Full length articleParental supply of alcohol as a predictor of adolescent alcohol consumption patterns: A prospective cohort
Introduction
Adolescent drinking is associated with a range of negative health outcomes, including injury and non-communicable disease (Patton et al., 2012) and is the primary cause of disability-adjusted life years among those aged 10–24 years (Mokdad et al., 2016), making it an important contributor to the burden of disease in this population (GBD 2016 Risk Factors Collaborators, 2017; Mathews et al., 2011). Parental supply of alcohol to adolescents is relatively common, with more than 20% of adolescents in Australia (White and Williams, 2016), England (Statistics Team NHS Digital, 2017), and the United States (Vidourek et al., 2017) reporting they are supplied alcohol by their parents.
It is a common belief that supplying alcohol to adolescents at home in a safe, supervised, and moderate way is likely to reduce risky drinking behaviour (Donovan and Molina, 2008; Gilligan et al., 2012; Jackson et al., 2012; Jones et al., 2015), despite a lack of robust evidence supporting this view. In fact, there is emerging evidence to the contrary. A 2014 review of cross-sectional and cohort studies found that parental supply was associated with increased alcohol consumption in adolescent offspring, although lack of control for confounding factors (such as parent alcohol consumption and peer influences) and relatively short follow-up (maximum of two years) were cited as limitations (Kaynak et al., 2014). Similarly, recent reviews found associations between alcohol use and parental supply of alcohol (Sharmin et al., 2017b), and parental rules and permissiveness about alcohol (Sharmin et al., 2017a), with both noting the need for increased control for confounding. Recent research following adolescents over six years and adjusting extensively for known confounders showed higher odds of subsequent binge drinking (>40 g of alcohol on a single occasion), alcohol-related harms, and symptoms of alcohol use disorder when parental supply of alcohol had occurred (Mattick et al., 2018). Additionally, adolescents whose parents have supplied alcohol are more likely to subsequently obtain alcohol from non-parental sources (i.e. other supply), which is particularly concerning given that other supply is associated with an even greater risk of adverse health outcomes compared to parental supply alone (Mattick et al., 2018). However, whether the role of parental supply on adolescent drinking patterns changes as a function of age remains unclear. To date, no studies have examined whether parental supply has less of an influence on the drinking patterns of older adolescents compared to younger adolescents. Although preliminary evidence suggests that any parental supply is likely to result in harm, limitations in study design calls for further research in order to properly address the misconceptions regarding its benefits, and to clarify whether the harms associated with parental supply are dependent on the age of the adolescent.
Additionally, the extant literature provides some evidence that heavy drinking and harms relating to alcohol consumption may be addressed by reducing parental supply of alcohol to minors. However, examination of the patterns of drinking behaviours in this population has been limited to relatively coarse measures, including whether an adolescent has consumed any alcohol (Wadolowski et al., 2015a), or much higher risk outcomes, such as alcohol use disorder symptomatology (Mattick et al., 2018). Thus, it remains unclear what specific role parental supply of alcohol has on patterns of adolescent alcohol consumption, namely frequency of consumption and typical quantity consumed on a drinking occasion. Examining these patterns of alcohol behaviours may reveal more subtle consequences of parental supply that are subclinical but nonetheless harmful.
The current study uses data from the ongoing Australian Parental Supply of Alcohol Longitudinal Study (APSALS) cohort, which has been followed up annually since 2010 (mean age 12.9) and is thus able to capture the long-term impact of parental supply and account for known confounders including parental, familial, and peer factors. We sought to examine whether: 1) parental supply of alcohol is associated with the overall amount of alcohol consumed by adolescents; 2) parental supply of alcohol is differentially associated with frequency of drinking compared to quantity typically consumed while drinking; and 3) associations between parental supply and later drinking remain consistent over the course of adolescence, from ages 12 to 18.
Section snippets
Participants and procedure
The study employs the APSALS cohort (registered at ClinicalTrials.gov: NCT02280551), comprising 1927 parent-adolescent dyads who opted to participate from Grade 7 classes in private independent (49%), Catholic (12%), and government (39%) schools in Australia in 2010–2011 and followed up annually. Recruitment methods are described in detail elsewhere (Aiken et al., 2017; Mattick et al., 2017). The cohort demographics were similar to the Australian population in terms of sex distribution,
Results
In Grade 7, 15.2% of adolescents reported receiving alcohol from parents. This increased steadily over the course of the study, with 56.7% reporting parental supply in Grade 12. Other supply was initially less common, with 9.3% reporting obtaining alcohol from others in Grade 7. However, other supply showed a much sharper increase over time, with 70.8% reporting supply from others by Grade 12. Around 2% of adolescents in Grade 11 and 30% in Grade 12 had reached the Australian legal age of
Discussion
This study presents a detailed examination of the association between parental supply and adolescent consumption of alcohol over the course of adolescence, adjusting for an array of confounding variables. Consistent with past research (Gilligan et al., 2012; Kaynak et al., 2014; Sharmin et al., 2017a), this study does not support the belief that parental supply of alcohol to adolescents provides protective benefits. Adolescents supplied alcohol by their parents reported greater of subsequent
Role of funding source
Funding bodies had no role in study design, data analysis, data interpretation, data collection or writing of the article.
Contributors
PC, RPM and AA conceptualised the study. RPM, JN, KK, TS, and DH conceptualised the cohort. MW, AA, RB, and NM designed the data collection methods for the cohort. PC, AA, RPM and MW acquired the data. PC conducted the data analyses and drafted the manuscript with RPM. All authors provided substantial contributions to the interpretation of the results, and all critically revised the manuscript, and approved the final manuscript as submitted.
Declaration of Competing Interest
None to declare.
Acknowledgements
PC receives PhD scholarships from The Australian Government under the Research Training Program, and the National Drug and Alcohol Research Centre. The APSALS study was funded by a 2010-2014 Australian Research Council Discovery Project Grant (DP:1096668) to RPM, JN, KK, TS, DH, two Australian Rotary Health Mental Health Research Grants to RPM, MW, AA, JN, KK, TS, DH, RB and an NHMRC project grant (APP1146634). Funding was also received from: an Australian Rotary Health Whitcroft Family PhD
References (38)
- et al.
Community level alcohol availability and enforcement of possession laws as predictors of youth drinking
Prev. Med.
(2005) - et al.
Association of parental supply of alcohol with adolescent drinking, alcohol-related harms, and alcohol use disorder symptoms: a prospective cohort study
Lancet Public Health
(2018) - et al.
Global burden of diseases, injuries, and risk factors for young people’s health during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013
Lancet
(2016) - et al.
Health of the world’s adolescents: a synthesis of internationally comparable data
Lancet
(2012) - et al.
Effects of parental alcohol rules on risky drinking and related problems in adolescence: systematic review and meta-analysis
Drug Alcohol Depend.
(2017) - et al.
The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies
Lancet
(2007) Manual for the Youth Self-Report and 1991 Profile
(1991)- et al.
Cohort profile: the Australian Parental Supply of Alcohol Longitudinal Study (APSALS)
Int. J. Epidemiol.
(2017) - et al.
Do maternal parenting practices predict problematic patterns of adolescent alcohol consumption?
Addiction
(2010) - et al.
Adolescent problem behavior: the influence of parents and peers
Behav. Res. Ther.
(1999)
2010 National Drug Strategy Household Survey Report
Redefine statistical significance
Nat. Hum. Behav.
Depressed mood in childhood and subsequent alcohol use through adolescence and young adulthood
Arch. Gen. Psychiatry
Secondary Supply of Alcohol to Minors by Parents and Adults Acting in Loco Parentis: A Literature Review
Children’s introduction to alcohol use: sips and tastes
Alcohol. Clin. Exp. Res.
Childhood risk factors for early-onset drinking
J. Stud. Alcohol Drugs
Predictors of initiation of alcohol use among US adolescents: findings from a prospective cohort study
Arch. Pediatr. Adolesc. Med.
Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016
Lancet
Changing parental behaviour to reduce risky drinking among adolescents: current evidence and future directions
Alcohol Alcohol.
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2022, Drug and Alcohol DependenceCitation Excerpt :Among the two classes who received sips from parents in early adolescence, those then supplied whole drinks in mid-adolescence (4 - Early parent sips to mid peer/parent whole drinks) had a higher risk of four of the five outcomes, compared with those supplied whole drinks in late adolescence (2 - Early parent sips to late peer/parent whole drinks). These findings are consistent with our previous work demonstrating that receiving sips of alcohol is associated with lower risk than receiving whole drinks (Aiken et al., 2020; Mattick et al., 2018) and that earlier initiation of supply is associated with greater risk (Clare et al., 2019, 2020), as well as work showing that early adolescent exposure to alcohol is associated with alcohol-related harms in adulthood (Boden et al., 2019). As established, not supplying alcohol to adolescents is associated with the lowest risk.
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2021, Drug and Alcohol DependenceCitation Excerpt :Participants were recruited from an existing and ongoing cohort of 1927 adolescents participating in the Australian Parental Supply for Alcohol Longitudinal Study (APSALS). APSALS was designed to investigate the impact of parental supply of alcohol on the initiation of risky drinking in adolescents (Clare et al., 2019; Mattick et al., 2018). It has collected information on drinking onset and characteristics along with a range of individual, family, peer, and environmental variables (see Aiken et al., 2017 for more detail on measures).
Parental supply of sips and whole drinks of alcohol to adolescents and associations with binge drinking and alcohol-related harms: A prospective cohort study
2020, Drug and Alcohol DependenceCitation Excerpt :While beyond the scope of the current study, the question of how parental supply of alcohol fits into and/or interacts with the wider context deserves further exploration and is particularly important to consider in the development of family-based prevention initiatives. The current findings are consistent with existing evidence showing that parental supply is associated with adverse outcomes (Clare et al., 2019, 2020; Gilligan et al., 2012; Henderson et al., 2013; Kaynak et al., 2014; Maggs and Staff, 2018; Mattick et al., 2018; McMorris et al., 2011; Sharmin et al., 2017). Current results also extend prior knowledge by explicitly comparing the supply of sips versus whole drinks in terms of their associations with later adverse outcomes.