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The shift towards a new generation has greatly decreased underage drinking, not only in the United States but across the developed world, especially in Europe where per capita alcohol consumption for teens and adults typically goes above and beyond US levels.

Experts cite changes in technology rather than policy, particularly the accountability and unintentional social oversight fostered by social media, as being key in the development of completely different attitudes towards alcohol and drunkenness. Kids are much more aware of the consequences of losing control and doing something reckless on the Internet.

Furthermore, today’s teens are much more likely to stay in and drink at home (even before the pandemic), in a safer environment. This doesn’t mean teen drinking has been eliminated. Despite a reduction in binge drinking and associated deaths, underage drinking remains an issue all around the developed world, and over 4,300 teens still die in the US every year as a direct result of excessive underage drinking.

How Many Teens Drink?

Teenage drinking is measured not by lifetime drinks, but by drinking habits within the last thirty days. As such, an underage “non-drinker” is someone who has not imbibed in the last month. An estimated 30 percent of teens have consumed some level of alcohol in the last month, with 14 percent having binged at least once.

Binge drinking is defined as consuming more than a set amount of alcohol in a single drinking session. This is defined as having a blood alcohol concentration of 0.08 grams of alcohol per deciliter of blood (100ml), or about 5 drinks for males and 4 drinks for females in two hours. A “drink” is equivalent to about one beer, a glass of wine, or a single shot of liquor (roughly 14 grams of alcohol).

Binge drinking is considered a youth risk behavior, and although it is not indicative of alcohol use disorder (alcohol addiction or alcohol dependence), teens who binge more often are at greater risk of developing alcoholism and associated physical and mental health issues. It’s worth noting binge drinking is certainly not unique to underage populations and is significantly more common in ages 18-34. However, teens may be disproportionately affected by the risks associated with excessive drinking.

Family Influences on Teen Drinking Risk Factors

The risk factors playing into teen drinking are complex and numerous. Some are external factors, and some are internal factors. Internal factors typically refer to genetics and the effects of alcohol on the brain, which differ from person to person. Some people are more naturally resistant to alcohol’s effects than others, and some people are genetically more likely to become physically dependent on alcohol or develop a substance use problem.

If alcoholism “runs in the family”, so to speak, a teen is at greater risk of developing similar issues if they begin to drink frequently versus peers who don’t have a family history of alcohol use issues. Home environment also plays a role as an external factor in a teen’s drinking behavior. A healthy home environment, especially one where child and parent are close, and the parent monitors their child’s substance use and talks them earnestly about drug use, can be greatly protective.

On the other hand, when a parent-child relationship is heavily strained, teens are more likely to engage in risk behavior including drug use, including drinking. Early childhood trauma, particularly in the form of abuse, also correlates with a higher rate of alcohol use disorder in adult women, but not necessarily in men. This link is still being researched.

How Important Is Peer Pressure?

Many parents cite they feel they may have less of an impact on their children’s behavior than their peers as they enter middle and late adolescence. While the impact of peer pressure is important, it is equally important not to overstate the impact or focus entirely on reducing its effects without taking note of how other factors influence a teen’s likelihood to use alcohol early or excessively.

Parents do remain a child’s strongest influence on attitudes towards drinking, an influence that persists all the way into emerging adulthood. Feeling comfortable and relaxed around alcohol or seeing many of their peers drink can increase their likelihood of imbibing. This is called social modeling.

Furthermore, peer selection is also an important factor. Teens with a laxer attitude towards drinking and alcohol are more likely to choose friends who are similarly lax towards drinking, and are thus more likely to drink. The classic model of a teen feeling pressured to drink at a party is still an existing issue.

But the factors going into influencing a teen’s decision to start drinking early are far more complex than just the attitude of their friends, and their friends’ likelihood to compel them to drink. Previous attitudes towards alcohol, home environment, parental influence, and even genetic factors remain important factors as well.

Teen Drinking and Mental Health

Teens with a history of mental health problems are more likely to try, and even regularly use, alcohol and other substances, such as (but not limited to):

    • Anxiety disorders
    • Forms of depression
    • Obsessive-compulsive disorder (OCD)
    • Attention-deficit/hyperactivity disorder (ADHD)
    • And other conditions

Research has also established there is a significant unmet need for treatment that addresses both mental health and substance use disorder among teens. Thus, existing numbers may be hiding an even greater co-occurring rate between mental health issues and drug use among teens, as researchers have generally only been able to test for both among the treatment-seeking population. Current estimates note anywhere from 11 to 40 percent of teens who need mental health treatment services are currently receiving them.

Alcohol Availability and Advertising

The role of alcohol advertising and media in developing attitudes towards alcohol cannot be understated. While parents and peers likely play a majority role in developing a teen’s attitude towards alcohol use, television programs, movies, and both video and print ads all heavily contribute as well.

Many advertising companies and marketing departments know this, and target youth and teens via advertising appealing to adults and adolescents alike, utilizing humor, animal characters, and depictions of immediate gratification or higher social status in association with the product and/or brand.

Delay Teen Drinking

The consequences of underage drinking are numerous, ranging from long-term memory issues and brain damage to increased risk of stroke, heart disease, and various forms of cancer, as well as a greater risk of alcohol-related injuries and death from car crashes, burns, falls, drowning, and poisoning. Teens who drink regularly are more likely to engage in risky sexual intercourse, experience unwanted or unplanned sex, and struggle more at school.

Research also shows prolonging a teen’s introduction to alcohol is their best bet of reducing harm in the long-term. It’s unlikely to completely prevent alcohol use, due to alcohol’s ubiquitous nature and the current drinking rate among adults in the US. However, delaying a teen’s first drink can reduce alcohol’s deleterious effects on a teen’s mental and emotional development, as well as reduce the risk of alcohol use disorder and associated consequences.