Drinking Patterns of Adolescents and Young Adults

by National Institute of Health

(Page 3 of 6)

The drinking patterns of people in various age groups are difficult to compare internationally because population surveys conducted in different countries often use different age groupings and varying measures of alcohol consumption levels. Furthermore, most surveys that compare drinking in various age groups have been conducted in the established market economies of Europe and North America, and their findings do not always apply to other regions of the world. Nevertheless, two common findings have emerged from these studies: (1) abstinence is more prevalent in older age groups than among young adults, and (2) intoxication is more frequent among young adults than older people.

One survey that has provided basic information on adolescents' alcohol consumption in various European countries is the European School Survey Project on Alcohol and Other Drugs. This multinational study of drinking habits and drug use among 15- to 16-year-old European students was first conducted in 1995, and a second survey followed in 1999. For the most recent data collection, conducted in 2003, students from 35 European countries filled out anonymous self-administered in-school questionnaires. Sample sizes, which were designed to be nationally representative, ranged from 555 in Greenland to almost 6,000 in Poland. The findings of this and other relevant surveys are summarized in the following sections.

Age at Onset of Drinking and Prevalence of Abstinence

Both the long-term and short-term health effects of alcohol consumption depend at least in part on the age when the person begins to consume alcohol. For example, results from a U.S. survey indicate that compared with those who begin drinking at a later age, respondents who begin drinking in their teenage years are more likely during late adolescence and adulthood to experience alcohol-related unintentional injuries (e.g., motor vehicle crashes, falls, burns, and drownings) and to be involved in fights after drinking. Furthermore, early onset of regular alcohol consumption is a significant predictor of lifetime alcohol-related problems, at least in some Western countries. However, it is not clear whether starting to drink at an early age actually causes alcohol-related problems and alcohol use disorders or whether it simply indicates an existing vulnerability to alcohol use disorders.

In the United States, the average age of first-time use of alcohol is about 13 years. In contrast, in a survey conducted in 23 European countries in the late 1990s, more than half of 11-year-olds reported having tasted alcohol. Still, at the beginning of adolescence, the abstinence rate in all European countries is high compared with the adult abstinence rate.

In the ESPAD study, the highest abstinence rate among European youths, 36 percent, was found in Iceland. In the other Nordic alcohol-monopoly countries Finland, Norway, and Sweden, about 20 percent of the 15- to 16-year-old students had not consumed any alcoholic beverages during the previous 12 months. (3 Although some decades ago there seemed to be relatively clear distinctions among European countries with respect to the beverages of preference - that is, northern European countries were classified as spirit-consuming, Anglo-Saxon and Central European countries were considered beer-consuming, and southern European countries were considered wine-consuming - drinking patterns in many countries have changed, and these distinctions have been blurring in recent decades.) Also, in some of the southern European wine-preferring countries, many of which are characterized as having the highest alcohol consumption in Europe, abstinence rates among youth were high. Conversely, the abstinence rate in Greece - also a wine-preferring country - was only 9 percent. Equally low or even lower abstinence rates also were found in beer-preferring countries such as Austria, the Czech Republic, Denmark, Germany, and the United Kingdom. All of these abstinence rates are substantially lower than in the United States, where 41 percent of students reported not having consumed any alcoholic beverages during the last 12 months.

Between adolescence and the onset of adulthood, abstinence rates decreased in most countries, and were about the same for people at age 25 as for middle-aged adults. Moreover, in many countries, differences in abstinence rates between males and females were smaller at age 15 than at age 25. In fact, among 15- to 16-year-old students, females in many countries showed lower abstinence rates than males.

Lifetime Frequency of Drinking

The frequency of alcohol consumption among adolescents is still relatively low. In almost all ESPAD countries and in the United States, less than half of 15- to 16-year-old students were considered frequent drinkers - that is, they had consumed alcohol on 40 or more occasions during their lifetime. The only country where 50 percent of adolescents reported such a frequency of alcohol consumption was Denmark. Otherwise, the countries with the highest proportion of frequent drinkers were Austria, the Czech Republic, the Netherlands, Ireland, and the United Kingdom. The lowest proportions of frequent drinkers were found in Greenland, Iceland, Norway, Portugal, and Turkey. In most countries, more boys than girls reported a lifetime prevalence of drinking at least 40 times.

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