COMMENTARY

5 Best of 2018: Pediatrics Viewpoints

William T. Basco, Jr, MD, MS

Disclosures

January 11, 2019

In This Article

Introducing Teens to Alcohol

Who is best suited to introduce an adolescent to alcohol? A study conducted in Australia compared the effect of parental supply of alcohol, nonparental supply of alcohol, or the combination of these approaches on subsequent alcohol use in a cohort of almost 2000 teens who were recruited at a mean age of 12.9 years.[11] The researchers examined five measures of alcohol use:

  • Binge drinking;

  • Alcohol-related harms;

  • Symptoms of alcohol abuse;

  • Alcohol dependence; and

  • Alcohol use disorder.

The teens and their parents completed baseline surveys that captured demographic information and alcohol behaviors. Alcohol-related harms, alcohol abuse, alcohol dependence, and alcohol use disorder were all assessed annually thereafter for 6 years. The adolescents reported who supplied them with alcohol during the previous 12-month period—their own parents, nonparents, self-supply, or no alcohol use—or a combination of parents and nonparents.

At the study's end (year 6), when the teens' average age was 17.8 years, 57% reported that they had been supplied alcohol by their parents. In general, compared with "no supply," parental supply of alcohol was associated with both binge drinking and risk for any alcohol-related harm. Alcohol-related harms were found among the 35% of teens who received alcohol from parents, 72% of the teens who received alcohol only from nonparents, and 86% among the teens who received alcohol from both sources. All of these frequencies were higher than among those without alcohol exposure. Provision of alcohol by nonparents was generally worse, with higher rates (15%-20%) of alcohol abuse, alcohol dependence, or alcohol use disorder by year 6. Compared with no supply of alcohol, the risk for all alcohol misuse measures was higher among teens who received alcohol only from nonparents.

Viewpoint

We need to rethink the notion that providing minor children with alcohol will protect them from adverse alcohol-related outcomes. The researchers acknowledge study limitations, including a nonrandomized design, conducted in a single country, and inability to control for sociodemographic variables known to be linked with alcohol consumption, such as education level and other substance use. That said, the longitudinal nature and repeated measures of the study adds power to its compelling findings.

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