Why Focus on Alcohol?

Within a period of about 10 years, young people change from individuals who have never had an alcoholic drink to individuals who, as an age group, are the heaviest drinking section of the population (1, 2).

The harm experienced by young people in alcohol use situations is associated with their own consumption of alcohol and other people's consumption of alcohol, and tends to occur with single occasion use (acute) rather than from long term use (chronic) (3). A higher number of years of potential life, quality of life, and productivity are lost from acute alcohol related events experienced by young people than those lost to chronic diseases associated with alcohol use in older consumers (3). In addition, alcohol is linked to the three leading causes of death among young people: unintentional injuries, homicide and suicide (4).

Approximately 80% of young Australians have consumed alcohol by age 19, with 62.4% of 14-19 year olds consuming alcohol in the last 12 months, and 21.8% consuming alcohol on a weekly basis (2). The success of the SHAHRP program in modifying alcohol-related behaviours is an important program impact, as alcohol use and risk of harm is high. The short and long term harms associated with alcohol use in young people are considerable as alcohol also acts as a precursor to other health and lifestyle problems experienced by young people that can impact negatively on their future (5). In particular, alcohol consumption can act as a risk factor for unsafe sexual practices (6), violence and injury, (7, 8), adverse behavioural problems (9), academic failure (5), and mental health and social problems (10). In addition, early age of onset and feeling drunk during initial drinking experiences increases probability of problem drinking in adulthood (11).

The National Drug Strategy Household Survey 2010 estimates that 57.4% of young Australians aged 14-19 were victims of an alcohol related incident in the previous 12 months (2). In addition, young people have factors unique to their situation that can impact on the potential for harm associated with alcohol consumption. In particular, young people generally have little experience in alcohol use situations and therefore have relatively limited capacity to predict factors that will impact on the event and potential outcomes (12). Young people also have lower tolerance to the effects of alcohol which makes the loss of physical, cognitive and emotional functions more immediate (12). In Australia, the age of first alcohol use remains stable (2), however, alcohol is still estimated to be responsible for 65% of the burden of disease in Australia compared to 19% for tobacco and 16% for illicit drugs respectively (13). To reduce this burden, effective early intervention and prevention strategies are essential.

If schools teach* the SHAHRP program to students, then they can assist in reducing the negative impact of alcohol on young people. The success of the SHAHRP program in modifying alcohol-related behaviours is an important program impact, as alcohol use and risk of harm is high, and alcohol also acts as a precursor to other health and lifestyle problems experienced by young people that can have an impact into their future. In particular, alcohol consumption can act as a risk factor for unsafe sexual practices, violence and injury, adverse behavioural problems, academic failure, and mental health and social problems. Young people also have factors unique to their situation that can impact on the potential for harm associated with alcohol consumption. In particular, young people generally have little experience in alcohol use situations and therefore have relatively limited capacity to predict factors that will impact on the event and potential outcomes. Young people also have lower tolerance to the effects of alcohol, which makes the loss of physical, cognitive and emotional functions more immediate.

References

1. Lowe G. Drinking behaviour and pleasure across the life span. In: Peel S, and Grant, M., editor. Alcohol and pleasure: A health perspective. Philadelphia: Brunner/Mazel; 1999. p. 249-77.
2. AIHW. 2010 National Drug Strategy Household Survey report. Canberra: AIHW, 2011.
3. Chikritzhs T, Jonas, H., Stockwell, T., Heale, P., and Dietze, P. Mortality and life-years lost due to alcohol: A comparison of acute and chronic causes. Medical Journal of Australia. 2011;174:281-4.
4. Miller J, Naimi, T., Brewer R et al. Binge drinking and associated health risk behaviours among high school students. Pediatrics. 2007;119:76-85.
5. NHMRC. Australian Guidelines to reduce health risk from drinking alcohol. Canberra: NHMRC; 2009.
6. Coleman L, and Carter, S. A qualitative study of the relationship between alcohol consumption and risky sex in adolescents. Arch Sex Behav. 2005;34:649 - 61.
7. Mattila V, Parkkari, J,. Lintonen, T., et al. Occurrences of violence and violent-related injuries among 12-18 year old Finns. Scand J Public Health. 2005;33:307-13.
8. Kodjo C, Auigner, P., and Ryan, S. Prevalence of, and factors associated with, adolescent physical fighting while under the influence of alcohol or drugs. Journal of Adolescent Health. 2004;35:346 e11.
9. French M, and Maclean, J. Underage alcohol use, delinquency, and criminal activity. Health Economics. 2006;15:1261-81.
10. Brown S, and Tapert, S. Adolescence and the trajectory of alcohol use: basic to clinical studies. Annals NY Acad Sci. 2004;1021:234-44.
11. Warner L, White, H., and Johnson, V. Alcohol initiation experiences and family history of alcoholism as predictors of problem-drinking trajectories. J Stud Alcohol. 2007;68:56-65.
12. Schippers G, van Aken, M., Lammers, S., and de Fuentes Merillas, L. Acquiring the competence to drink responsibly. In: Houghton E, Roche, A., editor. Learning about drinking. Phildelphia: Brunner-Routledge; 2011. p. 35-55.
13. Begg S, T. Vos, et al. The Burden of Disease and Injury in Australia 2003. Canberra: Australian Institute of Health and Welfare; 2007.

*The findings of SHAHRP are based on teaching 80% of the program as it is presented in the teacher manual