Youth drinking in decline: What are the implications for public health, public policy and public debate?

Holmes, J., Fairbrother, H., Livingston, M., Meier, P. S. , Oldham, M., Pennay, A. and Whitaker, V. (2022) Youth drinking in decline: What are the implications for public health, public policy and public debate? International Journal of Drug Policy, 102, 103606. (doi: 10.1016/j.drugpo.2022.103606) (PMID:35131690) (PMCID:PMC7612362)

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Youth drinking has declined across most high-income countries in the last 20 years. Although researchers and commentators have explored the nature and drivers of decline, they have paid less attention to its implications. This matters because of the potential impact on contemporary and future public health, as well as on alcohol policy-making. This commentary therefore considers how youth drinking trends may develop in future, what this would mean for public health, and what it might mean for alcohol policy and debate. We argue that the decline in youth drinking is well-established and unlikely to reverse, despite smaller declines and stabilising trends in recent years. Young people also appear to be carrying their lighter drinking into adulthood in at least some countries. This suggests we should expect large short- and long-term public health benefits. The latter may however be obscured in population-level data by increased harm arising from earlier, heavier drinking generations moving through the highest risk points in the life course. The likely impact of the decline in youth drinking on public and policy debate is less clear. We explore the possibilities using two model scenarios, the reinforcement and withdrawal models. In the reinforcement model, a ‘virtuous’ circle of falling alcohol consumption, increasing public support for alcohol control policies and apparent policy successes facilitates progressive strengthening of policy, akin to that seen in the tobacco experience. In the withdrawal model, policy-makers turn their attention to other problems, public health advocates struggle to justify proposed interventions and existing policies erode over time as industry actors reassert and strengthen their partnerships with government around alcohol policy. We argue that disconnects between the tobacco experience and the reinforcement model make the withdrawal model a more plausible scenario. We conclude by suggesting some tentative ways forward for public health actors working in this space.

Item Type:Articles
Additional Information:This work was supported by the Wellcome Trust (208090/Z/17/Z) and an ARC Discovery Early Career Research Award to AP (DE190101074).
Keywords:Alcohol, Policy debate, Trends, Young people, Policy process.
Glasgow Author(s) Enlighten ID:Meier, Professor Petra
Authors: Holmes, J., Fairbrother, H., Livingston, M., Meier, P. S., Oldham, M., Pennay, A., and Whitaker, V.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
Journal Name:International Journal of Drug Policy
ISSN (Online):1873-4758
Published Online:04 February 2022
Copyright Holders:Copyright © 2022 The Authors
First Published:First published in International Journal of Drug Policy 102: 103606
Publisher Policy:Reproduced under a Creative Commons License

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