Changing parental behaviour to reduce risky drinking among adolescents: current evidence and future directions
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Changing parental behaviour to reduce risky drinking among adolescents: current evidence and future directions.

Gilligan C., Kypri K, Lubman D.
Alcohol and Alcoholism: 2012, 47(3), p. 349–354.
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Should parents introduce their underage children to alcohol, and if they give their children alcohol, is it important that they supervise its consumption? Opinions and guidelines differ as do research findings, perhaps because much depends on the context.

Summary The featured article review research and makes suggestions regarding the pros and cons of parents supplying alcohol to their children (in particular, those below the legal alcohol purchase or drinking age), sometimes thought a way to inculcate healthy drinking habits.

It starts with the observation that children are exposed to and learn about alcohol from an early age from their parents and families, the wider community and the media. Early offers of drink to their children is one way parents affect their drinking; other influences (either direct or via choice of peer group) include positive family relationships and parenting behaviours.

Guidelines and policies in many countries encourage parents to delay their children's initiation in to drinking or to closely supervise their drinking to dampen progression to problem use. These guidelines are, however, based on limited evidence and mixed research findings which, in some cases, contradict the laws regarding purchase and supply. Epidemiological evidence supports the notion that a lower age of initiation in to drinking is associated with a higher risk of alcohol-related problems, but it seems that the risk factors for drinking per se differ from those for drinking at risky levels and developing alcohol-related problems. Some evidence suggests that the age of first drunkenness is more important than the age of first drink in predicting progression to heavy drinking, and the number of episodes of intoxication prior to age 16 has been found strongly related to adult alcohol problems.

Research on the impact of parental supply of alcohol

Research on whether parental supply of alcohol increases or decreases the risk of alcohol-related problems is limited to some studies which have assessed these relationships at the same point in time, and some which have followed up the children to assess the later effect of parental choices. [Editor's note: The implication is that no study has deliberately assigned families to early parental initiation of the child versus another approach to alcohol-related parenting, and that from the studies which have been done, it will be difficult to establish cause and effect.]

The literature to date presents inconsistent information about the impact of parental supply of alcohol, age of initiation and patterns of use. One Dutch follow-up study found no differences in progression to problem drinking among children whose parents provided high versus low levels of supervision of the child's drinking. [Editor's note: The study also found that children who drank at home or outside were equally more likely to later drink in a problematic way than children who did neither, and that there was no further increase in risk from actually drinking with parents inside or outside the home.] The conclusion was that adolescent alcohol consumption increases over time, regardless of the setting or who they drink with. Another follow-up study sampled families in an Australian and a US state. It found that children who drank under adult supervision [Editor's note: not necessarily the parents] were more likely to later drink and experience alcohol-related harms. As with many others, this study did not ask how much alcohol had been consumed, just how often "more than a few sips" had been drunk.

Other studies have related children's drinking to parental behaviour at the same point in time. One large US study found that supervised rather than unsupervised parental supply was associated with less alcohol being consumed per drinking episode, another that young female college students who had been allowed to drink at home later drank heavily more often, but those allowed to drink with friends drank more alcohol on each drinking occasion. Though the Dutch study referred to above found no effect of drinking at home versus outside the home on later problem drinking, it did find that at the same point in time, drinking at home was associated with lower alcohol consumption than drinking outside. Similarly, an Australian survey found that young people who reported drinking alcohol supplied by their parents, or drinking at home, drank less than those who sourced alcohol from friends or elsewhere and drank outside the home.

Studies by the review authors suggest there are important differences between parents supplying alcohol to drink under their supervision, versus under the supervision of another adult or no supervision. In Australia the latter was found to be linked to risky drinking, but parental supply per se was not, suggesting that its impact depends on how and if consumption is supervised.

Caution should be taken in the interpretation and comparison of results from these studies. Their relevant outcomes range from problem drinking and alcohol-related harms to the frequency and volume of alcohol consumed. Even in follow-up studies, failure to explore interactions between variables over may limit the interpretability of results. Most provide limited information about who was present during drinking occasions, and thus the potential influence of parents, other family members and peers in different circumstances.

Role of parental social networks

Parental decisions about introducing their children to alcohol and their attitudes towards alcohol consumption are fundamentally social phenomena but have not been studied as such. Correcting parents' misperceptions regarding the permissiveness of other parents may lead to them to re-evaluate their stances or adopt more effective rules in relation to drinking.

In relation to stopping smoking and other behaviour change, even individuals not directly in contact are able to influence each other through their common social links. For example, parents may be influenced by what their child tells them parents of their friends are doing. In this way, a network of children may be able to influence an entire more distal network of parents by feeding inaccurate information into that network. If the parents can be connected, information is likely to travel directly between them and maintain its integrity. How to do this is unclear; after their children reach a certain age, parents may be reluctant to intervene in their social lives or to contact other parents to discuss concerns.

The potential to intervene with parents

Few families participating and many dropping out have plagued efforts to address adolescent alcohol consumption through parents and families. Some studies have found that dropouts tend to be the parents most likely to have lenient attitudes to underage alcohol consumption. High dropout is also likely to be partly due to programmes not being acceptable to the parents involved. Those trialled to date are largely high intensity interventions requiring active and sustained parental involvement. Less intensive interventions based on parents' existing resources might be more acceptable and cost-effective. Among these may be web-based approaches, through which parents can engage with guidance and educational materials in a safe environment in their own time.

The authors' conclusions

Parental supply of alcohol and parental monitoring have been linked to initiation to drinking as well as levels of later use, and are likely to be influenced by the practices of other parents and their perceptions of social norms. Sufficient evidence already exists to indicate that intervening with parents, possibly via parental social networks, may be effective in reducing adolescent risky drinking. Future research might profitably explore the volume and contexts of parental alcohol supply, the structure of parent and adolescent social networks, and the existence of 'pluralistic ignorance' among parents, who may be unaware of how other parents handle alcohol-related issues with their children.

Thanks for their comments on this entry in draft to review author Conor Gilligan of the University of Newcastle in Australia. Commentators bear no responsibility for the text including the interpretations and any remaining errors.

Last revised 27 November 2013. First uploaded 23 November 2013

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