Beispielbild

Alcohol consumption patterns of young adolescents in Europe Renate Soellner & Astrid-Britta BräkerUniversity of Hildesheim

AAA-Prevent Alcohol Abuse among Adolescents in EuropeEffective Environmental Strategies for Prevention

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Agenda

1 • Prevalence

2 • Patterns of use

3 • Indicators for risky use

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Project AAA-preventBased on: International Self-Report Study of Delinquency

(ISRD-2; 2006-2010) N = 67.883, 30 countries, 7. – 9. Klasse (11 – 18 year olds) delinquency, leisure time, drug and alcohol use, family,

neighbourhood etc.

Alcohol Abuse among Adolescents in Europe. Effective environmental strategies for prevention N = 57.771 25 countries 7. – 9. Klasse (12 – 16 year olds )

AAA-Prevent

Junger-Tas, Marshall, Enzmann, Killias, Steketee & Gruszczynska (2010)

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Adolescent Alcohol Use in Europe

European School Survey Project on Alcohol and Other Drugs (ESPAD):

62% of the adolescents drank during the last month 39% have been drunken during the last year 43% used at least 5 units of alcoholic beverages (heavy

episodic drinking)Hibell, Guttormsson, Ahlström, Balakireva, Bjarnason, Kokkevi & Kraus (2009)

Health Behavior in School-Aged Children (HBSC) weekly use:

11% of the 13 year olds; 26% of the 15 year olds being drunken at least twice: 11% of the 13 year olds;

33% of the 15 year oldsCurrie, Nic Gabhainn, Godeau, Roberts, Smith, Currie, Picket, Richter, Morgan & Barnekow (2008)

ESPAD (2007):15-16 year olds

35 countries

HBSC (2005/2006):11-15 year olds41 countries

PREVALENCE

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Abstinence Rates

Notes:- lowest abstinence rates

in Eastern European countries

- High abstinence rates in Mediterranean countries, but also in Iceland, Bosnia-Herzegovina & Norway

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Prevalence last month(beer, wine, breezers; spirits)

Notes:- Less than 50%

report drinking alcohol last month

- Same pattern as regards lifetime use: Hungary, Estonia, Czech Republic and Denmark show higher use than Portugal, Iceland and Bosnia-Herzegovina

Bosnia and Herzegovina

Portugal

Spain

Sweden

Slovenia

Armenia

Poland

Ireland

Switzerland

Austria

Germany

Denmark

Hungary

0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50%

2.5%3.0%

6.2%6.4%

14.7%8.8%

13.7%10.6%

9.0%8.0%

6.2%10.6%

14.9%16.0%

20.7%11.6%

16.8%12.4%

17.0%15.2%15.2%

18.8%28.5%

26.8%24.7%

7.5%9.3%

12.5%12.9%

18.1%20.9%21.0%

23.2%24.6%24.9%

25.9%29.2%

30.5%31.2%31.4%

33.8%34.0%34.4%

35.0%36.4%

37.3%39.1%

39.8%44.6%

45.9%

beer/wine/breezersspirits

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Prevalence of drinking 5 times or more(last month) (beer/wine/breezers; spirits)

Notes:- Youngsters from

Central European countries show frequent use (e.g. Switzerland, the Netherlands, Germany)

- It is the only upper position of Switzerland in all rankings

- Portugal, Iceland and Bosnia-Herzegovina are lowest againBosnia-Herzegovina

IcelandPortugalArmenia

FranceNorwayFinlandSweden

SloveniaRussiaCyprus

Czech RepublicItaly

LithuaniaPoland

SpainIrelandAustria

BelgiumDenmarkHungary

GermanyNetherlandsSwitzerland

Estonia

0% 1% 2% 3% 4% 5% 6% 7% 8% 9% 10%

0.2%0.2%

0.5%0.7%

0.4%0.5%

1.2%1.3%

0.6%1.0%

1.6%1.4%

1.0%0.8%

1.3%2.5%

2.4%1.2%

1.1%3.5%

2.1%1.6%

1.4%2.8%

2.2%

0.4%0.9%0.9%

1.4%1.5%

1.9%2.3%2.4%2.5%

2.9%3.0%

3.3%3.4%3.5%3.5%3.5%

3.9%5.3%

5.5%6.1%

6.4%6.7%

7.4%7.9%

8.9%

beer/wine/breezers spirits

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Drunkenness due to beer, wine and breezers (lifetime users)

Ever been drunk?

Notes:- Estonia and Denmark

are leading - Youngsters from

Southern and Western European countries have less experience with drunkenness but also Armenia, Slovenia and Bosnia-Herzegovina

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Drunkenness due to spirits (lifetime users)

Ever been drunk?Notes:- Nearly same ranking

as regards the use of beer/wine/ breezers

- More youngsters reported getting drunken by using spirits than by beer, wine or breezers

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Prevalence of drinking 5 units or more last drinking occasion (beer/wine/breezers)

Notes:- Drinking high amounts

of alcohol (5 alcoholic beverages and more) is more common in Central and some Northern European countries

- Spain is ranked between Northern and Eastern European countries (and not next to the Mediterranean countries)

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Prevalence of drinking 5 units or more last drinking occasion (spirits)

Notes:- Drinking high amounts

of spirits is less common overall

- Similar ranking as regards the use of beer/wine/breezers

PATTERNS OF USE

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Cluster AnalysisVariables

Frequency of use last month (beer, wine, breezers) Amount of units last drinking occasion (beer, wine, breezers) Frequency of use last month (spirits) Amount of units last drinking occasion (spirits)

Data 12 – 16 year-olds, 25 countries,

with lifetime experience of drinking alcohol

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K-means clustering

no use mild use

episodic use

frequent use

heavy episodic

use

frequency beer/wine 0 0.62 1.91 12.47 3.38

units beer/ wine 0 1.52 5.46 6.17 15.52

frequency spirits 0 0.12 0.94 4.77 1.99

units spirits 0 0.55 3.79 4.79 6.83

size (%) 42.9 42.0 11.5 2.2 1.5

qualitative differencesCluster means differences

in level

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Identification of country clusters

Can the countries be categorized regarding the prevalence of alcohol consumption patterns?

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Three country clusters

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MAINLY MILD USE

MAINLY NO USE

HIGHEST

PROPORTION OF

INTENSE USE

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Country clusters

Percent East-Europe Central- Europe

North-West-Europe

mild use 58.1 41.1 27.0

episodic use 11.3 15.3 7.4

frequent use 1.6 1.7 0.7

heavy episodic use 1.3 3.5 1.3

no use 27.7 38.4 63.6

INDICATORS FOR RISKY USE

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What is risky drinking?

1. Which goals prevention programs aim at?

2. How is risky drinking behaviour measured in scientific studies?

Prevention aims and realities

Prevention goals

- late onset- low frequency- low amount- reduction of risky use

habits- drinking only in leisure-

time- contextual abstinence- avoid intoxication- …

Risky drinking may be

- early drinking (minor than 14)- drinking at all- drinking more than once (e.g.

weekly use)- high amounts (e.g. heavy

episodic drinking)- drinking during examinations- drunkenness (e.g. at least

twice in lifetime)- …

cp. ESPAD, HBSCabstinence and/or responsible drinking?

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Operationalisations of risky drinkingFrequency

1. Weekly

Amount of alcohol2. Heavy episodic drinking: last month3. Heavy episodic drinking: lifetime

Consequences of use4. Drunkeness lifetime (at least twice)

Setting of use5. Alone

Theoretical derived criteria6. No use under the age of 14 &

less than 5 times last month &less than 5 units last drinking occasion

RESULTS

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Distribution of indicators

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Distribution of sum of indicators

0 1 2 3 4 5 60%

10%

20%

30%

40%

50%

60%

70%

80%

69%

15%

5% 4% 4% 2% 0%

Over two thirds do not reach any of the criteria h.e.u. last month does not appear solely

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Relationships of indicators

risky use

h.e.u. l.m.

h.e.u. lifet.

drunkenness weekly alone

risky use 1 ,695 ,537 ,379 ,465 -,023

h.e.d. l.m.   1 ,845 ,500 ,469 -,058

h.e.d. lifet.     1 ,510 ,365 -,060

drunkenness       1 ,316 -,056

weekly         1 -,019

alone           1

Drinking alone does not measure the same Correlations of the indicators show middle to high size

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Ausgewählte Länder

Czech Republic

Denmark

Estonia

Finland

France

Germany

Ireland

Italy

Portugal

Russia

0% 5% 10% 15% 20% 25% 30% 35% 40%

alone

weekly

drunkenness

h.e.d. lifet.

h.e.d. l.m.

risky use

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Summary At least half of the students never drank alcohol in Iceland, Bosnia

Herzegovina, France, Portugal, Cyprus and Norway Estonia, Hungary, Czech Republic and Lithuania show the highest rates of

lifetime use Hungary, Estonia, Czech Republic, Denmark and Germany rank at the top and

Bosnia and Herzegovina, Iceland, Portugal and France at the bottom regarding last month use

Frequent drinking shows high ratings in Northern and Central European countries with Estonia, Switzerland, the Netherlands, Germany, Hungary and Denmark

Considering lifetime drunkenness Northern and Eastern European Countries are leading (Estonia, Denmark, Ireland, Finland, Russia, Sweden and Norway)

Heavy drinking of beer, wine and breezers is a common consumption pattern in Western countries (Ireland, Finland, Denmark, the Netherlands and Germany)

adolescent alcohol use varies enormously across Europe

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Summary Drinking at least 5 units of spirits during one occasion is popular in

countries like Estonia, Ireland, Denmark and Poland Adolescent alcohol use may be described in complex use patterns There are countries with similar alcohol use patterns The Nordic drinking style which is characterized by using spirits in high

amounts was found especially for Estonia and Lithuania. The more beer, wine and breezers drinking culture with high levels of episodic

drinking was more common in Central European countries The Mediterranean style of drinking alcohol frequently but in moderation

was more prevalent in France, Portugal and Bosnia and Herzegovina.

BUT: The problem‘s size differs dependent on the indicator chosen

For planing and evaluation of prevention programs a multiple perspective of risk indicators should be taken

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Open questions

�Which should be the aims of preventive efforts?

�Which country characteristics may explain these differences in adolescent alcohol use?

Beispielbild

Alcohol consumption patterns of young adolescents in Europe Renate Soellner & Astrid-Britta BräkerUniversity of Hildesheim

AAA-Prevent Alcohol Abuse among Adolescents in EuropeEffective Environmental Strategies for Prevention

32

Country clustering:

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country mild moderate frequent intense noGermany 0.43 0.14 0.03 0.04 0.36Netherlands 0.44 0.15 0.02 0.04 0.35Austria 0.40 0.15 0.02 0.03 0.40Switzerland 0.41 0.15 0.03 0.04 0.38Belgium 0.41 0.12 0.02 0.02 0.43Poland 0.42 0.13 0.01 0.04 0.40Italy 0.45 0.08 0.01 0.01 0.45Slovenia 0.47 0.10 0.01 0.02 0.40Denmark 0.35 0.24 0.02 0.05 0.34Finland 0.40 0.21 0.01 0.05 0.33Ireland 0.34 0.22 0.01 0.04 0.40Czech Rep. 0.64 0.15 0.01 0.02 0.19Estonia 0.59 0.18 0.03 0.02 0.18Lithuania 0.58 0.15 0.01 0.03 0.23Armenia 0.58 0.04 0.00 0.00 0.38Russia 0.53 0.07 0.01 0.01 0.39Hungary 0.58 0.10 0.02 0.01 0.29Norway 0.28 0.13 0.01 0.02 0.56Sweden 0.31 0.11 0.01 0.02 0.55Cyprus 0.33 0.06 0.01 0.01 0.59Portugal 0.30 0.07 0.01 0.01 0.61Bosnia/H. 0.29 0.05 0.00 0.01 0.65Spain 0.26 0.10 0.01 0.01 0.62France 0.24 0.05 0.00 0.01 0.70Iceland 0.14 0.04 0.01 0.00 0.81

based on %

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Armenia

Austria

Belgium

Bosnia and Herzegovina

Cyprus

Czech Republic

Denmark

Estonia

Finland

France

Germany

Hungary

Iceland

Ireland

Italy

Lithuania

Netherlands

Norway

Poland

Portugal

Russia

Slovenia

Spain

Sweden

Switzerland

0% 5% 10% 15% 20% 25% 30% 35% 40%

aloneweeklydrunkennessh.e.d. lifet.h.e.d. l.m.risky use