The adolescent drinker : correlates and predictors of alcohol consumption among Swedish youth

Sammanfattning: Background: Drinking among adolescents has declined in most high-income countries during the past two decades. In Sweden, the reduction in youth drinking has been more pronounced than in many other parts of the world. The lower alcohol consumption has been reflected in several indicators. However, many adolescents still drink, and there is an urgency to understand the current situation in light of the non-drinking trend. The studies in this thesis examine concurrent and longitudinal factors not previously examined in a Swedish context. Overall aim: The overarching objective of this thesis is to improve our understanding of alcohol use during mid and late adolescence among contemporary youth. The four studies included in this thesis address this aim by answering the following research questions: (I) What are the motivations for drinking, and how are motives associated with drinking? (II) How are general and institutional trust associated with drinking? (III) How are psychosocial factors related to two-year drinking status? and (IV) Does the age of onset have an independent effect on subsequent drinking? Data and method: All studies of this thesis exploited data from the Futura01 project. Since 2017, this project has followed a cohort of Swedish adolescents born in 2001. A self-reporting school survey was carried out at baseline (T1), and at a follow-up (T2) in 2019, when the respondents were 15/16 and 17/18 years, respectively. At T1, 5,537 individuals (81.7%) participated; at T2, 4,018 individuals (72.4%) participated. Multivariable linear and logistic regression models examined associations with alcohol use. Results: (I) Social and enhancement motives were most strongly associated with drinking frequency, whereas enhancement motives had the strongest association with heavy drinking frequency. Coping-depression motives also had a positive but weaker link with drinking and heavy drinking frequency. Conformity motives were negatively related to how often adolescents drank. (II) General and institutional trust was found to be negatively associated with drinking status, and institutional trust had the stronger link. Cross-combinations with low scores on both trust dimensions were related to the highest probability of drinking. Parental control and support, along with school satisfaction, modified the associations. (III) Abstainers reported better mental health and parental relationships, and worse friendships, whereas the opposite was true for early-onset drinkers. Later-onset drinkers were linked to a more favorable psychosocial situation than early drinkers. (IV) An early drinking onset predicted higher alcohol consumption two years later. Those with the earlier onset scored higher on AUDIT-C and had a higher probability of risky and binge drinking in late adolescence. Early binge drinking was found to be more predictive of later binge drinking than the age of onset of any drinking. Those with early drinking onset were more exposed to risk factors. Conclusions: Adolescents’ motivations for drinking are closely related to their consumption of alcohol. The social aspects of drinking are supported by the links between different forms of trust and alcohol use, in addition to patterns of parent/friend relationships and drinking status in adolescents. Early drinkers are a psychosocially vulnerable group burdened with numerous problems and risk factors for alcohol use. An early drinking onset is also related to more alcohol use in late adolescence. To prevent youth drinking, it is important to improve parent-child relationships, build trust, and support mental health. Preventing early drinking likely reduces alcohol consumption in late adolescence.