January 31, 2018
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Parental supply of alcohol does not limit harmful behavior

Adolescents who access alcohol from their parents have an increased risk of experiencing alcohol-related harms and partaking in binge drinking, according to findings published in The Lancet Public Health.

“In many countries, parents are a key provider of alcohol to their children before they are of legal age to purchase alcohol,” Richard Mattick, PhD, from the University of New South Wales, Australia, said in a press release. “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.”

Mattick and colleagues conducted a prospective cohort study to examine the relationship between parental supply of alcohol vs. supply from other sources and subsequent drinking outcomes among adolescents. Drinking outcomes assessed included binge drinking, which was defined as having more than four standard drinks during a single occasion, alcohol-related harms, symptoms of alcohol abuse, alcohol dependence and alcohol use disorder.

The researchers recruited 1,927 adolescents (mean age at start, 12.9 years; mean age at end, 17.8 years) and their parents from Australia between 2010 and 2011 and followed them until 2016. The adolescents and parents completed separate surveys annually on how the adolescents accessed alcohol, their experience with binge drinking, any alcohol-related harms and symptoms of alcohol abuse. In the last 2 years of the study, adolescents were also surveyed on symptoms of alcohol dependence and alcohol use disorder.

The analysis was adjusted for child, parent, family and peer variables.

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Subsequent binge consumption, alcohol-related harm and symptoms of alcohol use disorder were more likely in adolescents who received alcohol only by parents than those who had no supply.
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Data from the surveys indicated that as the age of the adolescents increased, so did the percentage of adolescents who received alcohol from their parents. This percentage rose from 15% at the start of the study to 57% by the end of the study. The percentage of adolescents who had no access to alcohol decreased from 81% to 21% over the course of the study.

Subsequent binge consumption (OR = 2.58; 95% CI, 1.96–3.41), alcohol-related harm (OR = 2.53; 95% CI, 1.99-3.24) and symptoms of alcohol use disorder (OR = 2.51; 95% CI, 1.46-4.29) were more likely in adolescents who received alcohol only by parents than those who had no supply. Binge drinking was reported by 81% of adolescents who were supplied alcohol from both their parents and other sources, 62% of those who received it from other sources only and 25% of those who were given it by their parents only.

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There was no significant association between parental supply of alcohol and symptoms of alcohol abuse or dependence. Adolescents who received alcohol from other sources had a significantly greater risk of all adverse outcomes, compared with those with no supply. Receiving alcohol from both parents and other sources posed the greatest risk for adverse outcomes. The odds of accessing alcohol from other sources doubled 1 year after adolescents were supplied with alcohol from their parents only.

“Our study is the first to analyze 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,” Mattick said in the release. “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.”

“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,” he added. “Parents, policymakers, and clinicians need to be made aware that parental provision of alcohol is associated with risk, not with protection, [if they are] 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.”

In an accompanying comment, Stuart A. Kinner, PhD, and Rohan Borschmann, PhD, both from the center for adolescent health at the Murdoch Children’s Research Institute, Australia, wrote that the findings by Mattick and colleagues compellingly indicate that parental provision of alcohol to adolescents does not reduce adverse outcomes and may actually increase risk.

“However, before drawing firm conclusions, it will be important to replicate this finding in larger samples that permit more granular characterization of both exposures and outcomes, and in samples with at least proportionate representation of socioeconomically disadvantaged families,” they wrote. “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.” – by Alaina Tedesco

Disclosure: The authors report no relevant financial disclosures.