Peer pressure. Suggestive advertising. Easy access. Family support. Which of these things is capable of stimulating adolescent alcohol abuse? The answer is surprising. A report in the May Journal of Studies on Alcohol and Drugs found that adult-supervised drinking results in higher levels of harmful alcohol use in adolescents, whether families live in an environment that supports supervised drinking or not. Rather than being a rite of passage to adulthood and a method of teaching responsible drinking behavior, allowing adolescents to drink alcohol—even under the supervision and guidance of their family—may be setting them up for future failure to control alcohol intake and effects.

Barbara McMorris, Ph.D., a senior research associate with the Center for Adolescent Nursing in the Healthy Youth Development Prevention Research Center at the University of Minnesota, and colleagues sought to compare adolescents in two opposing alcohol cultures. Washington state was chosen as representative of a culture that professes "zero tolerance" policies, in the form of laws setting a minimum age for possession and purchase of alcohol with severe consequences for use and school district policies that promote abstinence. Victoria, Australia, was selected to represent a "harm-minimization" policy, in which alcohol use is considered part of normal adolescent development that parents should supervise to encourage responsible drinking. Government guidelines in Victoria have, until recently, supported this approach.

The study consisted of three annual survey administrations from 2002 to 2004 to a cohort of students who were in seventh grade at initiation. A total of 1,945 students and their parents (961 in Washington and 984 in Victoria) participated; males and females were equally represented in both states. Annual survey completion rates during the three years of the project (grades seven through nine) were consistently high for both states, with more than 97 percent completing surveys at 12-month follow-up in 2003 and a 24-month follow-up in 2004.

Acknowledging the difficulty of an international comparison, the research team used longitudinal self-report data from a survey instrument that underwent several tests to ensure that items were being perceived in the same manner by U.S. and Australian teens. Matched sampling, recruitment, administration, and follow-up procedures were used to produce a panel of Australian and American youth participating in the International Youth Development Study.

Most survey measures originated from the Communities That Care self-report survey. Researchers asked the students questions about opportunities to use alcohol under adult supervision, frequency of alcohol use in the prior year, harmful consequences including loss of control and social conflict, and parental attitudes toward alcohol use. Sociodemographic variables such as gender, age, and family socioeconomic status were also determined.

"Predictably, the prevalence of alcohol-use behavior in both states increased over time between seventh and ninth grades," said the researchers. "Lifetime alcohol use by seventh grade among Victoria students was significantly higher than among Washington students" (59 percent vs. 39 percent) and continued to increase. By ninth grade, the rate of alcohol use had increased to 71 percent in Victoria and 45 percent in Washington.

Surprisingly, state context had no effect on the differences between the two groups: "The national policy contexts concerning adolescent drinking were strikingly different in Washington and Victoria at the time of this study. Despite policy differences, … relationships between family context variables and alcohol use and harms are remarkably similar between youth in both states," said the researchers

Their conclusions? "Despite policy differences in the two states, relationships between family context variables and alcohol use and harmful use are remarkably similar. Adult-supervised settings for alcohol use resulted in higher levels of harmful alcohol consequences, contrary to predictions derived from harm-minimization policy. Findings challenge the harm-minimization position that supervised alcohol use or early-age alcohol use will reduce the development of adolescent alcohol problems.

And their conclusions contained some advice for parents. "These results … lead us to suggest that policies should not encourage parents to drink with their children nor provide opportunities to supervise their use. Even after adolescents begin to drink, adult supervision of alcohol use appears to exacerbate continued drinking and harms associated with drinking."

An abstract of "Influence of Family Factors and Supervised Alcohol Use on Adolescent Alcohol Use and Harms: Similarities Between Youth in Different Alcohol Policy Contexts" is posted at <www.ncbi.nlm.nih.gov/pubmed/21513678>.