Investigating underage youth access to alcohol in Switzerland: inventory of modes of access and association with youth characteristics.

AIMS: While laws restrict alcohol access to youth under the age of 16/18 (fermented/distilled beverages) in Switzerland, direct underage accessibility is high. Focusing on underage youth, our study presents an inventory of primary and alternative modes of access to alcohol and investigates associations with youth characteristics. METHODS: Data were collected using semi-structured interviews and self-report questionnaires. In total, 223 underage youth aged 15-17 years were interviewed. RESULTS: Overall, about half of the participants reported illegal commercial purchase, either direct or by underage peer, in on- (49.3%) and/or off-premise (48.0%) contexts. Off-premise purchase by proxy of legal age (30.5%; excluding shoulder-tapping), social supply off-premise (i.e. receiving/exchanging alcohol; 26.5%) and direct purchases in on- (13.9%) and off-premise (11.2%) contexts were the most recurrent primary modes of access. Significant associations of direct purchases with frequency of consumption and perceived alcohol availability were recorded. Associations between primary and alternative ways to access alcohol, in particular, between on-premise modes, were also evidenced. CONCLUSION: Providing an overview of the context of underage alcohol access in Switzerland and an indirect view of youth perceptions of limitations of existing structural measures has identified particularly the need for enforcement of existing legislation.

Acute and usual drinking among emergency trauma patients: a study on alcohol consumption and injury patterns.

OBJECTIVE: To investigate the relationship between usual and acute alcohol consumption among injured patients and, when combined, how they covary with other injury attributes. METHODS: Data from a randomised sample of 486 injured patients interviewed in an emergency department (Lausanne University Hospital, Switzerland) were analysed using the chi(2) test for independence and cluster analysis. RESULTS: Acute alcohol consumption (24.7%) was associated with usual drinking and particularly with high volumes of consumption. Six injury clusters were identified. Over-representations of acute consumption were found in a cluster typical of injuries sustained through interpersonal violence and in another formed by miscellaneous circumstances. A third cluster, typical of sports injuries, was linked to a group of frequent heavy episodic drinkers (without acute consumption). CONCLUSIONS: Among injured patients, acute alcohol consumption is common and associated with usual drinking. Acute and/or usual consumption form part of some, but not all, injury clusters.

Alcohol outlet density, perceived availability and adolescent alcohol use: a multilevel structural equation model.

OBJECTIVES: Perceived availability is commonly associated with adolescent alcohol use. Little is known about the factors which shape this perceived availability. The present study investigates (1) whether perceived alcohol availability is related to the characteristics of the adolescents' social environment and the per capita outlet density in the community and (2) whether adolescent alcohol use is related to perceived availability, social environment characteristics and outlet density. METHODS: Multilevel structural equation models were estimated based on data from a national representative sample of 6183 adolescents in the 8th and 9th grades of school (mean age 14.8 years) in 254 communities in Switzerland. FINDINGS: Social environment characteristics, that is, having peers and siblings who drink, going out without parental knowledge of the adolescents' whereabouts, drinking in public settings and the density of on-premises but not off-premises alcohol outlets, were related to perceived availability. Adolescent alcohol use increased with the permissiveness of social environment characteristics and with increasing perceived availability. Community-level perceived availability and the density of on-premises but not off-premises outlets were related to volume drinking but not to the frequency of risky drinking occasions. CONCLUSIONS: Perceived availability and drinking volume appear to be shaped by the adolescents' social and physical environments. Adolescents who have a variety of opportunities to obtain alcohol might develop the impression that underage drinking is common and socially endorsed. Consequently, preventive actions to curb adolescent alcohol consumption should take into account the social acceptance of drinking and the physical availability of alcohol in the community.