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Health Education & Behavior | 1997

Homogeneity of Cigarette Smoking Within Peer Groups: Influence or Selection?

Rutger C. M. E. Engels; Ronald A. Knibbe; Maria J. Drop; Ypie T. de Haan

Many studies stress the relevance of peer group influence as a determinant of smoking behavior of adolescents. Recent research, however, concludes that homogeneity of behavior in friendships is also due to selection; youngsters choose new friends whose behavioral patterns are similar to their own. Data from a three-wave longitudinal study among students of secondary education (N = 1,063) was used to examine sources of peer similarities. The results demonstrated that both influence and selection processes contributed to peer group homogeneity, but the largest part of similarities in smoking status had to be attributed to selection. No support was found for friendships breaking down for reasons of dissimilarity in smoking status. Our findings underscore the complexity of processes and interactions with regard to the relationships of teenagers and offer new views on prevention programs.


Addictive Behaviors | 1997

Inconsistencies in adolescents' self-reports of initiation of alcohol and tobacco use

Rutger C. M. E. Engels; Ronald A. Knibbe; Maria J. Drop

This study focuses on errors in estimations of age at which alcohol and tobacco are used for the first time. The data come from a 5-year longitudinal study with three measurements. Self-reports about age of first use at the baseline measurement were compared with similar self-reports at two follow-up surveys. Adolescents were more likely to report a higher age of first use at follow-up measurements. Those who at the baseline measurement reported having smoked (n = 338) or consumed alcohol (n = 523) 61.7% and 89%, respectively, underestimated their years of use. By comparison with estimations at the first and third measurement, 13.6% for smoking and 4.6% for drinking were consistent about their age of first use. Self-reports about the age of onset at the baseline measurement were correlated with frequency and intensity of tobacco and alcohol use 5 years later to assess the predictive power of age of onset for later use. With one exception (correlation with intensity of alcohol use 5 years later, r = .14) no significant correlation was found. The results show that the concept age of first use should be utilized with caution for two reasons: (1) the reliability of assessment is insufficient, and (2) correlations of different estimates with actual frequency and intensity of consumption at the third wave are inconsistent. Explanations for errors in measurement, and recommendations for improvement, are discussed.


JAMA Pediatrics | 2011

Cultural and Gender Convergence in Adolescent Drunkenness: Evidence From 23 European and North American Countries

Emmanuel Kuntsche; Sandra Kuntsche; Ronald A. Knibbe; Bruce G. Simons-Morton; Tilda Farhat; Anne Hublet; Pernille Bendtsen; Emmanuelle Godeau; Zsolt Demetrovics

OBJECTIVE To investigate time-trend changes in the frequency of drunkenness among European and North American adolescents. DESIGN Cross-sectional surveys in the 1997/1998 and 2005/2006 Health Behaviour in School-Aged Children Study (HBSC). SETTING High schools in 23 countries. PARTICIPANTS A sample of 77 586 adolescents aged 15 years was analyzed by means of hierarchical linear modeling. MAIN OUTCOME MEASURE The frequency of drunkenness. RESULTS We observed a significant increase of about 40% in the mean frequency of drunkenness in all 7 participating Eastern European countries. This increase was evident among both genders, but most consistently among girls. Meanwhile, it declined in 13 of 16 Western countries, about 25% on average. Declines in Western countries were particularly notable among boys and in North America, Scandinavia, the United Kingdom, and Ireland. Despite this gender convergence, with few exceptions (Greenland, Norway, United Kingdom) boys continued to have a higher frequency of drunkenness in 2005/2006 than girls. CONCLUSIONS The confirmed cultural convergence implies that adoption and implementation of evidence-based measures to mitigate the frequency of adolescent drunkenness such as tax increases and restricting alcohol access and advertisement should get the same priority in Eastern European countries as in Western countries. Policy measures that might facilitate decreases in drunkenness such as server training and the promotion of alcohol-free leisure-time activities should be reinforced in Western countries. The gender convergence implies that prevention policy should be less exclusively focused on male adolescents.


European Addiction Research | 2006

Replication and Validation of the Drinking Motive Questionnaire Revised (DMQ-R, Cooper, 1994) among Adolescents in Switzerland

Emmanuel Kuntsche; Ronald A. Knibbe; Gerhard Gmel; Rutger C. M. E. Engels

This paper has two aims: (1) to replicate the four-dimensional structure of the Drinking Motive Questionnaire Revised (DMQ-R) in a national representative sample from Switzerland, and (2) to validate the relevance of distinguishing drinking motives by inspecting the relations with expected consequences, alcohol use, and alcohol-related and other problems. Confirmatory factor analysis and linear structural equation models were estimated based on answers of 5,617 8th to 10th graders (mean 15.1 years; SD = 0.95). The results confirm the four-dimensional factor structure in general and among subpopulations defined by gender, age, and linguistic region. It could also be confirmed that enhancement motives followed by coping motives were strongly related to alcohol use and heavy drinking, whereas conformity motives were negatively related. Coping motives were related to problems independent of whether they were assessed as alcohol-related or not, while enhancement motives were associated solely with alcohol-related problems. In sum, the results demonstrate the robustness of the DMQ-R and its usefulness for assessing drinking motives among European adolescents from different cultural backgrounds.


Addictive Behaviors | 2000

Alcohol use and intimate relationships in adolescence: when love comes to town.

Rutger C. M. E. Engels; Ronald A. Knibbe

The associations between alcohol consumption and intimate relationships in adolescence were examined. Data from a longitudinal study of 1,063 adolescents were used to investigate whether (a) alcohol use was a precursor of partnership and (b) adolescents tended to change their drinking habits once they became involved in a steady relationship. Youngsters who consumed alcohol at the ages of 14 and 15 were more likely to be involved in an intimate relationship 3 years later. Drinking in social settings particularly increased the likelihood of having a partner 3 years later. In addition, for males, partnership was associated with a smaller increase in alcohol consumption in public drinking places compared to the other categories (i.e., adolescents who never had a partner vs. adolescents who had no partner at the time of measurement). In contrast, the increase in consumption at home was the strongest for young men involved in a steady relationship. For females, the differences in changes in consumption between the partnership categories were in most cases not significant.


Substance Abuse | 2001

Alcohol Consumption Estimates in Surveys in Europe: Comparability and Sensitivity for Gender Differences

Ronald A. Knibbe; Kim Bloomfield

The comparability of general population studies on alcohol from nine European countries is evaluated from three points of view: (1) methodologic aspects influencing alcohol estimates, (2) variation between countries in coverage of sales estimates of alcohol consumption, and (3) associations between type of question used to measure alcohol consumption and gender differences in alcohol consumption. With respect to methodologic aspects, it was found that the studies differed on most of the 10 points included in this comparison. The coverage of sales estimates by surveys varies between 39% (Germany) and 56% (France). With respect to type of question and gender differences, it was found that more elaborate sets of questions on alcohol consumption are associated with smaller gender differences in the prevalence of heavy drinking (>600 g 100% alc/mo). It is concluded that the methodologic differences between studies and the differences in sales coverage do not allow cross‐national comparison of survey estimates of alcohol consumption of different European countries. Compared with more elaborate sets of questions on alcohol consumption, simple questions on alcohol consumption are likely to underestimate gender differences in the prevalence of heavier drinking.


Addiction | 2011

Alcohol-related negative consequences among drinkers around the world

Kathryn Graham; Sharon Bernards; Ronald A. Knibbe; Sylvia Kairouz; Sandra Kuntsche; Sharon C. Wilsnack; Thomas K. Greenfield; Paul Dietze; Isidore Obot; Gerhard Gmel

AIMS This paper examines (i) gender and country differences in negative consequences related to drinking; (ii) relative rates of different consequences; and (iii) country-level predictors of consequences. DESIGN SETTING AND PARTICIPANTS Multi-level analyses used survey data from the Gender, Alcohol, and Culture: An International Study (GENACIS) collaboration. MEASUREMENTS Measures included 17 negative consequences grouped into (i) high endorsement acute, (ii) personal and (iii) social. Country-level measures included average frequency and quantity of drinking, percentage who were current drinkers, gross domestic product (GDP) and Human Development Index (HDI). FINDINGS Overall, the three groupings of consequences were reported by 44%, 12% and 7% of men and by 31%, 6% and 3% of women, respectively. More men than women endorsed all consequences, but gender differences were greatest for consequences associated with chronic drinking and social consequences related to male roles. The highest prevalence of consequences was in Uganda and lowest in Uruguay. Personal and social consequences were more likely in countries with higher usual quantity, fewer current drinkers and lower scores on GDP and HDI. However, significant interactions with individual-level quantity indicated a stronger relationship between consequences and usual quantity among drinkers in countries with lower quantity, more current drinkers and higher scores on GDP and HDI. CONCLUSIONS Both gender and country need to be taken into consideration when assessing adverse drinking consequences. Individual measures of alcohol consumption and country-level variables are associated with experiencing such consequences. Additionally, country-level variables affect the strength of the relationship between usual quantity consumed by individuals and adverse consequences.


Substance Abuse | 2001

Gender differences in drinking patterns in nine European countries: descriptive findings

Salme Ahlström; Kim Bloomfield; Ronald A. Knibbe

Gender differences in drinking patterns in nine European countries (the Czech Republic, Finland, France, Germany, Italy, The Netherlands, Scotland, Sweden, and Switzerland) were examined using data from surveys conducted in the late 1980s and early 1990s. Drinking patterns were analyzed with regard to sociodemographic variables such as age, education, employment, marital status, and parenthood. Age was closely related to drinking in every society, but the patterns were different in different societies. Women with higher education tended to consume more alcohol than women with lower education in many societies, whereas a similar pattern was not found among men. Unemployment seemed to be more strongly related to womens drinking than to that of men. Divorced men consistently consumed the most alcohol in every country. Parenthood was profoundly and consistently associated across societies with womens monthly consumption and prevalence of heavy drinking.


Social Science & Medicine | 2009

Social roles and alcohol consumption: A study of 10 industrialised countries

Sandra Kuntsche; Ronald A. Knibbe; Gerhard Gmel

The empirical evidence as regards the precise associations between alcohol use and social roles, and these associations across genders and cultures is heterogeneous. The literature tends to focus on two central but conflicting theories. The first - classic role theory - assumes that a higher number of social roles is associated with a more structured life and thus fewer opportunities to drink heavily. The second - the multiple burden hypothesis - posits that the increasing complexity of multiple social roles leads to higher stress levels, and thus to increased alcohol use. Survey data on 25-54-year olds in 10 western industrialised countries which participate in the Gender, Alcohol and Culture: An International Study (GenACIS) project were used to test whether holding the three main social roles - partnership, parenthood, and paid labour - had a more protective or a more detrimental association with problematic alcohol use than holding fewer roles. Age and education were included as possible confounders, while the outcome variables were risky single occasion drinking (RSOD) and heavy-volume drinking. For both men and women and in almost all countries, the study found that those who had all three roles were least likely to drink heavily or engage in RSOD, thus supporting the assumptions of classic role theory. It also found that the protective effect of multiple roles was more consistent for RSOD. There were a few countries where a two-role model gave a better fit. Results for Germany (RSOD), Switzerland, and the Unites States (heavy-volume drinking) indicate that the role of paid labour appears to be particularly relevant for risky alcohol use among women. Despite some variability in the association between paid labour and heavy drinking or RSOD among women, in almost all countries the greater the number of roles a person held, the lower their risk of this type of alcohol use was.


Substance Use & Misuse | 2011

Contextual Determinants of Alcohol Consumption Changes and Preventive Alcohol Policies: A 12-Country European Study in Progress

Allaman Allamani; Fabio Voller; Adriano Decarli; Veronica Casotto; Karin Pantzer; Peter Anderson; Antoni Gual; Silvia Matrai; Zsuzsanna Elekes; Irmgard Eisenbach-Stangl; Gabriele Schmied; Ronald A. Knibbe; Sturla Nordlund; Oystein Skjaelaaen; Börje Olsson; Jenny Cisneros Örnberg; Esa Österberg; Thomas Karlsson; Martin Plant; Moira Plant; Patrick Miller; Nikki Coghill; Grazyna Swiatkiewicz; Beatrice Annaheim; Gerhard Gmel

Beginning with France in the 1950s, alcohol consumption has decreased in Southern European countries with few or no preventive alcohol policy measures being implemented, while alcohol consumption has been increasing in Northern European countries where historically more restrictive alcohol control policies were in place, even though more recently they were loosened. At the same time, Central and Eastern Europe have shown an intermediate behavior. We propose that country-specific changes in alcohol consumption between 1960 and are explained by a combination of a number of factors: (1) preventive alcohol policies and (2) social, cultural, economic, and demographic determinants. This article describes the methodology of a research study designed to understand the complex interactions that have occurred throughout Europe over the past five decades. These include changes in alcohol consumption, drinking patterns and alcohol-related harm, and the actual determinants of such changes.

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Emmanuel Kuntsche

Radboud University Nijmegen

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Emmanuel Kuntsche

Radboud University Nijmegen

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