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An estimated 54.1% of young Australians have tried alcohol by the age of 12 years, increasing to 80.9% by age 15 and 90.9% by age 17; 10% of 12-year-olds have reported consuming alcohol in the last week and this increases to 49% by age 17 . Furthermore, 5.1% of 12-year-olds are considered current drinkers (having consumed alcohol in the last week) and this increases to 36.7% by age 17 . These figures are comparable with those in the United Kingdom—for example, 84% of 15 to 16-year-olds surveyed in North West England had consumed alcohol —but substantially higher than in the USA. A recent study which compared reported alcohol use in the last year among children in Grade 5 and in the last month among children in Grades 7 and 9 in Victoria, Australia and Washington DC, USA, found that the Australian students were two to four times more likely to report consuming alcohol .
Regular alcohol consumption or binge drinking during adolescence predicts heavier alcohol consumption, binge drinking and poor health outcomes in later life [4,5]. The USA–Australian study  found that alcohol use was associated with substantial harms (such as sickness, trouble at school, accident and injury) and that, while the Australian students were more likely to initiate alcohol use earlier, once they started drinking the proportions escalating to misuse were similar.
Although a range of factors contribute to alcohol initiation and subsequent drinking patterns, there is evidence that the drinking behaviours and attitudes of peers and family members (and/or perceptions of these) impact on the drinking behaviours of young people. Data from cross-sectional and longitudinal studies have demonstrated that children with parents who drink are more likely to consume alcohol at a young age [6,7]; that young people with parents who permit, or are accepting, of underage drinking are also more likely to consume alcohol during adolescence and experience negative consequences , and those with parents who are perceived to have favourable attitudes towards drinking are more likely to report being drunk and participating in binge drinking . In contrast, adolescents with parents who are opposed to alcohol consumption  and those whose parents apply prohibitions and strict rules regarding drinking and emphasise the negative effects of alcohol  are less likely to consume alcohol. Interestingly, in a study of factors associated with drinking among early adolescents, it was found that parental alcohol use was not a significant factor but that alcohol-specific socialisation (having restrictive parental rules and attitudes regarding drinking) was associated with lower rates of consumption .
Several studies have also demonstrated that peer alcohol consumption and friends' approval of alcohol consumption are associated with an increased likelihood of adolescent drinking [6,11–13]. Similarly, individuals with siblings who consume alcohol are also more likely to drink at a young age . Recent longitudinal studies have provided further evidence that progression from non-drinker to drinker and escalation of drinking occurs with peer drinking [15,16], friends' approval of drinking , and perceived adult approval of drinking .
Although the role of parental and peer influence has been examined in other countries, there are limited data from an Australian context, where the legal drinking age is 18 years (lower than the USA). Furthermore, adolescent drinking rates are substantially higher in Australia than in the USA. Therefore, the purpose of the present study was to examine whether factors such as alcohol consumption and perceived attitudes towards underage drinking among parents, siblings and peers were associated with patterns of alcohol consumption among young Australians aged 12 to 17 years.
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In the present study, 43.7% of respondents indicated they had consumed alcohol in the past month, increasing from 22.6% of 12 to 14-year-olds to 60.6% of 17-year-olds. These figures are fairly consistent with those in the ASSAD school-based survey , and substantially higher than in similar studies with US adolescents. For example, a Minnesota survey of junior high and middle school students found that none reported being drunk and only 2% reported consuming alcohol in the last month; among high school students (9th to 11th grade), past month alcohol use was 26.1% and drunkenness was 8.7% .
Family and peer drinking patterns and attitudes towards drinking to get drunk were also found to be associated with young people's alcohol consumption. Parental drinking was associated with having consumed alcohol in the last month, but not with reported frequency of drinking. This is not surprising, given the inconsistency of findings from previous research, with some studies finding that parental drinking is associated with adolescent drinking and others finding no  or very weak associations .
Having friends or siblings who drink was associated with consumption in the last month and reported frequency of drinking. For example, individuals with friends who consumed alcohol were five times more likely to have consumed alcohol on a weekly basis, consistent with the findings from US studies [16,17]. In contrast, the results indicated that perceiving that more generic ‘other people your age’ drink was not associated with either measure. This is consistent with prior US research which has found that proximal norms are more predictive of drinking than distal norms among college students [19,20] and sub-groups such as college athletes .
Frequency of alcohol consumption was strongly associated with perceived parental and sibling approval of drinking to get drunk; and alcohol consumption in the previous month was strongly associated with sibling and friends' approval of drinking to get drunk. Friends' approval of drinking has been found in previous studies to be associated with adolescent drinking behaviour , whereas the effect of perceived parental approval has been less consistent, with some studies reporting significant results  and others no evidence of a significant association .
The present study supports previous findings from the USA which indicate that adolescents' perceptions of family and peer drinking patterns and attitudes to alcohol are associated with increased alcohol consumption in young people. Importantly, the present study was conducted in a country (Australia) with a lower legal drinking age (18 years) and high alcohol initiation among adolescents. We find an even stronger effect of family and friends' drinking behaviours and attitudes, in a culture where adult alcohol consumption rates are high; 89% of Australians aged 30 to 39 years and 86% aged 60+ are current drinkers , compared with around 60% of adults in the USA aged 30–39 and less than 45% aged 60+ .
As David Crosbie, then CEO of Odyseey House, stated in 2005: ‘The vast majority of Australian children grow up in a culture where alcohol plays a central role in almost every aspect of formal and informal social events. As adult Australians, we celebrate, commiserate and mark our social occasions as significant through the use of alcohol’ . Indeed, one of the key recommendations of Australia's National Preventative Health Taskforce was the long-term goal of reshaping Australia's drinking culture to produce healthier and safer outcomes .
This ‘drinking culture’ is reflected in the positioning of drinking as normative and not drinking as deviant. For example, a recent Australian qualitative study identified that individuals who participated in 1 month alcohol abstinence programmes (such as ‘Dry July’ and ‘Ocsober’) faced a number of cultural barriers to not drinking, including a perceived obligation to share and reciprocate in drinking practices and the perception of non-drinking as deviant behaviour . Similarly, research with pregnant women has found that these women experience a problematic conflict between the ‘good mother’ norm, which engenders a sense of guilt associated with drinking during pregnancy, and the ‘drinking’ norm, which labels non-drinkers as unsocial and makes many women feel pressured to consume alcohol (particularly during the early stages of pregnancy and those trying to become pregnant ). Given that many Australian adults struggle to resist the pro-drinking social norm, it is not surprising that these norms influence the behaviour of adolescents who are in the process developing their self-identity.
In Australia, high school students are perceived as ‘close’ to the drinking age and thus there is a widespread view that early experimentation is acceptable. It is important to note that, unlike the USA, Australia does not have a ‘legal drinking age’ per se, but rather a legal purchasing age; and no legal sanctions for provision of alcohol to children by their parents or guardians, although provision to others' children is illegal in most jurisdictions. A 2009 survey of Australian adults, conducted by a national health insurer, found that more than half of Australian adults believe that 15 to 17-year-olds should be allowed to consume alcohol under parental supervision at home , with endorsement of this view increasing with household income. Further, parents are often the providers of alcohol consumed by underage drinkers; in the 2005 national ASSAD survey, 32.9% of 12- to 17-year-olds indicated that their parents gave them their last drink .
A recent US study of 232 teen pairs found that concordance between teens' (mean age 14.2 years) perceptions of their friend's (mean age 14.25) drinking was high, but primarily driven by agreement on the absence of drinking, with only 60% of targets correctly identifying that their friend drinks. They conclude that adolescents do not have exaggerated perceptions of friends' behaviours, but also note that ‘drinking and smoking occur infrequently among (US) 13 to 15 year olds’, with only 22% of their sample reporting drinking alcohol .
The current study also identified a number of other demographic and economic factors associated with underage alcohol consumption, many of which are outside of the control of policy makers. For example, young people born overseas were more likely to report consuming alcohol weekly, those with higher weekly income were more likely to have consumed alcohol regularly and those who perceived that their peers spent more on alcohol each week were more likely to consume alcohol on a weekly basis (although the mutability of this factor would depend on whether this is an observed reality or a perception).
There are a number of limitations to this study that should be considered. First, this study was cross-sectional, so the temporal relationships between variables cannot be determined. Furthermore, subject reporting of alcohol consumption can be prone to inaccuracies and bias due to factors such as social norms and perceptions of legal sanctions. This study utilised a range of recruitment measures in an effort to address some of these limitations (e.g. online surveys to reduce the impact of social desirability which may be a factor when completing a survey in the presence of peers). This, however, brings with it the potential for differences in responses that are a function of the data collection method (paper and pen vs. online) rather than the respondents. As stated in the results, there were some differences between the participants recruited via different methods, and these differences were controlled for in the analyses. There were minor demographic differences in age (intercept group slightly younger), gender (proportion of women slightly higher from Facebook) and income (slightly lower in the school group) that may have influenced the findings. There were small differences in reported alcohol consumption (those from the intercept and focus groups were less likely to report having consumed more than 10 drinks and having consumed alcohol on a weekly basis) and perceived family consumption (Facebook and school groups more likely to indicate that their mother, father and siblings consumed alcohol), which may have been related to the age differences between groups. Those recruited via intercept were slightly less likely to believe that their friends and people their age regularly consumed alcohol and that their siblings would approve of them drinking to get drunk (again likely related to their slightly lower age). The Facebook and school groups were slightly more likely to report that their siblings consumed alcohol, and that their friends would approve of them drinking to get drunk; which may be a function of their slightly older age and/or the increased awareness of others' drinking, such as due to postings on Facebook.