Adolescents drink less, although levels of alcohol consumption are still dangerously high

A new WHO report published today, Adolescent alcohol-related behaviours: trends and inequalities in the WHO European Region, 2002–2014, provides new insights into data collected over 12 years on adolescent drinking. The report reveals that alcohol use has declined among adolescents in Europe. However, despite the reductions, levels of consumption remain dangerously high and this continues to be a major public health concern.

Over 1 in 10 adolescents in the Region were regular weekly drinkers by the age of 15 (9% of girls and 16% of boys) in 2014. “Young people are regular drinkers at an age where they should not be drinking at all. As we know that any alcohol consumption at this critical developmental stage in life is especially harmful, policy-makers have a responsibility to implement the measures we know are effective, such as limiting access, enforcing age checks and restricting any type of alcohol marketing, including digital marketing. Although the WHO European Region has already reached the target of a 10% reduction as set out in the noncommunicable disease framework for 2025, much more can be achieved to prevent the devastating impact of alcohol on premature death and disability,” said Dr Zsuzsanna Jakab, WHO Regional Director for Europe.

Key findings in the report:

The research, led by the University of St Andrews, documents the drinking habits of European adolescents in 36 countries. The trend analysis uses data collected during four rounds of the Health Behaviour in School-aged Children (HBSC) survey, conducted in 2002–2014. Worrying trends in drinking behaviour were identified:

• Excessive drinking is still common, with around a quarter of boys and more than 1 in 5 girls reporting having been drunk two or more times by the age of 15. Since 2002, the greatest declines in drunkenness were observed in Nordic countries.
• More than 1 in 4 15-year-olds (28%) reported that they started consuming alcohol at age 13 or younger (25% of girls and 31% of boys) in 2014. This has fallen from 46% in 2002, with downward trends similar in magnitude for boys and girls in most countries.
• Over time gender differences for weekly drinking have converged in northern Europe, with girls and boys now reporting similar levels. Wider gender divides persist in central-eastern and southern Europe, where prevalence for boys is currently around twice that of girls.
• Around 1 in 10 adolescents reported first being drunk at age 13 or younger (7% of girls and 9% of boys) in 2014. This has more than halved since 2002 (from 17% to 8%), with declines among both boys and girls, although in most countries the decline was greatest in boys.

Declines in alcohol consumption have been unevenly distributed, with some countries seeing no change, or only very small decreases, since 2002.

Dr Jo Inchley, lead editor of the report, said “Overall reductions in harmful drinking have been greatest in countries that traditionally have had higher prevalence, such as Great Britain and the Nordic region. This makes it clear that change is possible; however, more should be done to ensure that adolescents are effectively protected from the harms caused by alcohol”.

Adolescent drinking, what are the risks?

Drinking during adolescence, including early initiation, frequent consumption and drunkenness, impacts psychological, social and physical health. Alcohol is an important risk factor for fatal and nonfatal injuries, accidents, suicide attempts and use of other substances, and is linked to unintended pregnancy, sexually transmitted diseases, poor academic outcomes and violence.

Alcohol consumption during adolescence is also associated with functional and structural changes in the brain that persist into adulthood. Recent studies have demonstrated detrimental effects of early drinking on brain development that are associated with, for example, learning difficulties. Research has also shown that delaying the age at which young people take their first drink lowers their risk of becoming problem drinkers later in life.

Continued policy action needed

The dramatic shift in prevalence of regular and risky drinking in northern European countries demonstrates that concerted efforts at national and regional levels can have a big impact on drinking behaviour. WHO has identified a set of affordable, feasible and cost-effective policies that can reduce harmful alcohol use. These include: increasing alcohol prices, restricting alcohol availability, and comprehensive advertising, promotion and sponsorship bans.

Dr Carina Ferreira Borges, Programme Manager for Alcohol and Illicit Drugs at the WHO Regional Office for Europe urged policy-makers to make a commitment: “To ensure the successes achieved so far are maintained, governments are urged to adopt approaches which engage the population at all ages. In addition, more efforts are needed, particularly in countries where the rate of change has been slow. Investments in adolescent health pay off with a triple dividend of benefits for adolescents – now, for their future adult lives and for the next generation”.