The Bergen Clinics Foundation, Box 297, 5804 Bergen and University of Sport and Physical Education, Oslo,
1 Department of Health and Social Science, Lillehammer College and Institute of Psychology, Trondheim, Norway,
2 Oxford Centre for Health Research & Development, Oxford Brookes University, Oxford, UK,
3 Institute for Science in Sport, Norwegian University of Science and Technology, Trondheim and
4 Vestmo Treatment Centre for Substance Abuse, Ålesund, Norway
Received 27 November 2000; in revised form 19 June 2001; accepted 25 July 2001
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ABSTRACT |
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INTRODUCTION |
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The ESPAD studies in 1995 and 1999 are the most detailed and comprehensive contemporary studies of European teenagers, but somewhat surprisingly, no data on variables related to age of alcohol debut were presented. Age of alcohol debut is related to adult alcohol consumption and several studies have documented that an early debut is associated with later elevated alcohol consumption, problem drinking or health and social problems associated with increased drinking (Margulis et al., 1977; Stacy and Elvy, 1982; Clapper and Lipsitt, 1992
; Single and Wortly, 1993
). More recently, in their longitudinal study, Pedersen and Skrondal (1998) found alcohol debut to be an excellent predictor of subsequent alcohol consumption and alcohol problems. Employing structural equation modelling, they found that a 10% delay in debut age would lead to a 35% decrease in subsequent expected alcohol consumption. Thus, from a public health point of view, factors associated with early alcohol debut apparently warrant more research attention.
Generally, when discussing determinants of young adolescents' drinking habits, several investigators have acknowledged the importance of family socialization (e.g. Barnes et al., 1986; Weber et al., 1989
; Barnes, 1990
; Foxcroft and Lowe, 1991
; Miller, 1997
; Miller and Plant, 1999
). For example, Barnes et al. (1986) and Barnes (1990) found that adolescents' drinking was partly explained by parental models of drinking behaviour. Heavier drinking parents were more likely than other parents to have adolescents who were also heavy drinkers. Miller (1997) also found adolescents living in single-parent families, especially girls, more likely to have either tried, or to have frequently used, drugs. Based on a considerable amount of literature on the influence of family factors on young adolescents' drinking patterns in combination with theoretical work on the sociology of family by Parsons (1963), Barnes (1990) later constructed a comprehensive model of factors influencing adolescents' drinking behaviour. The most important family factors described by Barnes (1990) were family support and control in addition to parental models of drinking. Lamborn et al. (1991) also found that adolescents from indulgent homes had a strong sense of self-confidence, but reported a higher frequency of substance misuse, school misconduct and less school engagement.
Another important socialization domain, largely neglected in studies on drinking debut, is the sports domain (Edwards, 1973; McPherson et al., 1989
). Most teenagers are engaged in a number of sports such as European football (or soccer; hereafter denoted football), handball, golf, swimming etc. For instance, in the authors' home country (Norway) 44% of the children and youth aged 824 years are actively engaged in organized sports and are members of the Norwegian Olympic Committee and Confederation of Sports (NOCCS), actually one of the largest private organizations in Norway. The highest percentages most active are found in the 811 and 1215 year groups also the most relevant age groups in terms of alcohol debut. One of the declared aims of the NOCCS is to promote a healthy life-style, including sensible or no use of alcoholic drinks: the separate sports organizations within the NOCCS have strict rules for drinking in sports contexts. In addition to social norms and rules of conduct, sports organizations are also aware that alcohol has several detrimental effects upon human physiology, most notably energy metabolism, the vascular and muscular systems and functional integrity of the nervous system. These general systemic effects are clearly acting against the primary aims of athletic training: increased strength, endurance, speed and precision of athletic tasks. Thus, teenagers engaged in organized sports might have a later onset of drinking, compared to teenagers not engaged in sports. On the other hand, several studies have documented considerable alcohol consumption among sports participants (O'Brian, 1993
; Pedersen, 1993
; Anderssen et al., 1994
; Watten, 1995
; Bu, 1999), which again might reflect specific social norms in certain sports groups (McPherson et al., 1989
). However, keeping in mind the extensive global network organized sports represent, the impact of this large social domain upon alcohol debut should be more closely investigated.
The current study investigated the alcohol and intoxication debut age in a large, nationwide sample of young Norwegian adolescents of both sexes in terms of age when they first drank alcohol and the age when they reported being drunk for the first time. In addition to the relation between alcohol debut and sociodemographic variables, we investigated the impact of perceived parental and peer group drinking habits, family socialization factors and participation in organized sports activities. We also examined differences in current alcohol consumption between groups with early, compared to those with late, alcohol debut.
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MATERIALS AND METHODS |
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Measures
Drinking behaviour, sociodemographic factors and family variables were measured using the Adolescent Drinking and Family Life Questionnaire (ADFLQ) (Foxcroft and Lowe, 1991, 1992
). Using established translation methods (Sartorius and Kuyken, 1994
), the ADFLQ was independently translated into Norwegian and back-translated, and any discrepancies were discussed and resolved. The ADFLQ was completed in a classroom setting with a teacher present.
Demographic variables included age, gender, family composition, and living area: (1) living in or nearby a town (more than 100 000 people); (2) a small town (less than 100 000 people), and (3) in the countryside.
Alcohol debut was measured on a 5-point interval scale: (1) younger than 8 years; (2) 810 years; (3) 1113 years; (4) 1416 years; (5) have never tasted alcohol. Intoxication debut was registered according to the same interval scale as alcohol debut.
Family socialization was assessed using the Family Life Questionnaire section of the ADFLQ, a 69-item instrument assessing family life as perceived by the adolescents. There are three main scales: (1) family support; (2) family control; (3) family organization. The support scale consists of 20 items (e.g. in my family we really help and support one another; Cronbach's alpha: 0.88), the control scale consists of 14 items (e.g. it's important to follow rules in my family' Cronbach's alpha: 0.88) and the organization scale consists of five items (e.g. In my own family we make sure our rooms are neat and tidy; Cronbach's alpha: 0.88). The respondents indicated whether they strongly agreed (4) or strongly disagreed (1) with each item.
Statistical analyses
Predictors of age for alcohol and intoxication debut were investigated with logistic regression analyses in a forced entry forward step procedure. The dependent variables (alcohol and intoxication debut) were debut age dichotomized as <14 years and 14 years. Logistic regression analysis was undertaken in order to investigate the association between the dependent variables and the independent variables (family socialization, family integration, siblings, parents' and peers' drinking behaviour and attitudes towards drinking, place of residence and sports participation). The independent variables were entered in one block, employing a forward step procedure based on the Wald statistic. After entry one-by-one into the model, the variables were tested for removal according to the significance of the likelihood-ratio criterion. The variable with the largest probability greater than the specified POUT (probability of F to remove) value was removed and the model was re-estimated and evaluated for removal. The testing procedure was stopped when no more variables met the removal criteria.
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RESULTS |
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Figures 3 and 4 depict the distribution of drinking throughout the whole week for subjects with early and late drinking (Fig. 3
) and intoxication (Fig. 4
) debut, respectively. There was a significantly higher percentage of teenagers with early drinking debut who reported drinking through the week, compared to adolescents with later debut. Most drinking occurred at the weekend, specifically on Friday and Saturday.
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Table 4 presents the results from logistic regression analyses and shows the predictors of early alcohol debut. Early alcohol debut was positively associated with friends' and father's drinking frequency, single parent family, elevated scores on the family organisation dimension, and the number of younger siblings. Taking part in organized sports and elevated scores on the family support dimension were negatively associated with early alcohol debut.
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DISCUSSION |
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The family socialization styles seem to be important for onset of drinking. Most important was the support dimension. The group showing early drinking and intoxication debut perceived significantly lower family support than those with later debut. Family support is often used interchangeably with family cohesion and is regarded by family therapists as a major dimension of family functioning (Minuchin, 1974; Maccoby and Martin, 1983
; Foxcroft and Lowe, 1992
; Miller and Plant, 1996
, 1999
; Miller 1997
). In short, family support reflects emotional qualities, i.e. the emotional binding family members have toward each other. Families reporting high support scores are characterized with a positive emotional atmosphere, an accepting attitude and good emotional attachment. Attachment has been shown to be a crucial factor in childhood development (Bowlby, 1988
). However, at the extreme level, support can be dysfunctional by compromising boundaries between individual family members resulting in an enmeshed family system (Minuchin, 1974
). Elevated scores on the control and the organization dimensions, on the other hand, have been linked with early drinking and intoxication debuts, probably through the effect upon perceived autonomy leading to an oppositional and protesting attitude; an attitude which might bring the adolescents more into contact with the existing, anti-adult and experimenting youth culture.
In addition to family dynamics, our results also showed that teenagers' drinking behaviour was related to those of parents and peers. Parental models seemed to be important both for age of first drinking and age of first intoxication. Mothers' and fathers' drinking frequencies, as reported by their offspring, were positively associated with teenagers' alcohol debut; youngsters with early debut had parents with more frequent drinking (Table 3). It should be noted that, in the logistic regression analyses, the effect of the mother's drinking frequency disappeared. The reason might be statistical, since the drinking frequencies of the mothers and the fathers were strongly positively correlated. It should also be noted that the observed, actual drinking frequency was more important than parents' and peers' attitudes and norms for drinking (Bowlby, 1988
). Thus, parents' and peers' influence seems to take place through role modelling, rather than through drinking norms. These findings support previous empirical data from the alcohol expectancy literature (Barnes et al., 1986
), which documents the importance of young peoples' cognitive models of alcohol, models that are normally developed during the socialization process.
The third family factor related to onset of drinking was the number of siblings. Teenagers with early debut tended to have older siblings than teenagers with later debut; a factor pointing to the possible impact of role modelling, as mentioned above. Also parental status was important. Our results confirmed previous findings (Miller, 1997) suggesting that adolescents in single-parent families were more likely to drink and were over-represented in the group with early alcohol debut. Living area was a fourth influential factor. Early alcohol debut was associated with living in large cites. There were no significant differences between small cities or rural areas, suggesting that the (Norwegian) urban culture in large cities seems to promote early alcohol and intoxication debuts.
Participation in sports was an important factor delaying alcohol debut. Having developed interests in certain sports and regularly participating in sports was associated with later alcohol debut. There might be several explanations for this finding. First, most Norwegian sports clubs have strict rules for use of alcohol. For instance, according to the rules of the Norwegian Football Association, the largest organization within the NOCCS, drinking alcohol is not allowed when travelling with the soccer team, less than 48 h before a soccer match, and in all arrangements with other soccer teams. Second, from a familysociological point of view, sports organizations are also important as a socialization domain. The changing family structures in most Western countries, with an increase in the number of divorces and single-parent families (consisting mostly of single women and children), make sports organizations more important as a socialization domain. Sports organizations may offer role models and social networks previously provided by the traditional family, also giving rise to additional sources for emotional attachment. Third, sports participation by young athletes occupies a considerable amount of young peoples' time. For instance, in a recent nationwide investigation of Norwegian adolescents (aged 1218 years), 77.5% trained two or three times a week or more (Aas et al., 1995). The majority of those who competed at the national level trained daily. Thus, in addition to sport clubs' strict rules for drinking, the total amount of time directed at sports activities will reduce the possibility of taking part in norm-breaking activities, such as experimenting with alcohol or other substances.
The finding that participation in organized sports delays alcohol debut is interesting and points to possible primary prevention strategies. One element here is information about the adverse effects of alcohol upon the human body. Young athletes are probably more sensitive to this kind of knowledge, than are non-active youngsters. These effects can be summarized as: detrimental effects upon psychomotor skills, no improvement in work capacity and impairment of temperature regulation, with the consequence of decreased performance levels. Hangover effects are equally negative and might be summarized as impacting on: the citric acid cycle, aerobic metabolism, the lactatepyruvate ratio, dehydration, and reduction in available carbohydrates. Impaired psychological functions, mood variations and increased sensitivity towards outside stimuli add to these detrimental physiological effects. Moreover, there are hazards of acute alcohol intake, such as temporarily weakening of ventricular contractions (Sandberg, 1990; O'Brian, 1993
). It is especially important to convey such information to young athletes at the start of their sports career. Second, in addition to a number of other factors, the enormous social network organized sports represent make them well suited for large-scale, transnational prevention programmes in close cooperation with, for instance, the World Health Organization. Sports organizations should therefore be included systematically in alcohol primary prevention programmes at the national and global level.
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FOOTNOTES |
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