1. Beispielbild Alcohol consumption patterns of young adolescents in Europe Renate Soellner & Astrid-Britta Bräker University of Hildesheim AAA-Prevent Alcohol Abuse among Adolescents in Europe Effective Environmental Strategies for Prevention

2. 2 Agenda 1 Prevalence 2 Patterns of use 3 Indicators for risky use

3. 3 Project AAA-prevent Based on: International Self-Report Study of Delinquency (ISRD-2; 2006-2010)  N = 67.883, 30 countries, 7. – 9. Klasse (11 – 18 year olds)  delinquency, leisure time, drug and alcohol use, family, neighbourhood etc. Alcohol Abuse among Adolescents in Europe. Effective environmental strategies for prevention  N = 57.771  25 countries  7. – 9. Klasse (12 – 16 year olds ) AAA-Prevent Junger-Tas, Marshall, Enzmann, Killias, Steketee & Gruszczynska (2010)

4. 4 Adolescent Alcohol Use in Europe European School Survey Project on Alcohol and Other Drugs (ESPAD):  62% of the adolescents drank during the last month  39% have been drunken during the last year  43% used at least 5 units of alcoholic beverages (heavy episodic drinking) Hibell, Guttormsson, Ahlström, Balakireva, Bjarnason, Kokkevi & Kraus (2009) Health Behavior in School-Aged Children (HBSC)  weekly use: 11% of the 13 year olds; 26% of the 15 year olds  being drunken at least twice: 11% of the 13 year olds; 33% of the 15 year olds Currie, Nic Gabhainn, Godeau, Roberts, Smith, Currie, Picket, Richter, Morgan & Barnekow (2008) ESPAD (2007): 15-16 year olds 35 countries HBSC (2005/2006): 11-15 year olds 41 countries

5. PREVALENCE

6. 6 Abstinence Rates Notes : - lowest abstinence rates in Eastern European countries - High abstinence rates in Mediterranea n countries, but also in Iceland, Bosnia - Herzegovina & Norway

7. 7 Prevalence last month (beer, wine, breezers; spirits) Notes : - Less than 50% report drinking alcohol last month - Same pattern as regards lifetime use : Hungary, Estonia, Czech Republic and Denmark show higher use than Portugal, Iceland and Bosnia - Herzegovin a

8. 8 Prevalence of drinking 5 times or more (last month) (beer/wine/breezers; spirits) Notes : - Youngste rs from Central European countrie s show frequent use ( e. g. Switzerl and, the Netherla nds, Germany ) - It is the only upper position of Switzerl and in all rankings - Portugal, Iceland and Bosnia - Herzegov ina are lowest again

9. 9 Drunkenness due to beer, wine and breezers (lifetime users) Ever been drunk? Notes : - Estonia and Denmark are leading - Youngsters from Southern and Western European countries have less experience with drunkennes s but also Armenia, Slovenia and Bosnia - Herzegovin a

10. 10 Drunkenness due to spirits (lifetime users) Ever been drunk? Notes : - Nearly same ranking as regards the use of beer / wine / breezers - More youngsters reported getting drunken by using spirits than by beer, wine or breezers

11. 11 Prevalence of drinking 5 units or more last drinking occasion (beer/wine/breezers) Notes : - Drinking high amounts of alcohol (5 alcoholic beverages and more ) is more common in Central and some Northern European countries - Spain is ranked between Northern and Eastern European countries ( and not next to the Mediterrane an countries )

12. 12 Prevalence of drinking 5 units or more last drinking occasion (spirits) Notes : - Drinking high amounts of spirits is less common overall - Similar ranking as regards the use of beer / wine / br eezers

13. PATTERNS OF USE

14. 14 Cluster Analysis Variables  Frequency of use last month (beer, wine, breezers)  Amount of units last drinking occasion (beer, wine, breezers)  Frequency of use last month (spirits)  Amount of units last drinking occasion (spirits) Data  12 – 16 year-olds, 25 countries, with lifetime experience of drinking alcohol

15. 15 K-means clustering no use mild use episodic use frequent use heavy episodic use frequency beer/wine 00.621.9112.473.38 units beer/ wine01.525.466.1715.52 frequency spirits00.120.944.771.99 units spirits00.553.794.796.83 size (%)42.942.011.52.21.5 qualitative differences Cluster means differences in level

16. 16 Identification of country clusters Can the countries be categorized regarding the prevalence of alcohol consumption patterns?

17. 17 Three country clusters 17 MAINLY MILD USE MAINLY NO USE HIGHEST PROPORTION OF INTENSE USE

18. 18 Country clusters PercentEast-Europe Central- Europe North-West- Europe mild use58.141.127.0 episodic use11.315.37.4 frequent use1.61.70.7 heavy episodic use 1.33.51.3 no use27.738.463.6

19. INDICATORS FOR RISKY USE

20. 20 What is risky drinking? 1. Which goals prevention programs aim at? 2. How is risky drinking behaviour measured in scientific studies?

21. Prevention aims and realities Prevention goals - late onset - low frequency - low amount - reduction of risky use habits - drinking only in leisure-time - contextual abstinence - avoid intoxication - … Risky drinking may be - early drinking (minor than 14) - drinking at all - drinking more than once (e.g. weekly use) - high amounts (e.g. heavy episodic drinking) - drinking during examinations - drunkenness (e.g. at least twice in lifetime) - … cp. ESPAD, HBSC abstinence and/or responsible drinking?

22. 22 Operationalisations of risky drinking Frequency 1. Weekly Amount of alcohol 2. Heavy episodic drinking: last month 3. Heavy episodic drinking: lifetime Consequences of use 4. Drunkeness lifetime (at least twice) Setting of use 5. Alone Theoretical derived criteria 6. No use under the age of 14 & less than 5 times last month & less than 5 units last drinking occasion

23. RESULTS

24. 24 Distribution of indicators

25. 25 Distribution of sum of indicators  Over two thirds do not reach any of the criteria  h.e.u. last month does not appear solely

26. 26 Relationships of indicators risky use h.e.u. l.m. h.e.u. lifet. drunken nessweeklyalone risky use 1,695,537,379,465-,023 h.e.d. l.m. 1,845,500,469-,058 h.e.d. lifet. 1,510,365-,060 drunkenness 1,316-,056 weekly 1-,019 alone 1  Drinking alone does not measure the same  Correlations of the indicators show middle to high size

27. 27 Ausgewählte Länder

28. 28 Summary  At least half of the students never drank alcohol in Iceland, Bosnia Herzegovina, France, Portugal, Cyprus and Norway  Estonia, Hungary, Czech Republic and Lithuania show the highest rates of lifetime use  Hungary, Estonia, Czech Republic, Denmark and Germany rank at the top and Bosnia and Herzegovina, Iceland, Portugal and France at the bottom regarding last month use  Frequent drinking shows high ratings in Northern and Central European countries with Estonia, Switzerland, the Netherlands, Germany, Hungary and Denmark  Considering lifetime drunkenness Northern and Eastern European Countries are leading (Estonia, Denmark, Ireland, Finland, Russia, Sweden and Norway)  Heavy drinking of beer, wine and breezers is a common consumption pattern in Western countries (Ireland, Finland, Denmark, the Netherlands and Germany) adolescent alcohol use varies enormously across Europe

29. 29 Summary  Drinking at least 5 units of spirits during one occasion is popular in countries like Estonia, Ireland, Denmark and Poland  Adolescent alcohol use may be described in complex use patterns  There are countries with similar alcohol use patterns  The Nordic drinking style which is characterized by using spirits in high amounts was found especially for Estonia and Lithuania.  The more beer, wine and breezers drinking culture with high levels of episodic drinking was more common in Central European countries  The Mediterranean style of drinking alcohol frequently but in moderation was more prevalent in France, Portugal and Bosnia and Herzegovina. BUT: The problem‘s size differs dependent on the indicator chosen For planing and evaluation of prevention programs a multiple perspective of risk indicators should be taken

30. 30 Open questions � Which should be the aims of preventive efforts? � Which country characteristics may explain these differences in adolescent alcohol use?

31. Beispielbild Alcohol consumption patterns of young adolescents in Europe Renate Soellner & Astrid-Britta Bräker University of Hildesheim AAA-Prevent Alcohol Abuse among Adolescents in Europe Effective Environmental Strategies for Prevention

32. 32 Country clustering: 32 countrymildmoderatefrequentintenseno Germany0.430.140.030.040.36 Netherlands0.440.150.020.040.35 Austria0.400.150.020.030.40 Switzerland0.410.150.030.040.38 Belgium0.410.120.02 0.43 Poland0.420.130.010.040.40 Italy0.450.080.01 0.45 Slovenia0.470.100.010.020.40 Denmark0.350.240.020.050.34 Finland0.400.210.010.050.33 Ireland0.340.220.010.040.40 Czech Rep.0.640.150.010.020.19 Estonia0.590.180.030.020.18 Lithuania0.580.150.010.030.23 Armenia0.580.040.00 0.38 Russia0.530.070.01 0.39 Hungary0.580.100.020.010.29 Norway0.280.130.010.020.56 Sweden0.310.110.010.020.55 Cyprus0.330.060.01 0.59 Portugal0.300.070.01 0.61 Bosnia/H.0.290.050.000.010.65 Spain0.260.100.01 0.62 France0.240.050.000.010.70 Iceland0.140.040.010.000.81 based on %

33. 33