Parental supply of alcohol in childhood and risky drinking in adolescence: Systematic review and meta-analysis

© 2017 by the authors. Licensee MDPI, Basel, Switzerland. Whether parental supply of alcohol affects the likelihood of later adolescent risky drinking remains unclear. We conducted a systematic review and meta-analysis to synthesize findings from longitudinal studies investigating this association. We searched eight electronic databases up to 10 September 2016 for relevant terms and included only original English language peer-reviewed journal articles with a prospective design. Two reviewers independently screened articles, extracted data and assessed risk of bias. Seven articles met inclusion criteria, six of which used analytic methods allowing for meta-analysis. In all seven studies, the follow-up period was ≥12 months and attrition ranged from 3% to 15%. Parental supply of alcohol was associated with subsequent risky drinking (odds ratio = 2.00, 95% confidence interval = 1.72, 2.32); however, there was substantial risk of confounding bias and publication bias. In all studies, measurement of exposure was problematic given the lack of distinction between parental supply of sips of alcohol versus whole drinks. In conclusion, parental supply of alcohol in childhood is associated with an increased likelihood of risky drinking later in adolescence. However, methodological limitations preclude a causal inference. More robust longitudinal studies are needed, with particular attention to distinguishing sips from whole drinks, measurement of likely confounders, and multivariable adjustment

Parental supply of alcohol and alcohol consumption in adolescence: prospective cohort study

Background: Parents are a major supplier of alcohol to adolescents, yet there is limited research examining the impact of this on adolescent alcohol use. This study investigates associations between parental supply of alcohol, supply from other sources, and adolescent drinking, adjusting for child, parent, family and peer variables. Method: A cohort of 1927 adolescents was surveyed annually from 2010 to 2014. Measures include: consumption of whole drinks; binge drinking (>4 standard drinks on any occasion); parental supply of alcohol; supply from other sources; child, parent, family and peer covariates. Results: After adjustment, adolescents supplied alcohol by parents had higher odds of drinking whole beverages [odds ratio (OR) 1.80, 95% confidence interval (CI) 1.33–2.45] than those not supplied by parents. However, parental supply was not associated with bingeing, and those supplied alcohol by parents typically consumed fewer drinks per occasion (incidence rate ratio 0.86, 95% CI 0.77–0.96) than adolescents supplied only from other sources. Adolescents obtaining alcohol from non-parental sources had increased odds of drinking whole beverages (OR 2.53, 95% CI 1.86–3.45) and bingeing (OR 3.51, 95% CI 2.53–4.87). Conclusions: Parental supply of alcohol to adolescents was associated with increased risk of drinking, but not bingeing. These parentally-supplied children also consumed fewer drinks on a typical drinking occasion. Adolescents supplied alcohol from non-parental sources had greater odds of drinking and bingeing. Further follow-up is necessary to determine whether these patterns continue, and to examine alcohol-related harm trajectories. Parents should be advised that supply of alcohol may increase children's drinking

Effects of parental alcohol rules on risky drinking and related problems in adolescence: Systematic review and meta-analysis

Background: It is unclear what effect parents’ rules about their children’s alcohol use have on drinking inadolescence. This review and meta-analysis investigated associations between prospectively measured parentalalcohol rules and later adolescent risky drinking.Methods: Using the PRISMA guidelines, we searched eight electronic databases for a variety of terms up to 10September 2016. We imposed no restrictions on publication year. We assessed the risk of bias and conducted ameta-analysis.Results: We identified 13 eligible studies in four groups of specific exposures for meta-analysis. The pooledoverall estimate showed that when parents set rules concerning alcohol, their children were less likely to developrisky drinking and related problems (OR = 0.64, 95% CI = 0.48, 0.86). Pooled estimates illustrate that parentalalcohol rules were significantly negatively associated with adolescent risky drinking and related problems(OR = 0.73, 95% CI = 0.53, 0.99), as was parental approval of alcohol use (inverse OR = 0.41, 95% CI = 0.34,0.50). Neither parental permissiveness (inverse OR = 0.83, 95% CI = 0.59, 1.19) nor parental disapproval ofalcohol use (OR = 0.49, 95% CI = 0.20, 1.20) was significantly associated with alcohol-related problems.However, the small number of studies and variability in the point estimates in these latter two groups of studieslimits inferences.Conclusions: Parents’ restrictiveness of their children’s drinking was associated with lower risky drinking, but therisk of bias in the existing literature precludes strong inferences about the association. Further longitudinalstudies with prospective measurement of parent behaviour, low attrition, and control for likely confounders, areneeded

Cohort Profile: The Australian Parental Supply of Alcohol Longitudinal Study (APSALS)

The Australian Parental Supply of Alcohol Longitudinal Study (APSALS) was established in 2010 to investigate the short- and long-term associations between exposure to early parental alcohol provision, early adolescent alcohol initiation, subsequent alcohol use and alcohol-related harms, controlling for a wide range of parental, child, familial, peer and contextual covariates. The cohort commenced with 1927 parent-child dyads comprising Australian Grade 7 school students (mean age = 12.9 years, range = 10.8–15.7 years), and a parent/guardian. Baseline, 1- and 2-year follow-up data have been collected, with > 90% retention, and a 3-year follow-up is under way. The data collected include child, familial, parental and peer factors addressing demographics, alcohol use and supply, parenting practices, other substance use, adolescent behaviours and peer influences. The cohort is ideal for prospectively examining predictors of initiation and progression of alcohol use, which increases markedly through adolescence

Parents who supply sips of alcohol in early adolescence: A prospective study of risk factors

Copyright © 2016 by the American Academy of Pediatrics. BACKGROUND: Parents are a major supplier of alcohol to adolescents, often initiating use with sips. Despite harms of adolescent alcohol use, research has not addressed the antecedents of such parental supply. This study investigated the prospective associations between familial, parental, peer, and adolescent characteristics on parental supply of sips. METHODS: Participants were 1729 parent-child dyads recruited from Grade 7 classes, as part of the Australian Parental Supply of Alcohol Longitudinal Study. Data are from baseline surveys (Time 1) and 1-year follow-up (Time 2). Unadjusted and adjusted logistic regressions tested prospective associations between Time 1 familial, parental, peer, and adolescent characteristics and Time 2 parental supply. RESULTS: In the fully adjusted model, parental supply was associated with increased parentreport of peer substance use (odds ratio [OR] = 1.20, 95% confidence ratio [CI], 1.08-1.34), increased home alcohol access (OR = 1.07, 95% CI, 1.03-1.11), and lenient alcohol-specific rules (OR=0.88, 95% CI, 0.78-0.99). CONCLUSIONS: Parents who perceived that their child engaged with substance-using peers were more likely to subsequently supply sips of alcohol. Parents may believe supply of a small quantity of alcohol will protect their child from unsupervised alcohol use with peers. It is also possible that parental perception of peer substance use may result in parents believing that this is a normative behavior for their child's age group, and in turn that supply is also normative. Further research is required to understand the impacts of such supply, even in small quantities, on adolescent alcohol use trajectories

Early Adolescent Alcohol Use: Are Sipping and Drinking Distinct?

Background: Sipping alcohol is common during early adolescence, but research has ignored the distinction between sipping and drinking whole alcohol beverages, conflating the 2, or else simply classifying "sippers" as abstainers. Research has not addressed whether sippers are different to drinkers, in relation to variables known to be associated with adolescent alcohol consumption, or considered whether sipping and drinking behaviors may have quite different associations. Methods: Parent-child dyads (N = 1,823) were recruited in 3 states from Australian grade 7 classes. Multinomial logistic analyses compared adolescents who had only had a sip/taste of alcohol (sippers) with adolescents who had consumed at least a whole drink (drinkers) in the past 6 months. The multivariate model assessed a broad range of demographics, parenting practices, peer influences, and adolescent externalizing and internalizing behaviors, and controlled for school clustering. Results: Compared to drinkers, sippers were less likely to come from 1-parent households (odds ratio [OR] = 0.59, 95% confidence interval [CI]: 0.35 to 0.98); less likely to come from low-socioeconomic status (SES) households (OR = 0.54, 95% CI: 0.31 to 0.94); more likely to come from families where parents provide stricter alcohol-specific rules (OR = 1.21, 95% CI: 1.11 to 1.32), stricter monitoring of the child's activities (OR = 1.10, 95% CI: 1.04 to 1.16), more consistent parenting practices (OR = 1.13, 95% CI: 1.05 to 1.23), and more positive family relationships (OR = 1.56, 95% CI: 1.02 to 2.43); and report having fewer substance-using peers (OR = 0.80, 95% CI: 0.70 to 0.91) and greater peer disapproval of any substance use (OR = 1.30, 95% CI: 1.19 to 1.42). After adjustment for confounders, the associations with household composition and SES were no longer significant, but the familial and peer associations remained significant in the multivariate analysis, X2(40) = 1,493.06, p < 0.001. Conclusions: Sipping alcohol has different associations with known predictors of adolescent alcohol use than drinking whole beverages, and sipping may be a distinct or separable behavior. Future research should better define quantities of early consumption and assess the relationship between early sipping and drinking on long-term outcomes separately

Sipping, Drinking, and Early Adolescent Alcohol Consumption: A Cautionary Note

Background: Epidemiological studies report markedly varying rates of adolescent alcohol involvement. Despite being a common adolescent behavior, a potential cause of this variation is that consumption of sips is either not measured or not distinguished from consumption of whole beverages. Methods: Participants were 1,843 grade 7 adolescents recruited across 49 Australian secondary schools (M age = 12.4, SD = 0.5). Quantity and frequency of lifetime and past 6-month consumption were assessed, distinguishing between sipping and drinking. For comparison with international population surveys, quantity was reported as any consumption, sipping only, and drinking only. Results: Combining sipping and drinking into a single category, lifetime consumption was reported by 67.3% of the present sample. Distinguishing lifetime consumption by sipping and drinking: only 7.8% of adolescents had consumed a whole beverage; the remaining 59.6% had only sipped. Consumption of whole beverages was mostly limited to 1 to 2 drinks (84.2% of drinkers). Sipping and drinking were also infrequent: 78.2% of sipping and 60.4% of drinking, occurred less than monthly. Heavy episodic consumption was uncommon (1.2% of the sample). When other population studies were inspected, a clear trend for higher drinking rates were found in those studies where sipping was counted as drinking and vice versa. Conclusions: Consumption of whole beverages appears infrequent in early adolescence, as sipping, but not drinking, was common in our sample. Comparing the present data with international population consumption measures highlights the need to more precisely measure and report adolescent consumption, particularly in relation to sipping

Age of Alcohol Initiation and Progression to Binge Drinking in Adolescence: A Prospective Cohort Study

Copyright © 2017 by the Research Society on Alcoholism Background: Early alcohol initiation is common and has been associated with the development of alcohol problems. Yet, past research on the association of age of initiation with later problem drinking has produced inconsistent findings. Using prospective data from the Australian Parental Supply of Alcohol Longitudinal Study cohort, this study examined age of alcohol initiation, and of first drunkenness, and associations with subsequent drinking in adolescence. Methods: A total of 1,673 parent–child dyads recruited through Australian secondary schools completed annual surveys for 5 years (grades 7 to 11). Limiting the sample to those adolescents who had initiated alcohol use by age 17 (n = 839), multinomial logistic regression models were used to examine associations between (i) age of initiation to alcohol use (consuming at least 1 full serve) and (ii) age of first drunkenness, and 2 outcomes: (i) binge drinking (consuming &gt; 4 standard drinks on a single occasion), and (ii) the total number of alcoholic drinks consumed in the past year, adjusted for a range of potential child, parent, family, and peer covariates. Results: Fifty percent of adolescents reported alcohol use and 36% reported bingeing at wave 5 (mean age 16.9 years), and the mean age of initiation to alcohol use for drinkers was 15.1 years. Age of initiation was significantly associated with binge drinking and total quantity of alcohol consumed in unadjusted and adjusted models. Age of first drunkenness was associated with total quantity of alcohol consumed in unadjusted models but not adjusted models and was not associated with subsequent bingeing. Conclusions: Initiating alcohol use earlier in adolescence is associated with an increased risk of binge drinking and higher quantity of consumption in late secondary school, supporting an argument for delaying alcohol initiation for as long as possible to reduce the risk for problematic use in later adolescence and the alcohol-related harms that may accompany this use