%). Information concerning individual sociodemographics, family characteristics, exposure to media portrayals of drinking and alcohol ads on major marketing channels, and drinking experience was collected through web-based self-administered questionnaires. Complex survey analyses were used to evaluate the association estimates, with stratification by prior drinking experiences in childhood. ResultsTelevision, in-store displays, and websites are the three most common marketing channels for young adolescents to report past-month alcohol advertising exposure. With statistical adjustment for potential confounders and six market channels, exposure to alcohol ads on television was associated with subsequent increased drinking initiation (adjusted odds ratio [aOR]=2.62; 95% CI=1.14–6.02). For those who have initiated alcohol use in childhood, the exposure to ads on the web (aOR=1.50; 95% CI=1.04–2.15) and radio (aOR=2.58; 95% CI=1.60–4.15) may elevate subsequent risk of occasional drinking. Exposure to media drinking portrayals was not related to subsequent drinking behaviors in this sample. ConclusionsOur results demonstrated that the effects of alcohol advertising on drinking behaviors in early adolescence may differ by marketing channels. Preventive strategies targeting underage drinking should consider restraining marketing channels (e.g., websites and radio) from certain advertising content and placement.

Maternal risk-taking propensity and children's alcohol use: A latent growth curve approach

Maternal risk-taking propensity and children's alcohol use: A latent growth curve approach

A qualitative exploration of attitudes towards alcohol, and the role of parents and peers of two alcohol-attitude-based segments of the adolescent population

BackgroundAn earlier study using social marketing and audience segmentation distinguished five segments of Dutch adolescents aged 12–18 years based on their attitudes towards alcohol. The present, qualitative study focuses on two of these five segments (‘ordinaries’ and ‘ordinary sobers’) and explores the attitudes of these two segments towards alcohol, and the role of parents and peers in their alcohol use in more detail.MethodsThis qualitative study was conducted in the province of North-Brabant, the Netherlands. With a 28-item questionnaire, segments of adolescents were identified. From the ordinaries and ordinary sobers who were willing to participate in a focus group, 55 adolescents (30 ordinaries and 25 ordinary sobers) were selected and invited to participate. Finally, six focus groups were conducted with 12–17 year olds, i.e., three interviews with 17 ordinaries and three interviews with 20 ordinary sobers at three different high schools.ResultsThe ordinaries thought that drinking alcohol was fun and relaxing. Curiosity was an important factor in starting to drink alcohol. Peer pressure played a role, e.g., it was difficult not to drink when peers were drinking. Most parents advised their child to drink a small amount only. The attitude of ordinary sobers towards alcohol was that drinking alcohol was stupid; moreover, they did not feel the need to drink. Most parents set strict rules and prohibited the use of alcohol before the age of 16.ConclusionsQualitative insight into the attitudes towards alcohol and the role played by parents and peers, revealed differences between ordinaries and ordinary sobers. Based on these differences and on health education theories, starting points for the development of interventions, for both parents and adolescents, are formulated. Important starting points for interventions targeting ordinaries are reducing perceived peer pressure and learning to make one’s own choices. For the ordinary sobers, an important starting point includes enabling them to express to others that they do not feel the need to drink alcohol. Starting points for parents include setting strict rules, restricting alcohol availability at home and monitoring their child’s alcohol use.

Normative feedback for parents of college students: Piloting a parent based intervention to correct misperceptions of students' alcohol use and other parents' approval of drinking

ObjectiveMulti-component parent-based interventions (PBIs) provide a promising avenue for targeting alcohol use and related consequences in college students. Parents of college-aged children can have a significant influence on their children's alcohol use decisions. However, parents tend to underestimate their own child's alcohol use and overestimate other similar parents' approval of student drinking. These misperceptions could have important implications for parents' own attitudes and alcohol-related communication with their student. Targeting these misperceptions through normative feedback could help promote greater and more in-depth alcohol-related communication. The present study examines the potential efficacy of web-based alcohol-related normative feedback for parents of college students. MethodA sample of 144 parents of college students received web-based normative feedback about students' alcohol use and approval, as well as other same-college parents' alcohol approval. Parents completed measures of perceived student alcohol use, student alcohol approval, other-parent alcohol approval, and intentions to discuss alcohol use both pre- and post-normative feedback. ResultsPost-feedback, parents reported stronger intentions to talk to their student about alcohol, were less confident in their knowledge of their students' alcohol use, and believed that their student drank in greater quantity and more frequently than pre-feedback. Parents also perceived other parents to be less approving of alcohol use after viewing normative feedback. ConclusionsThese findings provide preliminary support for the use of web-based normative feedback for parents of college students. Given these promising results, further research developing and testing this approach merits attention.

Relationship between adolescent binge drinking and childhood alcohol use

In this issue of The Journal, Sanchez et al from the Universidade Federal de São Paulo have evaluated the hypothesis that childhood alcohol use may predict adolescent binge drinking in more than 17 000 high school students in Brazil. Logistic regression testing was used to evaluate the relationship between the first alcohol use and adolescent binge drinking. Adolescents who first used alcohol during childhood, as compared with those who only used alcohol at later stages, were more likely to engage in binge-drinking behaviors. They also had a pattern of heavy alcohol use and recent use of illegal drugs. The authors conclude that childhood alcohol use is a risk factor for the most dangerous patterns of alcohol use in adolescence, also noting an association with parental alcohol use. Article page 363▶ Childhood Alcohol Use May Predict Adolescent Binge Drinking: A Multivariate Analysis among Adolescents in BrazilThe Journal of PediatricsVol. 163Issue 2PreviewTo test the hypothesis that first alcohol use during childhood is associated with heavy drinking patterns during adolescence and with parental drinking patterns and parental rules about alcohol consumption. Full-Text PDF

Cross-national study on factors that influence parents' knowledge about their children's alcohol use.

Previous research has shown that parents underestimate their children's substance use. The aim of the present work was to analyze parental estimation of their children's use of alcohol in five countries from northern, central, and southern Europe, and to explore the variables that influenced this perceptual bias. The sample comprised 1181 parent-children dyads living in Sweden, Slovenia, the Czech Republic, Spain, and Portugal. In accordance with the findings of previous studies, we found high parental underestimation of substance use, which was greater for more frequent alcohol use or the use of illegal drugs. This underestimation appears to be subject to some degree of sociocultural influence, and is also influenced by the severity of the children's use.

Childhood Alcohol Use May Predict Adolescent Binge Drinking: A Multivariate Analysis among Adolescents in Brazil

To test the hypothesis that first alcohol use during childhood is associated with heavy drinking patterns during adolescence and with parental drinking patterns and parental rules about alcohol consumption. A national cross-sectional survey of 17,371 high-school students. Students were drawn from 789 public and private schools in all the Brazilian state capitals using a multistage probabilistic sampling method and a self-report questionnaire. Weighted data were analyzed through logistic regression testing for differences on the associated factors for first use of alcohol during childhood. Survival analysis and Cox proportional hazard models were used to confirm results. Among the 82% alcohol lifetime users, 11% had first used alcohol before age 12 years. The lack of perception of possible punishment by parents is associated with childhood alcohol use (OR 2.22, 95% CI 1.67-2.95). Adolescents who first used alcohol during childhood compared with those who only used alcohol at later ages are more likely to engage in binge drinking behaviors (OR 1.57, 95% CI 1.17-2.10), to have a pattern of heavy alcohol use (OR 1.98, 95% CI 1.26-3.09), and to have recently used illegal drugs (OR 1.74, 95% CI 1.39-2.16). According to hazard ratios, students with an earlier age of onset were more likely to have used tobacco and any illegal drug in the past year. Childhood alcohol may be a risk factor for the most dangerous patterns of alcohol use in adolescence and is associated with parental alcohol use. Parental rules about child alcohol use must be clear because perception of punishment might delay the age of first alcohol use.

Maternal depressive symptoms as a predictor of alcohol use onset and heavy episodic drinking in youths.

The current study addressed a gap in the literature by investigating the association between maternal depressive symptoms and subsequent timing of their children's alcohol use onset and heavy episodic drinking (HED). Childhood depression/dysthymia symptoms, harsh discipline, and parental positive regard were examined as potential mediators of this relation. Longitudinal self- and parent-report data were collected annually from a community sample of 754 youths (50% male; 43% African American) from kindergarten to Grade 11 (ages 5-18 years). The measures administered were the Things That You Have Done scale (Conduct Problems Prevention Research Group [CPPRG], 1995a) and the Tobacco, Alcohol, and Drugs measure (CPPRG, 1995b), which assessed alcohol use behaviors; the Center for Epidemiological Studies-Depression Scale (Radloff, 1977); the Diagnostic Interview Schedule for Children (Costello, Edelbrock, & Costello, 1985); and the Parental Discipline Scale (CPPRG, 1994). Maternal depressive symptoms significantly predicted an earlier onset of alcohol use and HED in youths. Harsh parental discipline mediated the relation between maternal depressive symptoms and alcohol use onset as hypothesized; however, childhood depressive/dysthymia symptoms and parental positive regard did not. In the parallel analyses testing the 3 potential mediating variables in the prediction of HED, no significant mediation was found. These findings suggest the importance of intervening to prevent early and risky alcohol use among youths who have been identified as having a mother who is clinically depressed or is experiencing depressive symptoms; part of this intervention effort could involve working with depressed mothers to reduce their use of harsh discipline. These improved intervention and prevention strategies could have important implications for reducing the occurrence and early initiation of alcohol use and HED among at-risk youths.

The influence of paternal and maternal drinking patterns within two-partner families on the initiation and development of adolescent drinking

As it is still unclear to what extent parental drinking is a predictor of children's alcohol use, we tested the association of specific paternal and maternal drinking patterns with both initiation and development of adolescent alcohol use. Longitudinal data (four annual measurements) of parent–child dyads (N=2319) have been used. Parental drinking patterns have been identified using latent class analysis. The association of parental drinking patterns with the initiation and development of 12–15year olds' drinking have been examined with latent growth curve modeling. Only two out of six parental drinking patterns were related to adolescent drinking. That is, having a heavy drinking father or two heavy episodic drinking parents particularly predicts early and heavier adolescent drinking. When controlled for parenting behaviors and background variables, such as adolescent gender, age and socioeconomic status (SES), these findings remained significant. Interaction analyses revealed that the influence of parental heavy (episodic) drinking differs across gender and is especially strong among adolescents with lower SES. Thus, parental heavy (episodic) drinking, and not so much the frequency of drinking, predicts the initiation and development of alcohol consumption in their offspring. Parents and professionals must be aware that parental heavy drinking affects their offspring, particularly adolescents with lower SES, resulting in earlier and heavier drinking among this high-risk group.

Examining Explanatory Mechanisms of the Effects of Early Alcohol Use on Young Adult Alcohol Dependence

This study examined potential explanatory mechanisms linking childhood alcohol use onset and chronicity of adult alcohol dependence by testing the following three competing hypotheses: (1) a marker hypothesis, where early onset of alcohol use may be simply a marker for other factors that have been linked to both age at initiation and adult alcohol problems; (2) a compromised development hypothesis, where early alcohol initiation may interfere with adolescent development, which can lead to later alcohol problems; and (3) an increased substance use hypothesis, where early onset of alcohol use may lead to increased substance use in adolescence and, in turn, chronic alcohol dependence. Data came from a longitudinal community sample of 808 participants recruited at age 10 in 1985. Participants were followed through age 33 in 2008 with 92% retention. Childhood onset of alcohol use (before age 11), when compared with initiation during adolescence, predicted an increased chronicity of adult alcohol dependence, even after accounting for the hypothesized confounds from the marker hypothesis. In addition, adolescent compromised functioning did not mediate this relationship between early alcohol use and chronicity of adult dependence (Hypothesis 2), nor did adolescent substance use (Hypothesis 3). However, compromised functioning and substance use in adolescence predicted increased chronicity of alcohol dependence in young adulthood. Prevention efforts as early as the elementary grades should focus on delaying the onset of alcohol use and reducing substance use in adolescence as well as improving school functioning, reducing adolescent problem behaviors, and targeting adolescent peer networks.

Alcohol Use: From Childhood Through Adolescence

Alcohol use is often overlooked and more importantly unsuspected in young children 3-11 years of age. Alcohol use in preteens is commonly overlooked when there is growing evidence to suggest that the age at which one begins drinking can be predictive of future problem drinking and other substance abuse. There is a need for health care professionals and elementary school educators to be aware of the real and growing problem of alcohol use from childhood through adolescence. It is sometimes difficult to recognize because many of the effects of alcohol mimic routine presentations seen in children. This article focuses on the significance, contributing factors, effects on the body, comorbidities, and social and psychological effects of alcohol use on children through adolescence. It also examines diagnostic screening for alcohol use in adolescence and the detrimental role of the nurse in assisting with identifying and preventing the problem of alcohol use in childhood through adolescence.