Alexandra Aiken

Cohort Profile: The Australian Parental Supply of Alcohol Longitudinal Study (APSALS)

The Australian Parental Supply of Alcohol Longitudinal Study (APSALS) was established in 2010 to investigate the short- and long-term associations between exposure to early parental alcohol provision, early adolescent alcohol initiation, subsequent alcohol use and alcohol-related harms, controlling for a wide range of parental, child, familial, peer and contextual covariates. The cohort commenced with 1927 parent-child dyads comprising Australian Grade 7 school students (mean age = 12.9 years, range = 10.8-15.7 years), and a parent/guardian. Baseline, 1- and 2-year follow-up data have been collected, with > 90% retention, and a 3-year follow-up is under way. The data collected include child, familial, parental and peer factors addressing demographics, alcohol use and supply, parenting practices, other substance use, adolescent behaviours and peer influences. The cohort is ideal for prospectively examining predictors of initiation and progression of alcohol use, which increases markedly through adolescence.

Parental supply of alcohol and alcohol consumption in adolescence: prospective cohort study

BACKGROUND Parents are a major supplier of alcohol to adolescents, yet there is limited research examining the impact of this on adolescent alcohol use. This study investigates associations between parental supply of alcohol, supply from other sources, and adolescent drinking, adjusting for child, parent, family and peer variables. METHOD A cohort of 1927 adolescents was surveyed annually from 2010 to 2014. Measures include: consumption of whole drinks; binge drinking (>4 standard drinks on any occasion); parental supply of alcohol; supply from other sources; child, parent, family and peer covariates. RESULTS After adjustment, adolescents supplied alcohol by parents had higher odds of drinking whole beverages [odds ratio (OR) 1.80, 95% confidence interval (CI) 1.33-2.45] than those not supplied by parents. However, parental supply was not associated with bingeing, and those supplied alcohol by parents typically consumed fewer drinks per occasion (incidence rate ratio 0.86, 95% CI 0.77-0.96) than adolescents supplied only from other sources. Adolescents obtaining alcohol from non-parental sources had increased odds of drinking whole beverages (OR 2.53, 95% CI 1.86-3.45) and bingeing (OR 3.51, 95% CI 2.53-4.87). CONCLUSIONS Parental supply of alcohol to adolescents was associated with increased risk of drinking, but not bingeing. These parentally-supplied children also consumed fewer drinks on a typical drinking occasion. Adolescents supplied alcohol from non-parental sources had greater odds of drinking and bingeing. Further follow-up is necessary to determine whether these patterns continue, and to examine alcohol-related harm trajectories. Parents should be advised that supply of alcohol may increase childrens drinking.

Parents Who Supply Sips of Alcohol in Early Adolescence: A Prospective Study of Risk Factors.

BACKGROUND: Parents are a major supplier of alcohol to adolescents, often initiating use with sips. Despite harms of adolescent alcohol use, research has not addressed the antecedents of such parental supply. This study investigated the prospective associations between familial, parental, peer, and adolescent characteristics on parental supply of sips. METHODS: Participants were 1729 parent–child dyads recruited from Grade 7 classes, as part of the Australian Parental Supply of Alcohol Longitudinal Study. Data are from baseline surveys (Time 1) and 1-year follow-up (Time 2). Unadjusted and adjusted logistic regressions tested prospective associations between Time 1 familial, parental, peer, and adolescent characteristics and Time 2 parental supply. RESULTS: In the fully adjusted model, parental supply was associated with increased parent-report of peer substance use (odds ratio [OR] = 1.20, 95% confidence ratio [CI], 1.08–1.34), increased home alcohol access (OR = 1.07, 95% CI, 1.03–1.11), and lenient alcohol-specific rules (OR=0.88, 95% CI, 0.78–0.99). CONCLUSIONS: Parents who perceived that their child engaged with substance-using peers were more likely to subsequently supply sips of alcohol. Parents may believe supply of a small quantity of alcohol will protect their child from unsupervised alcohol use with peers. It is also possible that parental perception of peer substance use may result in parents believing that this is a normative behavior for their child’s age group, and in turn that supply is also normative. Further research is required to understand the impacts of such supply, even in small quantities, on adolescent alcohol use trajectories.

Pre-Drinking Behavior of Young Heavy Drinkers

ABSTRACT Background: Pre-drinking has been linked to subsequent heavy drinking and the engagement in multiple risky behaviors. Objectives: The present study examined a group of adolescents who recently had a “big night out” to determine whether there were differences in their pre-drinking behavior based on age, gender, geographic location, and social setting. Methods: Participants (n = 351, aged 16–19) representing the heaviest 20–25% of drinkers in their age group were recruited using nonrandom sampling from metropolitan (Melbourne, Sydney, Perth) or regional (Bunbury) locations across Australia and administered a survey by a trained interviewer. Results: Almost half the sample pre-drank (n = 149), most commonly at a friends house. Those aged 18–19 were more likely to pre-drink, and did so at higher quantities compared to their younger counterparts. Males and females reported similar pre-drinking duration, quantity and amount spent on alcohol. Compared to those in cities, regional participants consumed greater quantities over longer periods of time. Two-thirds of participants consumed alcohol in excess of national guidelines during their pre-drinking session. These participants were more likely to nominate price as a motivation to pre-drink and were less likely to report that someone else provided them alcohol. Conclusions: This study sheds light on the pre-drinking habits of a population of young risky drinkers, and highlights the need for policy makers to address this form of drinking to reduce alcohol-related harm among young people.

Association of parental supply of alcohol with adolescent drinking, alcohol-related harms, and alcohol use disorder symptoms: a prospective cohort study

BACKGROUND Some parents supply alcohol to their children, reportedly to reduce harm, yet longitudinal research on risks associated with such supply is compromised by short periods of observation and potential confounding. We aimed to investigate associations between parental supply and supply from other (non-parental) sources, with subsequent drinking outcomes over a 6-year period of adolescence, adjusting for child, parent, family, and peer variables. METHODS We did this prospective cohort study using data from the Australian Parental Supply of Alcohol Longitudinal Study cohort of adolescents. Children in grade 7 (mean age 12 years), and their parents, were recruited between 2010 and 2011 from secondary schools in Sydney, Perth, and Hobart, Australia, and were surveyed annually between 2010 and 2016. We examined the association of exposure to parental supply and other sources of alcohol in 1 year with five outcomes in the subsequent year: binge drinking (more than four standard drinks on a drinking occasion); alcohol-related harms; and symptoms of alcohol abuse (as defined by Diagnostic and Statistical Manual of Mental Disorders, 4th edition [DSM-IV]), alcohol dependence, and alcohol use disorder (as defined by DSM-5). This trial is registered with ClinicalTrials.gov, number NCT02280551. FINDINGS Between September, 2010, and June, 2011, we recruited 1927 eligible parents and adolescents (mean age 12·9 years [SD 0·52]). Participants were followed up until 2016, during which time binge drinking and experience of alcohol-related harms increased. Adolescents who were supplied alcohol only by parents had higher odds of subsequent binge consumption (odds ratio [OR] 2·58, 95% CI 1·96-3·41; p<0·0001), alcohol-related harm (2·53, 1·99-3·24; p<0·0001), and symptoms of alcohol use disorder (2·51, 1·46-4·29; p=0·0008) than did those reporting no supply. Parental supply of alcohol was not significantly associated with the odds of reporting symptoms of either alcohol abuse or dependence, compared with no supply from any source. Supply from other sources was associated with significant risks of all adverse outcomes, compared with no supply, with an even greater increased risk of adverse outcomes. INTERPRETATION Providing alcohol to children is associated with alcohol-related harms. There is no evidence to support the view that parental supply protects from adverse drinking outcomes by providing alcohol to their child. Parents should be advised that this practice is associated with risk, both directly and indirectly through increased access to alcohol from other sources. FUNDING Australian Research Council, Australian Rotary Health, Foundation for Alcohol Research and Education, National Drug and Alcohol Research Centre.

Most recent risky drinking session with Australian teenagers

Objective: Despite declines in Australian alcohol consumption, youth alcohol related harms remain prevalent. These alcohol‐related consequences appear to be driven by a subset of risky drinkers who engage in ‘high intensity’ drinking episodes and are underrepresented in national health surveys. This project aims to investigate high risk drinking practices and alcohol‐related harms amongst young people not otherwise recorded in existing data.

Insomnia and regulation of sleep-wake cycle with drugs among adolescent risky drinkers

STUDY OBJECTIVES We aimed to explore symptoms of insomnia in a group of youths characterized as engaging in risky drinking, their use of drugs as sleep/ wake aids, and the relationships between alcohol and other drug use and insomnia. METHODS Face-to-face interviews were conducted with 596 Australian 14 to 19-year-olds identified as engaging in regular risky drinking. They completed the Insomnia Severity Index and were assessed for recent alcohol and other drug use, including drugs used specifically as sleep aids or to stay awake. Alcohol-related problems, emotional distress, self-control, and working outside of traditional hours were also assessed using validated scales. RESULTS More than one-third of the study participants (36%) reported moderate to very severe sleep-onset insomnia, and 39% screened positive for clinical insomnia using adolescent criteria. Three-fourths used drugs in the past 2 weeks to regulate their sleep cycle (65% used stimulants to stay awake, mainly caffeine, and 32% used a depressant to get to sleep, mainly cannabis). Regression analyses showed that after controlling for variables such as sex, emotional distress, self-control, alcohol use problems, and past 6-month illicit or non-prescribed drug use, those who used drugs specifically to get to sleep or to stay awake were 2.0 (P < .001) and 1.7 (P = .02) times more likely to report clinical insomnia, respectively. CONCLUSIONS Insomnia was commonly reported in this community sample of adolescents characterized as engaging in risky drinking. Those with symptoms of insomnia appeared to be managing their sleep-related symptoms through alcohol and other drug use, which may have further exacerbated their sleep issues.

Youth perceptions of alcohol advertising: are current advertising regulations working?

Objectives: We investigated young people’s exposure to alcohol advertising, their intentions to consume and purchase alcohol products following the viewing of advertisements, and whether they perceived the actors in the advertisements as being under the age of 25 years.

Parent characteristics associated with approval of their children drinking alcohol from ages 13 to 16 years: prospective cohort study

Objective: We investigated parent sociodemographic and drinking characteristics in relation to whether they approved of their children drinking at ages 13, 14, 15 and 16 years.

A prospective cohort study of adolescent alcohol initiation and progression to binge drinking

Introduction and Aims: Substance misuse results in a range of social harms. Estimating alcohol, nicotine and illicit drug use in the community is important, with current estimates reliant upon self-report data and subject to biases. Chemists can now quantify substances in wastewater using an internationally validated method. This research estimated consumption levels based upon contaminants discharged in municipal wastewater treatment plants in metropolitan and regional Victoria sites during a week in March and June/July 2015.National Drug and Alcohol Research Centre, University of New South Wale; Deakin University, School of Psychology, Faculty of Health,Centre for Social and Early Emotional Development; Murdoch Childrens Research Institute, The Royal Children’s Hospital Melbourne, The University of Melbourne (Paediatrics and Psychological Sciences); National Drug Research Institute, Curtin University; Queensland Alcohol and Drug Research and Education Centre and Schools of Population Health and Social Science, University of Queensland; Discipline of Paediatrics and Child Health, The University of Sydney, The Children’s Hospital at Westmead; Department of Obstetrics, Royal Prince Alfred Hospital; School of Nursing and Midwifery, Curtin University