Association of alcohol control policies with adolescent alcohol consumption and with social inequality in adolescent alcohol consumption: a multilevel study in 33 countries and regions

Leal-López, E. et al. (2020) Association of alcohol control policies with adolescent alcohol consumption and with social inequality in adolescent alcohol consumption: a multilevel study in 33 countries and regions. International Journal of Drug Policy, 84, 102854. (doi: 10.1016/j.drugpo.2020.102854) (PMID:32717703)

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Background: Previous research found inconsistent associations between alcohol control policies and socioeconomic inequality with adolescent drinking outcomes. This study expands the focus beyond individual associations to examine whether a combination of policies is related to socioeconomic inequality in adolescent drinking outcomes and whether this relationship varies across survey years. Methods: Multilevel modelling of 4 waves of repeat cross-sectional survey data (2001/02, 2005/06, 2009/10, and 2013/14) from the Health Behaviour in School-aged Children (HBSC) study was carried out. The sample was composed of 671,084 adolescents (51% girls) aged 11, 13, and 15 (mean age=13.58; SD=1.65) from 33 European and North American countries/regions. The dependent variables were lifetime alcohol consumption, weekly alcohol consumption, and lifetime drunkenness. Independent variables were of three types: individual-level variables (age, sex, Family Affluence Scale, and the Perceived Family Wealth), time-level variable (survey year), and context-level variables (minimum legal drinking age, physical availability, advertising restrictions, a total alcohol policy index, and affordability of alcohol). Results: The total alcohol policy index showed a negative relationship with both lifetime and weekly consumption. Higher affordability of alcohol was related to higher lifetime and weekly consumption and higher lifetime drunkenness. Family Affluence Scale was positively related to all three alcohol measures and Perceived Family Wealth was negatively related to lifetime drunkenness, with these associations increasing across survey years. The total alcohol policy index buffered the associations of Family Affluence Scale and Perceived Family Wealth with adolescent drinking outcomes. Conclusion: A combination of alcohol control policies is more effective in reducing adolescent drinking outcomes than single policy measures. Reducing the affordability of alcohol stood out as the most successful single measure. Socioeconomic inequalities (i.e. higher alcohol consumption and drunkenness in adolescents with higher family affluence and higher drunkenness in adolescents perceiving their families to be poor) have persisted and even increased across survey years. A combined alcohol control policy can help in tackling them.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Inchley, Dr Joanna
Authors: Leal-López, E., Moreno-Maldonado, C., Inchley, J., Deforche, B., Van Havere, T., Van Damme, J., Buijs, T., Sánchez-Queija, I., Currie, D., Vieno, A., and De Clercq, B.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO SPHSU
Journal Name:International Journal of Drug Policy
ISSN (Online):1873-4758
Published Online:24 July 2020
Copyright Holders:Copyright © 2020 The Authors
First Published:First published in International Journal of Drug Policy 84: 102854
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
727641SPHSU Core Renewal: Setting and Health Improvement Research ProgrammeKathryn HuntMedical Research Council (MRC)MC_UU_12017/12IHW - MRC/CSO SPHU
Chief Scientist Office (CSO)SPHSU12