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Keywords:

  • adolescent;
  • alcohol consumption;
  • family;
  • peer group

Abstract

  1. Top of page
  2. Abstract
  3. Introduction
  4. Methods
  5. Results
  6. Discussion
  7. Conclusion
  8. Acknowledgements
  9. References

Introduction and Aims

This study examines factors associated with alcohol-related attitudes and behaviours among 888 Australians aged 12 to 17 years. Although these influences have been examined in other countries, notably the USA, Australia's legal drinking age of 18 years is lower and adolescent drinking rates are substantially higher than in the USA.

Design and Methods

This is a survey of 888 adolescents aged 12–17; they were recruited via a variety of methods (including school based, interception in public places and online) to obtain a cross-section of participants across metropolitan, regional and rural New South Wales.

Results

Most respondents believed that people their age regularly consumed alcohol; and more than half believed that their siblings and peers would approve of them drinking. Predictors of frequent alcohol consumption included having a sibling or a friend who consumed alcohol; believing parents, friends and/or siblings approved of drinking; drinking behaviours of parents, friends and/or siblings; and having a higher disposable income.

Discussion and Conclusions

The results support previous findings from the USA. We find an even stronger effect of family and friends' drinking behaviours and attitudes in a country with a lower legal drinking age and high adult alcohol consumption rates.[Jones SC, Magee CA. The role of family, friends and peers in Australian adolescent's alcohol consumption. Drug Alcohol Rev 2014;33:304–313]


Introduction

  1. Top of page
  2. Abstract
  3. Introduction
  4. Methods
  5. Results
  6. Discussion
  7. Conclusion
  8. Acknowledgements
  9. References

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 [1]. 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 [1]. 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 [2]—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 [3].

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 [3] 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 [8], 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 [9]. In contrast, adolescents with parents who are opposed to alcohol consumption [6] and those whose parents apply prohibitions and strict rules regarding drinking and emphasise the negative effects of alcohol [9] 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 [10].

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 [14]. 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 [17], and perceived adult approval of drinking [15].

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.

Methods

  1. Top of page
  2. Abstract
  3. Introduction
  4. Methods
  5. Results
  6. Discussion
  7. Conclusion
  8. Acknowledgements
  9. References

Participants

Adolescents aged 12–17 years were recruited using several methods to gain a cross-section of participants across metropolitan, regional and rural New South Wales, Australia. Four independent (i.e. non-government) high schools distributed surveys to students aged 12 to 17 years (n = 247); intercept surveys were conducted at shopping malls (n = 192); focus group participants from a parallel study completed the survey (n = 103); and the social networking site ‘Facebook’ was used to recruit participants to complete the survey online (n = 346). An indicator variable was used to signify whether surveys were completed online or in hard copy to detect any likely sources of systematic error that may be attributable to the survey medium.

Materials

The questionnaire included items that assessed whether participants had ever consumed alcohol (coded as ‘never/a few sips’, ‘<10 drinks’ and ‘> 10 drinks’); if they had consumed alcohol in the previous four weeks (‘Yes’, ‘No’); and the frequency with which they had consumed alcohol in the previous 12 months (coded as never/rarely, fortnightly/monthly or weekly/more than weekly). Respondents were also asked to indicate whether their mother, father, siblings, friends and other people their age consumed alcohol, as well as whether they believed their parents, siblings and friends approved of them trying alcohol and drinking to get drunk.

Information on the following covariates was also included: age; gender; country of birth; religion; amount of money received through pocket money or paid employment (summed to provide a measure of weekly income); and perceptions of how much money their peers spent on alcohol each week.

Statistical analysis

The first stage of the analysis was to compare demographic characteristics, drinking patterns, family and peer consumption, and family and peer attitudes to alcohol consumption between the four recruitment groups. Differences between the groups were determined on the basis of analysis of variance and χ2-tests.

Three logistic regression models were then used to examine the multivariate associations between drinking patterns and family and peer drinking patterns and attitudes. Model 1 included the number of drinks ever consumed as the dependent variable; ‘never/a few sips’ was the reference category; and odds ratios (OR) were derived for >10 drinks versus <10 drinks relative to the reference category. The following independent variables were included: maternal drinking, paternal drinking, sibling drinking, peer drinking, friend drinking, parents' approval of drinking, sibling approval of drinking, friends' approval of drinking. The model controlled for age, gender, religion, country of birth, weekly income and perceptions of peer spending on alcohol.

Model 2 examined the association between the frequency of alcohol consumption in the previous 12 months and the variables listed previously. The reference category for the frequency of alcohol consumption was never/rarely, and ORs were calculated for fortnightly/monthly versus never/rarely and weekly/more than weekly versus never/rarely.

In Model 3, these variables were again entered to examine the factors associated with alcohol consumption in the previous four weeks (ORs were calculated for the ‘yes’ category relative to ‘no’).”

The data were analysed using spss version 15 and results are reported as ORs with 95% confidence intervals. Where appropriate, Bonferroni adjustments to α were performed to prevent Type 1 errors associated with performing multiple tests.

Results

  1. Top of page
  2. Abstract
  3. Introduction
  4. Methods
  5. Results
  6. Discussion
  7. Conclusion
  8. Acknowledgements
  9. References

The demographic characteristics of the sample are shown in Table 1. Most participants were born in Australia (89.3%), more than half were women (58.4%), and the majority indicated that they were Christian (58.4%) or that they had no religion (32.0%).

Table 1. Demographic characteristics of the sample of adolescents
 Intercept (n = 192; 21.6%)Focus (n = 103; 11.6%)Facebook (n = 346; 39.0%)School (n = 247; 27.8%)Total (N = 888)
  1. Data are presented as frequencies (with percentages in parenthesis) unless specified otherwise.

Age, years—mean (SD)14.4 (1.8)15.3 (1.6)15.8 (1.3)15.7 (1.2)15.4 (1.5)
Age categories (years) 
12–14106 (55.2)33 (32.0)56 (16.2)41 (16.6)236
15–1653 (27.6)41 (39.8)151 (43.6)123 (49.8)368
1753 (27.6)29 (28.2)139 (40.2)83 (33.6)236
Gender 
Male80 (41.7)49 (47.6)123 (35.5)117 (47.4)369
Female112 (58.3)54 (52.4)223 (64.5)130 (52.6)519
Country of birth 
Australia161 (83.9)103 (100.0)304 (87.9)225 (91.1)793
Other31 (16.1)0 (0.0)42 (12.1)22 (8.9)95
Weekly income ($)—mean (SD)54.0 (78.9)64.5 (70.4)64.0 (105.4)32.5 (48.0)53.1 (84.0)
Weekly income ($) 
1080 (38.6)32 (33.0)91 (41.2)89 (47.5)290
10–5073 (35.3)38 (39.2)66 (29.9)70 (38.3)247
>5054 (26.1)27 (27.8)64 (29.0)26 (14.2)171
Religion 
No religion/Atheist61 (34.3)31 (34.8)117 (36.6)31 (15.5)240
Christian109 (61.2)55 (61.8)183 (57.2)96 (48.0)443
Other religion8 (4.5)3 (3.4)20 (6.3)73 (36.5)104
Have you ever consumed alcohol? 
Never/a few sips122 (63.5)30 (29.1)129 (37.3)61 (24.7)342
Yes, <10 drinks18 (9.4)21 (20.4)59 (17.1)36 (14.6)134
Yes, >10 drinks52 (27.1)52 (50.5)159 (46.0)150 (60.7)412
Frequency of consumption in previous 12 months 
Never84 (43.8)25 (24.3)92 (26.6)38 (15.4)239
A few times per year58 (30.2)28 (27.2)128 (37.0)89 (36.0)303
Fortnightly—monthly28 (14.6)33 (32.0)91 (26.3)95 (38.5)247
Weekly22 (11.5)17 (16.5)35 (10.1)25 (38.5)99
Consumed alcohol in the previous month 
Yes59 (30.7)57 (55.3)158 (45.7)123 (49.8)397
No133 (69.3)46 (44.7)188 (54.3)124 (50.2)491

Comparison of recruitment groups

Table 1 indicates several differences between the recruitment groups. The intercept group was younger (χ2(6, N = 888) = 110.847, P < 0.001) and more likely to have been born overseas (χ2(3, N = 888) = 30.157, P < 0.001). Participants recruited through Facebook were more likely to be women (χ2(3, N = 888) = 10.144, P = 0.017), while the school group had a significantly greater proportion of Jewish participants than the other groups (χ2(9, N = 888) = 134.307, P < 0.001) but a lower weekly income (χ2(9, N = 888) = 16.897, P = 0.010).

Most participants indicated they had consumed some alcohol in their lives (89.1%), but the intercept and focus groups were less likely to report having consumed more than 10 drinks (χ2(9, N = 888) = 79.730, P < 0.001). Furthermore, 38.9% of respondents indicated they consumed alcohol on a regular basis (i.e. at least monthly) in the previous year, and this was less likely among the intercept and focus group participants (χ2(9, N = 888) = 62.703, P < 0.001).

As shown in Table 2, most participants indicated their mother (65.2%) consumed alcohol, which was highest in the Facebook and school groups (χ2(6, N = 888) = 26.217, P < 0.001). Similarly, most fathers were reported to consume alcohol (76.2%), particularly in the Facebook and school groups (χ2(6, N = 888) = 16.408, P = 0.012). Approximately half of participants (49.8%) indicated their siblings consumed alcohol, and this was most pronounced in the Facebook and school samples (χ2(6, N = 888) = 27.667, P < 0.001).

Table 2. Drinking patterns and drinking attitudes of family members and peers
 Intercept (n = 192; 21.6%)Focus groups (n = 103; 11.6%)Facebook (n = 346; 39.0%)School (n = 247; 27.8%)Total (N = 888)
Does your mother drink alcohol?
Yes113 (58.9)78 (75.7)216 (62.4)189 (76.5)596
No69 (35.9)20 (19.4)115 (33.2)54 (21.9)258
Don't know/Don't have a mother10 (5.2)5 (4.9)15 (4.3)4 (1.6)34
Does your father drink alcohol?
Yes143 (74.4)84 (81.6)246 (71.1)204 (82.6)677
No29 (15.1)12 (11.7)70 (20.2)33 (13.4)144
Don't know/Don't have a father20 (10.4)7 (6.8)30 (8.7)10 (4.0)67
Do your siblings drink alcohol
Yes72 (37.5)49 (47.6)168 (48.6)153 (61.9)442
No110 (57.3)51 (49.5)163 (47.1)85 (34.4)409
Don't know/Don't have siblings10 (5.2)3 (2.9)15 (4.3)9 (3.6)37
Do people your age regularly consume alcohol?
Yes124 (64.6)87 (84.5)291 (84.1)209 (84.6)711
No68 (35.4)16 (15.5)55 (15.9)38 (15.4)177
Do any of your friends regularly consume alcohol?
Yes95 (49.5)78 (75.7)240 (69.4)164 (66.4)577
No97 (50.5)25 (24.3)106 (30.6)83 (33.6)311
Would your sibling(s) approve of you consuming alcohol to get drunk?
Yes32 (16.7)31 (30.1)82 (23.7)71 (28.7)216
No128 (66.7)46 (44.7)184 (53.2)107 (43.3)465
Not sure32 (16.7)26 (25.2)80 (23.1)69 (27.9)207
Would your parent(s) approve of you consuming alcohol to get drunk?
Yes14 (7.3)14 (13.6)32 (9.2)20 (8.1)80
No161 (83.9)72 (69.9)278 (80.3)197 (79.8)708
Not sure17 (8.9)17 (16.5)36 (10.4)30 (12.1)100
Would your friends approve of you consuming alcohol to get drunk?
Yes82 (42.7)71 (68.9)221 (63.9)157 (63.6)531
No76 (39.6)19 (18.4)82 (23.7)52 (21.1)229
Not sure34 (17.7)13 (12.6)43 (12.4)38 (15.4)128

Most participants believed people their age regularly consumed alcohol (80.0%), but this was lower in intercept and focus groups (χ2(3, N = 888) = 33.348, P < 0.001). Approximately two-thirds indicated that their friends consumed alcohol (65.0%) and this was lowest in the intercept group and highest in the school group (χ2(6, N = 888) = 28.067, P < 0.001). The majority (79.7%) believed their parents would not approve of them drinking to get drunk and this did not differ significantly across the groups (χ2(6, N = 888) = 8.388, P = 0.211). Approximately half of participants believed that their siblings would approve of them drinking to get drunk (52.4%) and this was lowest in the intercept group (χ2(6, N = 888) = 27.060, P < 0.001). Most people believed that their friends would approve of them drinking to get drunk (59.8%), with the proportion higher in the Facebook and school groups (χ2 (6, N = 888) = 33.490, P < 0.001).

Regression models

The results for the model examining the association between family and peer influences and ‘ever’ alcohol consumption are shown in Table 3 (Model fit: χ2 54 = 657.95, P < 0.001 Nagelkerke R2 = 0.604). Individuals with a mother [OR = 2.22 (1.31, 3.76)] and sibling/s [OR = 2.27 (1.44, 5.60)] who consumed alcohol were more likely to have indicated that they had consumed more than 10 drinks. Furthermore, individuals who believed that their peers [OR = 2.77 (1.34, 5.74)] and friends [OR = 3.23 (1.88, 5.56)] regularly consumed alcohol were also more likely to indicate that they had consumed more than 10 drinks. Sibling approval of drinking alcohol to get drunk was significantly associated with an increased likelihood of having consumed more than 10 drinks [OR = 6.98 (3.23, 15.08)]. Having peers who consumed alcohol [OR = 2.70 (1.32, 5.54)] and friends who approved of drinking to see what it is like [OR = 8.70 (1.80, 41.96)] were also associated with an increased likelihood of having consumed <10 drinks.

Table 3. The association between family and peer influences and alcohol consumption
 <10 drinks>10 drinksP-valueb
OR95% CIOR95% CI
  1. aOdds ratio is significant at a P-value of .025. bP-value refers to the log-likelihood tests. cReference category is ‘no’. OR, odds ratio; Ref, referent group.

Age (years) <0.001
12–14Ref Ref 
15–162.79a1.50, 5.163.45a1.85, 6.45
171.630.79, 3.385.55a2.81, 10.96
Male gender1.150.70, 1.881.73a1.10, 2.720.036
Born overseas2.030.98, 4.211.060.52, 2.180.102
Religion 0.119
No religion/Atheist1.87a1.10, 3.161.240.76, 2.01
Other religion1.670.72, 3.901.790.79, 4.07
ChristianRef Ref 
Mother drinks alcoholc1.690.96, 2.992.22a1.31, 3.760.011
Father drinks alcoholc1.630.87, 3.071.580.89, 2.800.200
Siblings drink alcoholc1.450.88, 2.402.27a1.44, 5.600.002
Peers drink regularlyc2.70a1.32, 5.542.77a1.34, 5.740.004
Friends consume alcoholc1.280.73, 2.243.23a1.88, 5.56<0.001
Parents approve of drinking to see what it is likec 0.052
Yes1.911.02, 3.581.670.94, 2.97
Don't know0.870.32, 2.340.560.23, 1.38
Parents approve of drinking to get drunkc 0.249
Yes0.690.17, 2.911.700.52, 5.56
Not sure0.600.25, 1.440.630.29, 1.37
Siblings approve of drinking to see what it is likec 0.180
Yes1.680.79, 3.581.780.87, 3.65
Don't know0.850.34, 2.161.630.71, 3.77
Siblings approve of drinking to get drunkc <0.001
Yes2.400.98, 5.896.98a3.23, 15.08
Not sure2.50a1.30, 4.782.45a1.34, 4.48
Friends approve of drinking to see what it is likec 0.004
Yes8.70a1.80, 41.963.721.03, 13.44
Don't know3.330.55, 20.141.570.33, 7.49
Friends approve of drinking to get drunkc 0.170
Yes0.830.44, 1.561.800.95, 3.41
Not sure1.020.45, 2.331.440.61, 3.38
Weekly income ($)    0.003
10Ref Ref 
10–500.880.50, 1.530.940.56, 1.57
>501.921.04, 3.552.57a1.46, 4.53
How much do you think your friends spend on alcohol? ($) 0.014
10Ref Ref 
10–500.670.37, 1.231.140.63, 2.08
>501.650.53, 5.144.23a1.54, 11.64

The results for the model predicting alcohol consumption in the previous 12 months are shown in Table 4 (model fit: χ2 54 = 466.27, P < 0.001, Nagelkerke R2 = 0.489). The model indicated that having a sibling [OR = 2.26 (1.26, 4.07)] or friend [OR = 5.42 (2.06, 14.24)] who consumed alcohol was associated with weekly alcohol consumption. Furthermore, individuals who believed that their parents [OR = 3.11 (1.33, 7.27)] or siblings [OR = 4.95 (2.24, 10.93)] approved of them drinking to get drunk were more likely to have consumed alcohol on a weekly/fortnightly basis. Monthly consumption was higher where siblings [OR = 1.68 (1.14, 2.47)] or friends [OR = 2.79 (1.65, 4.70)] consumed alcohol, and among participants who believed their siblings approved of them drinking to get drunk [OR = 2.93 (1.72, 5.01)].

Table 4. The association between family and peer influences and frequency of alcohol consumption in the previous 12 months
 WeeklyMonthlyP-valueb
OR95% CIOR95% CI
  1. aOdds ratio is significant at a P-value of .025. bP-value refers to the log-likelihood tests. cReference category is ‘no’. OR, odds ratio; Ref, referent group.

Age (years) 0.055
12–14Ref Ref 
15–160.380.16, 0.910.920.77, 2.70
170.580.23, 1.421.440.50, 1.69
Male gender3.30a1.88, 5.801.370.94, 2.02<0.001
Born overseas2.54a1.19, 5.420.42a0.21, 0.88<0.001
Religion 0.107
No religion/Atheist1.570.89, 2.770.950.64, 1.41
Other religion2.971.10, 7.980.800.32, 1.97
ChristianRef Ref 
Mother drinks alcoholc1.350.70, 2.621.460.91, 2.350.276
Father drinks alcoholc1.460.72, 2.981.680.99, 2.840.142
Siblings drink alcoholc2.26a1.26, 4.071.68a1.14, 2.470.005
Peers drink regularlyc1.710.51, 5.741.610.78, 3.290.349
Friends consume alcoholc5.42a2.06, 14.242.79a1.65, 4.70<0.001
Parents approve of drinking to see what it is likec    0.655
Yes1.600.74, 3.461.290.77, 2.15
Don't know1.930.61, 6.071.510.67, 3.43
Parents approve of drinking to get drunkc    0.047
Yes3.11a1.33, 7.271.080.53, 2.19
Not sure1.240.51, 3.021.250.68, 2.31
Siblings approve of drinking to see what it is likec    0.605
Yes1.760.53, 5.821.670.81, 3.46
Don't know1.930.51, 7.311.460.63, 3.36
Siblings approve of drinking to get drunkc    <0.001
Yes4.95a2.24, 10.932.93a1.72, 5.01
Not sure1.330.56, 3.181.440.86, 2.39
Friends approve of drinking to see what it is likec    0.018
Yes0.400.08, 2.091.810.47, 7.01
Don't know0.070.01, 1.050.370.06, 2.17
Friends approve of drinking to get drunkc    0.626
Yes1.780.55, 5.821.480.80, 2.71
Not sure2.070.45, 9.611.600.71, 3.59
Weekly income ($)    0.001
10Ref Ref 
10–500.790.38, 1.661.010.63, 1.58
>502.89a1.44, 5.781.73a1.07, 2.78
How much do you think your friends spend on alcohol? ($)    <0.001
10Ref Ref 
10–503.52a1.30, 9.521.99a1.17, 3.37
>507.81a2.28, 26.731.120.46, 2.74

Several covariates were associated with weekly alcohol consumption. For example, men were more likely than women to consume alcohol on a weekly basis [OR = 3.30, (1.88, 5.80)]. Individuals earning more than $50 each week were more likely to consume alcohol on a weekly basis [OR = 2.89 (1.44, 5.78)] and monthly basis [OR = 1.73 (1.07, 2.78)] compared with those earning ≤$10. Individuals who indicated that they thought their friends spent more than $50 each week on alcohol [OR = 7.81 (2.28, 26.73)] or $10–50 per week [OR = 3.52 (1.30, 9.52)] were also more likely to consume alcohol on a weekly basis.

The results for the model predicting alcohol consumption in the previous month are shown in Table 5 (model fit χ2 31 = 353.08, P < 0.001, Nagelkerke R2 = 0.438). The results indicated that individuals whose mother [OR = 1.92 (1.27, 2.92)], siblings [OR = 1.43 (1.01, 2.03)] or friends [OR = 3.65 (2.32, 5.74)] drank alcohol were more likely to indicate that they had consumed alcohol in the previous month. Individuals whose siblings approved of them consuming alcohol to see what it is like [OR = 2.65 (1.75, 4.86)] or drinking to get drunk [OR = 2.90 (1.75, 4.82)] were also more likely to have consumed alcohol in the previous 1 month, as were those whose friends approved of them drinking to get drunk [OR = 1.74 (1.03, 2.93)]. Men [OR = 1.47 (1.04, 2.07)] and individuals earning more than $50 a week [OR = 2.43 (1.58, 3.75)] were also more likely to have consumed alcohol in the previous month.

Table 5. The association between family and peer influences and alcohol consumption in the past month
 Consumed alcohol in previous monthP-valueb
OR95% CI
  1. aOdds ratio is significant at a P-value of .05. bP value refers to the log-likelihood tests. cReference category is ‘no’. OR, odds ratio; Ref, referent group.

Age (years)  0.082
12–14Ref 
15–160.610.37, 1.01
170.820.49, 1.41
Male gender1.47a1.04, 2.070.028
Born overseas1.480.84, 2.590.169
Religion  0.337
No religion/Atheist1.120.56, 2.22
Other religion0.780.54, 1.12
ChristianRef 
Mother drinks alcoholc1.92a1.27, 2.920.002
Father drinks alcoholc1.360.87, 2.150.182
Siblings drink alcohol1.43a1.01, 2.030.046
Peers drink regularlyc0.980.56, 1.740.954
Friends consume alcoholc3.65a2.32, 5.74<0.001
Parents approve of drinking to see what it is likec  0.914
Yes0.990.63, 1.57
Don't know0.860.42, 1.78
Parents approve of drinking to get drunkc  0.568
Yes1.230.63, 2.39
Not sure0.810.46, 1.42
Siblings approve of drinking to see what it is likec  0.006
Yes2.65a1.44, 4.86
Don't know2.23a1.12, 4.46
Siblings approve of drinking to get drunkc  <0.001
Yes2.90a1.75, 4.82
Not sure1.230.78, 1.96
Friends approve of drinking to see what it is likec  0.130
Yes1.570.61, 4.06
Don't know0.720.22, 2.35
Ref
Friends approve of drinking to get drunkc  0.099
Yes1.74a1.03, 2.93
Not sure1.710.86, 3.40
Weekly income ($)  <0.001
10Ref 
10–501.280.85, 1.92
>502.43a1.58, 3.75
How much do you think your friends spend on alcohol? ($)  0.222
10Ref 
10–501.500.95, 2.36
>501.400.67, 2.93

Discussion

  1. Top of page
  2. Abstract
  3. Introduction
  4. Methods
  5. Results
  6. Discussion
  7. Conclusion
  8. Acknowledgements
  9. References

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 [1], 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% [18].

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 [10] or very weak associations [17].

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 [21].

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 [17], whereas the effect of perceived parental approval has been less consistent, with some studies reporting significant results [15] and others no evidence of a significant association [17].

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 [22], compared with around 60% of adults in the USA aged 30–39 and less than 45% aged 60+ [23].

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’ [24]. 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 [25].

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 [26]. 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 [27]). 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 [28], 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 [1].

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 [29].

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).

Limitations

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.

Conclusion

  1. Top of page
  2. Abstract
  3. Introduction
  4. Methods
  5. Results
  6. Discussion
  7. Conclusion
  8. Acknowledgements
  9. References

Alcohol consumption among adolescents in Australia, as in other countries, remains high—despite the recognised harms to this group from drinking. This study suggests that the role of family and peer drinking-related behaviours and attitudes on adolescent drinking is as important, if not more so, than shown in previous US-based studies. There is a need to educate adults about their role in facilitating and encouraging underage drinking, and to address the culture of tacit acceptance of drinking among young people.

Acknowledgements

  1. Top of page
  2. Abstract
  3. Introduction
  4. Methods
  5. Results
  6. Discussion
  7. Conclusion
  8. Acknowledgements
  9. References

The first author is the holder of an Australian Research Council Future Fellowship. This study was funded by NSW Health.

References

  1. Top of page
  2. Abstract
  3. Introduction
  4. Methods
  5. Results
  6. Discussion
  7. Conclusion
  8. Acknowledgements
  9. References
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