Association of alcohol control policies with adolescent alcohol consumption and with social inequality in adolescent alcohol consumption

A multilevel study in 33 countries and regions

Bibliographic Data

ID14905950
AuthorsEva Leal-López (0000-0001-7773-1723, Universidad de Sevilla, corresponding author), Concepción Moreno-Maldonado (0000-0001-5777-1285, Universidad de Sevilla), Joanna Inchley (0000-0001-8322-8817, University of Glasgow), Benedicte Deforche (0000-0002-1064-0525, Ghent University Hospital), Tina van Havere (0000-0003-0484-7463), J Van Damme (0000-0003-1670-3758), Thomas Buijs (Ghent University Hospital), Inmaculada Sánchez‐queija (0000-0002-4688-4206, Universidad de Sevilla), I Sánchez-Queija, Dorothy Currie (0000-0001-7321-9394, University of St Andrews), Alessio Vieno (0000-0003-4417-4822, University of Padua), Bart De Clercq (0000-0002-6908-4295, Ghent University Hospital)
Year2020
Volume84
Pages102854
Publication date2020-10-01
Open AccessYes
TypeARTICLE
VenueInternational Journal of Drug Policy (JOURNAL)
Journal identifiersISSN: 0955-3959 • E-ISSN: 1873-4758
PublisherElsevier BV (PUBLISHER)
DOI10.1016/j.drugpo.2020.102854
PMID32717703
OpenAlexW3044807613
LanguageEN
Citations received11
References cited46

Background Previous research found inconsistent associations between alcohol control policies and socioeconomic inequality with adolescent drinking outcomes. This study expands the focus beyond individual associations to examine whether a combination of policies is related to socioeconomic inequality in adolescent drinking outcomes and whether this relationship varies across survey years. Methods Multilevel modelling of 4 waves of repeat cross-sectional survey data (2001/02, 2005/06, 2009/10, and 2013/14) from the Health Behaviour in School-aged Children (HBSC) study was carried out. The sample was composed of 671,084 adolescents (51% girls) aged 11, 13, and 15 (mean age=13.58; SD=1.65) from 33 European and North American countries/regions. The dependent variables were lifetime alcohol consumption, weekly alcohol consumption, and lifetime drunkenness. Independent variables were of three types: individual-level variables (age, sex, Family Affluence Scale, and the Perceived Family Wealth), time-level variable (survey year), and context-level variables (minimum legal drinking age, physical availability, advertising restrictions, a total alcohol policy index, and affordability of alcohol). Results The total alcohol policy index showed a negative relationship with both lifetime and weekly consumption. Higher affordability of alcohol was related to higher lifetime and weekly consumption and higher lifetime drunkenness. Family Affluence Scale was positively related to all three alcohol measures and Perceived Family Wealth was negatively related to lifetime drunkenness, with these associations increasing across survey years. The total alcohol policy index buffered the associations of Family Affluence Scale and Perceived Family Wealth with adolescent drinking outcomes. Conclusion A combination of alcohol control policies is more effective in reducing adolescent drinking outcomes than single policy measures. Reducing the affordability of alcohol stood out as the most successful single measure. Socioeconomic inequalities (i.e. higher alcohol consumption and drunkenness in adolescents with higher family affluence and higher drunkenness in adolescents perceiving their families to be poor) have persisted and even increased across survey years. A combined alcohol control policy can help in tackling them

Alcohol · Alcohol consumption · Consumption (sociology · Context (archaeology · Environmental health · Geography · Inequality · Injury prevention · Multilevel model · Poison control · Population · Scale (ratio · Socioeconomic status · Sociology · Demography · Health disparities and outcomes · Homelessness and Social Issues · Medicine · Psychology · Substance Abuse Treatment and Outcomes

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