Consumo de bebidas azucaradas, agua y alcohol en adolescentes chilenos / Consumption of sugary drinks, water, and alcohol among chilean adolescents

Fundamentos: El objetivo de este estudio fue determinar el consumo de bebidas azucaradas, agua y alcoholen adolescentes chilenos.Métodos: Este estudio analizó datos secundarios de la Encuesta Nacional de Salud (ENS) de Chile 2016-2017,enfocándose en adolescentes de 15 a 18 años. Se analizó el consumo de bebidas azucaradas, agua y alcohol,así como variables antropométricas.Resultados: El estudio incluyó 226 adolescentes con una mediana de edad de 16 años (RI 15,0-17,0), siendoun 58,8% de sexo femenino y un 84,9% residentes en zonas urbanas. Se encontró que el 46,4% de losparticipantes tenían exceso de peso y el 24,1% presentaba riesgo de obesidad abdominal. El consumo regularde bebidas azucaradas fue del 87,6%, el 44,7% consumía al menos 1 trago en un día típico de consumo dealcohol y el 39,8% bebía menos de 3 vasos de agua diarios. No se observaron diferencias estadísticamentesignificativas en el comportamiento de las variables según el sexo y estado nutricional, pero sí se encontró unaumento en la proporción a medida que aumenta la edad.Conclusiones: Se observa una alta prevalencia de consumo de bebidas azucaradas y alcohol, y bajo consumode agua. Resalta la necesidad de promover el agua como principal fuente de hidratación en el ámbito escolary familiar.(AU)

Background: The objective of this study was to determine the consumption of sugary drinks, water, andalcohol among Chilean adolescents.Methods: This study analyzed secondary data from the Chilean National Health Survey (ENS) 2016-2017,focusing on adolescents aged 15 to 18 years. The consumption of sugary drinks, water, and alcohol, as well asanthropometric variables, were analyzed.Results: The study included 226 adolescents with a median age of 16 years (IQR 15.0-17.0), of whom 58.8%were female, and 84.9% resided in urban areas. It was found that 46.4% of the participants were overweight,and 24.1% had abdominal obesity risk. The regular consumption of sugary drinks was 87.6%, 44.7% consumedat least 1 alcoholic drink on a typical day, and 39.8% drank fewer than 3 glasses of water daily. There were nostatistically significant differences in the behavior of the variables according to sex and nutritional status, butan increase in the proportion was observed as age increased.Conclusions: A high prevalence of consumption of sugary drinks and alcohol, along with low water intake,highlights the need to promote water as the primary source of hydration in both school and family environments.(AU)

Consumo e exposição a bebidas alcoólicas entre adolescentes brasileiros: evidências das pesquisas nacionais de saúde do escolar de 2015 e 2019 / Consumo y exposición a bebidas alcohólicas entre los adolescentes brasileños: evidencia de las encuestas nacionales de salud escolar de 2015 y 2019 / Consumption of and exposure to alcoholic beverages among brazilian adolescents: diverse evidence from the 2015 and 2019 national school health surveys

RESUMO Objetivo: analisar os indicadores de consumo e exposição a bebidas alcoólicas entre escolares brasileiros em 2019 e compará-los aos de 2015. Método: estudo transversal com dados da Pesquisa Nacional de Saúde do Escolar (PeNSE), realizadas em 2015 e 2019. Em 2019, analisaram-se os indicadores referentes ao consumo e à exposição a bebidas alcoólicas, estratificadas por sexo, faixa etária, dependência administrativa, unidades da federação e região geográfica. Estimou-se as prevalências e os respectivos intervalos de 95% de confiança (IC 95%). Resultados: houve aumento na experimentação de bebidas alcoólicas antes de 13 anos (30,6% em 2015 para 34,6% em 2019); sofrer embriaguez na vida (27,2% em 2015 para 47,0% em 2019) e ter problemas com amigos devido ao consumo de bebidas alcóolicas (9,3% em 2015 para 15,7% em 2019). Todos os indicadores foram mais prevalentes entre meninas, exceto beber em binge e episódios de embriagues, que não tiveram diferenças entre os sexos, bem como foram mais elevadas entre estudantes mais velhos. Os episódios de embriaguez e ter amigos que ingerem bebida alcoólica foram mais prevalentes entre escolares de escolas públicas, enquanto o consumo de bebidas alcoólicas pelos pais e ter tido problemas com suas famílias ou amigos devido ao consumo de bebidas alcoólicas foram mais elevados em estudantes de escolas privadas. Conclusão: evidenciaram-se elevadas prevalências de experimentação, consumo e exposição a bebidas alcoólicas, mostrando que grande parcela dos adolescentes brasileiros se encontra exposta a uma carga evitável de morbimortalidade decorrente do consumo e exposição ao álcool.

RESUMEN Objetivo: analizar los indicadores de consumo y exposición a bebidas alcohólicas entre los estudiantes brasileños en 2019 y compararlos con los de 2015. Método: estudio transversal con datos de la Encuesta Nacional de Salud Escolar (PeNSE), realizada en 2015 y 2019. En 2019 se analizaron los indicadores referidos al consumo y exposición a bebidas alcohólicas estratificados por sexo, grupo de edad, dependencia administrativa, unidades federativas y región geográfica. Se estimó la prevalencia y los respectivos intervalos de confianza del 95% (IC 95%). Resultados: aumenta la experimentación con bebidas alcohólicas antes de los 13 años (30,6% en 2015 a 34,6% en 2019); sufrir borracheras en la vida (27,2% en 2015 a 47,0% en 2019) y tener problemas con los amigos por el consumo de alcohol (9,3% en 2015 a 15,7% en 2019). Todos los indicadores eran más frecuentes entre las chicas, excepto el consumo compulsivo de alcohol y los episodios de embriaguez, que no presentaban diferencias de género, además de ser más elevados entre los estudiantes de mayor edad. Los episodios de consumo de alcohol y el hecho de tener amigos que beben bebidas alcohólicas fueron más frecuentes entre los estudiantes de la escuela pública, mientras que el consumo de alcohol por parte de los padres y el hecho de haber tenido problemas con sus familias o amigos debido al consumo de alcohol fueron mayores en los estudiantes de las escuelas privadas. Conclusión: se evidenció una alta prevalencia de experimentación, consumo y exposición a bebidas alcohólicas, mostrando que una gran parte de los adolescentes brasileños está expuesta a una carga evitable de morbilidad y mortalidad resultante del consumo y exposición al alcohol.

ABSTRACT Objective: to analyze the indicators regarding consumption of and exposure to alcoholic beverages among Brazilian schoolchildren in 2018 and compare them to those from 2015. Method: a cross-sectional study conducted with data from the 2015 and 2019 National School Health Survey (Pesquisa Nacional de Saúde do Escolar, PeNSE). In 2019, the indicators referring to consumption of and exposure to alcoholic beverages were analyzed, stratified by gender, age group, administrative system, Federation Unit, and geographical region. The prevalence values and their respective 95 confidence intervals (95% CIs) were estimated. Results: there was an increase in trying alcoholic beverages before the age of 13 (from 30.6% in 2015 to 34.6% in 2019); being drunk in their lifetime (from 27.2% in 2015 to 47.0% in 2019) and having problems with friends due to alcohol consumption (from 9.3% in 2015 to 15.7% in 2019). All the indicators were more prevalent among the girls, except for binge drinking and drunkenness episodes, which presented no differences between the genders and were also higher among older students Episodes of drunkenness and having friends who drink alcohol were more prevalent among students from public schools, while consumption of alcoholic beverages by parents and having had problems with their families or friends due to alcohol consumption were higher in students from private schools. Conclusion: high prevalence of experimentation, consumption and exposure to alcoholic beverages was evidenced, showing that a large number of Brazilian adolescents are exposed to an avoidable burden of morbidity and mortality resulting from consumption of and exposure to alcohol.

The Role of Age of Onset in Problematic Alcohol Consumption: Artefact or Cohort Effect? / El papel de la edad de inicio en el consumo problemático de alcohol: ¿artefacto o efecto de cohorte?

Age of onset has been reported as a crucial predictor for alcohol consumption in adolescence. However, several authors have warned against it as an unreliable artefact accounted by the tendency to delay age of onset as respondents’ age increases (forward telescoping). This study aims to test whether age of onset is either a proxy for age or a predictor of alcohol consumption of its own. A hierarchical regression model and Process Macro for SPSS were used to test the effect of age of onset (controlling for age) on alcohol consumption and the mediating/moderator role of age of onset, parental control, and sex on alcohol consumption, respectively. Results support the role of age of onset as a significant predictor of alcohol consumption in Ecuadorian adolescents, rather than an artefact. Furthermore, age of onset completely mediated the effect of age on alcohol consumption, often moderated by sex. Practical implications are further discussed.

La edad de inicio se ha señalado como un predictor crucial del consumo de alcohol en la adolescencia. Sin embargo, varios autores han advertido que se trata de un artefacto poco fiable que se explica por la tendencia a retrasar la edad de inicio a medida que aumenta la edad de los encuestados (forward telescoping o sesgo de memoria). Este estudio pretende comprobar si la edad de inicio es una medida aproximativa de la edad o un predictor del consumo de alcohol por sí mismo. Se utilizó un modelo de regresión jerárquica y la Macro Process para SPSS para probar el efecto de la edad de inicio (controlando la edad) en el consumo de alcohol y el papel mediador/moderador de la edad de inicio, el control parental y el sexo en el consumo de alcohol, respectivamente. Los resultados confirman el papel de la edad de inicio como predictor significativo del consumo de alcohol en los adolescentes ecuatorianos en lugar de artefacto. Además, la edad de inicio medió completamente el efecto de la edad en el consumo de alcohol, con frecuencia moderado por el sexo. Se discuten posteriormente las implicaciones prácticas.

Impacto da exposição domiciliar ao tabaco e da composição familiar sobre a precocidade de uso de tabaco e álcool em adolescentes brasileiros / Impact of household exposure to tobacco and family composition on the early onset of alcohol use in Brazilian adolescents

O uso precoce de tabaco e álcool associa-se à maior morbimortalidade e manutenção desse consumo na vida adulta. Esta tese investiga o papel de fatores domiciliares e familiares sobre o início precoce do uso dessas substâncias entre adolescentes. Os dados analisados são do Estudo de Riscos Cardiovasculares em Adolescentes (ERICA), que investigou 74.589 adolescentes de escolas públicas e privadas, com idades entre 12 e 17 anos, residentes de 124 municípios com mais de 100 mil habitantes no país. O primeiro manuscrito teve como objetivo estimar o efeito da presença de fumantes no domicílio sobre o início mais precoce de tabagismo entre adolescentes. O segundo manuscrito teve como objetivo estimar o efeito da composição familiar sobre o início mais precoce de tabagismo e do uso de álcool entre adolescentes. Em ambas as análises foram usados Modelos de Regressão de Cox não ajustados e ajustados por um conjunto de variáveis com intuito de controlar vieses de confundimento. Os Hazard Ratios estimados no manuscrito 1 mostraram um aumento de 51% (IC95%: 31%-65%) na chance de um adolescente não fumante e exposto ao tabaco em casa começar a fumar mais precocemente do que aquele que não convivia com tabagistas no domicílio. Nos resultados do segundo manuscrito observou-se uma influência importante da composição familiar sobre a precocidade de início do uso de tabaco e álcool entre adolescentes. Segundo os Hazard Ratios estimados, houve um aumento de 68% (IC95%: 50%-89%) na chance de um adolescente não fumante que não residia com ambos os pais iniciar o uso de tabaco antes de um adolescente que residia com pai e mãe. Quanto àqueles que residiam apenas com a mãe ou apenas com o pai, esse aumento foi de 46% (IC95%: 32%-60%) e 54% (IC95%: 28%-84%), respectivamente. Em relação ao início do consumo de bebidas alcoólicas, observou-se um aumento de 35% (IC95%: 21%-52%) na chance de um adolescente que não bebe e não reside com pai e mãe de iniciar o uso de álcool mais precocemente do que aqueles que residiam com ambos os pais. Quanto aos adolescentes que residiam apenas com a mãe ou apenas com o pai, esse aumento foi de 22% (IC95%: 17%-28%) e 36% (IC95%: 24%-50%), respectivamente. O terceiro manuscrito teve como objetivo investigar o uso conjunto de tabaco e álcool através de análises de coocorrência e de agrupamento, assim como descrever a relação temporal do início do uso das duas substâncias entre adolescentes tabagistas e usuários de álcool. Para a análise de agrupamento foram obtidas razões entre os valores observados (O) e esperados (E) de uso de tabaco e álcool. Na amostra total a razão O/E foi 3,51 (IC95%: 3,39-3,65) indicando o agrupamento do uso dessas substâncias. Já a Razão de Chances de Prevalência foi de 14,7 (IC95%: 12,4-17,4). A maior parte dos usuários (45,2%) de ambas as substâncias iniciou pelo uso de álcool. Nossos resultados reforçam as propostas de que ações preventivas não devem estar focadas em cada droga isoladamente, e devem incluir não só o adolescente, mas também seu universo familiar.

Early use of tobacco and alcohol is associated with increased morbimortality and maintenance of their use during adulthood. This thesis investigates the role of household and family factors on adolescents' early onset of these substances. The data analyzed are from the Cardiovascular Risk Factors Study (ERICA), which investigated 74,589 adolescents from public and private schools, aged between 12 and 17 years old, living in 124 municipalities with more than 100 thousand inhabitants in the country. The first manuscript aimed to estimate the effect of the presence of smokers in the household on the earlier onset of smoking habit among adolescents. The objective of the second manuscript was to estimate the effect of family composition on the earlier onset of smoking and alcohol use among adolescents. In both analyses, unadjusted and adjusted Cox Regression Models were used to control for confounding variables. The Hazard Ratio estimated in manuscript 1 showed a 51% increase (95% CI: 31%-65%) in the chance that a nonsmoking adolescent exposed to tobacco at home would start smoking earlier than one who did not live with smokers. The results of the second manuscript depicted an important impact of family composition on the early onset of tobacco and alcohol use among adolescents. According to the estimated Hazard Ratios, there was a 68% increased chance (95% CI: 32%-60%) that a nonsmoking adolescent who did not live with both parents would initiate tobacco use earlier than an adolescent living with both parents. As for those who resided with only the mother or only the father, the increase was 46% (95% CI:32%-60%) and 54% (95%CI: 28%-84%), respectively. Regarding the onset of consumption of alcoholic beverages, there was a 35% increase (95% CI:21%-52%) in the chance of an adolescent who does not drink and does not reside with both parents to initiate alcohol use earlier than those living with the mother and the father. As for adolescents living only with the mother or only the father, this increase was 22% (95%CI: 17%-28%) and 36% (95%CI: 24%-50%), respectively. The third manuscript investigated the concurrent use of tobacco and alcohol through co-occurrence and clustering analyses. It also described the temporal relationship between the onset of tobacco and alcohol use among adolescents consuming both substances. For the clustering analysis, we calculated ratios between observed (O) and expected (E) values of tobacco and alcohol use. In the total sample, the O/E ratio was 3.51 (95% CI: 3.39-3.65), indicating the clustering of the use of these substances. The prevalence odds ratio was 14.7 (95% CI: 12.4- 17.4). Most of the users (45.2%) of both substances started with the use of alcohol. Our results reinforce the proposal that preventive actions should not be focused on each drug separately and should include the adolescents and their families.

The experience of physiological and psychosocial alcohol-related harms across adolescence and its association with alcohol use disorder in early adulthood: A prospective cohort study.

BACKGROUND: Different forms of alcohol-related harm (e.g., hangovers, fighting) may confer differential risk of clinically relevant alcohol problems. We examine: (i) patterns of transition in experiencing alcohol-related harms across adolescence; (ii) whether factors in early adolescence predict transition patterns; and (iii) whether transition patterns predict later alcohol use disorder (AUD) symptoms. METHODS: We used a longitudinal Australian cohort (n = 1828) to model latent class transition patterns of alcohol-related harms across three timepoints (Mage  = 13.9, 16.8, 18.8 years). Regression models assessed whether child, peer, and parent factors in early adolescence (Mage  = 12.9) predicted harms transition patterns and whether these patterns predicted AUD symptoms in early adulthood (Mage  = 19.8). RESULTS: Five transition patterns characterized most of the cohort (n ≈ 1609, 88.0%): (i) minimal harms (n ≈ 381, 20.8%); (ii) late physiological harms (n ≈ 702, 38.4%); (iii) early physiological harms (n ≈ 226, 12.4%); (iv) late all harms (n ≈ 131, 7.2%); and (v) gradual all harms (n ≈ 169, 9.2%). With late physiological harms as the reference, females had increased risk of experiencing early physiological harms (relative risk [RR]: 2.15; 99.5% CI: 1.19, 3.90). Late all harms (RR: 1.71; CI: 1.19, 2.47) and gradual all harms (RR: 1.84; CI: 1.37, 2.47) were each associated with increased odds of meeting criteria for AUD, even when patterns of alcohol consumption are considered. CONCLUSIONS: Adolescents display heterogeneous transition patterns across physiological and psychosocial alcohol-related harms. Females are at greater risk of experiencing early physiological harms. Experience of both physiological and psychosocial harms in late adolescence is an important and potentially modifiable precursor to clinically relevant alcohol problems in early adulthood.

Risk-taking behaviors in adolescent men who have sex with men (MSM): An association between homophobic victimization and alcohol consumption.

OBJECTIVE: The aim of this study was to determine whether homophobic victimization was associated with alcohol consumption and riding with an intoxicated driver or driving a car while under the influence of alcohol or drugs among adolescent men who have sex with men (MSM). METHODS: Cross-sectional analysis used baseline data from a national HIV prevention trial (NCT03167606) for adolescent MSM aged 13-18 years (N = 747). Multivariable logistic regression models assessed associations between homophobic victimization (independent variable) and alcohol-related outcomes (dependent variables), controlling for age, parents' education level, sexual orientation, health literacy, race, and ethnicity. RESULTS: Most participants (87%) reported at least one form of homophobic victimization in their lifetime, with verbal insults being the most frequently reported (82%). In the bivariate analysis, alcohol consumption and riding with an intoxicated driver or driving a car while under the influence were associated with many forms of victimization. Exposure to at least one form of victimization was associated with increased odds of alcohol consumption (OR: 2.31; 95% CI: 1.38-3.87) and riding with an intoxicated driver or driving a car while under the influence (OR: 2.25; 95% CI: 1.26-4.00), after controlling for covariates. CONCLUSION: Increased risk of alcohol consumption and risky alcohol-related behaviors were found among adolescent MSM who experienced homophobic victimization. Interventions should address homophobic victimization and its impact on adolescent MSM, as well as disentangling motivations for underage drinking, riding with an intoxicated driver or driving a car while under the influence.

An Internet Quiz Game Intervention for Adolescent Alcohol Drinking: A Clustered RCT.

BACKGROUND AND OBJECTIVES: Interventions on adolescent drinking have yielded mixed results. We assessed the effectiveness of an Internet quiz game intervention compared to conventional health education. METHODS: In this cluster randomized controlled trial with parallel group design, we randomly allocated 30 participating schools to the Internet quiz game intervention or the conventional health education (comparison) group, with 1:1 ratio. Students of Hong Kong secondary schools (aged 12-15 years) were recruited. The intervention was a 4-week Web-based quiz game competition in which participating students answered 1000 alcohol-related multiple-choice quiz questions. The comparison group received a printed promotional leaflet and hyperlinks to alcohol-related information. RESULTS: Of 30 eligible schools, 15 (4294 students) were randomly assigned to the Internet quiz game intervention group and 15 (3498 students) to the comparison group. Average age of participants was 13.30 years. No significant between-group differences were identified at baseline. Overall retention rate for students was 86.0%. At 1-month follow-up, fewer students in the intervention group reported drinking (9.8% vs 12.1%, risk ratio 0.79, 95% confidence interval [CI] 0.68 to 0.92; P = .003), and those who drank reported drinking less alcohol (standardized difference ß -0.06, 95% CI -0.11 to -0.01; P = .02). Between-group differences remained statistically significant at 3-month follow-up (10.4% vs 11.6%, risk ratio 0.86, 95% CI 0.74 to 0.999; P = .048; ß -0.06, 95% CI -0.11 to -0.01; P = .02). CONCLUSIONS: The Internet quiz game intervention reduced underage drinking by 21% at 1-month and 14% at 3-month follow-up compared with conventional health education.

Gender differences in the supply of alcohol to adolescent daughters and sons.

Background: Parents are the main supplier of alcohol to children but it is not known whether mothers and fathers equally contribute to the supply of alcohol to their female and male children as these children transition to adulthood.Objectives: i) to determine whether the gender of the parent is associated with the gender of the adolescent offspring when alcohol is supplied and ii) whether the gender of the parent supplying is associated with gender differences in adolescent binge drinking and alcohol related harms.Methods: Longitudinal cohort of 1,927 (males = 1052) Australian adolescents (mean age 12.9 years), recruited in 2010/11 from schools in Australia and surveyed annually for six years. We assessed the association between adolescent and parent gender related to subsequent adolescent drinking, binge drinking (>4 standard drinks), and alcohol-related harms.Results: At mean age of 12.9 years about one in ten children report parental supply of alcohol which increases to about four in ten children by 17.8 years. Mothers consistently more often supply their daughters with alcohol than their sons, [Wave 5 OR 1.77 (1.53,2.05)], while mothers less often supply sons than their daughters, [Wave 5 OR 0.82 (0.71,0.95)]. Mothers' supply of alcohol to daughters predicts substantially increased odds of daughters binge drinking, [OR 1.67 (1.10,2.53)] and experiencing alcohol related harms, [OR 1.65 (1.10,2.48)].Conclusion: There is a need to involve both mothers and fathers and to equally target female and male children in programs to reduce the harmful consequences of parental supply of alcohol to their children.

Do alcohol interventions affect peers who do not receive the intervention? Modeling treatment contagion effects via simulations of adolescent social networks.

OBJECTIVE: Adolescents' drinking is influenced by their friends' drinking. However, it is unclear whether individually-targeted alcohol interventions reduce drinking in the friends of individuals who receive the intervention. This study used simulations of drinking in simulated longitudinal social networks to test whether individually-targeted alcohol interventions may be expected to spread to non-targeted individuals. METHOD: Stochastic actor-based models simulated longitudinal social networks where changes in drinking and friendships were modeled using parameters from a meta-analysis of high school 10th grade social networks. Social influence (i.e., how much one's friends' drinking affects their own drinking) and social selection (i.e., how much one's drinking affects who they select as friends) were manipulated at several levels. At the midpoint of each simulation, a randomly-selected heavy-drinking individual was experimentally assigned to an intervention (changing their drinking status to non-drinking) or a control condition (no change in drinking status) and the drinking statuses of that individual's friends were recorded at the end of the simulation. RESULTS: Friends of individuals who received the intervention significantly reduced their drinking, with higher reductions occurring in networks with greater social influence. However, all effect sizes were small (e.g., average per-friend reduction of .07 on a 5-point drinking scale). CONCLUSIONS: Individually-targeted alcohol interventions may have small effects on reducing the drinking of non-targeted adolescents, with social influence being a mechanism that drives such effects. Due to small effect sizes, many adolescents may need to receive alcohol interventions to produce measurable effects on drinking outcomes for non-targeted individuals. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The Development of Drinking Trajectories Among Australian Young Adults.

OBJECTIVE: The present study compares drinking trajectories for two cohorts of adolescents and young adults, 10 years apart, to assess whether recent declines in adolescent drinking in Australia represent fundamental shifts in typical drinking behavior. METHOD: Six waves of annually collected, longitudinal responses from two cohorts of adolescents and young adults ages 15-25 in 2001 (n = 1,436, 48.3% male) or 2011 (n = 2,520, 48.1% male) were acquired from the Household, Income and Labour Dynamics in Australia survey (HILDA). Latent class growth analysis was used to determine the best fitting drinking trajectories for both cohorts. RESULTS: Four quadratic classes were identified for the earlier cohort, and three linear for the more recent one. Light/abstaining, moderate/moderate-steady, and heavy drinking classes were observed in both cohorts, whereas an additional moderate-increasing class in the earlier cohort was absent from the recent one. The two lowest trajectories (light/abstaining and moderate/moderate-steady) appeared relatively stable across cohorts, despite an increase in light/abstaining drinkers in the recent cohort, whereas the heaviest drinkers consumed substantially less in the recent cohort than the earlier one. CONCLUSIONS: We found reduced consumption across drinking patterns, suggesting that youth drinking declines are not attributable to significant shifts in drinking behaviors; rather, adolescents and young adults are drinking in a similar, albeit significantly lower, fashion. The stability of these trajectories, and the continuation of these declines into adulthood, suggest that reductions in alcohol-related harm may be likely for recent cohorts across their life course.

Adolescent Girls and Alcohol Use: Increasing Concern During the COVID-19 Pandemic.

ABSTRACT: Adolescence is a time known for risky behaviors and often the initiation of alcohol use. Readily available, alcohol is often one of the drugs of choice for adolescents. Whereas in the past 30 years, the overall consumption of alcohol is down, the data in the past 10 years have shown more girls are binge drinking and meeting criteria for alcohol use disorder (AUD). The alarm of early alcohol use is the association with problems with the substances later in life. Historically, men and male adolescents consumed more alcohol than females. Recent studies indicate girls' alcohol use surpasses boys, whereas women now are developing AUD at the same rate as men. The consequences of early use can result in women's increased risk for multiple cancers, having a more severe form of AUD with less alcohol consumption as well as premature death. To further exacerbate this growing concern, the novel coronavirus (COVID-19) pandemic has created a perfect storm for increased use of alcohol to cope with the stress of living in an uncertain world. Normal daily activities have been halted with the uncertainty of school closures, zoom classroom sessions, and living in mandated social isolation. All nurses need to be screening for how families under their care have been managing stress. The time is opportune to educate and support parents in engaging their children in conversations around substance use. Parents can be supported to increase awareness of their own coping mechanisms and strengthen positive coping. Adolescents need support to strengthen interpersonal skills as well as make informed decisions concerning when and how they engage in alcohol consumption. This article will illuminate the growing need for all healthcare providers to assess and guide adolescents' coping skills during COVID with a focus on mental health, high-risk behavior, and alcohol use.

Age of onset of adolescent binge drinking is differentially associated with cortical thickness in post-9/11 adult Veterans.

BACKGROUND: Adolescence is a critical period for neural development and has been associated with high rates of alcohol abuse. This research examined potential long-term brain and behavioral effects of early versus late-onset adolescent binge drinking in an adult sample of post-9/11 Veterans. METHODS: We compared cortical thickness measures in Veterans with a history of binge drinking that began before the age of 15 (n = 50; mean age = 32.1 years) to those with a history of binge drinking with onset after the age of 15 (n = 300; mean age = 32.1 years). Data processing was conducted with FreeSurfer. A targeted neuropsychological battery (Digit Span test, Delis-Kaplan Executive Function System Color-Word Interference Test, California Verbal Learning Test-II) was used to examine the relationships between cortical thickness and attention, memory, and inhibition. A reference group of social drinkers with no history of early binge drinking (n = 31) was used to provide normative data. RESULTS: Early-onset adolescent binge drinkers (EBD) had greater cortical thickness in several regions than late-onset adolescent binge drinkers (LBD); both binge-drinking groups had greater cortical thickness than the reference group. There was a stronger negative association between cortical thickness and age in EBDs than LBDs in the (i) lateral orbitofrontal cortex, (ii) supramarginal gyrus, (iii) paracentral lobule, and (iv) anterior caudal cingulate. Poorer performance on the attention and inhibition tasks in the EBDs was also associated with thicker cortices. CONCLUSIONS: This study demonstrates greater cortical thickness across frontoparietal regions in adults who began binge drinking in early versus late adolescence. A stronger negative association between cortical thickness and age in the EBDs suggests that early-onset adolescent binge drinking may be associated with accelerated cortical thinning. Thicker cortex in these regions, which are known to mediate inhibitory control, may increase impulsive behavior and contribute to the risk of alcohol addiction.

Association between a delay in driving licensure and driving while impaired and riding with an impaired driver among emerging adults.

BACKGROUND: Teens who delay driving licensure may not be subject to graduated driver licensing restrictions that are known to reduce crash risk. We explored the association of delay in licensure with driving while impaired (DWI) and riding with an impaired driver (RWI) among emerging adults. METHODS: Data from the NEXT Generation Health Study, starting with 10th grade (2009-2010), were analyzed. The outcome variables were Wave 7 (W7) self-reported DWI and RWI as dichotomous variables. The independent variable was delay in licensure. Covariates included sex, urbanicity, race/ethnicity, family structure, parent education, family affluence, teen's highest education, minimum legal drinking age laws, and onset age of alcohol use. Descriptive analysis and logistic regressions were conducted. RESULTS: Of 2525 participants eligible for licensure, 887 reported a delay in licensure by 1-2 years (38.9%, weighted) and 1078 by > 2 years (30.3% weighted) across 7 waves. In W7, 23.5% (weighted and hereafter, 5.6% once, 17.8% ≥twice) of participants reported DWI and 32.42% (5.6% once, 25.4% ≥twice) reported RWI. Logistic regressions showed no overall significant association of delay in licensure with either W7 RWI or W7 DWI. However, in stratified analyses, among African American youth, delay in licensure was positively associated with DWI (OR = 2.41, p = 0.03) and RWI (OR = 2.72, p = 0.05). Among those with ≤ high school or lower education by W7, delayed licensure was positively associated with RWI (OR = 2.51, p < 0.01). CONCLUSIONS: While in the overall sample, delayed licensure did not appear to be associated with DWI or RWI, our findings suggest that delayed licensure may be of concern to teen risk of DWI and RWI among African Americans and among those with lower educational attainment. Furthermore, as two-thirds of youth delayed licensure, more research is needed to determine whether this is more of a positive (i.e., protective) factor by reducing their exposure to crash risk or a negative (i.e., risk) factor due to their missing important driver safety stages of graduated driver licensing.

Exploring the Impact of Secondary Supply Laws on Adolescent Drinking Trends in Australia.

OBJECTIVE: Adolescent alcohol consumption has declined in Australia over the past 20 years. Secondary supply laws (SSLs) typically prohibit the supply of alcohol to adolescents by persons other than parents or guardians, or without parental consent. SSLs were introduced in Australia at different times in different states and territories over the period of declining alcohol consumption. In this study we examined the impact of variations in SSLs across Australia on young people's drinking. METHOD: We used six waves of the National Drug Strategy Household Survey, a cross-sectional survey of the Australian population, from 2001 to 2016. The study population was adolescents ages 14-17 years. Our primary measure of interest was exposure to SSLs. Data were analyzed using two-way linear and logistic regression models with fixed effects of Australian state/territory and time to identify the effect of SSLs on the frequency of drinking, past-year drinking, and the secondary supply source, respectively. RESULTS: We found no evidence of an association between SSLs and any of the three outcomes of interest. CONCLUSIONS: SSLs are challenging to enforce, and, although they may empower parents to have more control over their children's drinking, they were not associated with reductions in adolescent drinking in Australia. Researchers looking to explain the decline in adolescent drinking in Australia should investigate factors beyond SSLs.

Tendencias en el consumo de alcohol en adolescentes escolarizados en España (2010-2018) / Trends in alcohol consumption among school-aged adolescents in Spain (2010-2018)

OBJETIVO: Analizar las tendencias en el consumo de cerveza, vino y licores destilados, así como de los episodios de embriaguez de los chicos y chicas adolescentes en España, en 2010, 2014 y 2018, por sexo y edad. MÉTODO: La muestra está formada por 35.310 participantes de 15 a 18 años de edad representativos de la población adolescente escolarizada en España en 2010, 2014 y 2018. El cuestionario empleado fue el de consumo de alcohol y de episodios de embriaguez consensuado por el equipo internacional del estudio. Para lograr el objetivo se estimaron las razones de prevalencia y los intervalos de confianza del 95% mediante modelos de regresión de Poisson con varianza robusta. RESULTADOS: Los datos muestran un descenso global entre 2010 y 2018 en el consumo de alcohol (tanto de cerveza como de vino y licores destilados) y en los episodios de embriaguez, aunque este descenso se concentra principalmente entre 2010 y 2014. Las diferencias según el sexo (mayor consumo frecuente y episodios de embriaguez en los chicos) se observan a los 17-18 años, pero no a los 15-16 años. Respecto a la edad, el grupo de 17-18 años presenta mayores niveles que el de 15-16 años. CONCLUSIONES: Los resultados de este estudio confirman la importancia de realizar análisis específicos para identificar posibles grupos de riesgo que no se detectan con análisis más generales. Se destaca la necesidad de seguir trabajando en la prevención y en las políticas de control dado el riesgo de estabilización del consumo

OBJECTIVE: To analyze trends in beer, wine, and distilled spirits consumption, as well as drunkenness among school-aged adolescents in Spain from 2010 to 2018 by sex and age. METHOD: The sample is composed of 35,310 adolescents aged 15 to 18. The data is representative of the adolescent school population in Spain in 2010, 2014, and 2018. The alcohol consumption questionnaire and the drunkenness questionnaire provided by the international team of the study were employed. Prevalence Ratios and 95% confidence intervals were estimated using Poisson regression models with robust variance. RESULTS: the data show a general decrease in alcohol consumption (beer, wine, as well as distilled spirits) and in drunkenness, but the decrease mainly occurs between 2010 and 2014. Sex differences (higher consumption and drunkenness among boys) are found among adolescents aged 17-18 but not in the age group of 15-16 years old. Older adolescents show higher levels of consumption and drunkenness than younger adolescents. CONCLUSION: The results confirm the relevance of carrying out specific analyses in order to identify risk groups which are not detected through general analyses. This data highlights the need to maintain alcohol prevention and control policies due to the risk of stabilization in alcohol-related behaviours

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

This study aimed to identify differences in condom use among adolescents by alcohol consumption patterns using the 2017 Youth Risk Behavior Survey. 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. Findings highlight the need to tailor STI preventative measures accordingly.

Similar countries, similar factors? Studying the decline of heavy episodic drinking in adolescents in Finland, Norway and Sweden.

AIM: To (i) examine several factors associated with trends in heavy episodic drinking (HED) in Finland, Norway and Sweden, (ii) investigate similarities in these associations across the countries and (iii) analyse the contribution of these factors to the trend in HED and the differences across the countries. DESIGN AND SETTING: Observational study using five waves of the European School Survey Project on Alcohol and Other Drugs (ESPAD) from Finland, Norway and Sweden between 1999 and 2015. PARTICIPANTS: A total of 18 128 male and 19 121 female 15- to 16-year-old students. MEASUREMENTS: Monthly HED, perceived access to alcohol, truancy, parental control, leisure time activities and daily smoking. The Cochran-Armitage test was used to examine linear time trends in HED. Logit regression models using the Karlson-Holm-Breen (KHB) method were fitted for each country separately, including all the independent variables together with time and adjusted for family status, parental education and gender. FINDINGS: In Finland, Norway and Sweden, perceived access to alcohol, truancy and daily smoking decreased significantly between 1999 and 2015 whereas risk perceptions, parental control and participation in sports increased in the same period. The confounding percentage of all the independent variables related to the trend in HED was 48.8%, 68.9% and 36.7% for Finland, Norway and Sweden, respectively. Decline in daily smoking (P < 0.001) and perceived access to alcohol (P < 0.001) were positively and increase in parental control (P < 0.001) negatively associated with the decline in HED in all three countries. Changes in truancy, going out with friends, and engaging in sports and other hobbies had little or no impact on the decline in HED or displayed no consistent results across the countries. CONCLUSIONS: The decline in adolescent heavy episodic drinking in Finland, Norway and Sweden between 1999 and 2015 appears to be associated with a decline in adolescent daily smoking and perceived access to alcohol and an increase in parental control.

Early Adolescent Binge Drinking Increases Risk of Psychopathology in Post-9/11 Veterans and Mild Traumatic Brain Injury Exacerbates Symptom Severity.

AIMS: To demonstrate that early adolescent binge drinking (BD) increases the risk for and/or severity of psychopathology in post-9/11 Veterans and determine if mild traumatic brain injury (mTBI) modifies risk. METHODS: Post-9/11 Veterans (n = 375) were classified into two groups: 57 Veterans with a history of early adolescent BD (E-BD; age of onset <15) and 318 who did not BD until age 15 or older (late-BD or L-BD; age of onset ≥15). History of military mTBI and mental health disorders were also assessed following military service. RESULTS: Logistic regression and analysis of variance (ANOVA) analyses revealed that the E-BD's had significantly higher prevalence of alcohol use disorders (AUDs) and more severe symptoms of AUD, substance use disorder (SUD), depression and stress. Two-way ANOVAs showed that history of military mTBI was differentially associated with posttraumatic stress disorder (PTSD) incidence and severity among Veterans who had engaged in early adolescent BD. Specifically, Veterans with a history of both early adolescent BD and military mTBI were at greater risk for a PTSD diagnosis and had more severe symptoms of PTSD than those with only a history of adolescent BD. The greater PTSD symptom severity in the comorbid group was driven by hyperarousal symptoms. CONCLUSIONS: A history of BD during early adolescence is prevalent among Veterans and is related to higher risk for AUD and more severe AUD, SUD, mood and stress symptoms later in life. Veterans with early BD and military mTBI showed greater incidence and severity of PTSD, indicating that mTBI, a common comorbidity among post-9/11 Veterans, exacerbates risk.

Consumo de alcohol y factores de riesgo de conductas autolesivas en adolescentes españoles / Alcohol use and risk factors for self-harm behavior in Spanish adolescents

Las conductas autolesivas en niños y adolescentes constituyen un importante problema de salud pública con cifras de prevalencia en la población clínica entre el 40 y 80%. Los objetivos del estudio son analizar y comparar las submuestras españolas de dos trabajos, SEYLE y WE-STAY, para conocer la prevalencia, los patrones de autolesión y los factores asociados a las conductas autolesivas, en particular el consumo de alcohol o drogas. Los cuestionarios utilizados en ambos estudios fueron la Encuesta Global de Salud Escolar (GSHS), el Inventario de Depresión de Beck (BDI-II), el Cuestionario de Fortalezas y Dificultades (SDQ). Los comportamientos autolesivos fueron evaluados con una versión modificada de 6 ítems basada en el Inventario de Autolesiones Deliberadas (DSHI). La independencia de las variables categóricas del estudio se evaluó mediante la prueba Ji-Cuadrado. El cambio en el riesgo relativo de autolesión entre el estudio SEYLE y WE-STAY, se evaluó a través del cálculo de odds ratio (OR). Se calcularon dos modelos de regresión logística diferentes con el fin de establecer los factores asociados con comportamientos autolesivos en cada estudio. En el presente estudio las tasas de DSH varían en función del estudio y del sexo en un rango entre 0,58% y 2,08%, presentando patrones de autolesiones diferentes según el sexo, los hombres se autolesionaron más frecuentemente mediante golpes autoinfligidos y quemaduras, mientras que las mujeres se hicieron más frecuentemente cortes. La presencia de síntomas depresivos y el consumo de alcohol fueron los factores asociados de forma más robusta a un mayor riesgo de DSH

Self-harm behaviors in children and adolescents constitute an important public health problem with prevalence figures in the clinical population between 40 and 80%. The objectives of the study were to analyze and compare the Spanish sub-samples of two studies, SEYLE and WE-STAY to determine prevalence, self-harm patterns and factors associated with self-harm behaviors, notably the use of alcohol or drugs. The questionnaires used in both studies were the Global School Health Survey (GSHS), the Beck Depression Inventory (BDI-II), the Strengths and Difficulties Questionnaire (SDQ). The self-harm behaviors were evaluated with a modified 6-item version of s the Deliberate Self-Harm Inventory (DSHI). The independence of the study's categorical variables was assessed using the Chi-square test. The change in the relative risk of self-harm between the SEYLE study and WE-STAY was evaluated through the odds ratio (OR) calculation. Two different logistic regression models were calculated in order to establish the factors associated with self-harm behaviors in each study. In the present study, the rates of DSH vary according to study and sex, ranging from 0.58% to 2.08%, and different patterns of selfharm are evidenced by sex, with males self-injuring more frequently by self-inflicted blows and burns, while young women more often cut themselves. The presence of depressive symptoms and alcohol use were the factors most strongly associated with an increased risk of DSH

Empatía, estilos de afrontamiento y actitudes hacia el consumo como factores de protección del consumo intensivo de alcohol y el policonsumo en la adolescencia / Empathy, coping styles and attitudes towards consumption as protective factors for heavy alcohol consumption and polydrug use in adolescence

Desde el enfoque del desarrollo positivo adolescente cobra especial importancia la promoción de recursos personales de protección frente a algunos riesgos como el consumo de drogas. El objetivo de este estudio fue analizar la influencia de la empatía, los estilos de afrontamiento y las actitudes hacia el consumo respecto al uso intensivo de alcohol y el policonsumo en 799 estudiantes. Los resultados del análisis de regresión revelaron que el afrontamiento improductivo predijo un mayor consumo intensivo de alcohol, mientras que la actitud de rechazo ante el ofrecimiento de alcohol y la actitud de admiración hacia personas no usuarias de drogas institucionalizadas se asociaron con un menor hábito de consumo. Con relación al policonsumo, tanto la empatía afectiva, como el afrontamiento activo, la actitud contraria y de rechazo al consumo de drogas, así como la actitud de admiración hacia personas no usuarias de drogas institucionalizadas predijeron un menor uso simultaneo de alcohol y cannabis. Estos hallazgos aportan nuevas evidencias que podrían ser de utilidad para orientar intervenciones promotoras de la salud a edades tempranas (AU)

From a positive youth development perspective, the promotion of personal protective resources against certain risks such as drug consumption is especially relevant. The objective of this study was to analyze the influence of empathy, coping styles, and attitudes related to consumption with respect to binge drinking and polyconsumption in a sample of 799 students. The results of a regression analysis revealed that unproductive coping predicted binge drinking, while attitudes such as turning down a drink and admiration of non-users of institutionalized drugs were associated with a lower consumption habit. As for polyconsumption, affective empathy, active coping, a negative attitude to, and the rejection of drug consumption, as well as the admiration of non-users of institutionalized drugs, predicted a lower simultaneous use of alcohol and cannabis. These findings offer new evidence that may be useful in guiding interventions to promote healthy habits at early ages (AU)