essay on alcohol and youth

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Alcohol’s Impact on Young People

How does alcohol affect the young?

The papers in our collection focus on the relationship between alcohol and young people from childhood to early adulthood .

Research suggests that even moderate drinking by parents may impact children. At the same time, young children’s familiarity with alcohol may put them at risk of early alcohol initiation.

Our collection goes on to explore alcohol use in adolescence , from neurobiological implications to association with sexual identity and STI risk; and considers a cohort of adolescents and young adults when analysing the relationship of drinking behaviours with social media use and risk of violence respectively.

Finally, we follow trajectories of alcohol use in early adulthood , with articles assessing predictors of Alcohol Use Disorder (AUD), considering the role of gender and age on drinking practices, and examining withdrawal-associated muscle pain hypersensitivity in healthy episodic binge drinkers.

All articles will be free to access and share until the 30th of June, with a view to disseminating scientific knowledge on the impact of alcohol on young people.

Alcohol and Children

From age 4 to 8, children become increasingly aware about normative situations for adults to consume alcohol.

Children aged 4–8 become increasingly knowledgeable about drinking norms in specific situations which implies that they know in what kind of situation alcohol consumption is a common human behavior. This knowledge may put them at risk for early alcohol initiation and frequent drinking later in life.

An Exploration of the Impact of Non-Dependent Parental Drinking on Children

Findings suggest levels of and motivations for parental drinking, as well as exposure to a parent tipsy or drunk, all influence children’s likelihood of experiencing negative outcomes.

Alcohol and Adolescents

Lifetime alcohol use influences the association between future-oriented thought and white matter microstructure in adolescents.

These findings replicate reports of reduced future orientation as a function of greater lifetime alcohol use and demonstrate an association between future orientation and white matter microstructure, in the PCR, a region containing afferent and efferent fibers connecting the cortex to the brain stem, which depends upon lifetime alcohol use.

Differential Alcohol Use Disparities by Sexual Identity and Behavior Among High School Students

Results highlight the need to incorporate multiple methods of sexual orientation measurement into substance use research.

What a Difference a Drink Makes: Determining Associations Between Alcohol-Use Patterns and Condom Utilization Among Adolescents

Results suggest significant increased risk of condomless sex among binge drinking youth. Surprisingly, no significant difference in condom utilization was identified between non-drinkers and only moderate drinkers.

Alcohol and Adolescents and Young Adults

The association between social media use and hazardous alcohol use among youths: a four-country study.

Certain social media platforms might inspire and/or attract hazardously drinking youths, contributing to the growing opportunities for social media interventions.

Change in the Relationship Between Drinking Alcohol and Risk of Violence Among Adolescents and Young Adults: A Nationally Representative Longitudinal Study

Alcohol is most strongly linked to violence among adolescents, so programmes for primary prevention of alcohol-related violence are best targeted towards this age group, particularly males who engage in heavy episodic drinking.

Alcohol and Young Adults

Predictors of alcohol use disorders among young adults: a systematic review of longitudinal studies.

This review suggests that externalizing behaviour is a strong predictor of AUD. The risk of AUD is also high when illicit drug use co-occurs with externalizing behaviour. Environmental factors were influential but changed over time.More evidence is needed to assess the roles of early internalizing behaviour, early drinking onset and other distinctive factors on the development of AUD in young adulthood

Gender-Specific Drinking Contexts Are Associated With Social Harms Resulting From Drinking Among Australian Young Adults at 30 Years

We found that experiences of social harms from drinking at 30 years differ depending on the drinker’s gender and context. Our findings suggest that risky contexts and associated harms are still significant among 30-year-old adults, indicating that a range of gender-specific drinking contexts should be represented in harm reduction campaigns. The current findings also highlight the need to consider gender to inform context-based harm reduction measures and to widen the age target for these beyond emerging adults.

The Role of Sex and Age on Pre-drinking: An Exploratory International Comparison of 27 Countries

This exploratory study aims to model the impact of sex and age on the percentage of pre-drinking in 27 countries, presenting a single model of pre-drinking behaviour for all countries and then comparing the role of sex and age on pre-drinking behaviour between countries. Using data from the Global Drug Survey, the percentages of pre-drinkers were estimated for 27 countries from 64,485 respondents. Bivariate and multivariate multilevel models were used to investigate and compare the percentage of pre-drinking by sex (male and female) and age (16–35 years) between countries.

Hyperalgesia after a Drinking Episode in Young Adult Binge Drinkers: A Cross-Sectional Study

This is the first study to show that alcohol withdrawal-associated muscle hyperalgesia may occur in healthy episodic binge drinkers with only 2–3 years of drinking history, and epinephrine may play a role in binge drinking-associated hyperalgesia.

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• v.14(11); 2022 Nov

Substance Abuse Amongst Adolescents: An Issue of Public Health Significance

1 School of Epidemiology and Public Health, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND

Sonali G Choudhari

2 School of Epidemiology and Public Health; Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND

Sarika U Dakhode

3 Department of Community Medicine, Dr. Panjabrao Deshmukh Memorial Medical College, Amravati, IND

Asmita Rannaware

Abhay m gaidhane.

Adolescence is a crucial time for biological, psychological, and social development. It is also a time when substance addiction and its adverse effects are more likely to occur. Adolescents are particularly susceptible to the negative long-term effects of substance use, including mental health illnesses, sub-par academic performance, substance use disorders, and higher chances of getting addicted to alcohol and marijuana. Over the past few decades, there have been substantial changes in the types of illegal narcotics people consume. The present article deals with the review of substance abuse as a public health problem, its determinants, and implications seen among adolescents. A systematic literature search using databases such as PubMed and Google Scholar was undertaken to search all relevant literature on teenage stimulant use. The findings have been organized into categories to cover essential aspects like epidemiology, neurobiology, prevention, and treatment. The review showed that substance addiction among adolescents between 12 to 19 years is widespread, though national initiatives exist to support young employment and their development. Research on psychological risk factors for teenage substance abuse is vast, wherein conduct disorders, including aggression, impulsivity, and attention deficit hyperactivity disorder, have been mentioned as risk factors for substance use. Parents' attitudes toward drugs, alcohol, academic and peer pressure, stress, and physical outlook are key determinants. Teenage drug usage has a significant negative impact on users, families, and society as a whole. It was found that a lot has been done to provide correct intervention to those in need with the constant development of programs and rehabilitative centers to safeguard the delicate minds of youths and prevent them from using intoxicants. Still, there is much need for stringent policy and program guidelines to curb this societal menace. 

Introduction and background

Drug misuse is a widespread issue; in 2016, 5.6% of people aged 15 to 26 reported using drugs at least once [ 1 ]. Because alcohol and illegal drugs represent significant issues for public health and urgent care, children and adolescents frequently visit emergency rooms [ 2 ]. It is well known that younger people take drugs more often than older adults for most drugs. Drug usage is on the rise in many Association of Southeast Asian Nations, particularly among young males between the ages of 15 and 30 years [ 3 ]. According to the 2013 Global Burden of Disease report, drug addiction is a growing problem among teenagers and young people. Early substance use increases the likelihood of future physical, behavioral, social, and health issues [ 4 ]. Furthermore, recreational drug use is a neglected contributor to childhood morbidity and mortality [ 5 ]. One of the adverse outcomes of adolescent substance use is the increased risk of addiction in those who start smoking, drinking, and taking drugs before they are of 18 years. Moreover, most individuals with Substance Use Disorders begin using substances when they are young [ 6 ]. Substance use disorders amongst adolescents have long-term adverse health effects but can be mitigated with efficient treatment [ 7 ].

Childhood abuse is linked to suicidal thoughts and attempts. The particular mental behavior that mediates the link between childhood trauma and adult suicidal ideation and attempts is yet unknown. Recent studies show teens experiencing suicidal thoughts, psychiatric illness symptoms like anxiety, mood, and conduct disorders, and various types of child maltreatment like sexual abuse, corporal punishment, and emotional neglect that further leads to children inclining toward intoxicants [ 8 ]. Although teen substance use has generally decreased over the past five years, prolonged opioid, marijuana, and binge drinking use are still common among adolescents and young adults [ 9 ]. Drug-using students are more prone to commit crimes, including bullying and violent behavior. It has also been connected to various mental conditions, depending on the substance used. On the other hand, it has been linked to social disorder, abnormal behavior, and association with hostile groups [ 10 ]. Adolescent substance users suffer risks and consequences on the psychological, sociocultural, or behavioral levels that may manifest physiologically [ 11 ]. About 3 million deaths worldwide were caused by alcohol consumption alone. The majority of the 273,000 preventable fatalities linked to alcohol consumption are in India [ 12 ], which is the leading contributor. The United Nations Office on Drug and Crime conducted a national survey on the extent, patterns, and trends of drug abuse in India in 2003, which found that there were 2 million opiate users, 8.7 million cannabis users, and 62.5 million alcohol users in India, of whom 17% to 20% are dependent [ 13 ]. According to prevalence studies, 13.1% of drug users in India are under the age of 20 [ 14 ].

In India, alcohol and tobacco are legal drugs frequently abused and pose significant health risks, mainly when the general populace consumes them. States like Punjab and Uttar Pradesh have the highest rates of drug abuse, and the Indian government works hard to provide them with helpful services that educate and mentor them. This increases the burden of non-communicable illnesses too [ 15 ]. In addition, several substances/drugs are Narcotic and Psychotropic and used despite the act named ‘Narcotic Drugs and Psychotropic Substances Act, 1985. 

This review article sheds light on ‘substance abuse’ amongst adolescents as an issue of public health significance, its determinants, and its implications on the health and well-being of adolescents.

Methodology

The present article deals with the narrative review of substance abuse as a public health problem, its determinants, and implications seen among adolescents. A systematic literature search using databases such as PubMed and Google Scholar was undertaken to search all relevant literature on teenage stimulant use. The findings have been organized into categories to cover essential aspects like epidemiology, neurobiology, prevention, and treatment. Various keywords used under TiAb of PubMed advanced search were Stimulants, "Drug abuse", "Psychotropic substance", "Substance abuse", addiction, and Adolescents, teenage, children, students, youth, etc., including MeSH terms. Figure ​ Figure1 1 shows the key substances used by youth.

Reasons for abuse

People may initially choose to take drugs for psychological and physical reasons. Psychological issues, including mental illness, traumatic experiences, or even general attitudes and ideas, might contribute to drug usage. Several factors can contribute to emotional and psychosocial stress, compelling one to practice drug abuse. It can be brought on by a loss of a job because of certain reasons, the death of a loved one, a parent's divorce, or financial problems. Even medical diseases and health problems can have a devastating emotional impact. Many take medicines to increase their physical stamina, sharpen their focus, or improve their looks.

Students are particularly prone to get indulged in substance abuse due to various reasons, like academic and peer pressure, the appeal of popularity and identification, readily available pocket money, and relatively easy accessibility of several substances, especially in industrial, urban elite areas, including nicotine (cigarettes) [ 16 , 17 ]. In addition, a relationship breakup, mental illness, environmental factors, self-medication, financial concerns, downtime, constraints of work and school, family obligations, societal pressure, abuse, trauma, boredom, curiosity, experimentation, rebellion, to be in control, enhanced performance, isolation, misinformation, ignorance, instant gratification, wide availability can be one of the reasons why one chooses this path [ 18 ].

The brain grows rapidly during adolescence and continues to do so until early adulthood, as is well documented. According to studies using structural magnetic resonance imaging, changes in cortical grey matter volume and thickness during development include linear and nonlinear transformations and increases in white matter volume and integrity. This delays the maturation of grey and white matter, resulting in poorer sustained attention [ 19 ]. Alcohol drinking excessively increases the likelihood of accidents and other harmful effects by impairing cognitive functions like impulse control and decision-making and motor functions like balance and hand-eye coordination [ 20 ]. Lower-order sensory motor regions of the brain mature first, followed by limbic areas crucial for processing rewards. The development of different brain regions follows different time-varying trajectories. Alcohol exposure has adversely affected various emotional, mental, and social functions in the frontal areas linked to higher-order cognitive functioning that emerge later in adolescence and young adulthood [ 21 ].

Smoking/e-cigarettes

The use of tobacco frequently begins before adulthood. A worryingly high percentage of schoolchildren between 13 and 15 have tried or are currently using tobacco, according to the global youth tobacco survey [ 22 ]. It is more likely that early adolescent cigarette usage will lead to nicotine dependence and adult cigarette use. Teenage smoking has been associated with traumatic stress, anxiety, and mood problems [ 23 ]. Nicotine usage has been associated with a variety of adolescent problems, including sexual risk behaviors, aggressiveness, and the use of alcohol and illegal drugs. High levels of impulsivity have been identified in adolescent smokers.

Additionally, compared to non-smokers, smoking is associated with a higher prevalence of anxiety and mood disorders in teenagers. Smoking is positively associated with suicidal thoughts and attempts [ 24 ]. Peer pressure, attempting something new, and stress management ranked top for current and former smokers [ 25 ]. Most teenagers say that when they start to feel down, they smoke to make themselves feel better and return to their usual, upbeat selves. Smoking may have varying effects on people's moods [ 26 ]. Teenagers who smoke seem more reckless, less able to control their impulses, and less attentive than non-smokers [ 27 ].

Cannabis/Marijuana

Marijuana is among the most often used illegal psychotropic substances in India and internationally. The prevalence of marijuana usage and hospitalizations related to marijuana are rising, especially among young people, according to current trends. Cannabis usage has been connected to learning, working memory, and attention problems. Cannabis has been shown to alleviate stress in small doses, but more significant amounts can cause anxiety, emotional symptoms, and dependence [ 28 ]. Myelination and synaptic pruning are two maturational brain processes that take place during adolescence and the early stages of adulthood. According to reports, these remodeling mechanisms are linked to efficient neural processing. They are assumed to provide the specialized cognitive processing needed for the highest neurocognitive performance. On a prolonged attentional processing test, marijuana usage before age 16 was linked to a shorter reaction time [ 29 ]. Cannabis use alters the endocannabinoid system, impacting executive function, reward function, and affective functions. It is believed that these disturbances are what lead to mental health problems [ 30 ].

MDMA (Ecstasy/Molly)

MDMA (3,4-methylenedioxy-methamphetamine) was a synthetic drug used legally in psychotherapy treatment throughout the 1970s, despite the lack of data demonstrating its efficacy. Molly, or the phrase "molecular," is typically utilized in powder form. Serotonin, dopamine, and norepinephrine are produced more significantly when MDMA is used. In the brain, these neurotransmitters affect mood, sleep, and appetite. Serotonin also causes the release of other hormones that may cause emotions of intimacy and attraction. Because of this, users might be more affectionate than usual and possibly develop ties with total strangers. The effects wear off three to six hours later, while a moderate dose may cause withdrawal symptoms to continue for a week. These symptoms include a decline in sex interest, a drop in appetite, problems sleeping, confusion, impatience, anxiety, sorrow, Impulsivity and violence, issues with memory and concentration, and insomnia are a few of them. Unsettlingly, it is rising in popularity in India, particularly among teenagers [ 31 ].

Opium 

In addition to being a top producer of illicit opium, India is a significant drug consumer. In India, opium has a long history. The most common behavioral changes are a lack of motivation, depression, hyperactivity, a lack of interest or concentration, mood swings or abrupt behavior changes, confusion or disorientation, depression, anxiety, distortion of reality perception, social isolation, slurred or slow-moving speech, reduced coordination, a loss of interest in once-enjoyed activities, taking from family members or engaging in other illegal activity [ 32 ]. Except for the chemical produced for medicinal purposes, it is imperative to prohibit both production and usage since if a relatively well-governed nation like India cannot stop the drug from leaking, the problem must be huge in scope [ 33 ].

Cocaine is a highly addictive drug that causes various psychiatric syndromes, illnesses, and symptoms. Some symptoms include agitation, paranoia, hallucinations, delusions, violence, and thoughts of suicide and murder. They may be caused by the substance directly or indirectly through the aggravation of co-occurring psychiatric conditions. More frequent and severe symptoms are frequently linked to the usage of cocaine in "crack" form. Cocaine can potentially worsen numerous mental diseases and cause various psychiatric symptoms.

Table ​ Table1 1 discusses the short- and long-term effects of substance abuse.

Other cheap substances ( sasta nasha ) used in India

India is notorious for phenomena that defy comprehension. People in need may turn to readily available items like Iodex sandwiches, fevibond, sanitizer, whitener, etc., for comfort due to poverty and other circumstances to stop additional behavioral and other changes in youth discouragement is necessary [ 42 - 44 ]. 

Curbing drug abuse amongst youth

Seventy-five percent of Indian households contain at least one addict. The majority of them are fathers who act in this way due to boredom, stress from their jobs, emotional discomfort, problems with their families, or problems with their spouses. Due to exposure to such risky behaviors, children may try such intoxicants [ 45 ]. These behaviors need to be discouraged because they may affect the child's academic performance, physical growth, etc. The youngster starts to feel depressed, lonely, agitated and disturbed. Because they primarily revolve around educating students about the dangers and long-term impacts of substance abuse, previous attempts at prevention have all been ineffective. To highlight the risks of drug use and scare viewers into abstaining, some programs stoked terror. The theoretical underpinning of these early attempts was lacking, and they failed to consider the understanding of the developmental, social, and other etiologic factors that affect teenage substance use. These tactics are based on a simple cognitive conceptual paradigm that says that people's decisions to use or abuse substances depend on how well they are aware of the risks involved. More effective contemporary techniques are used over time [ 46 ]. School-based substance abuse prevention is a recent innovation utilized to execute changes, including social resistance skills training, normative education, and competence enhancement skills training.

Peer pressure makes a teenager vulnerable to such intoxicants. Teenagers are often exposed to alcohol, drugs, and smoking either because of pressure from their friends or because of being lonely. Social resistance training skills are used to achieve this. The pupils are instructed in the best ways to steer clear of or manage these harmful situations. The best method to respond to direct pressure to take drugs or alcohol is to know what to say (i.e., the specific content of a refusal message) and how to say it. These skills must be taught as a separate curriculum in every school to lower risk. Standard instructional methods include lessons and exercises to dispel misconceptions regarding drug usage's widespread use. 

Teenagers typically exaggerate how common it is to smoke, drink, and use particular substances, which could give off the impression that substance usage is acceptable. We can lessen young people's perceptions of the social acceptability of drug use by educating them that actual rates of drug usage are almost always lower than perceived rates of use. Data from surveys that were conducted in the classroom, school, or local community that demonstrate the prevalence of substance use in the immediate social setting may be used to support this information. If not, this can be taught using statistics from national surveys, which usually show prevalence rates that are far lower than what kids describe.

The role social learning processes have in teen drug use is recognized by competency-improvement programs, and there is awareness about how adolescents who lack interpersonal and social skills are more likely to succumb to peer pressure to use drugs. These young people might also be more inclined to turn to drug usage instead of healthier coping mechanisms. Most competency enhancement strategies include instruction in many of the following life skills: general problem-solving and decision-making skills, general cognitive abilities for fending off peer or media pressure, skills for enhancing self-control, adaptive coping mechanisms for reducing stress and anxiety through the use of cognitive coping mechanisms or be behavioral relaxation techniques, and general social and assertive skills [ 46 ].

Programs formulated to combat the growing risk of substance abuse

The Ministry of Health and Family Welfare developed Rashtriya Kishor Swasthya Karyakram for teenagers aged 10 to 19, with a focus on improving nutrition, sexual and reproductive health, mental health, preventing injuries and violence, and preventing substance abuse. By enabling them to make informed and responsible decisions about their health and well-being and ensuring that they have access to the tools and assistance they need, the program seeks to enable all adolescents in India in realizing their full potential [ 47 ].

For the past six years, ‘Nasha Mukti Kendra’ in India and rehabilitation have worked to improve lives and provide treatment for those who abuse alcohol and other drugs. They provide cost-effective and dedicated therapy programs for all parts of society. Patients come to them from all around the nation. Despite having appropriate programs and therapies that can effectively treat the disorder, they do not employ medication to treat addiction.

Conclusions

Around the world, adolescent drug and alcohol addiction has significantly increased morbidity and mortality. The menace of drugs and alcohol has been woven deep into the fabric of society. As its effects reach our youth, India's current generation is at high stake for the risk associated with the abuse of drugs like cannabis, alcohol, and tobacco. Even though the issue of substance abuse is complicated and pervasive, various stakeholders like healthcare professionals, community leaders, and educational institutions have access to a wealth of evidence-based research that can assist them to adopt interventions that can lower rates of teenage substance misuse. It is realized that while this problem is not specific to any one country or culture, individual remedies might not always be beneficial. Due to the unacceptably high rate of drug abuse that is wreaking havoc on humanity, a strategy for addressing modifiable risk factors is crucial. Because human psychology and mental health influence the choices the youth make related to their indulgence in drug misuse, it is the need of the hour to give serious consideration to measures like generating awareness, counseling, student guidance cells, positive parenting, etc., across the world. It will take time to change this substance misuse behavior, but the more effort we put into it, the greater the reward we will reap.

The content published in Cureus is the result of clinical experience and/or research by independent individuals or organizations. Cureus is not responsible for the scientific accuracy or reliability of data or conclusions published herein. All content published within Cureus is intended only for educational, research and reference purposes. Additionally, articles published within Cureus should not be deemed a suitable substitute for the advice of a qualified health care professional. Do not disregard or avoid professional medical advice due to content published within Cureus.

The authors have declared that no competing interests exist.

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Alcohol's Effects on Health

Research-based information on drinking and its impact.

National Institute on Alcohol Abuse and Alcoholism (NIAAA)

Make a difference: talk to your child about alcohol - parents.

Quick Facts

Kids who drink are more likely to be victims of violent crime, to be involved in alcohol-related traffic crashes, and to have serious school-related problems.

You have more influence on your child’s values and decisions about drinking before he or she begins to use alcohol.

Parents can have a major impact on their children’s drinking, especially during the preteen and early teen years.

Introduction

With so many drugs available to young people these days, you may wonder, “Why develop a booklet about helping kids avoid alcohol?”  Alcohol is a drug,  as surely as cocaine and marijuana are. The National Minimum Legal Drinking Age in the United States is 21.  And underage drinking is dangerous.  Kids who drink are more likely to:

Be victims of violent crime.

Have serious problems in school.

Be involved in drinking-related traffic crashes.

This guide is geared to parents and guardians of young people ages 10 to 14. Keep in mind that the suggestions on the following pages are just that—suggestions.  Trust your instincts.  Choose ideas you are comfortable with, and use your own style in carrying out the approaches you find useful. Your child looks to you for guidance and support in making life decisions—including the decision not to use alcohol.

“But my child isn’t drinking yet,” you may think. “Isn’t it a little early to be concerned about drinking?” Not at all. This is the age when some children begin experimenting with alcohol. Even if your child is not yet drinking alcohol, he or she may be receiving pressure to drink.  Act now.  Keeping quiet about how you feel about your child’s alcohol use may give him or her the impression that alcohol use is OK for kids.

It’s not easy.  As children approach adolescence, friends exert a lot of influence. Fitting in is a chief priority for teens, and parents often feel shoved aside.  Kids will listen,  however. Study after study shows that even during the teen years, parents have enormous influence on their children’s behavior.

The bottom line is that most young teens don’t yet drink. And parents’ disapproval of youthful alcohol use is the key reason children choose not to drink.  So make no mistake: You can make a difference.

(Note: This booklet uses a variety of terms to refer to young people ages 10 to 14, including youngsters, children, kids, and young teens.)

Young Teens and Alcohol: The Risks

For young people, alcohol is the drug of choice. In fact, alcohol is used by more young people than tobacco or illicit drugs. Although most children under age 14 have not yet begun to drink, early adolescence is a time of special risk for beginning to experiment with alcohol.

While some parents and guardians may feel relieved that their teen is “only” drinking, it is important to remember that alcohol is a powerful, mood-altering drug. Not only does alcohol affect the mind and body in often unpredictable ways, but teens lack the judgment and coping skills to handle alcohol wisely. As a result:

Alcohol-related traffic crashes are a major cause of death among young people. Alcohol use also is linked with teen deaths by drowning, suicide, and homicide.

Teens who use alcohol are more likely to be sexually active at earlier ages, to have sexual intercourse more often, and to have unprotected sex than teens who do not drink.

Young people who drink are more likely than others to be victims of violent crime, including rape, aggravated assault, and robbery.

Teens who drink are more likely to have problems with school work and school conduct.

The majority of boys and girls who drink tend to binge when they drink.

A person who begins drinking as a young teen is four times more likely to develop alcohol dependence than someone who waits until adulthood to use alcohol.

The message is clear: Alcohol use is unsafe for young people. And the longer children delay alcohol use, the less likely they are to develop any problems associated with it. That’s why it is so important to help your child avoid any alcohol use.

What is binge drinking?

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines binge drinking as a pattern of drinking that brings blood alcohol concentration (BAC) to 0.08 percent—or 0.08 grams of alcohol per deciliter—or higher.* For a typical adult, this pattern corresponds to consuming 4 or more drinks (female), or 5 or more drinks (male), in about 2 hours. Research shows that fewer drinks in the same timeframe result in the same BAC in youth; only 3 drinks for girls, and 3 to 5 drinks for boys, depending on their age and size.

*A BAC of 0.08 percent corresponds to 0.08 grams per deciliter, or 0.08 grams per 100 milliliters.

Your Young Teen's World

Early adolescence is a time of immense and often confusing changes for your son or daughter, which makes it a challenging time for both your youngster and you. Understanding what it’s like to be a teen can help you stay closer to your child and have more influence on the choices he or she makes—including decisions about using alcohol.

Changes in the Brain.  Research shows that as a child matures, his or her brain continues to develop too. In fact, the brain’s final, adult wiring may not even be complete until well into the twenties. Furthermore, in some ways, the adolescent brain may be specifically “wired” to help youth navigate adolescence and to take some of the risks necessary to achieve independence from their parents. This may help explain why teens often seek out new and thrilling—sometimes dangerous—situations, including drinking alcohol. It also offers a possible reason for why young teens act so impulsively, often not recognizing that their actions—such as drinking—can lead to serious problems.

Growing Up and Fitting In.  As children approach adolescence, “fitting in” becomes extremely important. They begin to feel more self-conscious about their bodies than they did when they were younger and begin to wonder whether they are “good enough”—tall enough, slender enough, attractive enough—compared with others. They look to friends and the media for clues on how they measure up, and they begin to question adults’ values and rules. It’s not surprising that this is the time when parents often experience conflict with their kids. Respecting your child’s growing independence while still providing support and setting limits is a key challenge during this time.

A young teen who feels that he or she doesn’t fit in is more likely to do things to try to please friends, including experimenting with alcohol. During this vulnerable time, it is particularly important to let your children know that in your eyes, they do measure up—and that you care about them deeply.

Did You Know?

That according to a recent national survey, 16 percent of eighth graders reported drinking alcohol within the past month?

That 32 percent of eighth graders reported drinking in the past year?

That 64 percent of eighth graders say that alcohol is easy to get?

That a recent survey shows that more girls than boys ages 12 to 17 reported drinking alcohol?

The Bottom Line: A Strong Parent–Child Relationship

You may wonder why a guide for preventing teen alcohol use is putting so much emphasis on parents’ need to understand and support their children. But the fact is, the best way to influence your child to avoid drinking is to have a strong, trusting relationship with him or her. Research shows that teens are much more likely to delay drinking when they feel they have a close, supportive tie with a parent or guardian. Moreover, if your son or daughter eventually does begin to drink, a good relationship with you will help protect him or her from developing alcohol-related problems.

The opposite also is true: When the relationship between a parent and teen is full of conflict or is very distant, the teen is more likely to use alcohol and to develop drinking-related problems.

This connection between the parent–child relationship and a child’s drinking habits makes a lot of sense when you think about it. First, when children have a strong bond with a parent, they are apt to feel good about themselves and therefore be less likely to give in to peer pressure to use alcohol. Second, a good relationship with you is likely to encourage your children to try to live up to your expectations, because they want to maintain their close tie with you. Here are some ways to build a strong, supportive bond with your child:

Establish open communication.  Make it easy for your teen to talk honestly with you. (See box “Tips for Talking With Your Teen.”)

Show you care.  Even though young teens may not always show it, they still need to know that they are important to their parents. Make it a point to regularly spend one-on-one time with your child—time when you can give him or her your loving, undivided attention. Some activities to share: a walk, a bike ride, a quiet dinner out, or a cookie-baking session.

Draw the line.  Set clear, realistic expectations for your child’s behavior. Establish appropriate consequences for breaking rules and consistently enforce them.

Offer acceptance.  Make sure your teen knows that you appreciate his or her efforts as well as accomplishments. Avoid hurtful teasing or criticism.

Understand that your child is growing up.  This doesn’t mean a hands-off attitude. But as you guide your child’s behavior, also make an effort to respect his or her growing need for independence and privacy.

Tips For Talking With Your Teen

Developing open, trusting communication between you and your child is essential to helping him or her avoid alcohol use. If your child feels comfortable talking openly with you, you’ll have a greater chance of guiding him or her toward healthy decisionmaking. Some ways to begin:

Encourage conversation. Encourage your child to talk about whatever interests him or her. Listen without interruption and give your child a chance to teach you something new. Your active listening to your child’s enthusiasms paves the way for conversations about topics that concern you.

Ask open-ended questions. Encourage your teen to tell you how he or she thinks and feels about the issue you’re discussing. Avoid questions that have a simple “yes” or “no” answer.

Control your emotions. If you hear something you don’t like, try not to respond with anger. Instead, take a few deep breaths and acknowledge your feelings in a constructive way.

Make every conversation a “win-win” experience. Don’t lecture or try to “score points” on your teen by showing how he or she is wrong. If you show respect for your child’s viewpoint, he or she will be more likely to listen to and respect yours.

Good Reasons For Teens Not To Drink

You want your child to avoid alcohol.

You want your child to maintain self-respect.

The National Minimum Legal Drinking Age is 21.

Drinking at their age can be dangerous.

You may have a family history of alcoholism.

Talking With Your Teen About Alcohol

For many parents, bringing up the subject of alcohol is no easy matter. Your young teen may try to dodge the discussion, and you yourself may feel unsure about how to proceed. To make the most of your conversation, take some time to think about the issues you want to discuss before you talk with your child. Consider too how your child might react and ways you might respond to your youngster’s questions and feelings. Then choose a time to talk when both you and your child have some “down time” and are feeling relaxed.

You don’t need to cover everything at once. In fact, you’re likely to have a greater impact on your child’s decisions about drinking by having a number of talks about alcohol use throughout his or her adolescence. Think of this talk with your child as the first part of an ongoing conversation.

And remember, do make it a conversation, not a lecture! You might begin by finding out what your child thinks about alcohol and drinking.

Your Child’s Views About Alcohol.  Ask your young teen what he or she knows about alcohol and what he or she thinks about teen drinking. Ask your child why he or she thinks kids drink. Listen carefully without interrupting. Not only will this approach help your child to feel heard and respected, but it can serve as a natural “lead-in” to discussing alcohol topics.

Important Facts About Alcohol.  Although many kids believe that they already know everything about alcohol, myths and misinformation abound. Here are some important facts to share:

Alcohol is a powerful drug that slows down the body and mind. It impairs coordination; slows reaction time; and impairs vision, clear thinking, and judgment.

Beer and wine are not “safer” than distilled spirits (gin, rum, tequila, vodka, whiskey, etc.). A 12-ounce can of beer (about 5 percent alcohol), a 5-ounce glass of wine (about 12 percent alcohol), and 1.5 ounces of 80-proof distilled spirits (40 percent alcohol) all contain the same amount of alcohol and have the same effects on the body and mind.

On average, it takes 2 to 3 hours for a single drink to leave a person’s system. Nothing can speed up this process, including drinking coffee, taking a cold shower, or “walking it off.”

People tend to be very bad at judging how seriously alcohol has affected them. That means many individuals who drive after drinking think they can control a car—but actually cannot.

Anyone can develop a serious alcohol problem, including a teenager.

Good Reasons Not to Drink.  In talking with your child about reasons to avoid alcohol, stay away from scare tactics. Most young teens are aware that many people drink without problems, so it is important to discuss the consequences of alcohol use without overstating the case. Some good reasons why  teens should not drink:

You want your child to avoid alcohol.  Clearly state your own expectations about your child’s drinking. Your values and attitudes count with your child, even though he or she may not always show it.

To maintain self-respect.  Teens say the best way to persuade them to avoid alcohol is to appeal to their self-respect—let them know that they are too smart and have too much going for them to need the crutch of alcohol. Teens also are likely to pay attention to examples of how alcohol might lead to embarrassing situations or events—things that might damage their self-respect or alter important relationships.

The National Minimum Legal Drinking Age is 21.  Getting caught with alcohol before age 21 may mean trouble with the authorities. Even if getting caught doesn’t lead to police action, the parents of your child’s friends may no longer permit them to associate with your child.

Drinking can be dangerous.  One of the leading causes of teen deaths is motor vehicle crashes involving alcohol. Drinking also makes a young person more vulnerable to sexual assault and unprotected sex. And while your teen may believe he or she wouldn’t engage in hazardous activities after drinking, point out that because alcohol impairs judgment, a drinker is very likely to think such activities won’t be dangerous.

You have a family history of alcoholism.  If one or more members of your family has suffered from alcoholism, your child may be somewhat more vulnerable to developing a drinking problem.

Alcohol affects young people differently than adults.  Drinking while the brain is still maturing may lead to long-lasting intellectual effects and may even increase the likelihood of developing alcohol dependence later in life.

The “Magic Potion” Myth.  The media’s glamorous portrayal of alcohol encourages many teens to believe that drinking will make them “cool,” popular, attractive, and happy. Research shows that teens who expect such positive effects are more likely to drink at early ages. However, you can help to combat these dangerous myths by watching TV shows and movies with your child and discussing how alcohol is portrayed in them. For example, television advertisements for beer often show young people having an uproariously good time, as though drinking always puts people in a terrific mood. Watching such a commercial with your child can be an opportunity to discuss the many ways that alcohol can affect people—in some cases bringing on feelings of sadness or anger rather than carefree high spirits.

How to Handle Peer Pressure.  It’s not enough to tell your young teen that he or she should avoid alcohol—you also need to help your child figure out how. What can your daughter say when she goes to a party and a friend offers her a beer? (See “Help Your Child Say No.”) Or what should your son do if he finds himself in a home where kids are passing around a bottle of wine and parents are nowhere in sight? What should their response be if they are offered a ride home with an older friend who has been drinking?

Brainstorm with your teen for ways that he or she might handle these and other difficult situations, and make clear how you are willing to support your child. An example: “If you find yourself at a home where kids are drinking, call me and I’ll pick you up—and there will be no scolding or punishment.” The more prepared your child is, the better able he or she will be to handle high-pressure situations that involve drinking.

Mom, Dad, Did You Drink When You Were a Kid?

This is the question many parents dread—yet it is highly likely to come up in any family discussion of alcohol. The reality is that some parents did drink when they were underage. So how can one be honest with a child without sounding like a hypocrite who advises, “Do as I say, not as I did”?

This is a judgment call. If you believe that your drinking or drug use history should not be part of the discussion, you can simply tell your child that you choose not to share it. Another approach is to admit that you did do some drinking as a teenager, but that it was a mistake—and give your teen an example of an embarrassing or painful moment that occurred because of your drinking. This approach may help your child better understand that youthful alcohol use does have negative consequences.

How To Host A Teen Party

Agree on a guest list—and don’t admit party crashers.

Discuss ground rules with your child before the party.

Encourage your teen to plan the party with a responsible friend so that he or she will have support if problems arise.

Brainstorm fun activities for the party.

If a guest brings alcohol into your house, ask him or her to leave.

Serve plenty of snacks and non-alcoholic drinks.

Be visible and available—but don’t join the party!

Taking Action: Prevention Strategies for Parents

While parent–child conversations about not drinking are essential, talking isn’t enough—you also need to take concrete action to help your child resist alcohol. Research strongly shows that active, supportive involvement by parents and guardians can help teens avoid underage drinking and prevent later alcohol misuse.

In a recent national survey, 64 percent of eighth graders said alcohol was “fairly easy” or “very easy” to get and 32 percent reported drinking within the last year. The message is clear: Young teens still need plenty of adult supervision. Some ways to provide it:

Monitor Alcohol Use in Your Home.  If you keep alcohol in your home, keep track of the supply. Make it clear to your child that you don’t allow unchaperoned parties or other teen gatherings in your home. If possible, however, encourage him or her to invite friends over when you are at home. The more entertaining your child does in your home, the more you will know about your child’s friends and activities.

Connect With Other Parents.  Getting to know other parents and guardians can help you keep closer tabs on your child. Friendly relations can make it easier for you to call the parent of a teen who is having a party to be sure that a responsible adult will be present and that alcohol will not be available. You’re likely to find out that you’re not the only adult who wants to prevent teen alcohol use—many other parents share your concern.

Keep Track of Your Child’s Activities.  Be aware of your teen’s plans and whereabouts. Generally, your child will be more open to your supervision if he or she feels you are keeping tabs because you care, not because you distrust him or her.

Develop Family Rules About Youthful Drinking.  When parents establish clear “no alcohol” rules and expectations, their children are less likely to begin drinking. Although each family should develop agreements about teen alcohol use that reflect their own beliefs and values, some possible family rules about drinking are:

Kids will not drink alcohol until they are 21.

Older siblings will not encourage younger brothers or sisters to drink and will not give them alcohol.

Kids will not stay at teen parties where alcohol is served.

Kids will not ride in a car with a driver who has been drinking.

Set a Good Example.  Parents and guardians are important role models for their children—even children who are fast becoming teenagers. Studies indicate that if a parent uses alcohol, his or her children are more likely to drink as well. But even if you use alcohol, there may be ways to lessen the likelihood that your child will drink. Some suggestions:

Use alcohol in moderation.

Don’t communicate to your child that alcohol is a good way to handle problems. For example, don’t come home from work and say, “I had a rotten day. I need a drink.”

Let your child see that you have other, healthier ways to cope with stress, such as exercise; listening to music; or talking things over with your spouse, partner, or friend.

Don’t tell your kids stories about your own drinking in a way that conveys the message that alcohol use is funny or glamorous.

Never drink and drive or ride in a car with a driver who has been drinking.

When you entertain other adults, serve alcohol-free beverages and plenty of food. If anyone drinks too much at your party, make arrangements for them to get home safely.

Help Your Child Say No

Your child can learn to resist alcohol or anything else he or she may feel pressured into. Let him or her know that the best way to say “no” is to be assertive—that is, say no and mean it.

Resist The Pressure To Drink

Say no and let them know you mean it.

Stand up straight.

Make eye contact.

Say how you feel.

Don’t make excuses.

Stand up for yourself.

Don’t Support Teen Drinking.  Your attitudes and behavior toward teen drinking also influence your child. Avoid making jokes about underage drinking or drunkenness, or otherwise showing acceptance of teen alcohol use. Never serve alcohol to your child’s underage friends. Research shows that kids whose parents or friends’ parents provide alcohol for teen get-togethers are more likely to engage in heavier drinking, to drink more often, and to get into traffic crashes. Remember, too, that in almost every State it is illegal to provide alcohol to minors who are not family members.

Help Your Child Build Healthy Friendships.  If your child’s friends use alcohol, your child is more likely to drink too. So it makes sense to try to encourage your young teen to develop friendships with kids who do not drink and who are otherwise healthy influences on your child. A good first step is to simply get to know your child’s friends better. You can then invite the kids you feel good about to family get-togethers and outings and find other ways to encourage your child to spend time with those teens. Also, talk directly with your child about the qualities in a friend that really count, such as trustworthiness and kindness, rather than popularity or a “cool” style.

When you disapprove of one of your child’s friends, the situation can be tougher to handle. While it may be tempting to simply forbid your child to see that friend, such a move may make your child even more determined to hang out with him or her. Instead, you might try pointing out your reservations about the friend in a caring, supportive way. You can also limit your child’s time with that friend through your family rules, such as how after-school time can be spent or how late your child can stay out in the evening.

Encourage Healthy Alternatives to Alcohol.  One reason kids drink is to beat boredom. So it makes sense to encourage your child to participate in supervised after-school and weekend activities that are challenging and fun. According to a recent survey of preteens, the availability of enjoyable, alcohol-free activities is a big reason for deciding not to use alcohol.

If your community doesn’t offer many supervised activities, consider getting together with other parents and teens to help create some. Start by asking your child and other kids what they want to do, because they will be most likely to participate in activities that truly interest them. Find out whether your church, school, or community organization can help you sponsor a project.

Could My Child Develop a Drinking Problem?

This booklet is primarily concerned with preventing teen alcohol use. We also need to pay attention to the possibility of youthful alcohol abuse. Certain children are more likely than others to drink heavily and encounter alcohol-related difficulties, including health, school, legal, family, and emotional problems. Kids at highest risk for alcohol-related problems are those who:

Begin using alcohol or other drugs before the age of 15.

Have a parent who is a problem drinker or an alcoholic.

Have close friends who use alcohol and/or other drugs.

Have been aggressive, antisocial, or hard to control from an early age.

Have experienced childhood abuse and/or other major traumas.

Have current behavioral problems and/or are failing at school.

Have parents who do not support them, do not communicate openly with them, and do not keep track of their behavior or whereabouts.

Experience ongoing hostility or rejection from parents and/or harsh, inconsistent discipline.

The more of these experiences a child has had, the greater the chances that he or she will develop problems with alcohol. Having one or more risk factors does not mean that your child definitely will develop a drinking problem, but it does suggest that you may need to act now to help protect your youngster from later problems.

Talking with your child is more important now than ever. If your child has serious behavioral problems, you may want to seek help from his or her school counselor, physician, and/or a mental health professional. And if you suspect that your child may be in trouble with drinking, consider getting advice from a health care professional specializing in alcohol problems before talking with your teen (see box “Warning Signs of a Drinking Problem”). To find a professional, contact your family doctor or a local hospital. Other sources of information and guidance may be found in your local Yellow Pages under “Alcoholism” or through one of the resources listed at the end of this booklet.

Warning Signs Of A Drinking Problem

Although the following signs may indicate a problem with alcohol or other drugs, some also reflect normal teenage growing pains. Experts believe that a drinking problem is more likely if you notice several of these signs at the same time, if they occur suddenly, and if some of them are extreme in nature.

Mood changes: flare-ups of temper, irritability, and defensiveness.

School problems: poor attendance, low grades, and/or recent disciplinary action.

Rebelling against family rules.

Switching friends, along with a reluctance to have you get to know the new friends.

A “nothing matters” attitude: sloppy appearance, a lack of involvement in former interests, and general low energy.

Finding alcohol in your child’s room or backpack, or smelling alcohol on his or her breath.

Physical or mental problems: memory lapses, poor concentration, bloodshot eyes, lack of coordination, or slurred speech.

Action Checklist

Establish a loving, trusting relationship with your child.

Make it easy for your teen to talk honestly with you.

Talk with your child about alcohol facts, reasons not to drink, and ways to avoid drinking in difficult situations.

Keep tabs on your young teen’s activities, and join with other parents in making common policies about teen alcohol use.

Develop family rules about teen drinking and establish consequences.

Set a good example regarding your own alcohol use and your response to teen drinking.

Encourage your child to develop healthy friendships and fun alternatives to drinking.

Know whether your child is at high risk for a drinking problem; if so, take steps to lessen that risk.

Know the warning signs of a teen drinking problem and act promptly to get help for your child.

Believe in your own power to help your child avoid alcohol use.

Partnership to End Addiction  485 Lexington Avenue, 3rd Floor  New York, NY 10017-6706  212–841–5200 Internet address: https://drugfree.org/

A national resource working to reduce teen substance abuse and to support families impacted by addiction.

National Institute on Alcohol Abuse and Alcoholism Publications Distribution Center P.O. Box 10686 Rockville, MD 20849–0686 301–443–3860 Internet address:   http://www.niaaa.nih.gov

Makes available free informational materials on many aspects of alcohol use, alcohol abuse, and alcoholism.

Substance Abuse and Mental Health Services Administration   National Drug Information Treatment and Referral Hotline 800–662–HELP (4357) (toll free) Internet address:   https://www.samhsa.gov/find-treatment

Provides information, support, treatment options, and referrals to local rehab centers for drug or alcohol problems. Operates 24 hours, 7 days a week.

To download or order, visit https://www.niaaa.nih.gov/publications . 

Or write to:

National Institute on Alcohol Abuse and Alcoholism Publications Distribution Center  P.O. Box 10686, Rockville, MD 20849–0686

niaaa.nih.gov

An official website of the National Institutes of Health and the National Institute on Alcohol Abuse and Alcoholism

Alcohol Among the Youth

How it works

Alcohol has always been around us even at a young age we see it everywhere and are allured by the concept of alcohol. The popularity of drinking alcohol starts to happen in 8th grade and 39% of students have tried alcohol (Johnston, O’Malley, Bachman, & Schulenberg, 2012). Students who have problems at home or who might feel the need to find an escape which is alcohol. In middle school, a student who identifies as a bully are three to five times more likely to drink alcohol (deBry & Tiffany, 2008; King & Chassin, 2007; Zucker et al.

, 2006). If this trend keeps persisting during the student’s earlier years this can lead to adulthood. Impaired social adjustments may be traced back to early parent-child attachments, and victimization and bullying perpetration may reflect dissatisfying interpersonal bonds early in development (Lereya, Samara, & Wolke, 2013). Living in a society where technology is striving, there is another form of aggression that has formed called cyberbullying which is hard to tackle. Mostly cyberbullying work has focused on more middle and high school students, with popularity rating ranging from twenty to forty percent (Selkie, E.). This type of bullying reports to have suicidal thoughts and feel depressed.

The Consequence of Drinking

The consequence that comes can have a major impact on those who drink alcohol irresponsibly. An article called “Cyberbullying, depression, and problem alcohol use in female college students” states, that thirty percent of college students are reported to have a diagnosis of depression. Also, sixty five percent of college students consume alcohol in any given month, and half of those students binge drink (Selkie, E.). According to (Pedrelli, P.), some large-scale national surveys have shown that nearly half (44%) of college students are binge drinkers [1–3] and that 22.7% binge frequently [4]. It has become so popular that it is part of the culture to drink. However, this is affecting the students’ performance at school which can lead to depression. Moreover, adolescent substance use is related to social and academic problems, such as academic failure and lower educational achievement (Crosnoe 2006; Latvala et al. 2014). The article called “Gender, Depressive Symptoms and Patterns of Alcohol Use among College Students” said it found that college students meeting criteria for alcohol abuse were 3.6 times more likely to have a history of major depressive disorder than their peers who did not meet criteria for alcohol abuse (Pedrelli, P.).

This is a lot more common in female students compared to males. Another issue that students go through is peer pressure. For example, peer victimization may lead to social anxiety and depressive symptoms (e.g., Hamilton et al. 2013; Landoll et al. 2013; Siegel et al. 2009; Thompson and Leadbeater 2012) and, in turn, social anxiety and negative affect may lead to greater substance use (e.g., Mason et al. 2009; Zehe et al. 2013). Anxiety can hinder college student’s concentration and social skills in school. To reduce the psychological and physical anxiety symptoms, students have the capability to drink alcohol a lot more easily because of the anxiolytic properties (Keyes, Hatzenbuehler, & Hasin, 2011; Low, Lee, Johnson, Williams, & Harris, 2008). In addition, the article called, “Correlation between anxiety and alcohol consumption among college students,” by Silva, E. C., & Tucci, A. M. (2018) says that 6.5% of students drink alcohol to reduce the symptoms of anxiety. The goal of this study was to examine further the use of alcohol among students and how that affects their behavior such as having low self-esteem and anxiety. This study took place in a university with a handful of students answering a survey.

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• Open access
• Published: 07 November 2021

How to prevent alcohol and illicit drug use among students in affluent areas: a qualitative study on motivation and attitudes towards prevention

• Pia Kvillemo   ORCID: orcid.org/0000-0002-9706-4902 1 ,
• Linda Hiltunen 2 ,
• Youstina Demetry 3 ,
• Anna-Karin Carlander 4 ,
• Tim Hansson 5 ,
• Johanna Gripenberg 1 ,
• Tobias H. Elgán 1 ,
• Kim Einhorn 4 &
• Charlotte Skoglund 1 , 4  

Substance Abuse Treatment, Prevention, and Policy volume  16 , Article number:  83 ( 2021 ) Cite this article

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The use of alcohol and illicit drugs during adolescence can lead to serious short- and long-term health related consequences. Despite a global trend of decreased substance use, in particular alcohol, among adolescents, evidence suggests excessive use of substances by young people in socioeconomically affluent areas. To prevent substance use-related harm, we need in-depth knowledge about the reasons for substance use in this group and how they perceive various prevention interventions. The aim of the current study was to explore motives for using or abstaining from using substances among students in affluent areas as well as their attitudes to, and suggestions for, substance use prevention.

Twenty high school students (age 15–19 years) in a Swedish affluent municipality were recruited through purposive sampling to take part in semi-structured interviews. Qualitative content analysis of transcribed interviews was performed.

The most prominent motive for substance use appears to be a desire to feel a part of the social milieu and to have high social status within the peer group. Motives for abstaining included academic ambitions, activities requiring sobriety and parental influence. Students reported universal information-based prevention to be irrelevant and hesitation to use selective prevention interventions due to fear of being reported to authorities. Suggested universal prevention concerned reliable information from credible sources, stricter substance control measures for those providing substances, parental involvement, and social leisure activities without substance use. Suggested selective prevention included guaranteed confidentiality and non-judging encounters when seeking help.

Conclusions

Future research on substance use prevention targeting students in affluent areas should take into account the social milieu and with advantage pay attention to students’ suggestions on credible prevention information, stricter control measures for substance providers, parental involvement, substance-free leisure, and confidential ways to seek help with a non-judging approach from adults.

Alcohol consumption and illicit drug use are major public health concerns causing great individual suffering as well as substantial societal costs [ 1 , 2 ]. Early onset of substance use is especially problematic since the developing brain is vulnerable to the effects of alcohol and drugs, increasing the risk of long-term negative effects, such as harmful use, addiction, and mental health problems [ 3 , 4 , 5 , 6 ]. Short-term consequences of substance use include intoxication [ 5 , 7 ], accidents [ 8 [, academic failure [ 9 ], and interaction with legal authorities [ 10 ], which calls for effective substance use prevention in adolescents and young adults. Such prevention interventions may be universal, targeting the general population, e.g., legal measures and school based programs, or selective, targeting certain vulnerable at-risk groups, i.e., subsections of the population [ 11 ]. Selective prevention can be carried out within a universal prevention setting, such as health care or school, but also be delivered directly to the group which it aims to target, face-to-face or digitally [ 12 , 13 , 14 , 15 ].

The motives to use substances are governed by a number of personal, social and environmental factors [ 16 ], ranging from personal knowledge, abilities, beliefs and attitudes, to the influence of family, friends and society [ 17 , 18 , 19 , 20 ]. Cooper and colleagues [ 21 ] have previously identified a number of motives for drinking, i.e., 1) enhancement (drinking to maintain or amplify positive affect), 2) coping (drinking to avoid or dull negative affect), 3) social (drinking to improve parties or gatherings), and 4) conformity (drinking due to social pressure or a need to fit in). Similar motives for illicit drug use have been found by e.g. Kettner and colleagues, who highlighted the attainment of euphoria and enhancement of activities as prominent motives for use of psychoactive substances among people using psychedelics in parallel with other substances [ 22 ], along with Boys and colleagues [ 23 , 24 , 25 ], who reported on changing mood (e.g., to stop worrying about a problem) and social purposes (e.g., to enjoy the company of friends) as motives for using illicit drugs among young people. Additionally, the authors found that the facilitation of activities (e.g., to concentrate, to work/study), physical effects (e.g., to lose weight), and the managing of the effects of other substances (e.g., to ease or improve) motivated young people to use illicit drugs.

Prior research has repeatedly shown that low socioeconomic status is a risk factor for substance use and related problems [ 26 , 27 , 28 ]. However, recent research from Canada [ 29 ], the United States [ 30 , 31 , 32 ], Serbia [ 33 ], Switzerland [ 34 ], and Sweden [ 35 ] suggest that high socioeconomic status too is associated with excessive substance use among young people, although for other reasons [ 29 , 30 , 31 , 32 , 33 , 34 ]. Previous research has highlighted two main explanations for excessive substance use among young people in families with high socioeconomic status; i) exceptionally high requirements to perform in both school and leisure activities and ii) absence of adult contact, emotionally and physically, due to parents in resourceful and affluent areas spending a lot of time on their work and careers [ 36 , 37 ]. In addition to these explanations, high physical and social availability due to substantial economic resources and a social milieu were substance use is a natural element, may enable extensive substance use among economically privileged young people [ 30 , 38 , 39 ].

In parallel with identification of various groups at risk for extensive substance use, a growing number of young people globally abstain from using substances [ 1 , 40 , 41 ]. By analyzing data derived from a nationally representative sample of American high school students, Levy and colleagues [ 40 ] found an increasing percentage of 12th-graders reporting no current (past 30 days) substance use between 1976 and 2014, showing that a growing proportion of high school students are motivated to abstain from substance use. However, while this global decrease in substance use among adolescents is mirrored in Swedish youths, in particular alcohol use, a more detailed investigation shows large discrepancies across different socioeconomic and geographic areas. Affluent areas in Sweden stand out as breaking the trend, showing increasing alcohol and illicit drug use among adolescents [ 42 , 43 ].

To date, we lack in-depth knowledge of why youths in affluent areas keep using alcohol and illicit drugs excessively. Furthermore, despite implementation of various strategies and interventions over the last decades [ 14 , 44 , 45 , 46 , 47 , 48 ], we have yet no clear guidelines on how to effectively prevent substance use in this specific group, although the importance of parents’ role for preventing substance use in privileged adolescents has been highlighted in a recent study [ 29 ]. Moreover, despite the fact that attitudes are assumed to guide behavior [ 49 , 50 ] and consequently the reception and effects (behavior change) of prevention interventions, the knowledge about affluent adolescents’ attitudes toward current substance use prevention interventions remains limited. To our knowledge, the only study exploring adolescents’ attitudes to substance use prevention was carried out among Spanish adolescents who participated in “open-air gatherings of binge drinkers”. The study concerned adolescents irrespective of their economic background and revealed positive attitudes to restrictions for drunk people [ 19 ]. Thus, extended knowledge on what motivates young people in affluent areas to excessively use substances, or abstaining from using, as well as their attitudes to prevention is warranted.

In the current study, we aim to explore motives for using, or abstaining from using, substances among students in affluent areas. In addition, we aim to explore their attitudes to and suggestions for substance use prevention. The findings may make a valuable contribution to the research on tailored substance use prevention for groups of adolescents that may not be sufficiently supported by current prevention strategies.

A qualitative interview study was performed among high school students in one of Stockholm county’s most affluent municipalities. The research team developed a semi-structured interview guide (supplementary Interview guide) covering issues regarding the individual’s physical and mental health, extent of alcohol and illicit drug use, motives for use or abstinence, relationships with peers and family, alcohol and drug related norms among peers, family and in the society, and attitudes towards strategies to prevent substance use. Examples of interview questions are: How would you describe your health? Which are the main reasons why young people drink, do you think? How do you get hold of alcohol as a teenager?

What do you know about drug use among young people in Municipality X? How would you describe your social relationships with peers in and outside Municipality X?

The study was approved by the Swedish Ethical Review Authority (dnr. 2019–02646).

Study setting

Sweden has strict regulations of alcohol and illicit drugs compared to many other countries [ 45 , 46 ]. Alcohol beverages (> 3.5% alcohol content by volume) can only be bought at the Swedish Alcohol Retailing Monopoly “Systembolaget” by people 20 years of age or older, or at licensed premises (e.g., bars, restaurants, clubs), at the minimum age of 18 years. The use of illicit drugs is criminalized. The study was carried out in a municipality with 45% higher annual median income than the corresponding figure for all of Sweden, along with the highest educational level among all Swedish municipalities, i.e., 58% of the population (25 years and over) having graduated from university and hold professional degrees, as compared with the national average of 26%. Furthermore, only 6.1% of the inhabitants receive public assistance, compared to a national average of 13.4% [ 51 ].

Recruitment

Purposive sampling was used to recruit students from the three high schools located in the selected municipality. Contact was established by the research team with the principals of the high schools that agreed to participate in the study. Information and invitation to participate in the study was published on the schools’ online platforms, visible for parents and students. Students communicated their initial interest in participating to the assistant principal. Upon consent from the students, the assistant principal forwarded mobile phone numbers of eligible students to the research team. Also, students from other schools in the selected municipality were asked by friends to participate and upon contact with the research team were invited to participate. Forty students signed up to take part in the study, of which 20 were finally interviewed, representing four schools (three in the selected municipality and one in a neighbor municipality). Before the interview, informed consent was obtained by informing the students about confidentiality arrangements, their right to withdraw their participation and subsequently asking them about their consent to participate. The consent was recorded and transcribed along with the following interview. Twenty students who had initially signed up were excluded after initial consent due to incorrect phone numbers or if the potential participants were not reachable on the agreed time for participation. The reason for terminating the recruitment after 20 interviewees was based on the fact that little or no new information was considered to occur by including additional participants.

Participants

The final sample consisted of 20 students. Background information of the participants is presented in Table  1 . The group included eleven girls and nine boys between 15 and 19 years of age. Seven participants attended natural sciences/technology/mathematic programs and 13 attended social sciences/humanities programs. Twelve participants lived in the socioeconomically affluent municipality where the schools were located and eight in neighboring municipalities. The sample included three abstainers and 17 informants who were using substances, the latter referring to self-reported present use of alcohol and/or illicit drugs (without further specification). Additionally, 18 of the participants reported that at least one of their parents had a university education.

During April–May 2020, semi-structured telephone interviews with the students were conducted by five of the authors (PK, YD, AKC, TH, CS). The interviewers had continuous contact during the interview process, exchanging their experiences from the interviews and also the content of the interviews. After 20 interviews had been conducted, it was assessed that no or little new information could be obtained by additional interviews and the interview process was terminated. The interviews, on average around 60 min long, were recorded on audio files and transcribed verbatim.

Qualitative content analysis, informed by Hsieh & Shannon [ 52 ] and Granheim & Lundman [ 53 ], was used to analyze the interview material. To increase reliability of the analytic process, a team based approach was employed [ 54 ], utilizing the broad expertise represented in the research team and the direct experience of information collected from the five interviewers.

The software NVivo 12 was utilized for structuring the interview data. Initially, one of the researchers (PK) read all the interviews repeatedly, searching for meaningful units which could be grouped into preliminary categories and codes, as exemplified in Table 2 . During the process, a preliminary coding scheme was developed and presented to the whole research team. After discussion, the coding scheme was slightly revised. Following this procedure, a second coder (CS) applied the updated coding scheme along with definitions (codebook) [ 54 ], coding all the interviews independently. Subsequent discussions between PK, YD and CS, resulted in an additionally revised coding scheme. This scheme was utilized by PK and another researcher (LH), who had not been involved in the interviewing or coding, coding all of the interviews independently. The agreement between the coders PK and LH was high and a few disagreements solved through discussion. No change in the codes was necessary and the research team agreed on the coding scheme as outlined in Fig.  1 .

Final coding scheme

The interview material generated three main categories, six subcategories and 27 codes. The results are presented under headings corresponding to the identified subcategories, since they are directly connected to the aim of the study. Content from the main category “External factors” is initially presented to illustrate the context in which the students form their motivation to use or abstain from using substances, as well as their attitudes towards prevention.

External factors

The external factors found in the interview material concerned wealth, availability of alcohol and other substances, parental norms and peer norms. Informants living in the affluent municipality described an expensive lifestyle with boats, ski trips, summer vacations abroad, and frequent restaurant visits, in contrast to informants from other areas who described a more modest lifestyle. These differences were further accentuated by informants’ descriptions of large villas in the affluent municipality, where students can arrange parties while the parents go to their holiday homes. Some informants further pointed to the fact that people in this municipality easily can afford to buy illicit drugs, increasing the availability.

The reason why they do it [use illicit drugs] in [the affluent municipality] is because the parents go away, which make it easier to have parties and be able to smoke grass at home, and also because they can afford it .

Parents’ alcohol norms seemed to vary between families, but most informants described modest drinking at home, with parents consuming alcohol on certain occasions and sometimes when having dinner. However, several informants described that they as minors/children were offered to taste alcohol from the parents’ glasses. Most of the informants meant that their parents trust them not to drink too much when partying.

They [my parents] have said to me that drinking is not good, but that they understand if I drink, sort of.

Both parents’ and peers’ norms appear to influence substance use among the students, The impression is that there is an alcohol liberal norm in the local society among adults as well as among adolescents.

If you want to have a social life in community X, then it is very difficult … you almost cannot have it if you don’t drink at parties.

Motives for using substances

Confirming that both alcohol and illicit drugs are frequently used among students in the current municipality, a number of motives for substance use were expressed by the participants. The most prominent motive appeared to be a desire to feel a part of the social milieu and to attain or maintain high social status, with fear of being excluded from attractive social activities and parties if abstaining from substance use. The participants indicated that you are expected to drink alcohol to be included in the local community social life, claiming that this applied to the adult population as well. Alcohol consumption and even intoxication are perceived to be the norm in the students’ social life and several of the participants noted that abstainers risk being considered too boring to be invited to parties.

The view is that you cannot have fun without alcohol and therefore, you don’t invite sober people.

There seemed to be a high awareness of one’s own as well as peers’ popularity and social status. Participants evaluated peers as high or low status, fun or boring, claiming that trying to be cool and facilitate contact with others motivates people to use substances. High status students are, according to some participants, frequently invited to parties where alcohol and other substances are easily accessible.

I would say that our group of friends has more status. [… ] You know quite a few [people] and you are invited to quite a lot of parties. You can often evaluate the group of friends, i.e. their status, based on which parties they are invited to. […] Some [groups of friends] only drink alcohol and some even take drugs and drink alcohol.

Some differences in traditions and norms between schools was discerned, with certain schools being especially known for high alcohol consumption and drug use procedures when including new students in the school-community. One of the participants described fairly extensive norm violations, with respect to the law, on these occasions, e.g., strong peer pressure to drink alcohol and use illicit drugs, combined with humiliation of new students, careless driving under the influence of substances with other students in the car, and “punishment” by future exclusion from social events of those who don’t participate at these occasions. On the other hand, already popular, or more senior students, appear to be able to abstain from substance use on occasions without being questioned or risk social exclusion. High self-esteem and a firm approach when occasionally saying no to substances is often respected according to the participants. To avoid peer pressure to use alcohol or illicit drugs, the participants suggested acceptable excuses, such as school duties, bringing your moped or car to the party, having a sports activity or work the day after, or having plans with your parents or extended family during the weekend.

Apart from peer influence, several students expressed hedonistic motives, such as enjoying a nice event or simply to have fun.

If you want a little extra fun, then you take drugs.

Apart from social enhancement motives for using substances, some students reported that relaxing from academic pressure or rewarding oneself after an intense period of studying motivates them to use substances. Almost every participant expressed high academic ambitions. One participant who claimed to be very motivated to study expressed drinking due to stress, as illustrated in the extract below:

You study a lot and you are stressed over school. Then it can be very nice to go out and drink and you can forget everything else for a few hours. […] So it can be a “stress reliever” in that way.

Yet another participant explained that academic failure had previously made her use substances to comfort herself. Coping with mental health problems, such as depression, was also stated as a reason for substance use. Moreover, some participants reported that they use ADHD (Attention Deficit Hyperactivity Disorder) medication to be able to study more intensively.

Motives for abstaining from using substances

A number of motives for totally or temporarily abstain from substance use were put forward by the students, such as a wish to be healthy, keep control and avoid embarrassment, influence of parents, academic pressure, sports ambitions or simply lack of interest. Lack of interest in alcohol and drugs was expressed foremost by those attending natural sciences programs and those who totally abstained from substance use.

I attend the engineering program and I don’t think the interest in alcohol and parties is as present as it might be on social sciences programs.

Fear of health consequences was predominantly related to abstaining from illicit drugs, but also alcohol. Motives for abstaining from alcohol included perceived risk of being addicted, due to relatives having alcohol problems (heredity), and taking medicine, for example ADHD medicine, since combining alcohol and medication was perceived as risky. Some students had observed friends getting “weird” or “laze” after using illicit drugs, which made them hesitant to use such substances themselves. With regard to parental norms, most parents were by the participants reported to be “normal drinkers” themselves and quite relaxed about their teens’ alcohol consumption. This applied to both the parents of older teens and minors. However, many of the participants reported that their parents would be upset and disappointed if they found out that their child used illicit substances, which motivated some of them to abstain. Reasons for abstaining from substance use included academic strivings, sports performance ambitions, driving, or other activities requiring sobriety, which the students referred to as socially acceptable reason to abstain from substance use. Prioritizing studies over partying was explicitly expressed as the primary motive to abstain by some of the participants.

We are a group of five or six who come from other municipalities. […] We don’t party and such things and we may be seen as a bit boring. But we are a little more responsible and we are more motivated to study than the others in the class.

A wish to save money and reluctance to support the illegal drug production were also mentioned as reasons to abstain from substance use, however to a lesser extent.

Universal prevention viewed as attractive or feasible

With regard to substance information interventions, some students wanted detailed information about different substances’ physical and psychological effects. The participants emphasized the importance of credible sources or persons providing the information, mentioning researchers, young medical students and even parents as credible sources of information. Individuals who had experience of substance use were also suggested.

You have to tell the facts in a way that makes us want to listen. With the help of various spokespersons who have been involved in it, for example.

Several students stressed the importance of being able to identify with the person sending the message and suggested influencers as plausible sources. Someone who is difficult to relate to was given as an example of a non-credible, as the following excerpt shows:

They shouldn’t take a heroin addicts who talk about having found Jesus, because I do not think it would touch the children or touch the young. You have to somehow find … someone that can relate to the young people.

As for universal prevention, the students also suggested intensified legal measures for companies and people providing young people with alcohol or drugs.

For example, make it difficult for young people to have access to alcohol [...], allocate more time as a police officer to catch the drug dealers.

Both alcohol and illicit drugs were reported as easily accessible. Students can obtain alcohol via social media platforms, such as Instagram and Snapchat, where “liquor cars” market themselves and offer home delivery. In addition, older siblings or peers and even some parents were, according to the informants, providing minor students with alcohol. The main way to access illicit drugs is via parties where older students offer drugs to younger peers. Access to prescription drugs was also reported.

Several of the participants agreed that parental involvement is constructive for substance use prevention. Many of them reported having supportive and caring parents involved in their lives, but at the same time referring to friends’ parents as being more absent, resulting in extensive partying in large homes without parental control. Some students reported that parents don’t realize to what extent youths are using substances and that the parents should pay even more attention to what their children do.

I think [parents should be] keeping track, good track of the kids […] . Keeping track of what they are doing and ask them how they feel and things, I think that helps.

In line with leisure activities as a reason to abstain from substance use, some participants suggested that social activities other than partying could be a way of preventing substance use, as expressed by one participant when asked about plausible ways to prevent substance use.

Find a sport or friend that you train with […] instead of going to a party,

Talking about their leisure activities, the participants expressed joy and that these activities made them relax while being social.

The leisure interests, like working out and hanging out with friends, is relaxing and in contrast to the everyday in some way .

Universal prevention viewed as inappropriate

Several of the participants expressed great skepticism towards traditional universal preventive strategies, such as lectures by teachers, social workers or researchers. Some teachers were perceived as ignorant and unengaged, lecturing about substances only by duty.

The teachers have been a bit like ‘now we’re going to talk about drugs […] and then you have fifteen minutes and they say something like ‘here we are a drug free and smoke and tobacco free school’, and no one obeys.

Some students also doubted that the information provided from school and society is true, suspecting exaggerated report on harm, and that they prefer information from social media platforms such as Youtube or other online sources.

It feels like the information we get in school is a bit exaggerated, a bit made up for us […] A bit like this, ‘now we’ll get the young people to stop’.

Selective prevention viewed as attractive or feasible

In circumstances where students are worried about their own or peers’ substance use, participants stressed the need for a way to connect with local authority, health care or other support anonymously, without being registered in medical records or being reported to the authorities. Moreover, the participants emphasized the importance of a non-judging approach from professionals when they reach out to students at risk of excessive substance use.

If you wonder about something or if you are worried about something, then you should be able to turn to adults without being yelled at and know that you are getting positive feedback like ‘I understand you’ and ‘how can we fix this?’

Selective prevention viewed as inappropriate

As indicated above, help-seeking seemed to be counteracted by fear of being recorded in medical records or in the criminal registries. One participant mentioned an incident where a student, caught smoking marijuana, was prosecuted and that this student’s life had been severely affected with cancellation of planned studies abroad and rejection of driving license application. These consequences had, according to the participant, resulted in the student “giving up” and selling illicit alcohol to other students instead of trying to strive for a good future life. Admitting that such an incident can serve as a warning to other students, the fear of consequences is, according to the participant, still an obstacle to seeking help.

People don’t really know what to do when they see their friends do it [use substances]. You don’t want to tell on them, because they are afraid that if it is written down somewhere, then everything can be ruined.

Also, parents were by the participants reported as being reluctant to seek help for their children, because of fear of the reporting of their child’s behavior or crime to authorities, with subsequent negative consequences.

Parents do not dare either because they don’t want it to be about their children. I know some parents who have found drugs in their children’s rooms, but do not want to ruin [future prospects] for them.

The current study aimed to explore motives for using or abstaining from using substances, including alcohol, among students in affluent areas, as well as their attitudes to and suggestions for substance use prevention.

Summary of results

The motives for using substances among the students are associated with social aspects as.

well as own pleasure and coping with stressful situations. The most prominent motive appears to be a desire to feel a part of the current social milieu and to attain or maintain high social status within the peer group. Several of the students expressed fear of being excluded from attractive social activities if abstaining from substance use, although some meant that they were not interested in substances and didn’t care if they were perceived as boring, and also had found a small group of friends with whom they socialized. Motives for abstaining, apart from lack of interest, included academic ambitions, activities requiring sobriety, parental influence, and a wish to stay healthy. The students expressed negative attitudes towards current information-based prevention as well as problems with using selective prevention interventions due to fear of being registered or reported to the authorities. Students’ suggestions for feasible universal prevention concerned reliable information from credible sources, stricter substance control measures, extended parental involvement, and social leisure activities without substance use. Suggestions regarding selective prevention were guaranteed confidentiality and non-judging encounters when seeking help due to substance use problems.

Comparison with previous research

Children of affluence are generally presumed to be at low risk for negative health outcomes. However, the current study, in accordance with other recent studies [ 29 , 55 ], suggest problems in several domains including alcohol and drug use and stress related problems, even if the cause of these problems cannot be determined based on our interview study. Previous explanations for extensive substance use among affluent young people have been exceptionally high-performance requirements in both school and in leisure activities, and absence of emotional and physical adult contact, resulting from parents in affluent areas spending a lot of time on their jobs and careers [ 30 , 56 , 57 , 58 ]. These explanations can be viewed in the light of Cooper and colleagues’ [ 21 ] as well as Boys and colleagues’ [ 23 , 24 , 25 ] previously identified coping motive for substance use. Coping appears among affluent young people as a central motive for substance use, i.e., coping with performance requirements and perhaps with negative affects due to parents’ absence. In the current study, however, social motives, including conformity, i.e., using substances due to social pressure and a need to fit in [ 21 , 23 , 24 , 25 ] appears to be the most prominent motive, supporting the social learning theory which proposes that behavior can be acquired by observing and imitating others and by rewards connected to the behavior [ 16 , 59 ]. Interestingly, a small group of participants, especially from natural sciences programs, resisted the general pressure to use substances and found a social context of a few friends with whom they socialized without striving for high social status in the larger social context. The wish to be included in the social life and achieve high social status within the peer group was described as a central motive for substance use among a majority of the students, along with fear of being excluded if abstaining. Previous research show that high socioeconomic status is a protective factor for substance use disorder among adults [ 60 ], but among young people it may be the opposite. High status appears to be an important risk factor for the use of substances, at least among those striving for higher status. The students report that they, to achieve high status, must attend parties and at least drink alcohol. After achieving high status, which has resulted in frequent invitations to parties, students then may pose an even higher risk of excessive alcohol and drug use. In line with previous studies, results show that individuals with larger social networks, which has shown to be an indicator for social status among young, also drink more [ 35 , 61 ]. However, status can also act as a protective factor. Individuals with higher status have, according to the interviewees, slightly more room for maneuver to temporarily say no to substances at a party, without being pressured or ashamed. Nevertheless, several of the interviewees reported that they have to choose between using substances or being excluded from desirable social activities, as abstainers are considered “boring”. The results further show that alcohol and other drugs are popular among affluent youth and the information from the participants indicate that the students perceive substance use to be under control. One possible explanation is that high affluence can contribute to a sense of control over one’s life [ 62 ]. Although previous studies show that young people from affluent areas drink more, the risk of developing alcohol problems is still greater among young people who grow up in more disadvantaged areas [ 57 ]. Why this is the case is unclear. There is a widespread belief that affluent youngsters have plenty of social and financial resources in the family and thus receive the right help (e.g., psychotherapy) when they have problems [ 62 ], which could explain why they do not develop alcohol problems. However, research also shows that parents in affluent areas seek less help than others when their children are troubled [ 30 , 63 ], partly due to difficulties in accepting and revealing problems within the family [ 62 ]. In the current study, the informants expressed doubts about the possibility to be guaranteed confidentiality when seeking help, which may mean that there are concerns among both children and parents about the risk of losing status and a good reputation if seeking help for substance use problems. Consequently, there is a risk that any substance use problems will not be noticed in this group [ 62 ].

Previous research indicates that academic pressure may promote substance use [ 56 , 64 ]. However, in the current study academic pressure, due to high ambitions, was reported both as a reason for using substances and abstaining, the former to cope with stress or relax, the latter to maintain a sharp intellect and receive high grades. Moreover, previous research has demonstrated an association between pressure from extracurricular activities or “over scheduling” and negative outcomes among affluent students ( 39 ). In the current study, this did not stand out as a critical vulnerability factor. Instead, students reported extracurricular and leisure activities as relaxing and fun and an accepted reason to abstain from substance use while still attending activities where peers were using substances.

With regard to adult or parental contact, previous research shows that mental health and substance use among adolescents in socioeconomic affluent areas are associated with parents’ lack of reaction to teenage substance use (i.e. liberal, allowing attitudes and minor or no repercussions on discovering use) and parents’ lack of knowledge of their teens’ activities [ 30 ]. In our study, the students reported that their parents do not generally react with punishment due to their child’s alcohol consumption. However, the participants thought that parents probably should react more condemningly due to illicit drug use, if revealed. The Swedish criminalization of illicit substance use [ 46 ] may influence parents to adopt stricter norms with regard to their children’s illicit substance, because of the consequences for revealed substance use that may occur in the Swedish context. Also, parents in the current study were reported as being reluctant to seek help for their children out of fear of negative consequences that may affect their children. This result is in line with previous research, showing that concern about admitting problems in their children is elevated among affluent parents [ 30 ], mentioned above. In the current study, the participants further reported closeness to their parents and that their parents cared about how they spent their time. That said, some parents of wealthy peers were reported as being more absent, resulting in extensive partying in large homes without parental control. Previous research has shown the nature of family relationships and perceptions of closeness to be important protective factors for adolescent mental health [ 56 ], and this seems to apply to the students in the current study.

The students’ attitudes to current substance use prevention, aimed to increase students’ knowledge, are to a large extent negative. Information provided in school were reported as exaggerated and uninteresting. Instead, students suggested interventions focusing on credible sources of reliable information, such as from people with personal adverse experiences of substance use and people whom they can identify with. Whether people with own experience of substance use are credible or helpful in a more objective way can be disputed, but the students seem to put their trust in them rather than other persons. This result is partly in line with previous research on school-based programs in general, suggesting that the role of the teacher (the one who deliver the information) is central and that the use of peer leaders can be successful in engaging the students who receive the message [ 65 , 66 ]. Some informants in the current study meant that the teachers in school were ignorant and unengaged, lecturing about substances only by duty, which of course can be problematic for the sense of credibility among those receiving the information. Previous research has demonstrated that for older adolescents, a social influence approach can increase the effectiveness of alcohol and drug prevention interventions, as can health education, basic skills training and the inclusion of parental support [ 67 ]. Again, this research applies to adolescents in general and not to affluent youth specifically.

Interestingly, the students also suggested stricter regulations on substances with intensified legal measures for those providing substances. Positive attitudes to limiting access of alcohol for drunk people have previously been shown in a Spanish study among adolescents participating in an open-air gatherings of binge drinkers [ 19 ]. The positive attitude to stricter regulations for those providing substances is interesting in the light of the students’ desire for a non-judging approach when having to seek help for own substance use, as described below. Previous research, however, supports strict policy measures to decrease availability as an effective measure for substance use prevention in the general population [ 68 ]. The students further suggested increased parental control and activities and venues which can be attended without using substances, for example sporting/training with friends. Leisure activities without substance use have recently been offered to e.g., adolescents in general in an Icelandic prevention strategy [ 69 ], however more research is needed to see if this kind of prevention is attractive also for large groups of affluent students as an alternative to parties and whether it also appears to be effective in reducing substance use in this group. Clearly, some affluent students without ambitions to receive high social status do find socialization without using substances attractive, as shown in the current study. With regard to selective prevention, the students were critical of the current risk of being reported to parents, registered within medical records or reported to the authorities if turning to professionals for support for substance use problems. They claimed that this circumstance serves as a massive counteracting force to seek help at an early stage for oneself or for peers and that the possibility of reaching out anonymously is essential for taking the first step in seeking help. Moreover, the adolescents in this study call for an open and non-judging approach when turning to health care staff, parents or other adults, which is in line with so called Motivational Interviewing, a non-judging approach aimed to enhance motivation to change by exploring and resolving ambivalence about e.g., substance-related behaviors [ 70 ], which has shown promising results with regard to reduction of alcohol consumption among young people [ 71 ].

Strengths and limitations

The current study has a number of strengths. Firstly, we were able to recruit both male and female students between 15 and 19 years of age, living inside the affluent community as well as in neighboring municipalities, which provided us with a broad base of the students’ social context. Secondly, we included informants using substances as well as abstainers, increasing the possibility to get a broad view of motives to use or abstain from using substances among affluent youth. Thirdly, the research group has extensive experience in qualitative analysis as well as working with adolescents and young adults with mental health problems, including alcohol and drug consumption or abuse. However, our study must also be viewed in the context of some limitations. Students with more severe health or psychosocial problems may have refrained from participating, biasing the results towards adolescents of more stable psychosocial functioning. Moreover, interview studies are always vulnerable for social desirability bias due to a potential desire to give socially acceptable answers [ 72 ]. However, the possibility to terminate participation at any time, along with the circumstance that most of the interviewers are health care professionals, thereby used to handle secrecy in consultation situations, may have decreased the risk of desirability bias in the current study.

Several of the motives guiding substance use behavior among young people in general also seem to apply to affluent youth. A desire to feel a part of the current social milieu and to attain or maintain high social status within the peer group were reported as prominent motives for substance use among affluent students in the current study. Given that the social milieu is crucial for the substance use behavior in this context, future research on substance use prevention targeting this group could with advantage pay attention to suggestions on prevention strategies given by the students. Students’ suggestions include reliable prevention information from credible sources, stricter substance control measures targeting those providing substances, parental involvement, leisure activities without substance use, and confidential ways to seek help, involving a non-judging approach from professionals and other adults.

Availability of data and materials

Collected data will be available from the Centre for Psychiatry Research, a collaboration between Karolinska Institutet and Region Stockholm, but restrictions apply to their availability, as they were used under ethical permission for the current study, and so are not publicly available. However, data are available from the authors upon reasonable request and with permission from the Centre for Psychiatry Research.

Abbreviations

attention deficit hyperactivity disorder

natural sciences/technology/mathematic programs

social sciences/humanities programs

Stockholm prevents alcohol and drug problems

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Acknowledgements

We would like to thank all the participating students for making this study possible.

The work was funded by the Alcohol Research Council of the Swedish Alcohol Retailing Monopoly (grant no. 2018–0010). The funding body had no role in study design, data collection, analysis, data interpretation or writing the manuscript. Open Access funding provided by Karolinska Institute.

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Linda Hiltunen

Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Liljeholmstorget 7, 117 63, Stockholm, Sweden

Youstina Demetry

Department of Neuroscience, Uppsala University, Uppsala, Sweden

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PK contributed to conceptualization, methodology, investigation (data collection), data curation, formal analysis, writing original draft, review & editing, funding acquisition. LH contributed to conceptualization, methodology, data curation, formal analysis, validation, review & editing. YD contributed to project administration, methodology, investigation (data collection), data curation, formal analysis, validation, review & editing. AC contributed to investigation (data collection), review & editing. TH contributed to investigation (data collection), review & editing. JG contributed to conceptualization, methodology, review & editing, funding acquisition. TE contributed to conceptualization, methodology, review & editing. KE contributed to review & editing. CS contributed to conceptualization, methodology, investigation (data collection), data curation, formal analysis, review & editing, funding acquisition, supervision. All authors approved the submitted manuscript version.

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Kvillemo, P., Hiltunen, L., Demetry, Y. et al. How to prevent alcohol and illicit drug use among students in affluent areas: a qualitative study on motivation and attitudes towards prevention. Subst Abuse Treat Prev Policy 16 , 83 (2021). https://doi.org/10.1186/s13011-021-00420-8

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The Problem of Teenage Substance Abuse and How to Prevent It

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Alcohol and its effects on teens, drugs and their side effects, preventing teenage substance abuse, causes of substance abuse, mental health effects, physical health effects, recovery from teenage substance abuse.

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Essay: Impact of Alcohol, Tobacco And Drug Abuse on Youth

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Impact of Alcohol, Tobacco And Drug Abuse on Youth

Alcohol, tobacco and other drugs are affect youth negatively. Youth especially student’s e.g. secondary and tertiary students abuse alcohol, tobacco and other Drugs. Drugs such as tobacco, cocaine and marijuana are the major drugs which students abuse or use. Youth may end up drinking alcohol and using drugs because of various situations or reasons e.g. youth especially school going drink alcohol, use tobacco and other drug as a result of peer pressure because they may want to feel grown up among their peers, some youth use drugs to relieve boredom and give themselves personal excitement, some use drugs to rebel and get violent without any fear of people or authority, some use drugs to experiment, some use drugs and drink alcohol because their parents also drink alcohol so they end up indulging in the practise as well, social background may also influence youths to use drugs and to drink alcohol e.g. if they are many drug dealers and bottle stores around its easier for youths to indulge in the use of this drugs and lastly some youth may drink alcohol and abuse drugs to feel pleasure and escape the pressures of life or to alter their view of reality. Youth who get into drugs may get it from a friend’s friend, who also got it from his friend’s friend and so on this is to say that drugs are not of easy access because they are illegal. At the end of this long line of friends is a dealer who is making money out of destroying young people futures. The use of alcohol, tobacco and other drugs has negative impacts amongst the students who abuse this substances e.g. excessive alcohol consumption and the abuse of drugs are dangerous because alcohol and drug abuse can affect health and ability to function and think properly, almost every system in the body can be negatively affected by use of drugs and drinking of alcohol. Alcohol can cause cancer, liver disease, heart attacks and brain damage, to mention a few. Alcohol, tobacco and other drug use does not only affect youth especially students’ health wise it also affects their academic performance, it also affect them financially, psychologically, physically and ultimately students may suffer some legal consequences. Youth more so teens, who engage in sexual intercourse and drug abuse including abuse of alcohol and tobacco, are more likely than youth who abstain from such activities to become depressed, have suicidal thoughts and or even attempt suicide.

HEALTH EFFECTS OF ALCOHOL, TOBACCO AND DIFFERENT DRUG USE The use of alcohol, tobacco and other drugs has detrimental effects on health of the youth which may turn out to be fatal. The type of drugs which students commonly use are Stimulants (drugs that produce alertness, high energy, more awake and confident e.g. cocaine, amphetamines, caffeine) and Hallucinogens (give strange and intense visions called hallucinations) ALCOHOL

The scientific name for alcohol that people drink is ethyl alcohol or ethanol. Beer, wine, and liquor all contain ethyl alcohol. Other types of alcohol, like rubbing alcohol are poisonous if ingested. . Excess alcohol is the most common cause of preventable death. Alcohol is highly toxic to almost every organ in the body but when alcohol is taken in allowed limits amounts it is detoxified by the liver and therefore does little or no harm to the body. Alcoholic drinks contain ethyl alcohol and it is metabolized in the body to acetaldehyde. Both ethanol and acetaldehyde interfere with normal functioning of organs in the body including the heart and the liver and therefore if the liver and the heart get damaged disease occur which may eventually kill, teenagers maybe more prone to this effects in the youth as their organs are still developing thus toxic substances from alcohol damage their body organs. When people drink too much, with time they risk becoming addicted to alcohol. This is called alcoholism, or alcohol dependence. It’s a disease, and it can happen at any age, Common signs include, loss of control not being able to stop or cut down drinking, not feeling well after heavy drinking (upset stomach, sweating, shakiness, or nervousness), neglecting activities giving up or cutting back on other activities. Binge drinking happens when someone drinks more than four (for women) or five (for men) alcoholic drinks in about two hours, with the intention to getting drunk. Binge drinking is the most harmful type of drinking. It usually happens at teen or student parties TOBACCO The dangers of smoking are so great, but because of it governments get a lot of tax money from tobacco and cigarettes manufacturers, they are less hesitant to ban it totally. Government and society is aware of the danger that is why they made it illegal for teens to possess and use cigarettes. Smoking of tobacco can cause many with many diseases like respiratory and heart disease including, respiratory infections, lung cancer as well as cancer of the larynx, pancreas, stomach, & uterine cervix, bronchitis, emphysema and stillborn or premature children ().Smoking causes surges in the concentrations of catecholamine’s (the stimulator chemical messengers of the autonomic nervous system) as well as increases in carbon monoxide in the blood. Both of these short- term effects can exacerbate existing heart disease, resulting, for instance, in attacks of angina (chest pain). Nicotine raises blood pressure and heart rate, requiring the heart to work harder. It also constricts the coronary arteries, thereby lessening the supply of blood and oxygen to the heart muscle. It also promotes irregular heartbeats (cardiac arrhythmias). Smokers are not the only people harmed by tobacco. Toxic fumes from cigarettes pose a health threat to all those around smoker’s family, friends, and. Because the organic material in tobacco does not burn completely, smoke contains many toxic chemicals, including carbon monoxide, nicotine, and tar. As a result of this exposure, smokers’ children have more colds and flu, and they are more likely to take up smoking themselves when they grow up. Smokers also affect other people as well e.g. passive smoking. This is the involuntary inhaling of smoke from other people cigarettes and we all suffer when we have people smoking around us. It is called second-hand smoking and it is known to be even more dangerous than smoking itself COCAINE

Use of cocaine has increased among youth over the years, along with the myth that the drug is relatively safe, especially when it is sniffed rather than injected or smoked as ‘crack.’ In fact, no matter how it is used, cocaine can kill. It can disturb the heart’s rhythm and cause chest pain, heart attacks, and even sudden death. These effects on the heart can cause death even in the absence of any seizures. Even in the absence of underlying heart disease, a single use of only a small amount of the drug has been known to be fatal. Cocaine use is not healthful for anyone, but especially for certain groups like the youth. Although the drug has been shown to impair the function of normal hearts, it seems even more likely to cause death in people with any underlying heart disease. When pregnant women use cocaine, they not only raise the likelihood of having a miscarriage, a premature delivery, or a low-birth-weight baby, but also of having a baby with a congenital heart abnormality, especially an atrial-septal or ventricular-septal defect.

Use of cocaine raises blood pressure, constricts blood vessels, and speeds up heart rate. It may also make blood cells called platelets more likely to clump and form the blood clots that provoke many heart attacks. In addition, cocaine’s effects on the nervous system disrupt the normal rhythm of the heart, causing arrhythmias (irregular heartbeats). Recently, scientists have established that cocaine binds directly to heart muscle cells, slowing the passage of sodium ions into the cells. Cocaine also causes the release of the neurotransmitter nor epinephrine (nor adrenaline), a chemical messenger that stimulates the autonomic nervous system. Both changes can lead to arrhythmias. Heart attacks in young people are rare. However, when they do occur, cocaine is frequently the cause.

Cocaine is a highly addictive substance, and crack cocaine is substantially more addicting, as the drug is far more potent and is smoked. Users quickly develop a tolerance to crack cocaine, needing more of the substance to achieve the desired effects. Because the high from crack cocaine is so short-lived, users commonly smoke it repeatedly in order to sustain the high. This can lead to an even faster onset of addiction. Also, because crack cocaine works on the brain’s system of reward and punishment, withdrawal symptoms occur when the drug’s effects wear off. These symptoms can include depression, irritability, and extreme fatigue, anxiety, an intense craving for the drug, and sometimes even psychosis. Users will often keep using crack cocaine simply to avoid the negative effects of withdrawal

Marijuana harms in many ways, and kids are the most vulnerable to its damaging effects. Use of the drug can lead to significant health, safety, social, and learning or behavioural problems, especially for young users. Making matters worse is the fact that the marijuana available today is more potent than ever. Short term effects of marijuana use include memory loss, distorted perception, trouble with thinking and problem solving, and anxiety. Students who use marijuana may find it hard to learn, thus jeopardizing their ability to achieve their full potential. Long term effects include reduced resistance to common illnesses (colds, bronchitis, etc.), suppression of the immune system, growth disorders, increase of abnormally structured cells in the body, reduction of male sex hormones, rapid destruction of lung fibre’s and lesions (injuries) to the brain could be permanent, Study difficulties: reduced ability to learn and retain information, apathy, drowsiness, lack of motivation, personality and mood changes, inability to understand things clearly.

ACADEMIC EFFECTS OF ALCOHOL, TOBACCO AND DIFFERENT DRUG USE Heavy drinking by students can lead to positive blood alcohol levels the next day, affecting whether or not they even get up for class and, if they do, the quality of how information is processed and ultimately stored. Sleeping off a buzz, a common practice, can interfere with the sleep cycle, resulting in an increase in anxiety, jumpiness, and irritability the next day, and fatigue the day after that With evening use, marijuana has the same impact on sleep that alcohol has, throwing off the sleep cycle and impacting how a person feels for at least two additional days. Marijuana suppresses neuronal activity in the hippocampus, resulting in problems with attention, memory, and concentration. There is increasing evidence that there is an impact to motivation following marijuana use. This could be due to the effect of THC in the body blocking the passage of nutrients through cells, the neuronal suppression in the hippocampus, or the decrease in energy accompanying the fatigue that follows night time use. Marijuana significantly increases heart rate, weakens the heart muscle, and affects blood pressure- the increase in heart rate can be a concern for someone already dealing with anxiety ( and particularly panic). College students often forget why they are supposed to be in school. Is the purpose of university life to party all the time or to get the most out of the learning environment? Substance abuse can seriously affect academic performance. Aside from long-term addiction (or possible emptying you bank account) it can cause grades to plummet. How? Substance use affects you entire body, including your brain, in a variety of ways. Judgment is often the first attribute to be affected. You may find it difficult to make good decisions, to make them quickly or to be realistic when you make them. Suddenly, it becomes much easier to wait until the last minute to cram for that exam or to crank.

First of all, drugs and alcohol are a drain on people’s finances. We have all experienced the stress associated with money at one time or another. For those who abuse drugs or alcohol, financial issues are further compounded by their need to feed their habit. They frequently accumulate debt, borrow or steal money from others, or choose their substance of choice over more important things like food for their family or utility bills. While no one wants to be homeless, in debt, or engaging in criminal activities, the financial impact of drug and alcohol abuse risks not only your ability to support yourself, but it can also destroy relationships. When you abuse drugs or alcohol, you are choosing that substance over everything else, including your loved ones. Whether they are suffering from your financial choices or have become mistrustful of you, you have placed a strain on your relationships, which can ultimately ruin those connections for good. Families and others that rely on a sufferer of alcoholism are likely to experience problems related to financial troubles caused by drinking habits. The costs of alcohol increase as the alcoholic person builds tolerance to the drug in his or her system. This requires the person to take in ever-greater amounts of alcohol in order to feel the same effects. The psychological effects of this alcohol tolerance and dependency may cause the sufferer to become withdrawn and less supportive of colleagues, friends and family members. Sufferers may no longer attend social functions that do not allow drinking and may not be fully aware of their behaviour if attending functions where their drug of choice is allowed. A lack of networking and communication with peers may cause further financial problems if the sufferer loses promotion opportunities. Greater drains on income and lessened opportunities may cause undue troubles for others financially dependent on the sufferer, requiring a spouse or roommate to pick up extra hours or a second job to keep bills at a manageable level.

SOCIAL EFFECTS OF ALCOHOL, TOBACCO AND DIFFERENT DRUG USE Excessive alcohol use can affect all areas of a person’s life, including family, work and personal relationships. Family problems: Arguments over someone’s drinking can cause family and relationship problems that may lead to break up. Work problems: Drinking alcohol at work and hangovers can lead to poor performance and accidents at work, while illness can result in absenteeism. Legal problems: Drink-driving may lead to fines, loss of license and even imprisonment Misbehaviour caused by alcohol can also have disastrous effects on a pupil’s educational attainment, as well on performance in tests of intellect in later life. Compared with those pupils who have never truanted, pupils who had ever truanted from school had increased odds of having drunk alcohol in the last week (odds ratios of 2.24 for those who had truanted in the last year, 1.69 who had truanted previously). 6.5% of permanent exclusions of children from English state-funded secondary schools in 2010/11 were due to alcohol. Women, especially young women, encounter special risks in groups of drinking friends and acquaintances. In many societies, a woman who drinks seems to signal that she is at least approachable, and to some men an intoxicated woman is by definition sexually available. Such concepts as ‘acquaintance rape’ and ‘date rape’ bear witness to recent concern with this problem. A large proportion of unwanted sexual advances are mediated by alcohol. Initiation into certain groups, such as military units or college fraternities, sometimes includes drinking very large amounts of alcohol, so-called ‘binge drinking’. This pattern of drinking entails high risks of accidental injury, violence and acute alcohol-poisoning. It has long been known that a heavy-drinking lifestyle in groups of friends is relatively common in the armed forces. More recently, the focus has been on such drinking patterns on college and university campuses and what they mean for the development of problem drinking patterns later in life. INTERVENTIONS

A drug intervention is a structured, solution-oriented process undertaken to persuade someone who is abusing drugs to seek help in overcoming the addiction. Family, friends, and others involved in the person’s life use the intervention to demonstrate the extent of the effects of drinking and related behaviours. A successful intervention is not a confrontation but an opportunity for an addicted individual to accept help in taking the first step toward recovery. Often, an interventionist is invited to serve as a guide and educator before, during, and after the intervention. Some drug addicts can and do recognize the extent of the problems stemming from drug abuse and seek treatment without the need for an intervention. Most, however, are reluctant or unable to realize that drugs are responsible for the problems in their relationships, health, or work. They ignore the safety issues related to drinking and driving and other high-risk behaviours. It is common for addicts to deny that drugs are the source of the difficulties they face. They may instead blame other people or circumstances in their lives. When that happens, an intervention can break through the denial and help these individuals clearly see the effects of their drug abuse on the people who matter most to them.

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Essay on Drugs And Alcohol

Students are often asked to write an essay on Drugs And Alcohol in their schools and colleges. And if you’re also looking for the same, we have created 100-word, 250-word, and 500-word essays on the topic.

Let’s take a look…

100 Words Essay on Drugs And Alcohol

Introduction.

Drugs and alcohol are substances that can change how your body and mind work. Drugs can be medicines or illegal substances. Alcohol is a type of drug that people often drink in social settings.

Effects on the Body

Effects on the mind.

Drugs and alcohol can also affect your mind. They can change your mood and make you feel happy, sad, angry, or scared for no reason. They can also make it hard for you to think clearly.

Sometimes, people can become addicted to drugs or alcohol. This means they feel a strong need to keep using these substances, even if they know it’s bad for them. Addiction can lead to serious health problems.

250 Words Essay on Drugs And Alcohol

Drugs and alcohol are substances that can change how your body and mind work. They can hurt you and lead to problems at home, school, and with friends.

What Are Drugs and Alcohol?

Drugs are chemicals that change the way your body works. Some are legal, like medicines prescribed by doctors or sold in stores. Others are illegal. Alcohol is a kind of drug that is legal for adults to use, but it can still be harmful.

Effects on Health

Drugs and alcohol can hurt your health. They can damage your brain, heart, and other important organs. If you use them a lot, you might not be able to think clearly or make good choices. Drugs and alcohol can also make it hard for you to control your actions.

Effects on Life

Using drugs and alcohol can cause problems at school and home. You might get bad grades, lose friends, or have fights with your family. Also, it’s illegal for kids and teens to buy alcohol or use illegal drugs. If you’re caught, you could get in trouble with the law.

Remember, it’s important to make smart choices about drugs and alcohol. If you’re feeling pressured to try them, talk to someone you trust. There are always better ways to handle stress, have fun, and fit in.

500 Words Essay on Drugs And Alcohol

What are drugs and alcohol, effects of drugs and alcohol.

Drugs and alcohol can have a big impact on the body and mind. They can make you feel happy, relaxed, or excited for a short time. But they can also make you feel sick, confused, or scared. Over time, using drugs and alcohol can lead to serious health problems. These can include heart disease, liver damage, and problems with the brain.

Drugs, Alcohol and Society

Drugs and alcohol can cause problems in society too. People who use drugs or drink too much alcohol might not do well at school or work. They might get into fights or cause accidents. They can even end up in jail. And it’s not just the people who use drugs or alcohol who are affected. Their families, friends, and communities can be hurt too.

Why Do People Use Drugs and Alcohol?

There are many reasons why people might start using drugs or alcohol. Some might do it to fit in with friends or to feel better when they’re sad or stressed. Others might be curious or just want to try something new. But no matter why they start, it can be very hard to stop. That’s because drugs and alcohol can be very addictive. This means that the more you use them, the more your body needs them.

Helping People with Drug and Alcohol Problems

In conclusion, drugs and alcohol can cause a lot of harm. They can hurt your body and mind, cause problems in society, and be very hard to quit. But there is help available for people who need it. And by learning about the dangers of drugs and alcohol, we can make better choices for ourselves and our communities.

Apart from these, you can look at all the essays by clicking here .

Happy studying!

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Whoa! This looks different. Meet the new DoSomething.

Welcome to DoSomething.org , a global movement of millions of young people making positive change, online and off! The 11 facts you want are below, and the sources for the facts are at the very bottom of the page. After you learn something, Do Something! Find out how to take action here .

• In 2012, nearly 3/4 of students (72%) have consumed alcohol (more than just a few sips) by the end of high school, and more than 1/3 (37%) have done so by 8th grade.^[University of Michigan. "NATIONAL SURVEY RESULTS ON DRUG USE, 1975–2009." Monitoring the Future. Accessed February 24, 2014, http://monitoringthefuture.org/pubs/monographs/vol1_2009.pdf.]
• According to a study by Columbia University, underage drinkers account for 11.4% of all of the alcohol consumed in the U.S.^[Columbia University. "New Study in Archives of Pediatrics and Adolescent Medicine and CASA* Report Reveal: Underage Drinkers, Alcoholics and Alcohol Abusers Consume Between 37.5% and 48.8% of Alcohol Sold." CASAColumbia. Accessed February 25, 2014, http://www.casacolumbia.org/newsroom/press-releases/2006-apam-commercial-value-of-underage-drinking.]
• The average age teen boys first try alcohol is age 11, for teen girls it’s 13.^[Harvard Health Publications. "Teenage Drinking." Help Guide. Accessed February 22, 2014, http://www.helpguide.org/harvard/alcohol_teens.htm.]
• Nearly 10 million young people, ages 12 to 20, reported that they've consumed alcohol in the past 30 days.^[Substance Abuse & Mental Health Services Administration. "National Survey on Drug Use and Health: Summary of National Findings." Results from the 2012 National Survey on Drug Use and Health. Accessed February 25, 2014, http://www.samhsa.gov/data/NSDUH/2012SummNatFindDetTables/NationalFindings/NSDUHresults2012.htm.]
• Teens who start drinking before age 15 years are 5 times more likely to develop alcohol dependence or abuse later in life than those who begin drinking at or after the legal age of 21.^[USA.gov. "Fact Sheets - Underage Drinking." Centers for Disease Control and Prevention. Accessed February 24, 2014, http://www.cdc.gov/alcohol/fact-sheets/underage-drinking.htm.]
• In 2010, there were approximately 189,000 emergency rooms visits by teens under age 21 for injuries and other conditions linked to alcohol.^[USA.gov. "Fact Sheets - Underage Drinking." Centers for Disease Control and Prevention. Accessed February 24, 2014, http://www.cdc.gov/alcohol/fact-sheets/underage-drinking.htm.]
• Teens who drink heavily are three times more likely to try and hurt themselves (self-harm, attempt suicide etc.) than those who don't.^[Marrow, M.S., Deborah. "Teenage Drinking Facts The Effects Of Teenage DrinkingTeenage Drinking Statistics." The Alcoholism Guide. Accessed February 25, 2014, http://www.the-alcoholism-guide.org/teenage-drinking-facts.html.]
• 9 out of 10 American teens report that drinking is not worth the consequences it can cause.^[Century Council. "Underage Drinking Research." Century Council. Accessed February 23, 2014, http://www.centurycouncil.org/underage-drinking/underage-drinking-research.]
• The 3 leading causes of death for 15 to 24-year-olds are automobile crashes, homicides and suicides – alcohol is a leading factor in all 3.^[Johns Hopkins Bloomberg School of Public Health. "The Toll of Underage Drinking." The Center on Alcohol Marketing and Youth. Accessed February 25, 2014, http://www.camy.org/factsheets/sheets/The_Toll_of_Underage_Drinking.html.]
• In 2010, 56% of drivers aged 15 to 20 who were killed in motor vehicle crashes after drinking and driving were not wearing a seat belt.^[USA.gov. "Teen Drivers: Fact Sheet." Centers for Disease Control and Prevention. Accessed February 25, 2014, http://www.cdc.gov/motorvehiclesafety/teen_drivers/teendrivers_factsheet.html.]
• The rate of current alcohol consumption increases with age, according to the 2011 National Survey on Drug Use and Health, from 2% at age 12 to 21% at age 16, and 55% at age 20.^[Substance Abuse & Mental Health Services Administration. "National Survey on Drug Use and Health: Summary of National Findings." Results from the 2012 National Survey on Drug Use and Health. Accessed February 25, 2014, http://www.samhsa.gov/data/NSDUH/2012SummNatFindDetTables/NationalFindings/NSDUHresults2012.htm.]

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Young people may see more than 20 alcohol ads per hour on social media, research finds

PhD Student, National Centre for Youth Substance Use Research, The University of Queensland

Associate Professor, Faculty of Health and Behavioural Sciences, The University of Queensland

Disclosure statement

Gary Chung Kai Chan receives funding from the National Health and Medical Research Council, Australia.

Brienna Rutherford does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

University of Queensland provides funding as a member of The Conversation AU.

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It’s a Friday night and you’re scrolling through Facebook, mindlessly thumbing past photos from friends, when a liquor advertisement catches your eye. It promises one-hour delivery and 30% off, and the next thing you know your Friday night has an entirely different trajectory.

It’s no secret the alcohol industry flocks to social media to promote its products. But to what extent is this really a problem?

Our research published today in Drug and Alcohol Review reveals that, on average, a large proportion of young social media users in Australia are exposed to alcohol ads more than every three minutes.

Regulations? What regulations?

In Australia, alcohol companies are responsible for regulating their own advertising behaviours . But there is no evidence this model successfully protects vulnerable populations, such as minors (under 18) and young adults, from exposure to alcohol ads, nor to potentially harmful messages regarding alcohol consumption.

This has resulted in an abundance of alcohol ads targeting young adults and even minors, without consequences from an overarching regulatory body.

Research has found products advertised using youth-oriented genres , reward appeals and stylistic features (such as animations) are more likely to be consumed by underage drinkers than by adults of legal drinking age.

And since social media ads reach millions of viewers , it’s no surprise 39% of 12–17-year-olds in Australia report having seen alcohol advertising online. The lack of regulation means there’s growing concern about the effects these ads may have on young people’s attitudes towards drinking.

A number of studies have found correlations between exposure to online alcohol ads and increased youth consumption , increased likelihood of drinking at a younger age , and the adoption of riskier drinking patterns .

One ad every three minutes

We set out to determine how often Australians aged between 17 and 24 were exposed to alcohol-related ads on social media, as well as what advertising qualities were present in these ads.

To do this, we recruited 125 students from the University of Queensland to scroll through Facebook or Instagram for a 30 minutes, screenshotting any alcohol-related ads they encountered.

We found 71 of our participants encountered an alcohol-related ad during this period. Alarmingly, five were under the legal drinking age of 18. In total, our participants came across 796 ads, encountering one ad every two minutes and 43 seconds on average.

These ads often promoted products using sales incentives such as bonus samples, promotional codes, or special offers. They also commonly emphasised the “ease” with which the product could be purchased, such as through a subscription or home delivery service .

Almost every ad also included some form of call to action , whether that was a link to more information about the product, or to an online storefront to purchase it.

• Youth drinking

Globally, we continue to see a gradual decline in drinking among young adults. Nonetheless, the National Drug Strategy Household Survey 2022–2023 found about 42% of people aged 18–24 engaged in risky levels of drinking. This figure was 5.5% for minors aged 14–17.

In this case, “risky” drinking was defined as having either more than ten standard drinks per week (on average) in the previous 12 months, or more than four drinks in a single day, at least once a month, over the previous 12 months.

While it’s hard to quantify the extent to which alcohol ads on social media translate to youth consumption, it’s not a stretch to suggest this content (which promotes the affordability and availability of alcohol) has some kind of impact.

In 2022–23, people aged 18–24 were the most likely to be victims of alcohol-related incidents , including physical and verbal abuse. So it’s important we monitor how alcohol is portrayed to this age group.

Thinking forward

Researchers recognise the need to investigate the impact of social media alcohol ads on young people’s drinking behaviours. However, research alone can’t minimise the risks.

In Europe, countries such as Finland, Norway and Sweden have implemented independent statutory bodies to ensure alcohol ads comply with their respective codes. Some have taken this even further, with Lithuania prohibiting alcohol companies from advertising online, and both Finland and Estonia prohibiting alcohol ads on social media.

In Australia, the introduction of an independent alcohol advertising administration would go a long way towards protecting minors and young adults from exposure to marketing that promotes underage or risky drinking.

Or, we could take a page from our neighbour’s book. The Association of New Zealand Advertisers offers a voluntary liquor advertising pre-vetting service to help alcohol companies comply with the country’s advertising code . A similar tool could be useful in Australia if it was mandated. Such a tool could hold both alcohol and social media companies accountable for targeting vulnerable people.

• Social media
• Alcohol advertising
• Alcohol policy
• Underage drinking
• Advertising standards

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Alcohol and Drug Services

The Alcohol & Drug Services program has prevention and outpatient treatment services. Prevention services are available for youth and adults offering education and supportive services. Latina Women’s Program, Parenting Wisely and Harm Reduction Intervention services are also included within the prevention programs. Adult Outpatient Treatment groups are gender specific. Walk-in assessments are held Monday, Tuesday and Thursday (clients are encouraged to come at 8 a.m. to sign up). Alcohol and drug prevention and treatment service times vary by program.

Prevention Services

Find a drug and alcohol addiction prevention programs including: REAL Life (Respect, Empower, Achieve, Lead), Latino Women's Prevention, Substance Abuse General Education (S.A.G.E.), You're Extra Special (Y.E.S.), and parenting classes.

Call 614-645-2457 or 614-645-1342 to learn more.

Treatment Services

Find outpatient treatment services to overcome drug and alcohol addiction.

Harm Reduction

Programs and education include safe needle disposal, naloxone, drug test strips, HIV and hepatitis C testing and prevention.

Fill out this online form to get free naloxone mailed to you. (For Franklin County residents only.)

Opiate Crisis Support

If you are in an immediate emergency, call 911.

  If you or a loved are experiencing a mental health or substance abuse related emergency call the Netcare Access Crisis Hotline at 614-276-2273 or call the Opiate Crisis Line at 614-724-4673 (available Monday-Friday, 9 a.m.-5 .pm.)

Columbus and Franklin County Addiction Plan

The Columbus and Franklin County Addiction Plan is a collaborative community effort led by Columbus Public Health to address the opiate crisis in central Ohio. Through targeted interventions and innovative programs, the plan works to decrease overdoses, overdose deaths and the spread of infectious diseases.

Learn more at https://cfcap-columbus.hub.arcgis.com/ .

Treatment Services (614) 645-6839

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Getting ahead of a non-alcoholic beverage boom among youths

By Molly Bowdring , Aaron S.B. Weiner , and Judith Prochaska June 20, 2024

T he non-alcoholic beverage market is booming right now : zero-proof bottle shops and bars are popping up across the country ; a non-alcoholic beer brand is even taking over as the top selling beer at Whole Foods . And the Olympic Games have their first beer sponsor , courtesy of alcohol-free Corona Cero.

While it’s great that more people are taking to heart public health messages that reducing alcohol consumption can improve well-being and extend life , an important lesson from vaping as a replacement for cigarettes is being overlooked: What may be good for adults may be harmful to kids. Without any meaningful restrictions on the sale of non-alcoholic beverages to youths, the country is just one JUUL-like marketing push away from a potential public health crisis.

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We recently contacted alcohol regulators and health departments in every U.S. state and learned that the majority of states lack age restrictions on the sale of non-alcoholic beverages. Some local laws exist, and individual retailers can choose to set restrictions. Target, for example, recently began carding for non-alcoholic beverages to confirm 21 years of age in their brick-and-mortar stores. But children and teens are, by and large, legally permitted to purchase non-alcoholic beverages. This is a huge liability.

International data on youths’ use of non-alcoholic beverages is revealing. Studies involving elementary , junior , and high school students in Japan found that many use non-alcoholic beverages: between 20% and 33% of students surveyed had consumed non-alcoholic beverages in the past year. For high school youths in Taiwan , exposure to marketing of non-alcoholic beverages by social media influencers increased their purchasing and consumption. U.S.-based studies aren’t available yet, but there are anecdotes: one retailer reported that 20% of its non-alcoholic beverage stock was being stolen by high schoolers.

Related: No, alcohol isn’t good for you. Will new dietary guidelines be shaped more by health or industry interests?

Taken on their own, these trends may not be that worrisome — these are non-alcoholic beverages, after all. But this behavior doesn’t exist in a vacuum: in all four studies, drinking non-alcoholic beverages was associated with kids’ increased interest in drinking, as well as actual drinking of alcoholic beverages.

The path from non-alcoholic beverage consumption to alcohol use among youths appears to be fairly direct. Regulated to contain less than 0.5% alcohol by volume , non-alcoholic beers, wines, liquors, and premade mocktails mirror the look and taste of their alcoholic siblings. That may be great for some adults who want to cut back on their consumption of alcohol. But among minors, consuming non-alcoholic beverages can socialize them to the drinking culture, with the beverages being perceived as cool, adult, and modern. These types of experiences and associations can then pique interest in full-strength alcohol — perhaps due to hoping that alcohol will enhance the experience, or trying to emulate influencers or celebrities who drink.

Because many alcohol producers now make non-alcoholic products, consumption of non-alcoholic beverages can familiarize young consumers with specific brands, increasing the likelihood of purchasing those brands’ alcoholic versions in the future. At the same time, non-alcoholic beverages enable alcohol-naive consumers to develop a taste for the flavor profile, without the sensations that can be unappealing to new drinkers, like a bitter taste or the sensation of burning in the mouth and throat.

While consumption of non-alcoholic beverages by U.S. children and teens does not yet seem to be widespread, the lack of sales and marketing restrictions leaves the possibility wide open for a future marketing push to influence uptake among younger people, posing a self-inflicted public health risk.

What the U.S. needs — before problems emerge, not after — is to prohibit the sale of non-alcoholic beverages that mirror alcoholic beverages to people under age 21.

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Prevention strategies involving marketing and availability are also needed. In 2023, the World Health Organization called for policies that prohibit non-alcoholic beverage ads that use colorful or playful aesthetics that could appeal to children, as well as ads that associate non-alcoholic beverage products with alcohol-based ones. Other ways to keep kids from being attracted to non-alcoholic beverages would be to increase taxes on them, limit locations where non-alcoholic beverages can be sold, and — counter to the new Olympic Games partnership — restrict exposure to non-alcoholic beverage ads overall.

The time to do this may be ticking away, as the marketing of non-alcoholic beverages is already expanding. Current marketing tactics encourage non-alcoholic beverage use in new contexts where alcohol is not typically consumed, such as at the gym.

The potential public health benefit of non-alcoholic beverages comes from their being consumed as a substitute for alcohol — not increasing their use by introducing them into novel contexts or to groups who generally do not consume alcohol.

Non-alcoholic beverages are made for adults. Their marketing and sale to minors shouldn’t be permitted. And the country shouldn’t have to look to Target for guidance on commonsense public health policy. Regulatory guardrails are needed now to be proactive, rather than reactive, on this issue.

Molly A. Bowdring is a clinical psychologist in Stanford’s Addiction Medicine Dual Diagnosis Clinic and a postdoctoral scholar at the Stanford Prevention Research Center who studies substance use behaviors. Aaron S. B. Weiner is a clinical psychologist in Lake Forest, Illinois, and a past president of the Society of Addiction Psychology. Judith J. Prochaska is a clinical psychologist at Stanford Health Care and a professor of medicine and deputy director of the Stanford Prevention Research Center at Stanford University.

LETTER TO THE EDITOR

Have an opinion on this essay submit a letter to the editor here ., about the authors reprints, molly bowdring, aaron s.b. weiner, judith prochaska.

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'An unfair fight': The U.S. surgeon general declares war on social media

Social media platforms are part of what the U.S. surgeon general is calling a youth mental health crisis. doble-d/Getty hide caption

Social media platforms are part of what the U.S. surgeon general is calling a youth mental health crisis.

Emma Lembke was 12 years old when many of her friends started using phones and social media. "Each one of them, as a result, was getting pulled away from kind of conversation with me, from hanging out with me, from even, like, playing on the playground, hanging out outside at school. It felt as though my interactions were dwindling," Lembke told NPR. It wasn't just her experience. On average, teens in the U.S. are spending nearly 5 hours on social media every day . And the children and adolescents doing so seem to be paying the price.

Shots - Health News

Teens say social media is stressing them out. here's how to help them.

Those who spend more than 3 hours a day on social media have double the risk of mental health problems like depression and anxiety, according to a study published in 2019 and cited by the Department of Health and Human Services . Clinical psychologist Lisa Damour, who specializes in adolescent anxiety, says the more time a teen spends on their phone, the less likely they are to be focusing on other aspects of their life. "Too much time on social media gets in the way of things that we know are good for kids, like getting a lot of sleep, spending time with people and interacting face to face, being physically active, focusing on their schoolwork in a meaningful way," Damour told NPR. "So that's one place that we worry about that they are missing out on things that are good for overall growth."

You're reading the Consider This newsletter, which unpacks one major news story each day. Subscribe here to get it delivered to your inbox, and listen to more from the Consider This podcast .

The surgeon general's call to action

Vivek Murthy, U.S. surgeon general, has zeroed in on what he has called the "youth mental health crisis" in the U.S. This week, he published an op-ed in the New York Times calling for social media warning labels like those put on cigarettes and alcohol, in order to alert young people of the danger social media poses to their mental wellbeing and development. He cites the success of the tobacco and alcohol labels, which have discouraged consumption. "The data we have from that experience, particularly from tobacco labels, shows us that these can actually be effective in increasing awareness and in changing behavior. But they need to be coupled with the real changes, [like] the platforms themselves," Murthy told Consider This host Mary Louise Kelly. "Right now, young people are being exposed to serious harms online, to violence and sexual content, to bullying and harassment, and to features that would seek to manipulate their developing brains into excessive use."

How to help young people limit screen time — and feel better about how they look

Part of Murthy's guidance includes keeping children off of social media platforms until their critical thinking skills have had more time to grow and strengthen against what the algorithms might be showing them. "Imagine pitting a young person — an adolescent, a teenager — against the best product engineers in the world who are using the most cutting edge of brain science to figure out how to maximize the time you spend on a platform. That is the definition of an unfair fight, and it's what our kids are up against today," he said.

New guidelines moving forward

Damour says that the surgeon general's call for a label is a great start to addressing the larger issue of how phone addictions are affecting young people.

"The other thing that is really important about the surgeon general's recommendation is that he's calling for legislation. He's calling for congressional action to get in there and help with regulating what kids can be exposed to," she said. "And I think this is huge right now. This is entirely in the laps of parents, and they are left holding the bag on something that really should be managed at a legal congressional level." Both Murthy and Damour say that raising awareness of certain strategies for parents can also help teenagers maintain more balanced lives. This can include:

• Waiting until after middle school to let kids get social media profiles.
• Using text messages as an intermediary step in allowing teens to keep in touch with their peers.
• And maintaining "phone free zones" around bedtime, meals and social gathering.

This episode was produced by Marc Rivers, Kathryn Fink and Karen Zamora, with additional reporting from Michaeleen Doucleff. It was edited by Courtney Dorning and Justine Kenin. Our executive producer is Sami Yenigun.

• social media
• Surgeon General
• phone addiction

Prevention of Alcohol Consumption Among Youth Proposal

• To find inspiration for your paper and overcome writer’s block
• As a source of information (ensure proper referencing)
• As a template for you assignment

Introduction and Rationale

Literature review, methodology, theory constructs and intervention components, intervention, measurement tools, measurement plan, operational plan, study strengths and limitations, works cited.

Globally, alcohol consumption is a big health risk. According to Birech et al. (137), it is the third biggest health risk and among the leading causes of high morbidity and mortality rates in developing countries. Indeed, the chronic intake, or long-term intake of alcohol, leads to serious health complications such as liver disease, mental health problems, and permanent head damage (National Institute on Alcohol Abuse and Alcoholism 5). To affirm this finding, studies done in the United Kingdom (UK) have shown that liver complication is the fifth largest cause of death in the country (Birech et al. 137). In fact, researchers estimate that it accounts for more than 15,000 deaths in the country, annually (National Institute on Alcohol Abuse and Alcoholism 5).

Associated socioeconomic effects of excessive, or irresponsible, alcohol consumption have also led to the increase of socioeconomic ills such as crime, sexual abuse, road accidents, and the likes (Grønbæk 407; Birech et al. 137). The British Crimes Survey reinforces the association between crime, injury, and alcohol by reporting that more than 76,000 incidences of facial injuries were associated with alcohol consumption (Birech et al. 137). Studies that have investigated the relationship between excessive alcohol consumption and mortality rates have also established that 26% of deaths among 16-24 year olds are because of irresponsible drinking (Grønbæk 407).

According to Birech et al. (137), the per capita consumption of alcohol in the US is more than 1.9 gallons. This statistic is equivalent to about two-thirds of an ounce of alcohol every day. Demographic differences explain how people consume this much alcohol. For example, studies conducted in Europe (the United Kingdom and Scandinavia in particular) have shown that there is a higher percentage of males who consume alcohol (75%) compared to their female counterparts (56%) (Birech et al. 137). Relative to these findings, health researchers have highlighted a growing problem of poor lifestyle choices among young people (Collins and Carey 498). In detail, there has been a lot of concern among different health groups regarding the increased incidences of smoking, irresponsible sexual practices, and alcoholism among the youth (Grønbæk 407).

Often, many public health campaigns have focused on addressing smoking and irresponsible sexual behaviors among the youth. Comparatively, there have been limited attempts to address alcoholism, which is a serious, and growing problem among this demographic. The seriousness of the health problem stems from the fact that alcoholism among the youth has become part of a young and growing culture among many American students who see it as a “part-time activity” (Collins, Witkiewitz, and Larimer 322). For example, in many colleges around the country, undergraduate students engage in binge drinking, not because it is beneficial to them, but because it is what they do to “pass time” and have fun.

To support the above observation, O’malley and Johnston (23) conducted a study to evaluate drinking practices in Michigan by reviewing 68 surveys, which showed that the rate of alcohol consumption among college students has significantly increased since the Second World War (and continues to do so today). The same phenomenon is highlighted in the book Drinking in College by Straus and Bacon (cited in O’malley and Johnston 23). Therefore, we could say that most students now see binge drinking in college as a “social norm.” Despite the existence of no health benefits associated with the practice and its multiple health problems, few health stakeholders have treated alcoholism among the youth with the seriousness it deserves.

Since most alcoholics and adults started drinking around their high school days or during their college years, this proposal intends to target undergraduate students as the main audience for a public health campaign to prevent alcohol abuse among the population called “Stop the Madness.” The goal is to prevent students from inculcating excessive alcohol consumption as part of their lifestyle during their younger years. The justification for doing so stems from the realization that many people start taking alcohol during their youth and continue the same habit throughout their entire lives. Therefore, addressing alcoholism among the population during their undergraduate years could amount to a concerted effort to addressing the larger health issue of alcoholism in America.

Using the theory of planned behavior would help to realize this goal because it focuses on changing people’s lifestyle habits – which is at the core of our analysis. More importantly, this theory would help us to communicate the message that young people do not need to partake in alcohol consumption to feel accepted. We presume that this strategy would be effective in solving alcoholism among the general population because it is easier to change the mindset of young people compared to older persons because the latter is hard-wired not to change their lifestyle. Therefore, changing the communication/message surrounding alcohol consumption among young people during their undergraduate years could have a significant impact on their future behavior change.

Different researchers have used different models to explain human behaviors associated with alcohol consumption (O’malley and Johnston 23). However, the theory of planned behavior emerges as the most commonly used model to explain this relationship. Proposed by Icek Ajzen, the theory of planned behavior explains human behavior by presupposing that the most important attribute to consider in understanding human behavior is the intention to partake in the behavior in the first place (Bilic 243). Using this analogy, the theory of planned behavior identifies three main factors to consider when understanding human behavior – attitude, subjective norms, and perceived behavioral controls (Javadi et al. 52-53).

Proponents of the theory see perceived behavioral controls as a combination of the limits that people experience when wanting to do something and the belief that they would be able to do it (O’malley and Johnston 23). When using the ideas of Ajzen, this relationship is represented by the combination of the perceptions of external barriers and self-efficacy (Javadi et al. 52-53). Proponents of the theory also point out that perceived behavioral control can accurately predict behavior if it correctly represents the actual control over behavioral performance (Collins and Carey 498).

In a study to investigate how the theory of planned behavior explains patterns of alcohol consumption, O’malley and Johnston (23) conducted a meta-analysis of 40 studies that analyzed alcohol consumption by investigating gender differences in alcohol consumption and age of participants. From the study, they found that people’s attitudes had the greatest effect on their alcohol consumption patterns (O’malley and Johnston 23). The researchers also highlighted the importance of understanding the importance of self-efficacy and intention in evaluating the patterns of alcohol consumption among the youth. Self-efficacy was found to have a strong relationship with intention, while intention was found to have a strong relationship with alcohol consumption as opposed to self-efficacy (O’malley and Johnston 23).

All these moderating effects were found to have a strong relationship with different components of the theory of planned behavior. More importantly, patterns of consumption that were more elaborate and clearly defined had the strongest relationships with the theory of planned behavior (O’malley and Johnston 23). The researchers also found that females reported a stronger effect of attitudes and relations when it came to understanding their effects of alcohol consumption (O’malley and Johnston 23). Comparatively, adults had a stronger attitude-intention relations and self efficacy-intention relations compared to adolescents (O’malley and Johnston 23). Nonetheless, these studies showed how well the theory of planned behavior could explain the different patterns of alcohol consumption among different demographics and identify the specific aspects of people’s intuition, thoughts, and beliefs affected their consumption of alcohol (Collins, Witkiewitz and Larimer 322).

Meta-analytic reviews that have investigated different applications of the theory of planned behavior in health sciences affirm that it is useful and reliable in predicting people’s intentions and behaviors for many health-related conditions (Collins and Carey 498). For example, Cooke et al. (149) reviewed more than 200 studies that used the theory to predict health-related behaviors and found that the model was reliable to use in predicting alcohol consumption patterns. The researchers also found that the theory used intention and perceived behavioral control to explain 19% of health-related problems (Cooke et al. 149). They also found that subjective norms and perceived behavioral controls could explain 44% of variance in intention (Cooke et al. 149).

Some observers have also documented different instances where health experts have used the model to analyze individual health-related behaviors (Collins and Carey 498). For example, numerous studies have highlighted different instances where health stakeholders have applied the theory to explain people’s physical activities (Collins, Witkiewitz and Larimer 322). Similar studies have used the theory of planned behavior to explain people’s smoking habits (Birech et al. 137). Here, studies that have investigated the relationship between the theory and smoking have established weak relationships between the theory’s variables and the habit (Birech et al. 137). For example, Cooke et al. (149) say there have been weak, or negative, relationships between smoking and PBC–intention and PBC–behavior relationships. Based on this observation, experts acknowledge that the outcome of investigations that have used the theory of planned behavior to explain behaviors that are beneficial to health and those that are not beneficial to health may be different (Collins, Witkiewitz and Larimer 322). The difference is mostly attributed to PBC.

The main point to note in understanding this relationship is the need to emphasize a lack of control that is often associated with certain health risks. This emphasis is particularly useful in evaluating human behavior that is sustained by some demographics, but that may be deemed socially undesirable (Grønbæk 407). For example, peer pressure may explain why some young people continue to engage in harmful lifestyle habits despite having knowledge that doing so would be harmful to their health (Grønbæk 407). Based on this understanding, some observers emphasize the need to explain some human behaviors by referring to external causes that may affect them in the first place (Cooke et al. 149).

By linking beliefs and behavior, the theory of planned behavior proposes that subjective norms, beliefs, and perceived behavioral control all contribute towards explaining why people do the things they do (Collins and Carey 498). Broadly, these underlying factors demonstrate that people do the things they do because of their beliefs. Although we intend to use this theory in a health context, other researchers have used it in different fields, including marketing, public relations, and advertising (among others) (Collins and Carey 498).

Although different reviews have used the theory of planned behavior to explain patterns of alcohol consumption among different demographics, most of their findings have had unique limitations. For example, some studies have failed to disassociate alcohol consumption from the use of other drugs and substances. Illustratively, a study by Collins, Witkiewitz and Larimer (322) used the theory of planned behavior to explain alcohol consumption patterns but failed to disassociate the behavior with substance abuse and smoking. A second limitation is the limited number of studies that have uniquely used the theory of planned behavior to explain alcohol consumption. For example, O’malley and Johnston (23) found only five studies that applied the theory of planned behavior to alcohol consumption. Lastly, another limitation that characterizes these studies is the presence of reviews that have obscured different episodes of alcohol consumption, such as episodic drinking, binge drinking, and abstinence. The failure to recognize the differences in alcohol consumption patterns has obscured differences in the prediction of the different patterns of alcohol consumption.

Based on the above limitations, the proposed health campaign intends to fill the research gaps for three reasons. The first one is to identify the unique constructs of the theory of planned behavior which best explain alcohol consumption patterns among the youth (some constructs of the theory of planned behavior, such as PBC, have been found to have a weak predictor of alcohol consumption patterns) (Javadi et al. 52-53). The second reason is to establish the true impact of PBC in predicting alcohol consumption patterns, especially because different research studies have shown a weak ability of PBC to estimate alcohol consumption patterns (Javadi et al. 52-53). This debate has been further compounded by the fact that researchers have used different measures to identify PBC. The last reason for undertaking this study is to establish the main moderators of alcohol consumption, such as the frequency of drinking and gender, which may explain alcohol consumption patterns among the youth.

For purposes of developing our public health campaign, we will engage a qualitative design of the health issue because the structure of the public health campaign is to appeal to people’s subjective beliefs and attitudes towards alcohol consumption. The initiative would borrow from the principles of Östlund et al. (369), which strive to seek a subjective meaning of a study phenomenon. This health promotion strategy would be useful in appealing to the underlying motivation, opinions, and reasons for why young people engage in alcohol consumption and why they should stop it (McKibbon and Gadd 1-3). To develop an effective marketing campaign, we intend to use different tenets of the theory of planned behavior to design the public health campaign. The following section of this proposal outlines the plan of doing so.

As highlighted in the literature review section of this proposal, the theory of planned behavior has unique tenets that underlie its application. We will use these unique tenets to develop a robust public health campaign that would use the following aspects of the theory of planned behavior to guide its design.

Normative beliefs and Subjective Norms

Understanding people’s normative beliefs and subjective norms is a key component of the theory of planned behavior. We will use this attribute of the theory to explain patterns of alcohol consumption among the target population. To understand how we would apply these specific tenets to the research problem, it is pertinent to understand the distinction between normative beliefs and subjective norms. Normative beliefs are those that influence an individual’s perception of social, or normative, pressures (Javadi et al. 52-53). Stated differently, these beliefs would dictate how people’s opinions about alcohol consumption would affect the behavior of the target group towards the same. Subjective norms would define how people consume alcohol, based on the beliefs and practices of people who are close to them, such as their spouses, friends, or family members (Collins and Carey 498). Generally, we will appeal to how these two sets of beliefs influence alcohol consumption patterns among the target group.

Control Beliefs and PBC

This section of our design would mostly focus on investigating how different factors would either support or hinder, the consumption of alcohol among the target population. This aspect of our analysis is mostly related to understanding the influence of self-efficacy in explaining alcohol consumption patterns. The concept of perceived behavioral control would help us understand an individual’s perceived ease, or difficulty, of consuming alcohol. Most researchers have related this attribute of the theory of planned behavior with the need to assess a total set of accessible control beliefs (Collins and Carey 498).

Behavioral intention and Behavior

Intention is a key concept of the theory of planned behavior, which we have consistently mentioned in the literature review section of this proposal. Broadly, it refers to a person’s readiness to undertake a specific action. Some people term it as an antecedent of behavior, but most researchers deem it as a basis for appealing to a person’s attitude towards a behavior (Collins and Carey 499). In this regard, it constitutes people’s subjective norms and perceived behavioral controls. Each of these factors is a predictor of human behavior and holds different weights. The concept of behavior (in isolation) refers to the observation of an individual’s response regarding a particular behavior intended to achieve a specific target. Proponents of the theory of planned behavior who contend that behavior is a function of compatible intentions propagate this view (Collins, Witkiewitz and Larimer 322). They also contend that perceived behavioral controls are bound to moderate the effect of intention on behavior. Using this analogy, we will use the effects of behavioral intention and behavior on the patterns of alcohol consumption among young people to design the campaign. This would be a key tenet of our design.

There are different types of interventions to use in public health campaigns. For purposes of this paper, these interventions refer to the mechanisms for delivering the program content. There would be two types of interventions used – posters and radio messaging. The goal is to reach as many people as possible. The campaign would be aired on-campus radio to sensitize people about the negative effects of alcohol because this form of media reaches a wide audience of students as most of them listen to the radio. Print media would be available to double down on the same message. It is preferable because it has a reinforcing effect on the messaging in the sense that many students would be seeing it all the time.

This section of the proposal outlines the plans for operationalizing the health program and measuring its efficacy. The measurement plan appears below.

To evaluate the performance of the health program, we would conduct an interview with a random sample of the student population. In such interactions, we would look for terms such as “I am sure I can,” I am confident I will” and such like terms to explain the students’ commitment towards stopping alcohol abuse. The point of doing so is to measure the confidence towards the probability of executing the behavior under investigation. To measure social influence on the behavior of the respondents, we would look at unique statements that show the respondents transferring the reason for engaging in alcohol consumption to other people. For example, we would look for statements, such as “most of my friends drink,” “I am uncomfortable drinking in front of people who do not drink,” “In my family, we all drink” and such like statements. Again, these statements would show the respondents’ vulnerability to social influence and they would indicate the failure of the health program. Therefore, the students’ response would play a big role in reviewing the efficacy of the public health campaign.

The operational plan would hinge on investigating the alcohol consumption patterns among the student population by comparing it against different measures of the theory of planned behavior. The different measures would be perceived behavior control vs. self-efficacy, attitude towards behavior vs. outcome expectancy, and social influence. We discuss these measures below.

Perceived Behavior Control vs. Self-Efficacy

In this section of our analysis, we would investigate the perceptions of the students regarding their views of behavior control and self-efficacy towards alcohol consumption. Some of the issues we would seek to understand in this section of analysis would be how well the respondents think they could stop drinking, whether they crave for it and whether it would be easy, or difficult, to stop the habit.

Attitude towards behavior vs. Outcome Expectancy

In this part of the conceptual framework, we will investigate how people’s beliefs translate to the subjective reality of their actions. In other words, we will explore how people’s expectations translate to value, in terms of the actions they pursue.

Social Influence

In this section of the conceptual framework, we would explore how much of young people’s decisions to drink stems from the expectations of their friends, family members, or their colleagues.

The main strength of this paper is the reliance on a proven theoretical underpinning of evaluating human behavior – theory of planned behavior. This theoretical framework has unique merits that would help in the comprehension of the research issue and in the holistic review of a common social and health issue among young people – alcohol abuse.

Limitations

The main limitation of this study is the limited demographic profile of the study group. The target group would mostly be undergraduate students aged between 16 – 25 years. This means that the findings of this study would mostly relate to young people within this age group. Lastly, because of resource constraints, the findings of this study would be limited to only one campus. Therefore, it may be difficult to extrapolate the findings of this paper to other campuses that do not share the same socio-political dynamics as the target group.

Bilic, Bojan. “The Theory of Planned Behavior and Health behaviors: Critical Analysis of Methodological and Theoretical Issues.” Hellenic Journal of Psychology 2.1 (2005): 243-259. Print.

Birech, Jeniffer, Kabiru Joseph, Misaro Josphine & Kariuki David. “Alcohol Abuse and the Family: A Case Study of the Nandi Community of Kenya.” International Journal of Humanities and Social Science 3.15 (2013): 137-144. Print.

Collins, Susan and Carey Kate. “The Theory of Planned Behavior as a Model of Heavy Episodic Drinking Among College Students.” Psychol Addict Behav . 21.4 (2007): 498–507. Print.

Collins, Susan, Witkiewitz Katie and Larimer Mary. “The Theory of Planned Behavior as a Predictor of Growth in Risky College Drinking.” J Stud Alcohol Drugs 72.2 (2011): 322–332. Print.

Cooke, Richard, Dahdah Mary, Norman Paul and French David. “How well does the Theory of Planned Behavior Predict Alcohol Consumption? A Systematic Review and Meta-Analysis.” Health Psychology Review 10.2 (2016): 148-167. Print.

Grønbæk, Morten. “The Positive and Negative Health Effects of Alcohol- and The Public Health Implications.” Journal of Internal Medicine 265 (2009): 407–420. Print.

Javadi, Marzieh, Kadkhodaee Maryam, Yaghoubi Maryam, Maroufi Maryam and Shams Asadollah. “Applying Theory of Planned Behavior in Predicting of Patient Safety.” Behaviors of Nurses Mater Sociomed 25.1 (2013): 52–55. Print.

McKibbon, Kathleen and Gadd Cynthia. “A Quantitative Analysis of Qualitative Studies In Clinical Journals For The 2000 Publishing Year.” Bmc Med Inform Decis Mak 4.11(2004): 1-8. Print.

National Institute on Alcohol Abuse and Alcoholism. “Health Risks and Benefits of Alcohol Consumption.” Alcohol Research & Health 24.1 (2000): 5-11. Print.

O’malley, Patrick and Johnston Lloyd. “Epidemiology of Alcohol and Other Drug Use among American College Students.” Journal of Studies on Alcohol / Supplement 14.1 (2002): 23-39. Print.

Östlund, Ulrika, Kidd Lisa, Wengström Yvonne and Rowa-Dewar Neneh. “Combining qualitative and quantitative research within mixed method research designs: A methodological review.” International Journal of Nursing Studies 48.3 (2011): 369-383. Print.

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Guest Essay

Surgeon General: Why I’m Calling for a Warning Label on Social Media Platforms

By Vivek H. Murthy

Dr. Murthy is the surgeon general.

One of the most important lessons I learned in medical school was that in an emergency, you don’t have the luxury to wait for perfect information. You assess the available facts, you use your best judgment, and you act quickly.

The mental health crisis among young people is an emergency — and social media has emerged as an important contributor. Adolescents who spend more than three hours a day on social media face double the risk of anxiety and depression symptoms, and the average daily use in this age group, as of the summer of 2023, was 4.8 hours . Additionally, nearly half of adolescents say social media makes them feel worse about their bodies.

It is time to require a surgeon general’s warning label on social media platforms, stating that social media is associated with significant mental health harms for adolescents. A surgeon general’s warning label, which requires congressional action, would regularly remind parents and adolescents that social media has not been proved safe. Evidence from tobacco studies show that warning labels can increase awareness and change behavior. When asked if a warning from the surgeon general would prompt them to limit or monitor their children’s social media use, 76 percent of people in one recent survey of Latino parents said yes.

To be clear, a warning label would not, on its own, make social media safe for young people. The advisory I issued a year ago about social media and young people’s mental health included specific recommendations for policymakers, platforms and the public to make social media safer for kids. Such measures, which already have strong bipartisan support, remain the priority.

Legislation from Congress should shield young people from online harassment, abuse and exploitation and from exposure to extreme violence and sexual content that too often appears in algorithm-driven feeds. The measures should prevent platforms from collecting sensitive data from children and should restrict the use of features like push notifications, autoplay and infinite scroll, which prey on developing brains and contribute to excessive use.

Additionally, companies must be required to share all of their data on health effects with independent scientists and the public — currently they do not — and allow independent safety audits. While the platforms claim they are making their products safer, Americans need more than words. We need proof.

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