Elsevier

Drug and Alcohol Dependence

Volume 204, 1 November 2019, 107529
Drug and Alcohol Dependence

Full length article
Parental supply of alcohol as a predictor of adolescent alcohol consumption patterns: A prospective cohort

https://doi.org/10.1016/j.drugalcdep.2019.06.031Get rights and content

Highlights

  • No evidence for any protective effect of parental supply on adolescent drinking.

  • Young adolescents supplied by parents later reported greater alcohol consumption.

  • Young adolescents supplied by parents later reported more frequent drinking.

  • Other supply had a stronger association with drinking than parental supply.

  • As the sample approached adulthood, drinking increased regardless of parental supply.

Abstract

Background

Recent research has not supported the idea that parental supply of alcohol to adolescents prevents later alcohol-related harm. Yet the specific role of parental supply in shaping patterns of drinking over time remains unclear. This study investigated the role of parental supply of alcohol in patterns of drinking across adolescence, and assessed whether that role remained consistent over time.

Method

Using a longitudinal cohort of 1927 adolescents (mean age 12.9 years), recruited in 2010 and 2011 from schools across Australia and followed up annually until 2016, we assessed three outcomes using mixed-effect negative binomial regression: frequency of consumption, typical quantity consumed, and overall alcohol consumption in the year (frequency * quantity). Child, parental, familial, and peer confounders of adolescent alcohol consumption were measured and adjusted for in the analyses.

Findings

Parental supply was associated with greater overall consumption in earlier adolescence: Grade 7–8 (incidence rate ratio [IRR]: 3.61; 95% CI: 2.55, 5.12; no supply IRR: 1.00), Grade 8–9 (IRR: 4.84; 95% CI: 3.66, 6.39; no supply IRR: 1.44) and Grade 9–10 (IRR: 8.33; 95% CI: 6.28, 11.05; no supply IRR: 4.75). Alcohol consumption continued to increase in later adolescence regardless of whether parental supply occurred.

Conclusions

Parental supply of alcohol was associated with increased alcohol consumption by their children during early adolescence. While parental supply appears to have less impact on drinking in later adolescence, there was no evidence to suggest it is protective. Parents should be advised to avoid supplying children with alcohol, particularly in early adolescence.

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

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