Day 2: Contributing Factors and Consequences: Why Do Kids Drink?
"Adolescents in the United States grow up in a world filled with messages about alcohol. Most of the messages present drinking in a positive light, and most of them show alcohol as a normal part of adult and teen social life. Warnings against underage drinking . . . may well be drowned out by the barrage of daily messages about alcohol in daily life." Reducing Underage Drinking, p. 70 |
As a prevention coordinator, it is important to remember there are no simple explanations for why some kids drink and others do not. We all know people who grew up in horrible conditions without ever using or abusing alcohol. On the flip side, we also know people who lived in what we thought were optimal conditions who had serious problems with alcohol throughout their lives. What is the trigger? Reducing Underage Drinking tells us that "it is impossible to isolate one factor as the primary cause" (Bonnie, p. 86). Instead, research has identified an array of biological, psychological, social, economic, and other factors that may contribute to whether or not an individual uses or abuses alcohol or other drugs (Halpern-Felsher and Biehl, NIAAA, et al).
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"Risk and protective factors often cluster . . . and are relevant to multiple social outcomes." Safe, Supportive, and Successful Schools Step by Step, Osher et al., p. 64 |
Researchers have divided these [factors] into risk and protective factors. Safe, Supportive, and Successful Schools Step by Step defines risk factors as any factor that increases the probability that a person will suffer harm. A protective factor is any factor that decreases (buffers) the potential harmful effect of a risk factor. "These factors can be inherent in the individual . . . or in an environment. . . More risk factors place a child or children at greater risk of poor social and academic outcomes; more protective factors increase the likelihood of improved outcomes" (Osher et al., p. 64). These risk and protective factors are important for us to be aware of because they relate to many negative behaviors, including school dropout, delinquency, violence, and substance abuse. Because of the way risk and protective factors interact and accumulate, Osher says, effective interventions that target one type of risk factor may reduce risk factors in a number of other areas. Understanding this connection will make it easier for you to build support for implementing a school-based program that targets underage drinking. |
For more information on how schools can create a safe
and supportive community, see online course School
Connectedness and Meaningful Student Participation |
Teens Speak Out: Why They Drink Journalist Gregory Morgan spent time with teens who regularly drink. Here's an excerpt from his article "What Kids Are Not Telling You: The Real Story on Underage Drinking." Why They Drink No doubt, social acceptance is a top motivation for underage drinkers. As Debbie...a college student, says, "It's not like I was pressured into drinking, but that's kind of what you do when you hang out with your friends. It's just the social norm." Similarly, others say they drink for fun. "I drink to be more social. It makes me more outgoing. Alcohol basically enhances anything you do," Mark says. Ginger agrees, saying she feels like the life of the party when she's been drinking. Justin says he drinks for fun -- and for the relaxed feeling. "Anything that gets me to that feeling is great. I don't mind mixing drinks. It gets you buzzed quicker," he says. Besides drinking for social reasons, what might surprise parents is the big-time boredom that many underage drinkers say they are trying to beat. "If you're bored, beer is key. It'll give you something to do even if you don't remember it," says Melissa, a 14-year-old who lives in a rural area. There's boredom in the big city too. …Allison, a regular on the teen scene outside the movies [said] "You can only hang out at the movies or the mall so many times before it gets old," she says. In fact, she says, the main reason she drank and interacted sexually with a stranger this summer was boredom. Some interviewees openly admit they like the feeling of losing control. Others feel like alcohol gives them more control -- more courage to do things they might not ordinarily do. Other underage drinkers say that they are stressed out by their parents, their studies or life in general. For example, 13-year-old Tyler says he doesn't drink much -- maybe two beers in a sitting. But when he does, he's usually alone. "I've got school stress. Beer helps me calm down," he says. And Justin...whose parents busted him for marijuana use, says he turned to beer and marijuana because of the pressure they put on him to get good grades. "If I'm stressed by my parents, getting drunk or high makes it all go away," he says. |
In Reducing Underage Drinking: A Collective Responsibility, the Institute of Medicine draws on extensive research to look even deeper at the reasons underage youth drink. If we can understand the reasons for youth drinking, we can better take action to protect them from drinking and the consequences of underage drinking.
The report points out that adolescents are going through rapid changes, including a wish to practice adult roles. In the U.S., alcohol use is an important symbol of adult status. These adolescents also want to try on decision-making as they explore their "real selves." During this period, adolescents report having a "true self" (who they really are inside) and a "false self" (who they want other people to think they are, to impress or please them) (Harter et al., 1996).
"At this point, adolescents may knowingly make choices that…they
may later regret 'just to see what it is like,' to act more like an adult, or
to impress others" (Moffit, 1993). Some of these choices are likely to involve
alcohol consumption.
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"More disturbing still is that young people seem to be aware that using alcohol influences their decisions about sexual behavior: 29 percent of 15- to 17-year-olds and 37 percent of 18- to 24-year-olds said that alcohol or drugs influenced their decision to do something sexual. In other words, young people choose to drink even though they realize that alcohol affects their decision making and may cause them to engage in sexual behaviors they would not do while sober."
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Both adolescents and adults make decisions that could harm them for a number of reasons. For one, the negative consequences of bad decisions may or may not occur. A teen may drive home drunk without getting into an accident or injuring anyone. She may interpret that one outcome as evidence that drinking and driving is not dangerous. In addition, several studies find that most adolescents overestimate the number of others who drink alcohol. Thus, those who drink may feel that "everybody does it" -- both a sanction for their drinking and a reinforcement to continue. The IOM report, however, stops short of endorsing a popular approach with underage drinking called "social norms." Social norms attempts to provide adolescents with more realistic information about the extent to which people drink. Instead, the report said that a focus on "injunctive norms," which are views concerning what others think about one's drinking, might be more effective (Berkowitz, 2004). |
Teens are also likely to be influenced by their friends' values and standards rather than an amorphous peer group. If the friends they hang out with don't want to drink, chances are they won't either. But if their friends include drinking as a regular part of their social life, it will be much harder for them to resist drinking. In other words, it is "friend pressure", not "peer pressure" that most influences adolescents to drink (Prinstein, 1996).
Is There a Drinking Personality? Researchers have looked into whether there are personalities that are more at risk for alcohol and other substance abuse. Cloninger (1991) found that three traits, present as early as age 10, were associated with alcoholism at age 28: (1) being easily bored and needing constant stimulation; (2) being driven to avoid negative consequences for actions; and (3) craving immediate external rewards for efforts. In addition, antisocial personality disorder has been linked to alcohol misuse among adolescents (Clark et al., 1998) Similarly, a recent study of children aged 8-15 found that conduct disorder often predates and predicts later alcohol use (Clark et. al, 1998). |
Adolescents who have better refusal skills are less likely to drink than those with poor refusal skills. Researchers refer to those skills as self-efficacy, which is a belief in one's ability to resist urges or social pressures to drink, drink in particular situations, or consume large amounts of alcohol at one time. The construct of self-efficacy has grown out of social cognitive theory (Bandura, 1977). Perceived self-efficacy refers to "a judgment of one’s ability to organize and execute given types of performances" (Bandura, 1997, p. 21). Personal beliefs about capabilities are a vital and yet too-often ignored part of attempts to create learning. Indeed, measures of self-efficacy may be better predictors of behavior than what one is actually capable of achieving (Bandura, 1989). "There is evidence that adolescents can be taught drinking refusal self-efficacy skills and that such skills can then result in less substance use" (Bell, 1993).
In Day 3, we will look at several model programs that have been demonstrated to be effective in reducing underage drinking.
Surrounded by Alcohol
Practically everywhere they look, adolescents are bombarded by messages that promote alcohol. One study found that alcohol use was depicted, usually in a positive light, in more than 70 percent of a sample of episodes in prime-time television (Christensen et al., 2000) and in more than 90 percent of the two hundred most popular movie rentals for 1996-1997 (Roberts et al., 1999b).
Teens are inundated with alcohol advertising in the media. Studies conducted by the Center on Alcohol Marketing and Youth (CAMY) analyzed alcohol product advertising on television and in the media. Their findings were eye-opening:
Summary Brochure: Alcohol Marketing
and Youth The Center on Alcohol Marketing and Youth |
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| "While many factors may influence
an underage person's drinking decisions, including among other things parents,
peers and the media, there is reason to believe that advertising also plays a
role."
Self Regulation in the Alcohol Industry: Report to the Federal Trade
Commission, |
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Many agencies, ranging from the Federal Trade Commission to the National Institute on Alcohol Abuse and Alcoholism, have called for changes in how and where the alcohol industry advertises its products. "The industry has the prerogative -- indeed, the social obligation -- to regulate its own practices and to refrain from marketing products or engaging in promotional activities that have a particular appeal to youngsters, irrespective of whether such practices can be proven to 'cause' underage drinking" (Reducing Underage Drinking, p.135).
According to the Federal Trade Commission, Self Regulation in the Alcohol Industry, "economic theory predicts, and various empirical research studies confirm, that advertising can influence consumer demand for products" (Evans and Kelly, 1999).
Alcohol and the Community
The drinking environment of a community may contribute to drinking as well. "A 'wet' community is one in which drinking is prevalent and common, public opinion is generally tolerant or positive, and alcohol is readily available both commercially and at private social occasions and is advertised as available," according to Reducing Underage Drinking. A 'dry' community would be one in which drinking at social occasions is not the norm and is generally frowned on, and alcohol outlets are relatively scarce (pp. 79-81). Other research suggests that a 'wetter' environment may provide adolescents with more social occasions to drink, more positive attitudes about drinking, more advertising and outlets, and more lenient regulations concerning the sale and consumption of alcohol. In short, such environments have an enabling effect on underage drinking (Chaloupka and Wechsler, 1995).
"Schools have a responsibility to have a safe and healthy learning environment, and alcohol and other drugs is a barrier to getting that done," said John Bunker, president of New Futures, a nonprofit, nonpartisan organization seeking to reduce underage alcohol problems and increase access to treatment. "One of the problems is that the community often looks to schools to solve this problem. The message that I would strongly urge is that alcohol and other drugs is a community problem. It's about the parents who supply the alcohol, it's about merchants who sell alcohol to underage youth, it's about the community fair that allows open containers of alcohol, and it's about schools having appropriate policies." Bunker, Personal Communication |
Changes in the environment can have an affect on drinking. For example, increases in the beer tax, which raises the price of beer, generally tend to lower drinking. Adolescents are influenced by the advertising that most all see most days, by the standards in . . . communities, by their friends, and finally by the most local community of all -- their family. Researchers have found the strongest association with adolescents' refraining from drinking are parent norms against underage drinking. Similarly, having parents who sanction use (even in their own houses) for their children is related to heavier drinking among adolescents. These teens are more likely to binge drink if their parents or friends' parents provide alcohol at their home for a party (Barnes et al., 1995; Peterson et al., 1994).
Parental approval of underage alcohol use is surprisingly prevalent," said Kristie Foley, Ph.D., a researcher at Wake Forest Baptist and the principal investigator of the study. Approximately 1 in 4 respondents, ages 16 to 20, attended a party where alcohol was supplied by a parent. "Parents have good intentions, thinking the teenagers won't drink and drive, that they are safer staying at home, but it sends the wrong message. Adolescents interpret this behavior as an approval to drink alcoholic beverages. Our study showed that teenagers whose parents provided alcoholic beverages for their children and their peers at a party were two times more likely to binge drink and to use alcohol within a 30 day period."
Strict consequences of breaking the house rules regarding drinking also helped deter underage drinking among teens, the study found. "If a teen thinks he or she will receive severe punishment (as perceived by the teen) if they are caught drinking, they are less likely to consume alcoholic beverages," Foley said (Adults' Approval and Adolescents' Alcohol Use, Journal of Adolescent Health).
65% of kids get alcohol from friends and family |
Parental monitoring and involvement are key components in reducing adolescent alcohol use. Monitoring of an adolescent's behavior involves the parent supervising the adolescent; knowing [their] whereabouts; knowing [their] friends and peers, setting expectations that are fair, affirming, and useful; and communicating with the adolescent. How neighborhoods affect educational outcomes in middle childhood and adolescence:
Conceptual issues and an empirical example. |
Alcohol and School Culture
During adolescence, one of the cognitive changes that occur is the development of a social perspective -- "the ability to recognize how the thoughts and actions of one person influences those of another and to imagine how others might perceive them" (Steinberg and Cauffmann, 1996). This, in turn, develops into friend pressure. As older teens join groups of teens with similar values and life-styles, "some . . . groups include drinking as part of how they spend their time, and an adolescent's choice to be involved in that crowd will include the knowledge that drinking is a typical activity for that group" (Prinstein, 1996). This makes prevention initiatives and the culture of our schools a critical component in the battle to reduce underage drinking.
Safe, Supportive, and Successful Schools Step by Step lists these four key elements of a comprehensive schoolwide plan to support a healthy, positive school culture:
- Creating a caring school community in which all members feel connected, safe, and supported
- Teaching appropriate behaviors and social problem-solving skills
- Implementing positive behavior support systems
- Providing appropriate academic instruction
When these interdependent elements are present in a school, student behavior and grades improve and promotion rates and graduation rates increase (Osher et al., p. 63).
In Improving the Odds: The Untapped Power of Schools to Improve the Health of Teens, Robert Blum and Clea McNeely write, "When middle and high school students feel cared for by people at their school and when they feel like they are part of school, they are less likely to engage in unhealthy behaviors. When they feel connected to school, they also report higher levels of emotional well-being."
"Kids who have the sense of connection with teachers not only smoke cigarettes less but when they have started to smoke, they are less likely to become heavy smokers and more likely to transition out," Blum says. "They are less likely to become heavy drinkers and less likely to have ongoing suicidal thoughts. The impact on health behavior is very, very substantial." Improving the Odds: The Untapped Power of Schools to Improve
the Health of Teens, |
These findings were initially reported in the National Longitudinal Study of Adolescent Health (Add Health). Add Health surveyed a representative sample of students from 80 high schools and 52 middle schools from the United States. Data at the individual, family, school, and community levels were collected in two waves between 1994 and 1996. In 2001 and 2002, Add Health respondents, 18 to 26 years old, were re-interviewed in a third wave to investigate the influence that adolescence has on young adulthood.
The Add Health study found that students who feel connected to school are:
- Less likely to use alcohol and illegal drugs
- Less likely to engage in violent or deviant behavior
- Less likely to become pregnant
- Less likely to experience emotional distress and suicidal thoughts or attempts
How "connected" are the
students in your school? Click
here to see the school connectedness survey |
To learn more about the benefits of a caring school community,
view the online course on School
Connectedness and Meaningful Student Participation |
Click here
to print today's materials in PDF format. |
Discussion Questions Please think about the questions below and share your responses, comments, and/or any questions about today's material in the Discussion Area . Complete the Media Questionnaire Post your responses to these discussion questions:
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This completes today's work.
Please visit the Discussion Area to share your responses to the discussion questions! |
References for Day 2 materials:
Bandura, Albert. (1997). Self-efficacy: The exercise of control. New York: W.H. Freeman
Bandura, Albert. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice Hall.
Barnes, G.M., Farrell, M.P., and Banerjee, S. (1995). Family influences on alcohol abuse and other problem behaviors among black and white Americans. In Boyd, G.M., Howard, J., and Zucker, R.A. Alcohol problems among adolescents. Hillsdale, NJ: Lawrence Erlbaum.
Bell, R.M., Ellickson, P.L., and Ko, M. (1995). Do drug prevention effects persist into high school? How Project ALERT did with ninth graders. Preventive Medicine: An International Journal Devoted to Practice and Theory, 22, 463-483.
Berkowitz, A.D. (2004) The Social Norms Approach: Theory, Research and Annotated Bibliography. Newton, MA: Higher Education Center. Available: http://www.alanberkowitz.com/articles/social_norms.pdf
Blum, R.W., McNeely, C.A., & Rinehart, P.M. (2002). The Untapped Power of Schools to Improve the Health of Teens. Minneapolis, MN: Center for Adolescent Health and Development, University of Minnesota. Available: http://www.allaboutkids.umn.edu/presskit/monograph.pdf
Bonnie, Richard J., and O'Connell, Mary Ellen. (Eds.) (2004). Reducing Underage Drinking: A Collective Responsibility. Washington: National Research Council, Institute of Medicine, The National Academies Press. Available: http://www.nap.edu/books/0309089352/html/
The Center on Alcohol Marketing and Youth. (2005). Summary Brochure: Alcohol Marketing and Youth. Available: http://camy.org/factsheets/index.php?FactsheetID=24
Chaloupka, F.J., and Wechsler, H. (1995) Price, tobacco control policies,
and smoking among young adults. Working Paper 5012 (National Bureau of Economic
Research). Available: http://dnichols.wustl.edu/352sp2005/
chaloupka%20and%20wechcler%20govt
%20intervention%20smoking.pdf
Christensen, P.G., Henrikesen, L., and Roberts, D.F. (2000). Substance use in popular prime-time televeision. Washington, DC: Office of National Drug Control Policy.
Connell, J.P., and Halpern-Felscher, B.L. (1997). How neighborhoods affect educational outcomes in middle childhood and adolescence: Conceptual issues and an empirical example. In Brooks-Gunn, J., Duncan, G., and Aber, J.L. Neighborhood poverty volume 1: Context and consequences for children (pp. 174-199). New York: Russell Sage Foundation.
Evans, J., and Kelly, R. (1999). Self-regulation in the alcohol industry. A review of industry efforts to avoid promoting alcohol to underage consumers. Report to the Federal Trade Commission.
Foley, K. L., Altman, D., & DuRant, R.H. (2004). Adults' Approval and Adolescents' Alcohol Use. Journal of Adolescent Health, volume 35, issue 4, 345.e17-e26.
Halpern-Felsher, B.L., & Biehl, M. Developmental and Environmental Influences on Underage Drinking: A General Overview. (2005). Reducing Underage Drinking. CD: pages 402-416.
Harter, S., Marold, D.B., Whitesell, N.R., and Cobbs, G. (1996). A model of the effects of perceived parent and peer support on adolescent false self behavior. Child Development, 67, 360-374.
Hawkins, J.D., Catalano, R.R., and Miller, J.Y. (1992). Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: Implications for substance-abuse prevention. Psychological Bulletin, 112(1), 64-105.
Millstein, S.G., Ellen, J., Adler, N., Tschann, J., & Biehl, M. (2001). The Role of Behavioral Experience in Judging Risks. Health Psychology, 20, 120-126.
National Center on Addiction and Substance Abuse. (1999). Survey of American Attitudes and Substance Abuse V: Teens and Their Parents. New York: Columbia University.
National Institute on Alcohol Abuse and Alcoholism (NIAAA). (2003). Underage Drinking: A Major Public Health Challenge. Available: http://www.niaaa.nih.gov/publications/aa59.htm.
Osher, David, Dwyer, Kevin, & Jackson, Stephanie. (2004). Safe, Supportive, and Successful Schools Step by Step. Colorado: Sopris West.
Ott, C. H., & Doyle, L. H. (2005). An Evaluation of the Small Group Norms Challenging Model: Changing Substance Use Misperceptions in Five Urban High Schools. The High School Journal, 88, 45-55.
Peterson, P.L., Hawkins, J.D., Abbott, R.D., and Catalano, R.F. (1994). Disentangling the effects of parent drinking, family management, and parental alcohol norms on current drinking by Black and White adolescents. Journal of Research on Adolescence, 4, 203-228.
Prinstein, M. J., Fetter, M. D., & La Greca, A, M. (1996, March). Can you judge adolescents by the company they keep? Peer group membership, substance use, and risk-taking behaviors. Paper presented at the meeting of the Society for Research on Adolescence, Boston, MA.
Resnick, M.D., Bearman, P.S., Blum, R.W., Bauman, K.E., Harris, K.M., Jones, J., Tabor, K., Beuhring, T., Sieving, R.E., Shaw, M., Ireland, M., Bearinger, L.I., & Udry, J.R. (September 10, 1997). Protecting Adolescents from Harm: Findings from the National Longitudinal Study on Adolescent Health. Journal of the American Medical Association, 278 (10), 823-832.
Roberts, D.F., Henrikesen, L., and Christensen, P.G. (1999b). Substance use in popular movies and music. Washington, DC: Office of National Drug Control Policy.
Steinberg, L., and Cauffman, E. (1996). Maturity of judgment in adolescence: Psychosocial factors in adolescent decision making. Law and Human Behavior, 20, 249-272.
Udry, J. R. 2003. The National Longitudinal Study of Adolescent Health (Add Health), Waves I & II, 1994–1996; Wave III, 2001–2002 [machine-readable data file and documentation]. Chapel Hill, NC: Carolina Population Center, University of North Carolina at Chapel Hill.
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