January 18, 2021
Preventing or delaying young people using alcohol and drugs
The ADF has written an extensive paper on Preventing and delaying AOD uptake by young people.
This Insights article provides a short summary of the paper’s findings and outlines what we found ‘works’ to prevent and delay use of alcohol and drugs among 12 to 17-year olds.
Adolescence is a time of immense physical and social change, where the brain undergoes rapid growth and development. There are significant concerns that the use of alcohol or other drugs at this time may impact brain development. Drinking alcohol can impact brain development up until the age of 25 years – affecting cognitive abilities such as attention, memory, and decision-making.1, 2
There are also concerns that early use of alcohol and other drugs by a young person can increase the likelihood of dependence and harm in the future.3
Delaying the use of alcohol and other drugs by young people, for as long as possible, can help to reduce harms.
The Australian alcohol guidelines recommend that young people delay their first drink until they are at least 18 years old.3
There are programs and approaches that can help prevent and reduce alcohol and other drug issues and related harms for young people, including vulnerable youth populations.
There are many factors that influence a young person’s health, wellbeing and development, including:
- individual, personal circumstances
- what they do for fun and leisure
- local community and broader environment.
What can help and what can hinder?
During adolescence, young people typically become more involved with their friends and have more unsupervised time, including time outside the home.
Peer programs are activities led by peers of the same age or older at schools, community, and youth centres. Some peer programs have been shown to help prevent or delay young people using alcohol or other drugs, but they need to be part of a larger prevention program, not just ‘stand-alone’.4 (Note: some peer support initiatives may lead to an increase in alcohol or other drug use.5, 6)
More effective peer education programs often include:
- peer leaders nominated by peers; rather than non-peer adults
- peer leaders role-modelling desired behaviours
- young people engaged in the program’s content development.6
Parents and carers play a critical role in a young person’s development and can take steps to help prevent - or delay - a young person’s initial use of alcohol and other drugs.
What increases the likelihood of underage drinking?
- parental drinking
- parents who talk about alcohol ‘positively’
- parents who talk about their own negative drinking experiences.7
What decreases the likelihood of underage drinking?
- parental monitoring of their children
- a quality parent-child relationship
- parental support and involvement in their child’s lives.7
When parents give young people alcohol, or let them drink at home, young people are more likely to start drinking earlier, drink more often, and drink higher quantities of alcohol.7
Boosting parents and carers understanding about why their children shouldn’t drink during adolescence, and the supportive actions they can take, may reduce the likelihood that their child will drink and drink in harmful ways.
Research suggests parenting programs that strengthen the parent-child bond can positively affect a young person’s use of alcohol and other drugs.8
These programs focus on:
- promoting parent-child connection
- problem solving
- resolving problems.
Parent and child conversations
Open conversations about alcohol and other drug use between parents and their children should start early, and will prepare young people for times when they encounter alcohol or other drugs.
Through conversation, parents can support young people with the right attitude and information before they reach high school, creating an understanding that there are no ‘silly’ questions and no topics off-limits.
Mentoring usually involves an older person (mentor) providing support and guidance to the younger person (mentee) based on their experience and skills. Formal mentoring programs may be established through an in-school program, an after-school program, a weekly meeting in a community setting, or online.
Some evidence points to youth mentoring as a way to prevent or reduce young people’s use of alcohol and other drugs, but the findings are mixed.9 Mentoring programs may be more effective when they include a focus on the mentor providing emotional support.5
Fun and recreation
How young people spend their spare time may influence their use of alcohol and other drugs.
Having significant unsupervised and unstructured time may increase the risk of alcohol or other drug use; while being engaged in structured and supervised activities can potentially reduce the risk.10, 11
Being involved in sport and other activities such as music, dance, skateboarding and gaming, can help prevent - or delay - a young person’s initial use of alcohol and other drugs.
Key factors to success include:
- participation in positive activities with adult engagement
- positive role models, including around alcohol and other drug use
- a sense of belonging and community connectedness.
Note: There is some evidence that the impact of sport participation on alcohol use may differ depending on the type of sport; for example, team sports may be associated with higher alcohol consumption than individual-based sports.12
Schools can play a role in preventing and delaying the use of alcohol and other drugs by young people.
Effective school-based initiatives may increase an individual’s sense of belonging and connection to school, and improved participation.13 On the other hand, poor quality student-teacher relationships and students feeling disengaged from school is associated with higher alcohol and other drug use.13
Drug education programs that show positive results will often explore participants’ values, attitudes, knowledge and skills. In doing so, these programs aim to improve a young person’s capacity to make healthy decisions about using alcohol, tobacco or other drugs.14
Availability of alcohol
The availability of alcohol is affected by how many venues sell alcohol in an area (outlet density), venue opening hours, and the age for legal purchase of alcohol.15
Australian research has found that a higher density of shops selling alcohol in a community – specifically take-away liquor outlets – is linked to a higher risk of alcohol consumption for adolescents between 12–14 years of age.16
Access to online sales of alcohol, as well as poor enforcement of underage purchasing or secondary supply laws can also result in increased drinking among adolescents.15, 17
Price of alcohol
Cheaper alcohol tends to encourage underage drinking and higher levels of alcohol consumption, including short-term risky drinking.18, 19 When the cost of alcohol increases, young people are likely to consume less – reducing the likelihood of experiencing alcohol-related harms.20, 21
Promotion of alcohol
Young people are exposed to alcohol advertising through television, radio, print and social media, alcohol branded merchandise, and outdoor billboards.
Exposure to alcohol advertising is one factor that shapes young people’s attitudes to, and consumption of, alcohol.22-24
The more exposed to alcohol advertising a young person is, the more likely they are to engage in problematic drinking.22
Social media allows brands to target young people in ways that are difficult to regulate, and sport sponsorships allow alcohol brands to bypass regulations that prohibit alcohol advertising during children’s viewing times.
With social media becoming such a major part of the lives of so many adolescents and young adults,25 it provides an easy opportunity for alcohol companies to advertise their products to millions of young people cheaply.26
On social media, alcohol consumption (binge drinking in particular) is normalised and often glamourised among adolescents and young adults.25 There is strong evidence that this is linked to increased alcohol consumption and alcohol-related problems.25, 27
Prevention strategies to reduce AOD harm amongst young people
Parenting_ADF position paper
- Spear LP. Effects of adolescent alcohol consumption on the brain and behaviour. Nature Reviews Neuroscience. 2018(4):197.
- Guerri C, Pascual M. Impact of neuroimmune activation induced by alcohol or drug abuse on adolescent brain development. International Journal of Developmental Neuroscience. 2019;77:89-98.
- National Health and Medical Research Council. Australian Guidelines to Reduce Health Risks from Drinking Alcohol. Canberra: Australian Government; 2020.
- MacArthur GJ, Harrison S, Caldwell DM, Hickman M, Campbell R. Peer-led interventions to prevent tobacco, alcohol and/or drug use among young people aged 11–21 years: a systematic review and meta-analysis. Addiction. 2016;111(3):391-407.
- Snijder M, Stockings E, Munro A, Barrett E, Knight A, Doyle M et al. Alcohol and other drugs prevention in vulnerable young people. Sax Institute: NSW Ministry of Health; 2018.
- Hunt S, Kay-Lambkin F, Simmons M, Thornton L, Slade T et al. Evidence for the effectiveness of peer-led education for at risk youth: an Evidence Check rapid review. Sax Institute: NSW Ministry of Health; 2016.
- Yap MBH, Cheong TWK, Zaravinos-Tsakos F, Lubman DI, Jorm AF. Modifiable parenting factors associated with adolescent alcohol misuse: a systematic review and meta-analysis of longitudinal studies. Addiction. 2017;112(7):1142-62.
- Petrie J, Bunn F, Byrne G. Parenting programmes for preventing tobacco, alcohol or drugs misuse in children <18: a systematic review. Health Education Research. 2007;22(2):177-91.
- Thomas RE, Lorenzetti D, Spragins W. Mentoring adolescents to prevent drug and alcohol use. Cochrane Database of Systematic Reviews. 2011(11).
- Kristjansson AL, James JE, Allegrante JP, Sigfusdottir ID, Helgason AR. Adolescent substance use, parental monitoring, and leisure-time activities: 12-year outcomes of primary prevention in Iceland. Preventive Medicine. 2010;51(2):168-71.
- Kristjansson AL, Mann MJ, Sigfusson J, Thorisdottir IE, Allegrante JP, Sigfusdottir ID. Development and Guiding Principles of the Icelandic Model for Preventing Adolescent Substance Use. Health Promotion Practice. 2019;21(1):62-9.
- Kwan M, Bobko S, Faulkner G, Donnelly P, Cairney J. Sport participation and alcohol and illicit drug use in adolescents and young adults: A systematic review of longitudinal studies. Addictive Behaviors. 2014;39(3):497-506.
- Fletcher A, Bonell C, Hargreaves J. School Effects on Young People’s Drug Use: A Systematic Review of Intervention and Observational Studies. Journal of Adolescent Health. 2008;42(3):209-20.
- Teesson M, Newton NC, Barrett EL. Australian school-based prevention programs for alcohol and other drugs: A systematic review. Drug and Alcohol Review. 2012;31(6):731-6.
- Gruenewald PJ. Regulating availability: How access to alcohol affects drinking and problems in youth and adults. Alcohol Research: Current Reviews. 2011;34(2):248-56.
- Rowland B, Toumbourou JW, Satyen L, Tooley G, Hall J, Livingston M, et al. Associations between alcohol outlet densities and adolescent alcohol consumption: A study in Australian students. Addictive Behaviors. 2014;39(1):282-8.
- Fletcher LA, Toomey TL, Wagenaar AC, Short B, Willenbring ML. Alcohol home delivery services: a source of alcohol for underage drinkers. Journal of Studies on Alcohol. 2000;61(1):81-4.
- Babor T, Caetano R, Casswell S, Edwards G, Giesbrecht N, Graham K, et al. Alcohol: no ordinary commodity: research and public policy. Rev Bras Psiquiatr. 2010;26(4):280-3.
- Wall M, Casswell S, Yeh L-C. Purchases by heavier drinking young people concentrated in lower priced beverages: Implications for policy. Drug and Alcohol Review. 2017;36(3):352-8.
- Cousins G, Mongan D, Barry J, Smyth B, Rackard M, Long J. Potential Impact of Minimum Unit Pricing for Alcohol in Ireland: Evidence from the National Alcohol Diary Survey. Alcohol and Alcoholism. 2016;51(6):734-40.
- Gill J, Black H, Rush R, O’May F, Chick J. Heavy Drinkers and the Potential Impact of Minimum Unit Pricing—No Single or Simple Effect? Alcohol and Alcoholism. 2017;52(6):722-9.
- Jernigan D, Noel J, Landon J, Thornton N, Lobstein T. Alcohol marketing and youth alcohol consumption: a systematic review of longitudinal studies published since 2008. Addiction. 2017;112(S1):7-20.
- Morgenstern M, Isensee B, Sargent JD, Hanewinkel R. Attitudes as Mediators of the Longitudinal Association Between Alcohol Advertising and Youth Drinking. Archives of Pediatrics & Adolescent Medicine. 2011;165(7):610-6.
- Fleming K, Thorson E, Atkin CK. Alcohol Advertising Exposure and Perceptions: Links with Alcohol Expectancies and Intentions to Drink or Drinking in Underaged Youth and Young Adults. Journal of Health Communication. 2004;9(1):3-29.
- Curtis BL, Lookatch SJ, Ramo DE, McKay JR, Feinn RS, Kranzler HR. Meta-Analysis of the Association of Alcohol-Related Social Media Use with Alcohol Consumption and Alcohol-Related Problems in Adolescents and Young Adults. Alcohol Clin Exp Res. 2018;42(6):978-86.
- Weaver ERN, Wright CJC, Dietze PM, Lim MSC. ‘A Drink That Makes You Feel Happier, Relaxed and Loving’: Young People's Perceptions of Alcohol Advertising on Facebook. Alcohol and Alcoholism. 2016;51(4):481-6.
- Noel JK, Sammartino CJ, Rosenthal SR. Exposure to Digital Alcohol Marketing and Alcohol Use: A Systematic Review. Journal of Studies on Alcohol and Drugs, Supplement. 2020(s19):57-67.