Fish, J. N., Pollitt, A. M., Schulenberg, J. E., & Russell, S. T. (2017). Alcohol use from adolescence through early adulthood: an assessment of measurement invariance by age and gender. Addiction, 112(8), 1495-1507.

Previous research studies on alcohol use have seldom tested for variables across different subpopulations and ages. The researchers of this study argue that this omission may result in biased estimates and inferences. They aimed to correct this in their study by testing measurement invariance of alcohol consumption in relation to age and gender. The data was collected from the National Longitudinal Study of Adolescent to Adult Health. This was a nationally represented longitudinal study performed in 1994-95, 2001-02 and 2008. Participants were selected using a clustered sample design from 80 high schools representing all regions in the USA. The sample was made up of youth and young adults aged 13-31 years and the data was gathered from those who provided valid data on three measurement items from a 12 month retrospective period in each wave. These three items were drinking frequency, heavy episodic drinking and average quantity drunk. The authors discuss three waves: wave 1 comprised of adolescents enrolled in 80 schools in the 1994-95 school year (n = 20745); wave 3 about 6 years later when they were aged 18-24 years (n = 151970) and wave 4 in 2008, when the participants were aged 24-32 years (n = 15701). The authors didn’t discuss wave 2. The data collected was then structured so that all the measurements were compared by age year and gender and not wave. They found that gender and age year were variables in alcohol use in the age group measured and concluded that they need to be included in future studies to prevent bias in the results. A limitation of this study is that it only provides data from adolescence to young adulthood and the researchers postulate that these variables may also occur in middle and old age.

Hodder, R. K., Campbell, E., Gilligan, C., Lee, H., Lecathelinais, C., Green, S., & … Wiggers, J. (2018). Association between Australian adolescent alcohol use and alcohol use risk and protective factors in 2011 and 2014. Drug and Alcohol Review, 37(Supplement 1), S22-S33.

The recent decline in alcohol use by adolescents may be due to changes in risk and protective factors. Risk factors include parental alcohol use and permissive attitudes, availability and peer pressure. Protective factors include self-esteem, parental support with clear rules and connection to family and school. The aim of this study was to establish the level of alcohol use, risk and protective factors between 2011 and 2014 and determine if there was an association between alcohol use and risk and protective factors. Students aged 15-17 years were surveyed in 2011 and 2014. The participants attended 32 schools in a health region of New South Wales. The students completed a self-report survey on alcohol use (ever, recent, binge drinking), risk factors and protective factors. The data was analysed using descriptive statistics and multi variable logistic analyses were used to determine associations between alcohol use and risk and protective factors separately in 2011 and 2014. In 2014, fewer adolescents reported alcohol use than in 2011 and significant differences were found in some risk and protective factors. The strength of relationship with alcohol use, and reduction in the incidence of some risk factors in 2014 compared to 2011, indicates that these factors may be contributing to the decline in adolescent alcohol use. A limitation in this study was that it was limited to the population in a single health region so may not be applicable to adolescents in other areas.

MacArthur, G.J., Harrison, S., Caldwell, D.M., Hickman, M. & Campbell, R. (2016). 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, 111(3), 391-407.

Substance abuse in young people may be prevented by the use of peer-led interventions (PLI), but their impact had not yet been quantified. This study involved a systematic review of PLI which aimed to prevent alcohol, tobacco and other drug use among young people aged 11-21 years. The researchers searched several databases for relevant studies published up until 2015 and that were all randomised control trials. Screening and data extraction was conducted on the eligible studies by two independent researchers to produce a final selection of 17 studies. About half of these were school-based interventions targeting tobacco use. Ten of the studies, which targeted tobacco were combined to represent 13706 young people in 220 schools. A meta-analysis indicated PLI reduced smoking incidence in comparison to the controls. Six studies were pooled for alcohol use, which represented 1699 young people in 66 schools and these also demonstrated that PLI were associated with a reduction in use. Similarly, the three studies that were pooled for cannabis use (976 young people in 38 schools suggested an association with PLI and lower cannabis use. This was the only illicit drug in which eligible studies were found. This review indicated that PLI may be effective in preventing alcohol, tobacco and cannabis use, although the reviewers found that the evidence was limited due to the studies being small and of low quality.

Newton, N. C., Champion, K. E., Slade, T., Chapman, C., Stapinski, L., Koning, I., & … Teesson, M. (2017). A systematic review of combined student‐ and parent‐based programs to prevent alcohol and other drug use among adolescents. Drug and Alcohol Review, 36(3), 337-351.

Adolescent use of alcohol and other drugs is a major concern, so effective prevention is essential. Evidence suggests that developing school‐based prevention programs to include parenting elements can improve outcomes. This study was a systematic review which aimed to discover, describe and evaluate the efficacy of combined student‐ and parent‐based programs that were designed to prevent alcohol and other drug use in adolescents. The researchers searched PsycINFO, Medline, Central Register of Controlled trials and Cochrane databases in April 2015 and then found other studies from the reference lists. They included research which evaluated any combined universal intervention for students (aged 11–18 years old) and their parents. The programs needed to have been developed to prevent alcohol and/or other drug use, and have been delivered in a school‐based setting. Two independent reviewers assessed each study to reduce any bias.  The researchers reviewed the titles and abstracts of 1654 papers, and of these 22 met inclusion criteria. These papers included 13 trials of 10 programs, , nine of which demonstrated significant intervention effects in postponing or decreasing adolescent alcohol and/or other drug use in at least one trial. The authors state that it was impossible to perform a meta-analysis due to the large variables between the studies reviewed but they did provide qualitative descriptions and this was identified as a limitation in the study. They felt that this was the first review of combined student and parent‐based interventions developed to prevent and reduce alcohol and other drug use and that these programs may have promising outcomes. They felt that there were gaps in the literature, which they discussed in the context of the development of future programs.

Salom, C. L., Kelly, A. B., Alati, R., Williams, G. M., Patton, G. C., & Williams, J. W. (2016). Individual, school‐related and family characteristics distinguish co‐occurrence of drinking and depressive symptoms in very young adolescents. Drug and Alcohol Review, 35(4), 387-396.

Alcohol use and depressive symptoms are not unusual in early adolescence. In adults who have a comorbidity of these conditions, there is a relationship with poorer health and social outcomes. Despite this little research has examined the comorbidity of alcohol use and depressive symptoms in early adolescents. This study aimed to assess risk and protective factors in pre‐teens with simultaneous depressed mood and early alcohol use. Data was collected from a large school‐based sample of children aged 10–14 years (n= 7289) from late primary and early secondary school classes in government, Catholic and independent sectors. Parental consent was gained prior to participation and the data was collected using the cross‐sectional Healthy Neighbourhoods Study. Measures included depressed mood in the two weeks prior, alcohol use in the month prior, school mobility, family relationship quality, school engagement and coping style. The data was collected via self-reported surveys completed by the children. Multinomial logistic regression analyses were used to identify school and family‐related factors to differentiate children with co‐occurring drinking and depressive symptoms from children with either condition occurring alone. Comorbid conditions were reported by 5.7% of students and recent drinkers were more liable than their non‐drinking counterparts to have symptoms of depression. There was a relationship between low school attendance and co‐occurring drinking and depressive symptomology. This relationship however, seemed to be weaker in children with stress‐coping skills. The researchers identified factors that differentiate early adolescents who have an early comorbidity of drinking and depressed mood. This will enable the development of protective factors and school‐based prevention programmes targeting these conditions.

Toumbourou, J. W., Rowland, B., Ghayour‐Minaie, M., Sherker, S., Patton, G. C., & Williams, J. W. (2018). Student survey trends in reported alcohol use and influencing factors in Australia. Drug and Alcohol Review, 37(Supplement 1), S58-S66.

The authors of this study identified a need to clarify reported reductions of alcohol and substance use in Australian children. They did this using data obtained from student surveys in Victoria, Queensland and Western Australia, which enabled them to scrutinise trends in substance and alcohol use together with any related elements. They looked at 11 cross-sectional surveys completed by 41328 adolescents in 109 communities between 1999 and 2015. The average participant age was 13.5 years old and 52.5% were female. Trends in reported lifetime alcohol, tobacco and cannabis use, adjusted for age, gender, social disadvantage and minority status were evaluated using multi-level analysis. They also looked for any trends in influencing factors, including individual attitudes, family, school and community to estimate the main factors associated with alcohol and substance use. In the period studied use of alcohol, tobacco and cannabis all fell significantly in adolescents. Victoria had higher levels of use than both Queensland and Western Australia. They also found that reductions in favourable parental attitudes and reduced availability of the substances contributed directly to reductions in use of alcohol. A strength of the study was the large sample size. Conversely, a limitation was that the data collected was self-reported and may have been affected by participant bias.

 Waaktaar, T., Kan, K., & Torgersen, S. (2018). The genetic and environmental architecture of substance use development from early adolescence into young adulthood: a longitudinal twin study of comorbidity of alcohol, tobacco and illicit drug use. Addiction, 113(4), 740-748.

The aim of this study was to examine how alcohol, tobacco and other drug use in adolescents developed from substance-specific pathways and pathways general to all substances. This was done by analysing a population-based survey of adolescent twins, who reported alcohol use (AU), tobacco use (TU) and illicit drug use (IDU) at three time periods (2006, 2008 and 2010). Participants were recruited from seven national twin birth cohorts in Norway born between 1988 and 1994. There were a total of 1483 pairs: identical and non-identical; same and opposite gender. The data was measured using six-point Likert scores of AU, TU and IDU on items obtained from the Monitoring the Future Study. They found that substance use was very heritable at all ages and that genetic effects on substance use detected at ages 12-14 were still detectable 4 years later. Growing up in the same environment only impacted on AU and that was a small effect. They concluded that among the participants there seemed to be strong genetic influence on both substance-specific and comorbid use of alcohol, tobacco and other drugs and that individual differences in AU could be partly explained by their family background. The data collected was self-reported which could have resulted in participant bias. Attrition may have also affected the results, as those who didn’t continue with the study may have had a higher or lower incidence of substance use than those who continued.

White, V., Azar, D., Faulkner, A., Coomber, K., Durkin, S., Livingston, M., & … Wakefield, M. (2018). Adolescents’ alcohol use and strength of policy relating to youth access, trading hours and driving under the influence: findings from Australia. Addiction, 113(6), 1030-1042.

The aim of this study was to establish if the strength of Australian alcohol control policy had changed during the 2000s in three areas: youth access, trading hours and drink driving. The researchers then wanted to determine relationships between these policies and adolescent drinking after adjusting for variables. These variables were television alcohol advertising exposures, alcohol outlet density, alcohol price changes, exposure to negative articles about alcohol in daily newspapers and adult drinking prevalence. The data was collected in four Australian capital cities between 2002 and 2011, using repeated cross‐sectional surveys conducted every three years between 2002 and 2011. Multi‐level modelling was used to determine the association between alcohol control policies and drinking prevalence after adjusting for covariates. The participants were adolescents aged 12–17 years and the data was obtained using a triennial national representative school‐based survey.  Measurements were: drinking in the month prior and risky drinking, defined as 5+ drinks a day. The variables which were identified as key were policy strength in each of the previously mentioned areas. They also used covariates including television advertising, alcohol outlet density, alcohol price change, adult alcohol drinking and participant demographics. They found the strength of youth access policies increased in all three policy areas during the period studied and past month and risky drinking prevalence decreased. Multivariable analyses were performed that included all policy variables and were adjusted for other covariates. These analyses showed past‐month drinking to be associated inversely with stronger trading hours policies, but not youth access or drink‐driving. Risky drinking was associated inversely with stronger youth access policies, but not trading hours or drink‐driving policies. They concluded that policies designed to reduce the availability and promotion of alcohol may decrease alcohol use by adolescents. A limitation in the study is that it only examined the three policy variables and there were other policy measures such as educational initiatives and responsible service of alcohol, which may also have had an effect on adolescent alcohol use during the study period.

All the papers are available to Healthy Options staff via the library database