From the Journals

Declines in frequent binge drinking vary in some teen subgroups

Publish date: May 22, 2017
Author(s):
Catherine Cooper Nellist

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Decline in binge drinking not uniform

Teens who drink heavily are more likely to have unprotected sex, perform poorly at school or work, and have problems with their parents.‍ Monitoring the Future data previously have shown that since the late 1990s, the prevalence of binge drinking has dropped to lows of 3%, 10%, and 16% among 8th, 10th, and 12th graders, respectively.

Dr. Jang et al. took a look at Monitoring the Future data to see how age, period, and cohort effects might alter FBD patterns among teens. There was an overall decrease in FBD since the 1990s, with the greatest decline among teens born between 1985 and 1990. It appeared that period and cohort effects drove this decline.

However, some subgroups exhibited differences. “The decline in frequent heavy drinking is not uniform, with female adolescents, black youth, and youth from low-SES backgrounds experiencing a less steep decline.”

“Pediatric primary care providers have an opportunity to screen all adolescents for alcohol use as part of routine annual care and to provide brief prevention and early intervention strategies.‍ Despite the reassuring decline in frequent heavy drinking, it is critical that ongoing efforts address differences in declining rates to avoid exacerbating disparities.”

Justine Wittenauer Welsh, MD, of Emory Adolescent Substance Abuse Treatment Services, Emory University, Atlanta; John Rogers Knight, MD, at the Center for Adolescent Substance Abuse Research, Boston Children’s Hospital; and Scott Evan Hadland, MD, MPH, of Boston University, made these comments in an accompanying editorial (Pediatrics. 2017 May 22;139[6]:e20170932). The authors said they received no funding and have no relevant financial disclosures.


 

FROM PEDIATRICS

The drop in frequent binge drinking (FBD) among adolescents can be attributed to age, period, and cohort effects, but there are variations in certain subgroups of teens, said Joy Bohyun Jang, PhD, and her associates.

The decline in FBD is not as great in teen girls, African American youth, and youth from low socioeconomic backgrounds, so those groups deserve close attention by researchers and clinicians, they said.

Galina Barskaya/Fotolia
Monitoring the Future has conducted nationally representative cross-sectional surveys of 8th-, 10th-, and 12th-grade students annually since 1991, with roughly 45,000 adolescents included each year. This study includes 1,065,022 student responses on self-administered questionnaires during 1991-2015 regarding binge drinking (at least five alcoholic drinks in a row) during the prior 2 weeks (Pediatrics. 2017 May 22;139[6]:e20164023).

The study used an age-period-cohort analysis to examine how these variables affected drinking trends among adolescents, with a particular focus on FBD, which was defined as two or more occasions of consuming at least five alcoholic drinks in a row in the past 2 weeks.

FBD decreased in recent years in all ages during adolescence, suggesting that declines in teen FBD in the past 25 years were “driven by factors influencing all age groups simultaneously as well as influences on particular birth cohorts,” the researchers said. These factors might include greater public efforts to lessen the risk of underage drinking and disapproval of heavy alcohol use among the recent cohorts of teens. “Those born around 1990 had the highest decline of FBD compared with those in the preceding and subsequent cohorts of adolescents.”

But there are variations in FBD among teens by demographics. Boys and those of higher socioeconomic status (SES) showed rapid increases in FBD by age, compared with girls and teens of lower SES, respectively. However, there also has been a convergence in FBD by sex in the more recent time periods because of greater declines in FBD among boys than in girls. Likewise, there is a growing discrepancy by SES in FBD in U.S. teens because higher SES teens were less likely than those from a lower SES to engage in FBD and “the strength of the association is growing in more recent time periods.”

African American youth had the lowest rates of FBD for all the racial groups, yet declines in FBD have been slower among African American youth, compared with white adolescents, since 2007, reported Dr. Jang of the University of Michigan, Ann Arbor, and her associates.

The study was supported by grants from the National Institute on Alcohol Abuse and Alcoholism, the National Institute on Drug Abuse, and was funded by the National Institutes of Health. Dr. Jang and her associates said they had no relevant financial disclosures.

cnellist@frontlinemedcom.com

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