Underage Alcohol Consumption Research Articles

Social work assessment of underage alcohol consumption: Non-specialised social services comparison between Sweden and Italy

AimThis research contributes to highlighting social work assessment of family situations with underage alcohol consumption and abuse. The comparative study invites reflection on the main features influencing an initial approach to adolescent problematic alcohol consumption outside specialised addiction services.Design– The study is based on a cross-national comparison. A questionnaire including a vignette story of a young girl (“Nadja”) and her family was submitted to thirty-five social workers employed in public social services in Stockholm, Malmö (Sweden), and Genoa (Italy). The participants were then invited to focus groups to discuss the main features that had emerged in the assessments.Results– Results show significant variations between Italian and Swedish social workers' assessments. Italian social workers are in general more concerned and interventionist than are their Swedish colleagues. Swedish social workers tend to intervene less, assuming that Nadja's consumption is “normal” teenage behaviour, while the Italian social workers, less accustomed to considering such behaviour as common, are more worried and prone to intervene immediately, in particular when Nadja is found drunk in the city centre.ConclusionThe assessment proposed by public social workers appears to be informed by cultural understandings of alcohol consumption which permeate and reveal predominant tendencies in the two groups of professionals. Moreover, in Italy the social service mandate appears to be fragmented among different service units, whereas Swedish social workers operate within a broad welfare system that allocates specific resources for adolescent alcohol consumers. Further elements influencing the assessment are found in the legislative framework and consequently in the different practices and perspectives of intervention social workers assume in Sweden and Italy.

Scoring the Strengths and Weaknesses of Underage Drinking Laws in the United States.

Several studies have examined the impact of a number of minimum legal drinking age 21 (MLDA-21) laws on underage alcohol consumption and alcohol-related crashes in the United States. These studies have contributed to our understanding of how alcohol control laws affect drinking and driving among those who are under age 21. However, much of the extant literature examining underage drinking laws use a "Law/No law" coding which may obscure the variability inherent in each law. Previous literature has demonstrated that inclusion of law strengths may affect outcomes and overall data fit when compared to "Law/No law" coding. In an effort to assess the relative strength of states' underage drinking legislation, a coding system was developed in 2006 and applied to 16 MLDA-21 laws. The current article updates the previous endeavor and outlines a detailed strength coding mechanism for the current 20 MLDA-21 laws.

Underage access to online alcohol marketing content: a YouTube case study.

With the proliferation of the Internet and online social media use, alcohol advertisers are now marketing their products through social media sites such as YouTube, Facebook and Twitter. As a result, new recommendations have been made by the Federal Trade Commission concerning the self-regulation of digital marketing strategies, including content management on social and digital media sites. The current study sought to determine whether alcohol companies were implementing the self-imposed mandates that they have developed for online marketing. Specifically, we examined whether alcohol companies were implementing effective strategies that would prevent persons under the minimum legal drinking age in the USA from accessing their content on YouTube. We assessed 16 alcohol brands (beer and liquor) associated with the highest prevalence of past 30 day underage alcohol consumption in the USA. Fictitious YouTube user profiles were created and assigned the ages of 14, 17 and 19. These profiles then attempted to access and view the brewer-sponsored YouTube channels for each of the 16 selected brands. Every underage profile, regardless of age, was able to successfully subscribe to each of the 16 (100%) official YouTube channels. On average, two-thirds of the brands' channels were successfully viewed (66.67%). Alcohol industry provided online marketing content is predominantly accessible to underage adolescents. Thus, brewers are not following some of the self-developed and self-imposed mandates for online advertising by failing to implement effective age-restriction measures (i.e. age gates).

New research findings since the 2007 Surgeon General's Call to Action to Prevent and Reduce Underage Drinking: a review.

In 2007, the U.S. Department of Health and Human Services issued The Surgeon General's Call to Action to Prevent and Reduce Underage Drinking, a publication documenting a problem linked to nearly 5,000 injury deaths annually and poor academic performance, potential cognitive deficits, risky sexual behavior, physical and sexual assaults, and other substance use. This report reviews subsequent underage drinking and related traffic fatality trends and research on determinants, consequences, and prevention interventions. New research reports, meta-analyses, and systematic literature reviews were examined. Since the Call to Action, reductions in underage frequency of drinking, heavy drinking occasions, and alcohol-related traffic deaths that began in the 1980s when the drinking age nationally became 21 have continued. Knowledge regarding determinants and consequences, particularly the effects of early-onset drinking, parental alcohol provision, and cognitive effects, has expanded. Additional studies support associations between the legal drinking age of 21, zero tolerance laws, higher alcohol prices, and reduced drinking and related problems. New research suggests that use/lose laws, social host liability, internal possession laws, graduated licensing, and night driving restrictions reduce traffic deaths involving underage drinking drivers. Additional studies support the positive effects of individually oriented interventions, especially screening and brief motivational interventions, web and face-to-face social norms interventions, college web-based interventions, parental interventions, and multicomponent community interventions. Despite reductions in underage alcohol consumption and related traffic deaths, underage drinking remains an enduring problem. Continued research is warranted in minimally studied areas, such as prospective studies of alcohol and brain development, policy studies of use/lose laws, internal possession laws, social host liability, and parent-family interventions.

Brand-Specific Consumption of Alcohol Among Underage Youth in the United States

Little is known about brand-specific alcohol consumption among underage youth, as existing information is collected at the level of alcoholic beverage type. This study identifies the alcohol brands consumed by a nationally representative sample of underage youth in the United States. We obtained a national sample of 1,032 underage youth, aged 13 to 20, using a pre-recruited Internet panel maintained by Knowledge Networks. Youth aged 18 to 20 were recruited directly from the panel via email invitation. Teens aged 13 to 17 were identified by asking adult panelists to identify a member of their household. The survey assessed the past 30-day consumption of 898 brands of alcohol among 16 alcoholic beverage types, including the frequency and amount of each brand consumed in the past 30 days. Market share for a given brand was calculated by dividing the total number of drinks for that brand in the past 30 days across the entire sample by the total number of drinks for all identified brands. The alcohol brands with highest prevalence of past 30-day consumption were Bud Light (27.9%, 95% confidence interval [CI] 23.3 to 32.4%), Smirnoff malt beverages (17.0%, 95% CI 12.9 to 21.1%), and Budweiser (14.6%, 95% CI 11.0 to 18.3%). Brand market share was concentrated in a relatively small number of brands, with the top 25 brands accounting for nearly half of all market shares. Underage youth alcohol consumption, although spread out over several alcoholic beverage types, is concentrated among a relatively small number of alcohol brands. This finding has important implications for alcohol research, practice, and policy.

Study of Acute Alcohol Poisoning in Children Admitted to a Emergency Hospital Pirogov in Sofia, Bulgaria

Aim: The aim of the current study is to analyze the medical and social dimensions of acute alcohol poisoning in children with regard of improving prevention of addictive habitis and develop effective preventative strategies for reducing underage alcohol consumption. Material and Methods: We have studied the patients at the age up to 18 years with acute alcohol poisoning hospitalized in the Children Toxicology Department of Emergency Hospital Pirogov, Sofia, Bulgaria, from January 1, 2007 to June 31, 2008. All of them were at teen years – between 12 and 17 years old. Data on children were retrived from hospital medical records (age, sex, level of consciousness, blood ethanol level). The initial blood ethanol level was measured on admission by thin-layer chromatography for each patient. We have used the inquiry method - specially created for the purpose of the survey questionnaire comprising 39 questions (location and the reason for drinking, type of alcoholic beverage, age at first drink, combination alcohol-illicit drug, type of family, education and employment of parents, frequency of alcohol consumption by parents, consecutiveness of the children in family, presence of siblings, presence of children in a single room, interests etc.). Psychiatric interview was used. Results: We have studied 137 children with acute alcohol poisoning. Average age of children intoxicated by alcohol was 14.91±1.45 years. 77 (56.2%) are boys and 60 (43.8%) girls. The results demonstrate tendency of increase of the poisonings in weekends and in late afternoon and evening. On admission to hospital most of them had different levels of depressed consciousness: 61.3% were somnolent, 28.5% were soporous and 5.1% were comatose. Blood ethanol level was over 2.00 mg/ml in 40.2%. In the 21 (15.3%) cases children have been poisoned at the first alcohol consumption. No repeated hospitalization for acute alcohol poisoning in the study group for that period has been registered. Combination alcohol-illicit drug was observed in 13 children (9.5%). Children most often used one type of alcoholic beverage. The most frequent alcoholic beverage leading to intoxication is the vodka (63.1%). 64% of the children come from complete families. Both parents have secondary education in 79.7% and in 53.3% both parents are employed. 60% were the first born child in the family. First alcohol consuption was at the12 years and 10 months for boys, and at 13 years for girls. The most frequent reason for alcohol consumption was meeting and communicing with friends. The students have approximately 1.20 euro daily. Conlusion: Influence of “the group” is the main cause of alcohol consumption in adolescence. There is no increasing tendency for combining alcohol with other psychoactive drugs. We consider the brief intervention prior to hospital discharge as a preventive factor for repeated poisonings.

Alcohol intoxication requiring hospital admission in children and adolescents: retrospective analysis at the University Children's Hospital in the Slovak Republic

Background. Few epidemiological studies have investigated the problem of children and adolescents taken to hospital with acute alcohol intoxication. Methods. We reviewed the medical records of children and adolescents aged ≤ 18 years hospitalized with alcohol intoxication alone in the University Children's Hospital in Bratislava, Slovak Republic, during the years 1996–2005 and compared their characteristics between the first and the second 5-year time periods. Results. 537 patients (273 boys and 264 girls) were admitted to the hospital with intentional acute alcohol intoxication (1.5% of all admissions and 34.2% of all intoxications) between 1996 and 2005. The average age of the patients with alcohol intoxication presenting to hospital was 15.1 ± 1.7 and the youngest were 9-year-old children. The proportion of children admitted with alcohol intoxication increased every year (R2 = 0.935) (p < 0.001). The average blood alcohol concentration was 1.98 ± 0.57 g/L, and it increased in 2001–2005 in relation to the previous 5 years (p < 0.001). The highest estimated alcohol concentration (4.39 g/L) was found in the blood of a 17-year-old boy. The mean poisoning severity score was 1.53 ± 0.61 and had increased in line with blood alcohol concentration for the years 2001–2005 (p < 0.001). Conclusions. The results of this analysis emphasize the severity of underage alcohol consumption by young people in the Slovak Republic. Measures are needed to decrease alcohol abuse in children and adolescents.

Underage Drinking: A Developmental Framework

A developmental framework for understanding and addressing the problem of underage alcohol consumption is presented. The first section presents the rationale for a developmental approach, including striking age-related data on patterns of onset, prevalence, and course of alcohol use and disorders in young people. The second section examines the fundamental meaning of a developmental approach to conceptualizing underage drinking. The third section delineates contemporary principles of developmental psychopathology as a guide to future research and intervention efforts. Strategic, sensitive, and effective efforts to address the problem of underage drinking will require a developmentally informed approach to research, prevention, and treatment.

Binge Drinking and Associated Health Risk Behaviors Among High School Students

Underage drinking contributes to the 3 leading causes of death (unintentional injury, homicide, and suicide) among persons aged 12 to 20 years. Most adverse health effects from underage drinking stem from acute intoxication resulting from binge drinking. Although binge drinking, typically defined as consuming > or = 5 drinks on an occasion, is a common pattern of alcohol consumption among youth, few population-based studies have focused specifically on the characteristics of underage binge drinkers and their associated health risk behaviors. We analyzed data on current drinking, binge drinking, and other health risk behaviors from the 2003 National Youth Risk Behavior Survey. Prevalence estimates and 95% confidence intervals were calculated by using SAS and SUDAAN statistical software. Logistic regression was used to examine the associations between different patterns of alcohol consumption and health risk behaviors. Overall, 44.9% of high school students reported drinking alcohol during the past 30 days (28.8% binge drank and 16.1% drank alcohol but did not binge drink). Although girls reported more current drinking with no binge drinking, binge-drinking rates were similar among boys and girls. Binge-drinking rates increased with age and school grade. Students who binge drank were more likely than both nondrinkers and current drinkers who did not binge to report poor school performance and involvement in other health risk behaviors such as riding with a driver who had been drinking, being currently sexually active, smoking cigarettes or cigars, being a victim of dating violence, attempting suicide, and using illicit drugs. A strong dose-response relationship was found between the frequency of binge drinking and the prevalence of other health risk behaviors. Binge drinking is the most common pattern of alcohol consumption among high school youth who drink alcohol and is strongly associated with a wide range of other health risk behaviors. Effective intervention strategies (eg, enforcement of the minimum legal drinking age, screening and brief intervention, and increasing alcohol taxes) should be implemented to prevent underage alcohol consumption and adverse health and social consequences resulting from this behavior.

Alcohol Advertising in Magazines: Effects of Price, Demographics, and Audience Size

In 2003, the alcohol beverage industry spent more than $1.6 billion on advertising in measured media outlets, including $394 million on ads placed in magazines. Industry critics assert that some of these activities intentionally target adolescent audiences and thereby contribute importantly to social problems associated with underage alcohol consumption. Several recent studies attempt to demonstrate targeting of youth by evaluation of audience compositions for magazines and other media. Some of these studies claim that magazine audiences with more than 15% underage youth result in overexposure to alcohol ads, and critics allege that this demonstrates targeting of underage youth. This paper examines annual count data for alcohol ads placed in 28 magazines in 2001-2003. Specifying a demand function for advertising space, Poisson and negative binomial regressions are estimated conditional on magazine characteristics and readership demographics, including the percent of youth in the audience. The explanatory variables also include real prices of standardized advertisements, a measure of audience size, and a control variable for exposure in the count data model (annual issues). The analysis fails to demonstrate that alcohol advertisers are targeting youth. Adult audience size and price are key variables affecting advertising placement decisions. Implications of the findings for regulation of alcohol advertising are examined.

Sociodemographic and Individual Predictors of Alcohol Policy Attitudes: Results From a US Probability Sample

Public views on alcohol policies have facilitated legislative change. Given limited resources, however, policy makers and prevention advocates cannot make haphazard attempts to mobilize public resources. This investigation reports sociodemographic and individual traits predicting attitudes on alcohol policies designed to reduce underage alcohol consumption. Previous studies have examined single-item measures of alcohol policy. We examined predictors of multi-item scales measuring five core dimensions of alcohol policy. A survey of public attitudes on alcohol policies was administered to a US national probability sample of 7021 adults. Women, infrequent drinkers, and adults with greater knowledge about or concern for youth exhibited the greatest support across five alcohol policy scales. Older adults favored policies that restrict alcohol use in public places, whereas younger adults favored an increase in alcohol taxes to address underage alcohol use. Individual factors such as alcohol use frequency and concern for youth explained larger proportions of variance in alcohol policy attitudes than did sociodemographic factors. Consistent with previous research, political orientation, parental status, employment status, and marital status did not predict attitudes on alcohol policy.

The role of designated driver programs in the prevention of alcohol-impaired driving: a critical reassessment.

We review the "designated driver" concept and the current debate over its role in preventing alcohol-impaired driving. In our view, the focus on this strategy by broadcasters, the alcohol industry, and various public service groups has deflected attention from other alcohol-related problems that account for the vast majority of deaths and injuries associated with alcohol use. This focus has also distracted many public health advocates and policymakers from the bigger and more important jobs of increasing public awareness of the social, environmental, and economic factors that influence alcohol consumption and promoting debate on legislation and other public policy solutions to alcohol-impaired driving. As part of a comprehensive strategy, we strongly encourage a renewed focus on "sobriety checkpoints," strict enforcement of laws against alcohol sales to minors, alcohol advertising reform, increased excise taxes, and other public policy initiatives supported by the Surgeon General. These measures will curb underage and heavy alcohol consumption and will create a legal and social environment in which individuals are motivated to avoid impaired driving through several alternative strategies, including but not limited to the use of designated drivers.