YOUNG TEENAGERS' DRINKING

by Alcohol Concern

As the furore over alcopops begins to die down, this factsheet looks at the wider context of young people’s drinking, concentrating on those under sixteen.

Key points

• Young people are drinking more alcohol, and drinking more often.
• The age they begin to drink unsupervised is probably more crucial than the age they first try alcohol.
• Young people drink for a variety of reasons, including to look more grown-up.
• Alcopops account for about 17% of all alcohol drunk by 11-15 year-olds.
• Though young people may drink in an uncontrolled way, most will not go on to develop serious problems.
• Young people’s alcohol problems include the effects of severe intoxication, accidents, criminal involvement and unsafe sex.
• Young adults are the heaviest drinking section of the population and have the highest rates for signs of dependence on alcohol.

Recent trends

While the proportion of 11-15 year-olds who don’t drink at all has remained at about 40% since 1988, two disturbing trends have emerged in recent years.

• Young people are drinking larger amounts of alcohol. Average consumption among 11-15 year-olds in England has more than doubled in the 1990s, from 0.8 units a week in 1990 to 1.8 units in 1996. If non-drinkers are excluded from the calculation, the increase is from 5.4 units a week in 1990 to 8.4 units a week in 1996. (Goddard, 1997)
• Young people are drinking more often. The proportion of 11-15 year-olds who drink at least once a week has risen from 13% in 1988 to 17% in 1994 and 20% in 1996.

First drinks

It is not easy to pinpoint the actual age when they first try alcohol. Recall of this event is vague, and as children get older, their definition of a proper drink changes. Drinkers start to outnumber non-drinkers from the age of twelve and by the age of 15 nearly all young people have tried alcohol. Many in this age group drink only small amounts and only occasionally, often under parental supervision. More crucial than the first drink is the age young people start to drink unsupervised, signifying a shift to drinking with friends rather than parents, and in open spaces, clubs and pubs rather than at home.

Why do young people drink?

The University of Glasgow examined young people’s changing reasons for drinking. (Hughes et al, 1997)

• 12-13 year-olds use alcohol to experience the adult world; to satisfy their curiosity; to start socialising and to say they have tried alcohol. They experiment with any available drinks.
• 14-15 year-olds are testing out their own limits and having fun. They enjoy losing control occasionally, getting drunk and sharing the experience with others. They prefer their drinks relatively strong, cheap and pleasant-tasting.
• 16-17 year-olds are anxious to show their maturity and experience by drinking more like adults. They want to appear adult and sophisticated and to impress their girlfriends and boyfriends.

While peer group pressure is often accepted as a major factor, there is also evidence pointing to a reverse phenomenon, peer association: young people who are already experimenting with certain behaviours such as using alcohol are likely to choose as friends those who share similar interests. (May, 1993)

Parents’ drinking

Children’s attitudes and behaviours are initially shaped by families - both directly, in that parents act as role models, and indirectly in that levels of family support, control and conflict are linked to teenage drinking. A sensible drinking example set by parents seems to be particularly important as both abstainers and heavy drinkers are more likely to have heavy drinking children. (Velleman, 1992)

Alcopops

In autumn 1997, alcopops accounted for about 17% of all alcohol consumed by children aged 11-15.

Many young people drink more than one kind of drink. Looking at the complex drinking preferences and patterns of this age group, the ONS study finds some support for the claim that those who drink alcopops may do so because the taste of alcohol is masked by the addition of fruit juice or cola. On the other hand this study queries the idea that alcopops encourage non-drinking children to drink; rather, it suggests, "alcopops are probably mainly an additional drink option for children who would have been drinking anyway." Not all commentators agree: a recent Welsh study attributed to the rise in young teenage drinking specifically to the introduction of alcopops. (Roberts et al, 1997)

While the rise in consumption pre-dates the introduction of alcopops, the long term impact of products orientated at a youthful market (though manufacturers deny specifically targeting young teenagers) has yet to be assessed.

Buying alcohol

About 10% of 12-13 year-olds, 16% of 13-14 year-olds and 25% of 14-15 year-olds claim to have bought alcohol recently, with off-licences the most widely-used outlet. (Balding, 1997)

Problems

For adults, guidelines warn of risks to health if men regularly drink four or more units a day or women three or more units a day. For young people, who come in all shapes and sizes, and whose bodies may still be developing, there are no established "safe levels". Not only sex, build and weight, but also physical tolerance, experience of drinking and the context in which it takes place are all crucial factors. (RCP, 1995)

A significant number of young people drink more than the amounts advised for adults. While most studies look at weekly consumption, a study in North West England asked 800 14-15 year-olds how much they drank last time - over half had drunk more than 4 units, including 10% who had drunk more than 25 units. (Newcombe et al, 1995)The ONS study, looking at weekly consumption, found that 5% of boys and 3 % of girls had drunk 15 or more units in the previous week. Among 15 year-olds, this rose to 15% of boys and 7% of girls.

The consequences of young people’s drinking are more likely to be related to intoxication rather than long-term health risks or incipient alcohol dependence. Young people drink less often than adults, but when they drink, they tend to drink in large amounts. (Lowe et al, 1993)

Hospital admissions

Experimental drinking can lead to severe intoxication, which is more dangerous for children and adolescents than for adults, as they experience coma at lower blood alcohol levels and can develop hypoglycaemia (low levels of blood sugar), hypothermia and breathing difficulties. (Balding, 1996) In the early 1980s, hospital admissions for alcohol poisoning were calculated at about 1,000 a year. (Beattie et al, 1986)

More than ten years on, these figures are still not collected routinely. Research from the Royal Liverpool Children’s Hospital Accident and Emergency Department shows a ten-fold increase in such admissions between 1985 and 1996. In 1996, about 200 children under the influence of alcohol were brought into the department, ranging in age from 9 to 16. All either needed resuscitation from a large overdose or had injuries from accidents or assaults sustained while drunk. Most had drunk strong cider or vodka. The range of blood alcohol levels was 35 to 372 mg/100ml. (Robson, 1997) Press reports and anecdotal evidence suggest this increase is not unique to Liverpool.

Deaths

All these patients need close observation for a few hours, many need admission and a few require intensive care. Fortunately deaths are rare. In 1993, 17 people under the age of 25 died from direct effects of alcohol; in 1994 the figure was 12 and in 1995, 11. (ONS, 1997) However, older teenagers are far more likely to die from the indirect effects of alcohol than from its direct effects. Accidents, suicide and violence are significant causes of death in the 16 to 25 age group, and alcohol is often implicated in all three.

Drunkenness

Only the most severely intoxicated children need hospital treatment. For others, the effects may range from the unpleasant (hangovers, headaches, minor accidents and falls) to the more serious. Up to ten percent of children in one study experienced being ill enough to stay at home, needing a drink the next day or having problems at school as a result of drinking. (Newcombe et al, 1995) Young women may be sexually abused or have unsafe sex. (RCP, 1995) A study of Scottish schoolchildren found that over half reported having been drunk. (McKeganey et al, 1996)Both this study (done before the introduction of alcopops) and a later study by the same author (Forsyth et al, 1997) found that drunkenness was particularly associated with drinking white cider, fruit wines and vodka.

Dependence

For young teenagers, there is nothing in between anecdotal and often sensationalist coverage in the media and incomplete official data: in 1994-5, 50 children aged 10-14, and 129 aged 15-19 were treated in hospital for "alcohol dependence syndrome." (DoH, 1996) It is not clear if these overlap with the emergency admissions referred to above or refer to genuine cases of dependence on alcohol. Nor can we establish how many other young people need treatment or, in the few areas where interventions are available for young people, are actually receiving it.

Information on older adolescents is a little more accessible. A national investigation found a significant number of young people were at risk of becoming dependent on alcohol. Nearly 12% of young men aged 16-19 showed signs of alcohol dependence, as did about 7% of women of this age - the highest rates for women. (Melzer, 1995)

Crime

The peak age for arrests for drunkenness is 18 years (see Factsheet no.21, Drunkenness offences).

In a Manchester-based study of the associations between alcohol and deviancy in young people, 25% of weekly drinkers had a criminal record compared with 6-7% of occasional and non-drinkers, with criminal damage, disorderly behaviour and shoplifting being the commonest offences. (Newcombe et al, 1995)

A recent report by the chief inspector of prisons found that a quarter of young prisoners had been drinking when they committed their crime. (Ramsbottom, 1997)

Problems as adults

Surprisingly little is known about whether teenagers who drink heavily become problem drinking adults. 18-24 year-old men are the heaviest drinking section of the population and for young women, consumption reaches its peak in the late teenage years. This is sometimes referred to as a "wilds oats" phase.

For both men and women, consumption then declines with the formation of steady relationships, parenthood, financial pressures and alternative leisure pursuits. Further research is needed to establish whether those people whose problems continue beyond the "wild oats" phase are the ones who drank heavily in their early teens.

References

Balding, J - Young people in 1996. 1997. Schools Health Education Unit. Exeter: University of Exeter

Beattie, J, Hull, D. and Cockburn, F - Children intoxicated by alcohol in Nottingham and Glasgow 1973-84. 1986 British Medical Journal, vol.292, 22/02/1986

Department of Health (DoH) - Hospital episode statistics 1994-1995. 1996. London: HMSO

Forsyth, A, Barnard, M and McKeganey, N - Alcopop supernova: are alcoholic lemonades (alcopops) responsible for under-age drunkenness? 1997. International Journal of Health Education, vol.35, no.2

Goddard, E - Young teenagers and alcohol in 1996; volume 1 England. 1997. London: TSO.

Hughes, K et al - Young people, alcohol and designer drinks: quantitative and qualitative study.1997. British Medical Journal, vol 314, 8/02/1997

Lowe, G, Foxcroft, D and Sibley, D - Adolescent drinking and family life. 1993. London: Harwood.

May, C - Resistance to peer pressure: an inadequate basis for alcohol education. 1993. Health Education Research, vol 8, no 2

McKengney, N et al - Designer drinks. 1996. British Medical Journal, vol 313, no 7053

Melzer, H, Gill, B and Petticrew, M - The prevalence of psychiatric morbidity among adults aged 16-64, living in private households, in Great Britain. 1995. London: OPCS.

Newcombe, R., Measham, F. and Parker, H.- A survey of drinking and deviant behaviour among 14/15 year olds in North West England. 1995. Addiction Research, vol.2, no.4.

Office for National Statistics (ONS) - Mortality statistics, cause: England and Wales. 1995 London: TSO.

Ramsbottom, D - Young prisoners: a thematic review. 1997. Home Office.Quoted in Guardian, 25/11/1997.

Roberts, C.,Blakey, V, Tudor-Smith, C - The impact of alcopops on the drinking patterns of young people in Wales. 1997. Cardiff: Health Promotion Wales.

Robson, W - Alcohol and young people. 1997. Alcoholism, the newsletter of the MCA, vol 16, no 6.

Velleman, R - The development of drinking behaviour in families. 1992. Alcohol and young people: learning to cope, conference proceedings, Addiction Forum.