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Teenagers and alcohol: results of a Scottish national survey
Drug and Alcohol Dependence.
Elsevier Scientific Publishers
28 (1991) 203-210 Ireland Ltd.
203
Teenagers and alcohol: results of a Scottish national survey Martin A. Plant and Jean Foster Alcohol Research
Group, Department
of Psychiatry,
University of Edinburgh, Scotland (U.K.)
Morningside
Park, Edanburgh EHlO 5HF.
(Received April li’th, 1991)
During 1990 a survey was conducted of the self-reported drinking habits and alcohol-related knowledge and beliefs of a national sample of 7009 Scottish teenagers. The study group were age 14-16. Results indicated that only 3% of respondents had never consumed alcohol. The great majority of teenagers reported consuming only moderate quantities of alcohol. Even so 18.9% of males and 10.3% of females reported consuming 11 or more units on their last drinking occasion. The proportion of teenagers classified as ‘heavy drinkers’ increased markedly between the ages of 14 and 16. This study confirmed earlier findings indicating that Scottish teenagers are more likely than those in England to drink heavily and rather less frequently. Key words: alcohol consumption;
drinking habits; teenagers;
Introduction The use and misuse of alcohol by teenagers is firmly established as a focus for public concern [eg. l-81. Even so British surveys have only attempted to elicit detailed self-reports of alcohol consumption by young people during the past 15 years. Only a relatively small number of such self-report surveys have been conducted in Britain and even fewer of these have related to national samples [9- 121. A conference was arranged to provide a forum for Scottish teenagers to discuss topics related to alcohol and young people. This event, which was organized by the Scottish Office Education Department and the Scotch Whisky Association, was held in Edinburgh in November 1990. As a prelude to this meeting a survey was undertaken to provide some basic information on the self-reported drinking habits and alcohol-related experiences of beliefs, motivations and Correspondence
to: Martin A. Plant, Alcohol Research Group, Department of Psychiatry, University of Edinburgh, Morningside Park, Edinburgh EHlO 5HF, Scotland, U.K.
03768716/91/$03.50 0 1991 Elsevier Scientific Publishers Printed and Published in Ireland
Scotland
teenagers attending schools which were selected to participate in the conference. This paper describes some of the results of this study. Method A total of 25 state secondary (high) schools in Scotland were selected. A stratified random procedure ensured that each region of Scotland was included and that the number of schools selected within each region was weighted in accordance with the total number of schools therein. Individual schools were selected from alphabetical lists of schools within each region using a random number table (131. Small rural schools were excluded from this study, as were schools which had recently been, or were currently, involved with other health related surveys. These constraints ensured that the selected sample did not give due weight to small schools. A total of 25 schools were selected of which 23 took part in the survey. Fieldwork for the survey was conducted between February and May 1990. This paper relates to information elicited from pupils aged 14-16 in the 23 Ireland Ltd.
204
cooperating schools. Data were obtained by the completion of a short standardized anonymous questionnaire filled in by respondents during school hours under the supervision of teaching staff. The questionnaire took between 15 and 30 min to fill in. Upon completion all questionnaires were sealed in plain envelopes and returned to the Alcohol Research Group for analysis. These instruments included questions on self-reported alcohol-related knowledge, drinking habits, beliefs, attitudes, experiences and some aspects of the social context of drinking. Both the questionnaire and methodology were similar to those employed during a 1988/89 survey of teenagers in England [ 11,121. Data collection within each school was organized by teaching staff and by teenagers who had been selected to attend the Edinburgh conference. These individuals were provided with guidelines to ensure uniformity of data collection procedures. As noted earlier [ll] this strategy, though simple and inexpensive to implement, is not as rigorous as data collection supervised by a single research team. Before fieldwork was carried out all pupils aged 14-16 received from the Alcohol Research Group a standardized letter which was addressed to parents. The letter provided a brief description of the study together with assurances of anonymity and confidentiality. Parents who wished to exclude their children from the survey were requested to indicate this by completing and returning a form. This method of ‘contracting out’ had been used successfully in earlier studies (e.g. 4,8,11,12). Results
were female. The age distribution respondents is shown in Table I. Drinking
habits
Only 3% of those surveyed reported never having consumed alcohol. Approximately half had drunk in the previous two weeks. The recenalcohol consumption cy of self-reported (drinkers only) is shown by Table II. The sexes did not differ significantly in relation to the recency of their last reported alcohol consumption. Even so some significant sex differences did emerge in relation to reported companions on last drinking occasion. As Table III shows females were more likely than males to have last consumed alcohol with a mixed group of friends and were less likely than males to have last drunk with their parents. The teenagers in this survey, like those in earlier British studies, were more likely to report having last consumed alcohol in their own homes than in any other single type of location. This is shown in Table IV. Respondents were asked to record details of exactly what alcohol they had consumed on their most recent drinking occasion. These quantities were recorded in ‘units’. Each unit is equivalent to half a pint of ordinary beer, lager, cider or stout or to a single public house measure of spirits or to a single glass of wine. Each unit contains approximately 7.9 g or 1 cl of absolute alcohol. As Table V shows most respondents reported drinking only relatively modest quantities. Even so, 18.9% of males and 10.3% of females reported that on their last drinking occasion
Response
A total of 7009 questionnaires were completed. In addition 95 pupils or their parents (1.0%) refused to take part in the study. Twentyseven questionnaires (0.3%) were incomplete and 2141 pupils (23.1%) were absent from school or were otherwise unavailable for inclusion in the survey. The net response rate was 75.6%.
Age A total of 3521 (50.03%) of the study group
of
Table I.
Age
Age distribution. Males n
Females %
14 15
1625 1313
46.6 37.6
16
550
Total X2
3488
n
% 46.2 37.3
15.8
1625 1313 583
100.0%
3521
100.0%
= 0.81; d.f. = 2; NS.
16.6
205
Table II.
Recency of last drinking occasion (n = 6684).
Recency
Males n
Females %
?I,
%
Within last week 1-2 weeks ago 3-4 weeks ago 4 weeks-3 months ago Over 3 months ago
1062 675 455 364 770
31.9 20.3 13.7 10.9 23.2
996 697 472 403 790
29.7 20.8 14.1 12.0 23.5
Total
3326
100%
3358
100.1%
x2 = 4.87; d.f. = 4; NS.
The same authors also noted;
they had consumed at least eleven units, equivalent to 5.5 pints of beer. Self-report surveys of alcohol consumption are notoriously beset by underreporting and over-reporting (e.g. 4,9). The authors of an earlier British study of Adolescent Drinking [9] have commented on the difficulty of interpreting youthful self-reports of ‘heavy drinking’:
‘Some of these very high values undoubtedly contain a few spurious reports, particularly among the youngest respondents. A few questionnaires and diaries of this kind were taken out of the sample when returns were first inspected. Typically they were completed by young boys each of whom claimed to be drinking sufficient alcohol in a week to prove fatal to creatures larger than themselves’. [op cit. p. 311
‘Some of these will be spurious reports and some may be genuine. Some will be small exaggerations others large. A sceptical view seems the most appropriate although the presence of over-reported amounts in the data will almost certainly be balanced by much underreporting too’ . [p. 31)
Table III.
Companions on last drinking occasion (drinkers only, n = 6653).
Companions
Males n
Friends - both sexes Parents Friends - same sex Parents and others Parents and friends Friends - opposite sex Other relatives Other Drank alone Total
A similar problem emerged in relation to the present study. A minority of respondents reported having consumed quantities of alcohol which, though possible, were judged to be
916 540 924 362 153 110 181 33 98 3317
x2 = 115.5; d.f. = 8; P < 0.001.
Females %
n
W
27.6 16.3 27.9 10.9 4.6 3.3 5.5 1.0 3.0
1221 486 657 449 158 121 139 42 63
36.6 14.6 19.7 13.5 4.7 3.6 4.2 1.3 1.9
100.1%
3336
100.1%
206 Table IV.
Location of last drink (drinkers only; n = 6620). Females
Males
Location
%
n
n
%
Own home Pub, hotel, club, disco Friend’s home Out of doors Relative’s home Elsewhere
1012 534 544 653 260 285
30.8 16.2 16.5 19.9 7.9 8.7
1044 618 679 479 260 252
31.3 18.5 20.4 14.4 7.8 7.6
Total
3288
100.0%
3332
100.0%
x2 = 50.0; d.f. = 5; P < 0.001.
unlikely. Accordingly it was decided to exclude from the analysis self-reports of alcohol consumption exceeding 32 units on the last occasion. Such high reports were excluded from the data presented in Tables Via and VIb. The wisdom of this strategy may be disputed. It is emphasized that teenagers do sometimes drink very heavily. Even so the authors believe that, in the context of this particular study, this procedure reduced the likely level of exaggerated reporting. Details of last occasion’s alcohol consumption were used to classify respondents as ‘light’ and ‘heavy’ drinkers. For the purposes of this analysis the male ‘heavy drinkers’ were defined as those who reported imbibing 11 units or more.
Table V. Alcohol consumption (drinkers only). Units
on last drinking occasion
Males n
Females %
n
%
l-2 3-4 5-6 7-8 9-10 11 or more
1297 464 306 255 151 575
42.6 15.2 10.0 8.4 5.0 18.9
1574 610 258 234 90 317
51.1 19.8 8.4 7.6 2.9 10.3
Total
3048
100.1%
3083
100.1%
X2
= 141.4; d.f. = 5; P < 0.001.
Female ‘heavy drinkers’ were defined as those who had consumed 8 units or more. ‘Abstainers’ were defined as those who had never tasted alcohol. This is elaborated in Tables Via and VIb. As Table Via shows, there were significant differences between the proportions of respondents aged 14-16 who were classified as ‘heavy drinkers’. Amongst males these increased from 10.6% amongst those aged 14-22.5% amongst those aged 15. Amongst females the corresponding increase was from 11.4% amongst those aged 14-22.4% amongst those aged 15. The proportions of abstainers amongst both males and females fell by over 50% between the ages of 14 and 16. Beliefs about alcohol The study group were questioned on their beliefs about alcohol. Seventy-seven per cent of males and 79% of females agreed that eating along with alcohol slows down the effects of alcohol. Sixty-eight per cent of males and 68% of females correctly disagreed with the view that all beers contain about the same amount of alcohol. There was, however, a very slight but significant difference in the male and female responses to the view that ‘alcohol makes you more alert’. Ninety-five per cent of males and 93% of females did not agree with this view (x2 = 13.32; d.f. = 1; P < 0.001). Seventy-five per cent of males and 78% of females wrongly
207 Alcohol consumption
Table Via.
amongst males aged 14-16
Abstainers
Age
(n = 3184).
Light drinkers
Heavy drinkers
Total
12
%
n
%
n
%
n
%
14 15
66 30
4.5 2.5
1243 906
84.9 75.1
155 271
10.6 22.5
1464 1207
100% 100%
16
11
2.1
389
75.8
113
22.0
513
100%
x2 =
84.35: d.f. = 4; P < 0.001.
Table VIb.
Age
14 15 16
Alcohol consumption
Abstainers
amongst females aged 14-16
(n = 3234).
Light drinkers
Heavy drinkers
Total
n
%
12
%
n
%
n
YO
85 22 11
5.9 1.8 2.0
1197 932 441
82.7 75.8 79.2
165 276 105
11.4 22.4 18.9
1447 1230 5.57
100% 100% 100%
x2 = 89.14; d.f. = 4; P < 0.001.
reported that a single whisky is stronger than a pint of beer (x2 = 5.60; d.f. = 1; P < 0.05). Thirty-eight per cent of males and 31% of females wrongly reported that a glass of table wine contains more alcohol than half a pint of cider (x2 = 18.23; d.f. = 1; P < 0.001). Twenty-
Table VII. Preferred alcoholic drinks. Preferred
minimum legal age for purchasing
Males
Females
Drinking
age 12 14 or younger 15 16 17 18 19 20 21 or older Don’t know Total X2
seven per cent of males asserted that in their view it was safe to drive after one or two drinks as opposed to only 15% of females who took this view (x2 = 119.22; d.f. = 1; P < 0.001). (All the percentages relating to beliefs about alcohol excluded the category of those who said they did not know). Respondents were asked about their preferences for the legal age of alcohol purchase in the United Kingdom. This is currently 18. Most favoured a slight reduction. This is elaborated in Table VII.
170 279 1358 347 855 63 112 192 71 3447
%
n
%
4.9 8.1 39.4 10.1 24.8 1.8 3.2 5.6 2.1
211 1379 343 1022 65 125 158 122
1.7 6.1 39.6 9.8 29.3 1.9 3.6 4.5 3.5
100.0%
3486
100.0%
= 93.22; d.f. = 8; P < 0.001.
61
and driving
The teenagers were asked to indicate how many drinks it was ‘safe’ for a male and female to consume before driving. The overall pattern of responses is shown by Tables VIIIa and VIIIb. The mean alcohol level which was assessed by males to be safe for women drivers to drink was 1.67 drinks, the mean level assessed by females to be safe for women drivers to drink was slightly but significantly less - 1.32 drinks (t = 11.03; P < 0.001). The mean level assessed safe by males for men drivers to drink was 2.28 drinks and again the
208 ‘Safe’ levels of alcohol consumption
Table VIIIa. female driver.
Females
Males
Quantities of alcohol
Table VIIIb. male driver.
for a
n
n
%
Quantities of alcohol
‘Safe’ levels of alcohol consumption
Males n
%
No alcohol 1-2 drinks 3-4 drinks 5-6 drinks 7 drinks or more Don’t know
574 1918 557 32 50
16.9 56.3 16.4 0.9 1.5
902 1844 406 18 12
26.1 53.3 11.7 0.6 0.3
275
8.1
276
8.0
Total
3406
100.1%
3458
100.0%
for a
Females %
n
%
No alcohol l-2 drinks 3-4 drinks 5-6 drinks 7 drinks or more Don’t know
528 1339 1035 169 100
15.5 39.4 30.4 5.0 2.9
863 1365 859 100 13
24.9 39.4 24.8 2.9 0.4
232
6.8
249
7.5
Total
3403
100.0%
3459
99.9%
x2 = 124.85; d.f. = 5; P < 0.001.
x2 = 183.00; d.f. = 5; P < 0.001.
mean level assessed safe by females for men drivers to drink was significantly less - 1.75 drinks (t = 13.23; P c 0.001).
again those whose self-reports of consumption on the last occasion exceeded 32 units were excluded. The results are shown in Tables IXa and IXb. The comparison of the data in Tables IXa and IXb with those in Tables Via and VIb revealed that both amongst males and females, there was a markedly higher proportion of ‘heavy drinkers’ amongst the Scottish teenagers than amongst their counterparts in England.
Comparison with English teenagers An analysis on the same lines as that done for the Scottish schools by ‘heavy’ and ‘light’ drinkers and abstainers was carried out on data from an earlier study of English teenagers [11,12]. The same criteria were applied, and
Table IXa.
Alcohol consumption
Age
Abstainers
14 15 16
amongst males aged 14-16 in English schools survey (n = 2718). Light drinkers
Heavy drinkers
Total
n
%
n
90
n
%
n
%
49 60 15
5.0 4.4 4.2
889 1183 292
89.9 86.0 82.7
51 133 46
5.2 9.7 13.0
989 1376 353
100% 100% 100%
x2 = 26.22; d.f. = 4; P < 0.001. Table IXb.
Alcohol consumption
Age
Abstainers
14 15 16
n 47 65 10
amongst females aged 14-16 in English schools survey (n = 3087). Light drinkers
Heavy drinkers
%
n
%
n
%
n
%
4.4 4.0 2.4
947 1387 339
88.6 86.3 82.7
75 156 61
7.0 9.7 14.9
1069 1608 410
100% 100% 100%
x2 = 23.75; d.f. = 4; P < 0.001.
Total
209
Conclusions
and Discussion
These findings confirm other evidence indicating that most British teenagers do consume alcohol, but do so in moderation [e.g. 4,8-121. Equally important, it is also clear from these results that, even taking into account a degree of exaggeration and inaccuracy, a substantial older minority of teenagers, especially teenagers, drink heavily. A comparison of these Scottish data with a similar English survey [ 11,121 indicated that these Scottish teenagers were markedly more likely to drink heavily than were their English peers. Further comparison of these two similar studies also indicated that teenagers in Scotland were less likely than those in England to drink frequently. These national differences are broadly similar to those noted earlier by Marsh et al. [9]. In relation to a number of knowledge items the Scottish teenagers were slightly better informed than those in England. Available information indicates that drinking habits amongst adolescents and young adults in Britain have remained relatively stable during the past decade [4,9,14,15]. Alcohol misuse amongst the young is a chronic problem, both in Britain and in many other countries. Youthful heavy drinkers are especially likely to indulge in other ‘risky’ or ‘deviant’ activities. These involve tobacco smoking, illicit drug use, truancy and unprotected sex [4,16,17]. Risk taking to a degree is normal youthful behaviour. Heavy drinking and other potentially harmful activities are fostered by strong peer pressure amongst some subgroups of adolescents and young people. As noted by Bagnall [18] and by other researchers, past health education in relation to alcohol and illicit drug use has produced at best only very modest results. This survey adds weight to earlier evidence [ll] that many young adults drink in licensed premises before they are legally old enough to do so. In addition, most of those surveyed favoured a reduction in the legal minimum age of alcohol purchase. A law is a bad one if not enforced and widely flouted. At present there appears to be little general public support for reducing this age limit. At the same
time there is clearly political public concern about youthful alcohol misuse [e.g. 5,7]. It is evident that ‘under age drinking’, though not in itself a form of alcohol misuse, is endemic in Britain. This situation appears to be widely tolerated both by parents, politicians, licensees and the police. Very few people in Britain are convicted for under age purchase or consumption of alcohol or for selling alcohol to minors [19]. Practical inaction in this regard fails to mirror public rhetoric. Acknowledgements This study was funded by the Scotch Whisky Association with additional support from the Portman Group. The survey was planned and conducted with the help and cooperation of Mr. Richard Grindal (the Scotch Whisky Association), Mr. Nicholas Atkinson, Mr. Alistair Donaldson, Mr. James Lonie, Mr. Alan Owenson, Mrs. Moira MacFarlane, Mr. Michael Rhodes (Scottish Office Education Department), Dr. Alistair Noble and Mr. Ian Young (Health Education Board for Scotland, formerly the Scottish Health Education Group). In addition Mrs. Gellisse Bagnall, Mrs. Sheila McLennan and Mrs. Janis Nichol of the Alcohol Research Group are thanked for assistance with implementing this study. References Davies, J.B. and Stacey, B. (1972) Teenagers and Alcohol, London, HMSO. Aitken, P.P. (1978) Ten-To-Fourteen Year Olds and Alcohol, Edinburgh, HMSO. Hawker, A. (1978) Adolescents and Alcohol, Edsall, London. Plant, M.A., Peck, D.F. and Samuel, F. (1986) Alcohol, Drugs and School-leavers, Tavistock, London. British Medical Association Young People and Alcohol. British Medical Association, London, 1986. Balding, J. (1987) Young People in 1986, Health Education Authority, Health Education Unit, University of Exeter. Home Office Young People and Alcohol, Home Office, London, 1987. Bagnall, G. (1988) ‘Use of alcohol, tobacco and illicit drugs amongst 13 year-old in three areas of Britain. Drug Alcohol Depend. 22, 241.
210 9 10
11
12
13
Marsh, A., Dobbs, J. and White, A. (1986) Adolescent Drinking, HMSO, London. Ghodsian, M. and Power, C. (1987) ‘Alcohol consumption between the ages of 16 and 23 in Britain: a longitudinal study’. Br. J. Addict. 82, 175. Plant, M.A., Bagnall, G., Foster J. and Sales, J. (1990) ‘Young people and drinking: results of an English national survey’. Alcohol Alcoholism 6, 685. Plant, M.A., Bagnall, G. and Foster, J. (1990) ‘Teenage heavy drinkers: alcohol-related knowledge, beliefs, experiences, motivation and the social context of drinking’. Alcohol Alcoholism 6, 691. Kirkwood, B.R. (1988) Essentials of Medical Statistics, Blackwell Scientific Publications, Oxford.
14 15
16
17 18 19
Goddard, E. and Ikin, C. (1988) Drinking in England and Wales 1987, HMSO, London. Duffy, J.C. (1991) Trends in Alcohol Consumption Patterns 1978-1989, NTC Publications, Henley on Thames. Jessor, R. and Jessor, S.C. (1977) Problem Behaviour and Psychosocial Development: A longitudinal study of youth, Academic Press, New York. Plant, M.A. and Plant, M.L. (1991) Risk-Takers, Tavistock/Routledge, London (in press). Bagnall, G. (1991) Educating Young Drinkers, Tavistock/Routledge, London. Home Office, Offences in Drunkenness in England and Wales 1989, Statistical Bulletin 40190, Home Office, London.
Elsevier Scientific Publishers
28 (1991) 203-210 Ireland Ltd.
203
Teenagers and alcohol: results of a Scottish national survey Martin A. Plant and Jean Foster Alcohol Research
Group, Department
of Psychiatry,
University of Edinburgh, Scotland (U.K.)
Morningside
Park, Edanburgh EHlO 5HF.
(Received April li’th, 1991)
During 1990 a survey was conducted of the self-reported drinking habits and alcohol-related knowledge and beliefs of a national sample of 7009 Scottish teenagers. The study group were age 14-16. Results indicated that only 3% of respondents had never consumed alcohol. The great majority of teenagers reported consuming only moderate quantities of alcohol. Even so 18.9% of males and 10.3% of females reported consuming 11 or more units on their last drinking occasion. The proportion of teenagers classified as ‘heavy drinkers’ increased markedly between the ages of 14 and 16. This study confirmed earlier findings indicating that Scottish teenagers are more likely than those in England to drink heavily and rather less frequently. Key words: alcohol consumption;
drinking habits; teenagers;
Introduction The use and misuse of alcohol by teenagers is firmly established as a focus for public concern [eg. l-81. Even so British surveys have only attempted to elicit detailed self-reports of alcohol consumption by young people during the past 15 years. Only a relatively small number of such self-report surveys have been conducted in Britain and even fewer of these have related to national samples [9- 121. A conference was arranged to provide a forum for Scottish teenagers to discuss topics related to alcohol and young people. This event, which was organized by the Scottish Office Education Department and the Scotch Whisky Association, was held in Edinburgh in November 1990. As a prelude to this meeting a survey was undertaken to provide some basic information on the self-reported drinking habits and alcohol-related experiences of beliefs, motivations and Correspondence
to: Martin A. Plant, Alcohol Research Group, Department of Psychiatry, University of Edinburgh, Morningside Park, Edinburgh EHlO 5HF, Scotland, U.K.
03768716/91/$03.50 0 1991 Elsevier Scientific Publishers Printed and Published in Ireland
Scotland
teenagers attending schools which were selected to participate in the conference. This paper describes some of the results of this study. Method A total of 25 state secondary (high) schools in Scotland were selected. A stratified random procedure ensured that each region of Scotland was included and that the number of schools selected within each region was weighted in accordance with the total number of schools therein. Individual schools were selected from alphabetical lists of schools within each region using a random number table (131. Small rural schools were excluded from this study, as were schools which had recently been, or were currently, involved with other health related surveys. These constraints ensured that the selected sample did not give due weight to small schools. A total of 25 schools were selected of which 23 took part in the survey. Fieldwork for the survey was conducted between February and May 1990. This paper relates to information elicited from pupils aged 14-16 in the 23 Ireland Ltd.
204
cooperating schools. Data were obtained by the completion of a short standardized anonymous questionnaire filled in by respondents during school hours under the supervision of teaching staff. The questionnaire took between 15 and 30 min to fill in. Upon completion all questionnaires were sealed in plain envelopes and returned to the Alcohol Research Group for analysis. These instruments included questions on self-reported alcohol-related knowledge, drinking habits, beliefs, attitudes, experiences and some aspects of the social context of drinking. Both the questionnaire and methodology were similar to those employed during a 1988/89 survey of teenagers in England [ 11,121. Data collection within each school was organized by teaching staff and by teenagers who had been selected to attend the Edinburgh conference. These individuals were provided with guidelines to ensure uniformity of data collection procedures. As noted earlier [ll] this strategy, though simple and inexpensive to implement, is not as rigorous as data collection supervised by a single research team. Before fieldwork was carried out all pupils aged 14-16 received from the Alcohol Research Group a standardized letter which was addressed to parents. The letter provided a brief description of the study together with assurances of anonymity and confidentiality. Parents who wished to exclude their children from the survey were requested to indicate this by completing and returning a form. This method of ‘contracting out’ had been used successfully in earlier studies (e.g. 4,8,11,12). Results
were female. The age distribution respondents is shown in Table I. Drinking
habits
Only 3% of those surveyed reported never having consumed alcohol. Approximately half had drunk in the previous two weeks. The recenalcohol consumption cy of self-reported (drinkers only) is shown by Table II. The sexes did not differ significantly in relation to the recency of their last reported alcohol consumption. Even so some significant sex differences did emerge in relation to reported companions on last drinking occasion. As Table III shows females were more likely than males to have last consumed alcohol with a mixed group of friends and were less likely than males to have last drunk with their parents. The teenagers in this survey, like those in earlier British studies, were more likely to report having last consumed alcohol in their own homes than in any other single type of location. This is shown in Table IV. Respondents were asked to record details of exactly what alcohol they had consumed on their most recent drinking occasion. These quantities were recorded in ‘units’. Each unit is equivalent to half a pint of ordinary beer, lager, cider or stout or to a single public house measure of spirits or to a single glass of wine. Each unit contains approximately 7.9 g or 1 cl of absolute alcohol. As Table V shows most respondents reported drinking only relatively modest quantities. Even so, 18.9% of males and 10.3% of females reported that on their last drinking occasion
Response
A total of 7009 questionnaires were completed. In addition 95 pupils or their parents (1.0%) refused to take part in the study. Twentyseven questionnaires (0.3%) were incomplete and 2141 pupils (23.1%) were absent from school or were otherwise unavailable for inclusion in the survey. The net response rate was 75.6%.
Age A total of 3521 (50.03%) of the study group
of
Table I.
Age
Age distribution. Males n
Females %
14 15
1625 1313
46.6 37.6
16
550
Total X2
3488
n
% 46.2 37.3
15.8
1625 1313 583
100.0%
3521
100.0%
= 0.81; d.f. = 2; NS.
16.6
205
Table II.
Recency of last drinking occasion (n = 6684).
Recency
Males n
Females %
?I,
%
Within last week 1-2 weeks ago 3-4 weeks ago 4 weeks-3 months ago Over 3 months ago
1062 675 455 364 770
31.9 20.3 13.7 10.9 23.2
996 697 472 403 790
29.7 20.8 14.1 12.0 23.5
Total
3326
100%
3358
100.1%
x2 = 4.87; d.f. = 4; NS.
The same authors also noted;
they had consumed at least eleven units, equivalent to 5.5 pints of beer. Self-report surveys of alcohol consumption are notoriously beset by underreporting and over-reporting (e.g. 4,9). The authors of an earlier British study of Adolescent Drinking [9] have commented on the difficulty of interpreting youthful self-reports of ‘heavy drinking’:
‘Some of these very high values undoubtedly contain a few spurious reports, particularly among the youngest respondents. A few questionnaires and diaries of this kind were taken out of the sample when returns were first inspected. Typically they were completed by young boys each of whom claimed to be drinking sufficient alcohol in a week to prove fatal to creatures larger than themselves’. [op cit. p. 311
‘Some of these will be spurious reports and some may be genuine. Some will be small exaggerations others large. A sceptical view seems the most appropriate although the presence of over-reported amounts in the data will almost certainly be balanced by much underreporting too’ . [p. 31)
Table III.
Companions on last drinking occasion (drinkers only, n = 6653).
Companions
Males n
Friends - both sexes Parents Friends - same sex Parents and others Parents and friends Friends - opposite sex Other relatives Other Drank alone Total
A similar problem emerged in relation to the present study. A minority of respondents reported having consumed quantities of alcohol which, though possible, were judged to be
916 540 924 362 153 110 181 33 98 3317
x2 = 115.5; d.f. = 8; P < 0.001.
Females %
n
W
27.6 16.3 27.9 10.9 4.6 3.3 5.5 1.0 3.0
1221 486 657 449 158 121 139 42 63
36.6 14.6 19.7 13.5 4.7 3.6 4.2 1.3 1.9
100.1%
3336
100.1%
206 Table IV.
Location of last drink (drinkers only; n = 6620). Females
Males
Location
%
n
n
%
Own home Pub, hotel, club, disco Friend’s home Out of doors Relative’s home Elsewhere
1012 534 544 653 260 285
30.8 16.2 16.5 19.9 7.9 8.7
1044 618 679 479 260 252
31.3 18.5 20.4 14.4 7.8 7.6
Total
3288
100.0%
3332
100.0%
x2 = 50.0; d.f. = 5; P < 0.001.
unlikely. Accordingly it was decided to exclude from the analysis self-reports of alcohol consumption exceeding 32 units on the last occasion. Such high reports were excluded from the data presented in Tables Via and VIb. The wisdom of this strategy may be disputed. It is emphasized that teenagers do sometimes drink very heavily. Even so the authors believe that, in the context of this particular study, this procedure reduced the likely level of exaggerated reporting. Details of last occasion’s alcohol consumption were used to classify respondents as ‘light’ and ‘heavy’ drinkers. For the purposes of this analysis the male ‘heavy drinkers’ were defined as those who reported imbibing 11 units or more.
Table V. Alcohol consumption (drinkers only). Units
on last drinking occasion
Males n
Females %
n
%
l-2 3-4 5-6 7-8 9-10 11 or more
1297 464 306 255 151 575
42.6 15.2 10.0 8.4 5.0 18.9
1574 610 258 234 90 317
51.1 19.8 8.4 7.6 2.9 10.3
Total
3048
100.1%
3083
100.1%
X2
= 141.4; d.f. = 5; P < 0.001.
Female ‘heavy drinkers’ were defined as those who had consumed 8 units or more. ‘Abstainers’ were defined as those who had never tasted alcohol. This is elaborated in Tables Via and VIb. As Table Via shows, there were significant differences between the proportions of respondents aged 14-16 who were classified as ‘heavy drinkers’. Amongst males these increased from 10.6% amongst those aged 14-22.5% amongst those aged 15. Amongst females the corresponding increase was from 11.4% amongst those aged 14-22.4% amongst those aged 15. The proportions of abstainers amongst both males and females fell by over 50% between the ages of 14 and 16. Beliefs about alcohol The study group were questioned on their beliefs about alcohol. Seventy-seven per cent of males and 79% of females agreed that eating along with alcohol slows down the effects of alcohol. Sixty-eight per cent of males and 68% of females correctly disagreed with the view that all beers contain about the same amount of alcohol. There was, however, a very slight but significant difference in the male and female responses to the view that ‘alcohol makes you more alert’. Ninety-five per cent of males and 93% of females did not agree with this view (x2 = 13.32; d.f. = 1; P < 0.001). Seventy-five per cent of males and 78% of females wrongly
207 Alcohol consumption
Table Via.
amongst males aged 14-16
Abstainers
Age
(n = 3184).
Light drinkers
Heavy drinkers
Total
12
%
n
%
n
%
n
%
14 15
66 30
4.5 2.5
1243 906
84.9 75.1
155 271
10.6 22.5
1464 1207
100% 100%
16
11
2.1
389
75.8
113
22.0
513
100%
x2 =
84.35: d.f. = 4; P < 0.001.
Table VIb.
Age
14 15 16
Alcohol consumption
Abstainers
amongst females aged 14-16
(n = 3234).
Light drinkers
Heavy drinkers
Total
n
%
12
%
n
%
n
YO
85 22 11
5.9 1.8 2.0
1197 932 441
82.7 75.8 79.2
165 276 105
11.4 22.4 18.9
1447 1230 5.57
100% 100% 100%
x2 = 89.14; d.f. = 4; P < 0.001.
reported that a single whisky is stronger than a pint of beer (x2 = 5.60; d.f. = 1; P < 0.05). Thirty-eight per cent of males and 31% of females wrongly reported that a glass of table wine contains more alcohol than half a pint of cider (x2 = 18.23; d.f. = 1; P < 0.001). Twenty-
Table VII. Preferred alcoholic drinks. Preferred
minimum legal age for purchasing
Males
Females
Drinking
age 12 14 or younger 15 16 17 18 19 20 21 or older Don’t know Total X2
seven per cent of males asserted that in their view it was safe to drive after one or two drinks as opposed to only 15% of females who took this view (x2 = 119.22; d.f. = 1; P < 0.001). (All the percentages relating to beliefs about alcohol excluded the category of those who said they did not know). Respondents were asked about their preferences for the legal age of alcohol purchase in the United Kingdom. This is currently 18. Most favoured a slight reduction. This is elaborated in Table VII.
170 279 1358 347 855 63 112 192 71 3447
%
n
%
4.9 8.1 39.4 10.1 24.8 1.8 3.2 5.6 2.1
211 1379 343 1022 65 125 158 122
1.7 6.1 39.6 9.8 29.3 1.9 3.6 4.5 3.5
100.0%
3486
100.0%
= 93.22; d.f. = 8; P < 0.001.
61
and driving
The teenagers were asked to indicate how many drinks it was ‘safe’ for a male and female to consume before driving. The overall pattern of responses is shown by Tables VIIIa and VIIIb. The mean alcohol level which was assessed by males to be safe for women drivers to drink was 1.67 drinks, the mean level assessed by females to be safe for women drivers to drink was slightly but significantly less - 1.32 drinks (t = 11.03; P < 0.001). The mean level assessed safe by males for men drivers to drink was 2.28 drinks and again the
208 ‘Safe’ levels of alcohol consumption
Table VIIIa. female driver.
Females
Males
Quantities of alcohol
Table VIIIb. male driver.
for a
n
n
%
Quantities of alcohol
‘Safe’ levels of alcohol consumption
Males n
%
No alcohol 1-2 drinks 3-4 drinks 5-6 drinks 7 drinks or more Don’t know
574 1918 557 32 50
16.9 56.3 16.4 0.9 1.5
902 1844 406 18 12
26.1 53.3 11.7 0.6 0.3
275
8.1
276
8.0
Total
3406
100.1%
3458
100.0%
for a
Females %
n
%
No alcohol l-2 drinks 3-4 drinks 5-6 drinks 7 drinks or more Don’t know
528 1339 1035 169 100
15.5 39.4 30.4 5.0 2.9
863 1365 859 100 13
24.9 39.4 24.8 2.9 0.4
232
6.8
249
7.5
Total
3403
100.0%
3459
99.9%
x2 = 124.85; d.f. = 5; P < 0.001.
x2 = 183.00; d.f. = 5; P < 0.001.
mean level assessed safe by females for men drivers to drink was significantly less - 1.75 drinks (t = 13.23; P c 0.001).
again those whose self-reports of consumption on the last occasion exceeded 32 units were excluded. The results are shown in Tables IXa and IXb. The comparison of the data in Tables IXa and IXb with those in Tables Via and VIb revealed that both amongst males and females, there was a markedly higher proportion of ‘heavy drinkers’ amongst the Scottish teenagers than amongst their counterparts in England.
Comparison with English teenagers An analysis on the same lines as that done for the Scottish schools by ‘heavy’ and ‘light’ drinkers and abstainers was carried out on data from an earlier study of English teenagers [11,12]. The same criteria were applied, and
Table IXa.
Alcohol consumption
Age
Abstainers
14 15 16
amongst males aged 14-16 in English schools survey (n = 2718). Light drinkers
Heavy drinkers
Total
n
%
n
90
n
%
n
%
49 60 15
5.0 4.4 4.2
889 1183 292
89.9 86.0 82.7
51 133 46
5.2 9.7 13.0
989 1376 353
100% 100% 100%
x2 = 26.22; d.f. = 4; P < 0.001. Table IXb.
Alcohol consumption
Age
Abstainers
14 15 16
n 47 65 10
amongst females aged 14-16 in English schools survey (n = 3087). Light drinkers
Heavy drinkers
%
n
%
n
%
n
%
4.4 4.0 2.4
947 1387 339
88.6 86.3 82.7
75 156 61
7.0 9.7 14.9
1069 1608 410
100% 100% 100%
x2 = 23.75; d.f. = 4; P < 0.001.
Total
209
Conclusions
and Discussion
These findings confirm other evidence indicating that most British teenagers do consume alcohol, but do so in moderation [e.g. 4,8-121. Equally important, it is also clear from these results that, even taking into account a degree of exaggeration and inaccuracy, a substantial older minority of teenagers, especially teenagers, drink heavily. A comparison of these Scottish data with a similar English survey [ 11,121 indicated that these Scottish teenagers were markedly more likely to drink heavily than were their English peers. Further comparison of these two similar studies also indicated that teenagers in Scotland were less likely than those in England to drink frequently. These national differences are broadly similar to those noted earlier by Marsh et al. [9]. In relation to a number of knowledge items the Scottish teenagers were slightly better informed than those in England. Available information indicates that drinking habits amongst adolescents and young adults in Britain have remained relatively stable during the past decade [4,9,14,15]. Alcohol misuse amongst the young is a chronic problem, both in Britain and in many other countries. Youthful heavy drinkers are especially likely to indulge in other ‘risky’ or ‘deviant’ activities. These involve tobacco smoking, illicit drug use, truancy and unprotected sex [4,16,17]. Risk taking to a degree is normal youthful behaviour. Heavy drinking and other potentially harmful activities are fostered by strong peer pressure amongst some subgroups of adolescents and young people. As noted by Bagnall [18] and by other researchers, past health education in relation to alcohol and illicit drug use has produced at best only very modest results. This survey adds weight to earlier evidence [ll] that many young adults drink in licensed premises before they are legally old enough to do so. In addition, most of those surveyed favoured a reduction in the legal minimum age of alcohol purchase. A law is a bad one if not enforced and widely flouted. At present there appears to be little general public support for reducing this age limit. At the same
time there is clearly political public concern about youthful alcohol misuse [e.g. 5,7]. It is evident that ‘under age drinking’, though not in itself a form of alcohol misuse, is endemic in Britain. This situation appears to be widely tolerated both by parents, politicians, licensees and the police. Very few people in Britain are convicted for under age purchase or consumption of alcohol or for selling alcohol to minors [19]. Practical inaction in this regard fails to mirror public rhetoric. Acknowledgements This study was funded by the Scotch Whisky Association with additional support from the Portman Group. The survey was planned and conducted with the help and cooperation of Mr. Richard Grindal (the Scotch Whisky Association), Mr. Nicholas Atkinson, Mr. Alistair Donaldson, Mr. James Lonie, Mr. Alan Owenson, Mrs. Moira MacFarlane, Mr. Michael Rhodes (Scottish Office Education Department), Dr. Alistair Noble and Mr. Ian Young (Health Education Board for Scotland, formerly the Scottish Health Education Group). In addition Mrs. Gellisse Bagnall, Mrs. Sheila McLennan and Mrs. Janis Nichol of the Alcohol Research Group are thanked for assistance with implementing this study. References Davies, J.B. and Stacey, B. (1972) Teenagers and Alcohol, London, HMSO. Aitken, P.P. (1978) Ten-To-Fourteen Year Olds and Alcohol, Edinburgh, HMSO. Hawker, A. (1978) Adolescents and Alcohol, Edsall, London. Plant, M.A., Peck, D.F. and Samuel, F. (1986) Alcohol, Drugs and School-leavers, Tavistock, London. British Medical Association Young People and Alcohol. British Medical Association, London, 1986. Balding, J. (1987) Young People in 1986, Health Education Authority, Health Education Unit, University of Exeter. Home Office Young People and Alcohol, Home Office, London, 1987. Bagnall, G. (1988) ‘Use of alcohol, tobacco and illicit drugs amongst 13 year-old in three areas of Britain. Drug Alcohol Depend. 22, 241.
210 9 10
11
12
13
Marsh, A., Dobbs, J. and White, A. (1986) Adolescent Drinking, HMSO, London. Ghodsian, M. and Power, C. (1987) ‘Alcohol consumption between the ages of 16 and 23 in Britain: a longitudinal study’. Br. J. Addict. 82, 175. Plant, M.A., Bagnall, G., Foster J. and Sales, J. (1990) ‘Young people and drinking: results of an English national survey’. Alcohol Alcoholism 6, 685. Plant, M.A., Bagnall, G. and Foster, J. (1990) ‘Teenage heavy drinkers: alcohol-related knowledge, beliefs, experiences, motivation and the social context of drinking’. Alcohol Alcoholism 6, 691. Kirkwood, B.R. (1988) Essentials of Medical Statistics, Blackwell Scientific Publications, Oxford.
14 15
16
17 18 19
Goddard, E. and Ikin, C. (1988) Drinking in England and Wales 1987, HMSO, London. Duffy, J.C. (1991) Trends in Alcohol Consumption Patterns 1978-1989, NTC Publications, Henley on Thames. Jessor, R. and Jessor, S.C. (1977) Problem Behaviour and Psychosocial Development: A longitudinal study of youth, Academic Press, New York. Plant, M.A. and Plant, M.L. (1991) Risk-Takers, Tavistock/Routledge, London (in press). Bagnall, G. (1991) Educating Young Drinkers, Tavistock/Routledge, London. Home Office, Offences in Drunkenness in England and Wales 1989, Statistical Bulletin 40190, Home Office, London.