Sign In
Australia; NSW; VIC; QLD; WA; TAS
Media release
From:
The Lancet Public Health: Parental provision of alcohol to teenagers does not reduce risks, compared to no supply
There is no evidence to support the practice of parents providing alcohol to their teenagers to protect them from alcohol-related risks during early adolescence, according to a prospective cohort study in Australia published in The Lancet Public Health journal.
The six year study of 1927 teenagers aged 12 to 18 and their parents found that there were no benefits or protective effects associated with giving teenagers alcohol when compared to teenagers who were not given alcohol. Instead, parental provision of alcohol was associated with increased likelihood of teenagers accessing alcohol through other sources, compared to teenagers not given any alcohol.
Alcohol consumption is the leading risk factor for death and disability in 15-24 year olds globally. Drinking during adolescence is of concern as this is when alcohol use disorders (ie, dependence on or abuse of alcohol) are most likely to develop.
“In many countries, parents are a key provider of alcohol to their children before they are of legal age to purchase alcohol. This practice by parents is intended to protect teenagers from the harms of heavy drinking by introducing them to alcohol carefully, however the evidence behind this has been limited,” says lead author Professor Richard Mattick, University of New South Wales, Australia. “Our study is the first to analyse parental supply of alcohol and its effects in detail in the long term, and finds that it is, in fact, associated with risks when compared to teenagers not given alcohol. This reinforces the fact that alcohol consumption leads to harm, no matter how it is supplied. We advise that parents should avoid supplying alcohol to their teenagers if they wish to reduce their risk of alcohol-related harms.” [1]
The study recruited teenagers and their parents between 2010 and 2011 from secondary schools in Perth, Sydney and Hobart (Australia). The teenagers and their parents completed separate questionnaires every year from 2010 to 2016 including information about how teenagers accessed alcohol (from parents, other non-parental sources, or both), binge drinking levels (defined as drinking more than four drinks on a single occasion in the past year), experience of alcohol-related harm, and alcohol abuse symptoms [2]. In the final two years, teenagers were also asked about symptoms of alcohol dependence and alcohol use disorder that could predict alcohol misuse problems in the future.
At the start of the study, the average age of the teenagers was 12.9 years old and by the end of the study the average age was 17.8 years old. The proportion of teenagers who accessed alcohol from their parents increased as the teenagers aged, from 15% (291/1910) at the start of the study to 57% (916/1618) at the end of the study [3], while the proportion with no access to alcohol reduced from 81% (1556/1910) teenagers to 21% (341/1618).
At the end of the study, 81% (632/784) of teenagers who accessed alcohol through their parents and others reported binge drinking, compared with 62% (224/361) of those who accessed it via other people only, and 25% (33/132) of teens who were given alcohol by their parents only. Similar trends were seen for alcohol-related harm, and for symptoms of possible future alcohol abuse, dependence and alcohol use disorders. The group of teenagers supplied with alcohol from both their parents and other sources were at the greatest risk of the five adverse outcomes, potentially as a result of their increased exposure.
Importantly, teenagers supplied with alcohol by only their parents one year were twice as likely to access alcohol from other sources the next year. As a result, the authors suggest that having alcohol supplied by parents does not mitigate risk of it being supplied by other people, and that parental provision of alcohol did not appear to help teenagers deal with alcohol responsibly.
“While governments focus on prevention through school-based education and enforcement of legislation on legal age for buying and drinking alcohol, parents go largely unnoticed. Parents, policy makers, and clinicians need to be made aware that parental provision of alcohol is associated with risk, not with protection, to reduce the extent of parental supply in high-income countries, and in low-middle-income countries that are increasingly embracing the consumption of alcohol.” Says Professor Mattick. [1]
The authors note some limitations, including that teenagers from low socioeconomic status backgrounds – for whom alcohol-related issues are more common – were underrepresented in the study. In addition, the binge drinking measure (defined as drinking more than four drinks on a single occasion in the past year) was conservative, which may affect the associations identified.
The results may not apply to other countries, in particular where there is lower alcohol consumption than Australia, and the research does not account for the amount of alcohol supplied by parents, or the context in which it is given.
Writing in a linked Comment, Professor Stuart Kinner, Murdoch Children’s Research Institute, Australia, says: “An important strength of the study is the careful adjustment for potential confounders. Nevertheless, it is difficult to exclude the possibility that some parents provided alcohol to their children in response to other, unmeasured risk factors, such as alcohol expectancies… Further research is required to better understand why some parents choose to supply their children with alcohol… The findings by Mattick and colleagues strongly suggest that parental supply of alcohol to adolescents does not protect against future alcohol-related harm, and might in fact increase risk. However, before drawing firm conclusions, it will be important to replicate this finding in larger samples that permit more granular characterisation of both exposures and outcomes, and in samples with at least proportionate representation of socioeconomically disadvantaged families. In view of the substantial role of alcohol in the burden of disease for adolescents, evidence-based prevention of alcohol-related harm across the social gradient is crucial."
Expert Reaction
These comments have been collated by the Science Media Centre to provide a variety of expert perspectives on this issue. Feel free to use these quotes in your stories. Views expressed are the personal opinions of the experts named. They do not represent the views of the SMC or any other organisation unless specifically stated.
Dr Liz Temple is a Senior Lecturer in Psychology at the University of New England
The release of this research on Australia Day, which is viewed by many Australians as an opportunity for increased alcohol consumption (if not binge-drinking), is certainly timely.
The study clearly shows the obvious: regardless of the source, consumption of alcohol by high school students is associated with some level of risk.
However, the ‘take-home’ message for parents is muddied by not calculating the risks separately for providing ‘sips’ of alcohol in comparison to a full standard drink (e.g., a glass of wine, a beer or cider, a shot of vodka, etc.). There is most likely a vast difference in the levels of risk associated with sips vs. full drinks across the range of harms measured, which will also likely vary for adolescents of different ages (e.g., higher risk at 12 years than 17 years), and for a variety of reasons (e.g., dose vs. body-size, stage of brain development, etc.).
It would, therefore, be useful for the study data to be analysed in greater depth, enabling the development of more detailed advice for parents.
The conclusion that “there is no evidence to support the view that parental supply protects from adverse drinking outcomes by providing alcohol to their child” is also somewhat misleading. Specifically, it is based on the assumption that, if there was no parental supply of alcohol, adolescents would not consume any alcohol at all. While this may be true for some teenagers, (as their data shows) it is clearly not the case for many.
If the assumption was, instead, that “adolescents who are not supplied with alcohol by their parents will seek alternate sources”, the conclusion would be the opposite. That is, the results clearly indicate a higher level of risk of harms for adolescents who are supplied alcohol by people other than their parents.
As such, I think there is a need to look at the data in a more detailed manner before we suggest that allowing your 16 year old a sip of beer on Australia Day might increase their risk of future binge-drinking.
Professor Melissa Norberg is from the School of Psychological Sciences at Macquarie University.
The study published by Mattick and colleagues (2018) provides a great resource for parents.
Parents may be tempted to supply alcohol to their children, perhaps thinking that “it will be better if I give it to them than someone else” or 'it may ensure that in this instance their drinking leads to no harms.'
Although the study does not shed light on what happens during a single occasion, it does tell us that parental supply of alcohol increases risk over no supply.
This makes sense. If adolescents cannot access alcohol, then they will be unable to experience problems from drinking.
Importantly, this study also has found that parental supply of alcohol doubled the odds of adolescents later having alcohol supplied through other sources. Adolescents who received alcohol from parents and other sources were the most likely to experience alcohol-related problems.
Thus, these data tell us that in the long-run, supplying alcohol to our adolescent children is not a great idea.
Julia Stafford is the Alcohol Program Manager at Cancer Council WA.
The message to parents and others is that no one should provide alcohol to under 18s. The best thing parents can do to protect young people from alcohol harms is not supply them with alcohol.
Parents have an enormously important role in protecting their children from alcohol harms, even when those children are in their mid-late teen years. Parents are still an important influence for teenagers and have control over one potential source of alcohol. The research shows that teens often top-up what their parents give them with alcohol from other sources, so that’s even more reason for parents not to provide alcohol to their children.
The research provides further support for the Australian low-risk drinking guidelines that recommend for under 18s, no alcohol is the safest choice. There is an ongoing need to ensure the public is aware of these guidelines and is informed about the best ways to reduce their own and others’ risks from alcohol. Good public education programs targeting parents are run in Western Australia, but unfortunately most of the rest of the country are missing out on these important messages.
Elizabeth Elliott AM is Professor of Paediatrics & Child Health at University of Sydney, Children's Hospital Westmead and Director of the Australian Paediatric Surveillance Unit
This very important longitudinal study clearly indicates that parents should not be encouraging drinking in their teenage children.
Contrary to previously touted “advice” that parents may encourage safe drinking practices by supplying their children with alcohol from an early age, this study confirms that the early provision of alcohol by parents only is harmful, not protective - it more than doubles the later risk of binge or risky drinking, alcohol related harms, and symptoms of alcohol use disorder.
In Australia it is illegal for someone under 18 years of age to buy alcohol, so it is somewhat surprising that 15 per cent of Year 7 children with a mean age of 12 years were given alcohol by their parents, often for special occasions and albeit in small amounts.
The health, social and economic costs of alcohol use in Australia are enormous and we must alert parents to the harms of supplying alcohol to children and support them to avoid doing so.
Professor Richard Mattick is a Principal NHMRC Research Fellow at the National Drug and Alcohol Research Centre at the University of New South Wales and is the lead author of the paper
If you received alcohol only from your parents in any one year you were twice as likely to be getting alcohol from others in the next year.
We started the study in the first place because many Australian parents have the view have that it is their responsibility to assist their children to drink responsibility and to do that they have to give them small amounts of alcohol.
This was quite a common assumption, yet the evidence in favour of that was actually non-existent, despite how appealing it is to think that parents can somehow improve their children’s drinking behaviour.
This is very important information for parents: by giving alcohol to your children, even for the very best of reasons, you are not reducing their risks of harmful drinking - you are actually increasing their risk of harms.
The reasons for this are most likely that by giving children alcohol you are giving them permission to drink, making them more likely to continue to do so.
In year 10 they were drinking in a less harmful way and less frequently. By year 12 those children who had been supplied alcohol by their parents were more likely to show signs of risky drinking – drinking more on a single occasion and drinking more frequently.
Professor Jane Halliday is a group leader in Public Health Genetics, from the Murdoch Children's Research Institute
In the AQUA study comprising a cohort of pregnant women in Victoria, we found that women who began drinking regularly and/or were first intoxicated before 18 years of age have a substantial risk of being a binge drinker in the first trimester of pregnancy, compared to someone who delays such experiences.
This is of course a serious risk factor for the developing baby.
Attachments
Note: Not all attachments are visible to the general public. Research URLs will go live after the embargo ends.
