Consultation on Underage Drinking: Response to the Department of Health and Ageing (October 2004)

Contact: Rosemary McClean
Policy & Program Adviser
Australian Drug Foundation
PO Box 818
North Melbourne VIC 3051
Tel: 03 9278 8817
E-mail: rosemary@adf.org.au

The Australian Drug Foundation

The Australian Drug Foundation is a charitable, not–for-profit, independent organisation. The ADF is the largest non-government organisation in Australia working in the area of prevention of drug problems. It has been serving the community since 1959.

The ADF ’s mission is to work in partnership with the community so as to strengthen their capacity to prevent alcohol and drug problems and reduce alcohol and drug harms. The concept of harm minimisation underpins the work of the ADF .

To efficiently utilise resources and achieve maximum outcomes the ADF has identified two priority issues on which to focus its energies and efforts.

The priority issues for 2004 –2006 are:

• The harm experienced by young people through the heavy and unsafe use of alcohol.
• The capacity of the Australian community to respond promptly and effectively to emerging and current drugs and drug use patterns.

These issues are being addressed though the main program strategies of research, information, community education and development; and advocacy.

Current ADF programs and services include:

• The DrugInfo Clearinghouse (incorporating the Resource Centre, the Somazone and ADIN websites and the Druginfo Shop), works to develop and disseminate quality, reliable information on alcohol and drugs to the wider community.
• The Centre for Youth Drug Studies conducts a range of research studies into the factors that influence young people’s drinking and drug use. The findings from these studies feed directly into developing more effective responses.
• The Good Sports Program: an innovative community development project working with community sporting clubs to enable them to manage alcohol in a responsible manner.
• Community Alcohol Action Network , an advocacy program assisting the community to respond to inappropriate alcohol marketing and supply issues.
• Policy development: the ADF contributes to the development and review of drug and alcohol policy, regulation and legislation.

The ADF ’s position on youth alcohol use

The Australian Drug Foundation welcomes this opportunity to present its views and concerns regarding the harmful use of alcohol by young people to this review of underage drinking. The consultation paper circulated is broad in context and raises many of the issues of interest to the ADF and we will confine our comments to these. ADF representatives have also participated in a consultation forum in Melbourne.

This submission avoids the term ‘underage drinking’ as the ADF finds this misleading, implying that the harm lies in the fact that the drinkers are not 18 years of age rather than the harmful pattern and levels being consumed. It makes it a legal issue rather than a health or welfare issue. The terms ‘youth drinking’ and ‘harmful use of alcohol by young people’ will be used instead.

The fact that the ADF has identified the harm experienced by young people through the heavy and unsafe use of alcohol, as one of its two priority issues for 2004 –2006 is evidence of the level commitment that the ADF has to this issue.

The ADF advocates that young people under the age of 16 years should avoid the consumption of alcohol, due to the increased risk of harm posed by their physical, mental and emotional immaturity. Please see Appendix 1 for more detail.

Responses to key questions posed on the consultation paper

1. What should the realistic goals of such a strategy be in terms of actual youth behaviour?

It is unrealistic to aim to stop or prevent all underage drinking. It is more appropriate to focus on goals which contribute to a reduction in the level of harm experienced by young drinkers. Goals could include:

• Delaying the age of commencement of drinking;
• Reducing the frequency of incident of intoxication experienced by high risk drinkers;
• Increasing the knowledge and understanding among young people of what constitutes high risk and low risk drinking and the ‘real’ consequences of harmful alcohol use.
• Increasing s upport for young people in their choice not to drink or to practice low risk drinking.

2. In relation to community norms and values:
What are the social structures that we need to influence to increase understanding of low risk drinking?

The key social Influencers of young people include parents; peers and friends; educators and teachers; the media; entertainments and sporting personalities; and the environments in which young people socialise such as sporting clubs.

The ADF believes there are a number of key social and cultural factors, which are working to support and promote harmful alcohol use by young people.

1. Our alcohol culture: alcohol is associated with every aspect of life in Australia. Young people are ‘taught’ to drink, and to expect to drink, in our society through their exposure to our alcohol culture. They see adults drinking and associate the use of alcohol with reaching maturity. Significant role models include parents, older siblings, sports people and media identities. This is an issue when the alcohol use being modelled is high risk. The depiction of alcohol use in youth orientated media is of particular concern.

In 2003 the ADF established the Community Alcohol Action Network. CAAN is an advocacy program that addresses social and cultural factors that promote unsafe drinking. CAAN currently has over 1200 community members. The key issues for CAAN are the marketing and supply of alcohol.

2. New alcohol products: a worrying development has been the emergence of a new style of alcoholic beverages that are more attractive to younger drinkers. These designer drinks/alcopops/alcoholic sodas/RTDs are generally sweeter, come in bright colours and are packaged and promoted in ways which appeal to the younger end of the market. The alcohol industry denies that these drinks are designed to attract young drinkers but research shows that these drinks have been enthusiastically taken up by young drinkers. Designer drinks are popular with underage drinkers. The 1999 Australian School Students Alcohol and Drug Survey, found alcopops were the third favourite alcoholic beverage overall, replacing beer and spirits as preferred drinks for older and younger girls.

While problem drinking is multi-causal, influenced by a combination of psychological, biological and environmental influences, there is little doubt the new generation of designer drinks encourage young people to drink and make it easier for them to do so. The way these drinks look, taste, are packaged, marketed and priced all contribute to their appeal to very young drinkers.

3. Alcohol marketing: the alcohol industry is powerful and sophisticated, employing cutting edge marketing techniques. While the National Committee for the Review of Alcohol and Advertising reviewed the self-regulation system of alcohol advertising in 2003 and several recommendations were implemented in March 2004, the ADF still has grave concerns about how effectively alcohol advertising is controlled.

The code has been extended to cover advertising on the Internet, however this does not cover other forms of promotion on the Internet such as games, animations, quizzes and give-aways; marketing techniques commonly used by alcohol companies.

Another area of alcohol marketing with powerful influence, but which is still largely unregulated, is alcohol sponsorship of sporting and cultural events.

As controls are tightened on advertising, the industry is developing more creative 'below the line' marketing activities. Strategies such as roaching and SMS-based campaigns have emerged which are not covered by the existing code.

How do we identify community champions and role models for young people?

To identify positive role models (there are already plenty of role models for poor alcohol practices) it is essential to understand and be in tune with current youth culture. This requires a constant dialogue with young people that covers the whole spectrum of youth (they are not a homogenous group), including variables such as age, gender, level of maturity, ethnicity, location, work or education status etc etc.

As well as high profile role models from sports, television and music, effective role models can be parents, peers, older siblings, teachers, and community leaders. The role of youth ‘mentors’ on a local level could be further investigated.

Care needs to be taken when using high profile role models. Given the frailties of human nature, the type of events attended by celebrities and the vagaries of the media spotlight, they run the risk of being portrayed as negative role models when pictured having a drink at an event.

What are the educational strategies that will help?

Any educational or information strategy must be founded in research as discussed above. Messages and information needs to be targeted at particular influences of young people. Strategies must be responsive to new trends such as changes in drinking behaviours and emergence of new (sub)cultures.

Education needs to be tailored to be relevant to the particular development phases and specific to (sub) groups. Various developmental transition periods should be recognised (moving to secondary school; leaving school/starting work or tertiary education) – which can be times of considerable stress and trauma creating a high-risk period.

It is essential that there is a consistent understanding of what is being communicated. Too often campaigns are delivered without sufficient briefing and support information for health and welfare workers to implement and support the campaign at a local level.

The education and information must be delivered in appropriate format. There is a need to get cleverer and look for innovative ways to deliver the information and messages via channels that have credibility and are influential with young people. Government, in particular should be aware that government generated campaigns run the risk of not being credible with a youth target group. Governments may be better off being the facilitator of information and education programs to the groups, organisations and individuals who have credibility amongst young people.

The education of young people, re alcohol should not necessarily be separate from wider community alcohol education programs. The ADF ’s Good Sports program is a good example of a ‘whole community’ approach - where the ‘community’ is the community sporting club. By implementing practical measures to improve the responsible management of alcohol, the whole club community, including juniors, are being exposed to more appropriate modelling of alcohol use.

Parents have a central role through their behaviour and examples. However parents often express confusion and a lack of confidence on what to say and do. Practical and relevant education and guidelines for parents is required.

Education and information programs and strategies need to be properly researched and evaluated. Research evidence of ‘what work’s needs to be conducted and disseminated in ways that can be effectively translated into practice.

One of the aims of the ADF ’s DrugInfo Clearinghouse is to inform professionals of the most current evidence available for use in their prevention work. This is achieved by gathering, developing and disseminating the drug prevention research and evidence base through a variety of formats, tailored to suit a variety of audiences. Research reports, fact sheets, newsletters and e-mail alerts are all utilised. Visit www.druginfo.adf.org.au for more details.

3. In relation to availability of alcohol to young people
· What are the legal frameworks that will help?
· Should we review the minimum drinking age?
· Whose responsibility is it to manage the licensed environment?
· What are the economic strategies that will help?
· Should pricing be a disincentive to consume alcohol?

Alcohol is easily available with research showing teenagers having little or no difficulty in obtaining alcohol. Many young people are supplied alcohol by adults, not always their parents or guardians. Generally it is not an offence for an under-18 year old to consume alcohol in a private home but legislation differs between states and territories. For example, in NSW, it is an offence to supply or buy alcohol for a minor without being authorised to do so by the minor’s parents or guardian. This has important implications for private parties and other events where alcohol is supplied outside of licensed premises. There is an urgent need to standardise liquor supply legislation nationally with regard to this issue with the ADF supporting adoption of the NSW legislation.

Within licensed premises there is great variation on how responsibly alcohol is supplied. It is appropriate that there be continued and increased pressure on licensees and their staff to ensure responsible service of alcohol.

The ADF does not propose that the legal drinking age be raised, due to a range of social and cultural considerations. Again we stress that the major issue is not whether someone has turned 18 but the level and pattern of drinking and so the level of harm that is being experienced. The ADF does advise that those under the age of 16 years should avoid alcohol (see Appendix 1).

Cost is well known as a disincentive and one move that may be effective is to have a system of minimum pricing related to alcoholic content. Recently the ADF discovered alcoholic sodas on sale in rural Victoria for $1 a bottle. This made a standard drink cheaper than chewing gum. Many young people have a high level of disposable income – the ADF has conducted research with teenagers on the relationship between disposable income and their choice and level of alcohol use. The ADF intends to repeat and extend this research across a larger sample. The implications of raising the cost of alcohol must also be considered in relation to how young people may switch to other more affordable drugs.

Key strategies

Key strategies which the ADF believes will make a difference to harmful youth alcohol use are:

• An education campaign focusing on parents and other adults who provide young people with alcohol
• A standard drinks campaign to improve the overall awareness and understanding of standard drinks in the general community.
• Greater restrictions on alcohol advertising as the revised code is weak. There is an urgent need for more government influence.
• Introduction of a ban on alcohol sponsorship of youth oriented events
• Introduction of a ban on alcohol sponsorship of sport events
• Introduction of a ban on alcohol advertising on public transport and waiting shelters
• A review of product placement in media

Appendix 1
Teenagers and alcohol: Position statement by the Australian Drug Foundation

• The ADF advocates that young people under the age of 16 years should avoid the consumption of alcohol.

• There are a range of health, safety, legal and liability issues which must be considered before providing alcohol to young people under the age of 18 years.
• Intoxicated young people are at greater risk of harm from accidents, violence and unsafe sexual behaviour.
• Alcohol affects the developing brain, making young people more vulnerable to alcohol –induced impairments of learning and memory abilities.
• Early alcohol use has been linked with the development of problems at a later age with alcohol and other drugs such as cannabis.
• Early alcohol use has been linked with the development of other problems such as crime and delinquency.

Adopted by the ADF Board May 2003

Teenagers and alcohol

The Australian Drug Foundation takes the position that younger teenagers (those under 16 years of age) should avoid the consumption of alcohol. The arguments in support of this fall under four main headings.

1. The impact of early alcohol use on physical and mental development

The human brain continues to develop throughout adolescence and into early adulthood (1) . As a result of changes in brain function that occur during adolescence, alcohol affects adolescents and adults differently (2) . Research evidence suggests that adolescents are more vulnerable to alcohol –induced learning and memory impairments (1) in the short term.

There is also some evidence to suggest that adolescents are less sensitive to the sedative and motor effects of alcohol, allowing them to continue drinking for longer, before falling asleep or falling over. This can extend their exposure to higher levels of alcohol and so increase their risk of cognitive impairments and brain damage (1) .

As well as short-term effects, adolescents may be more vulnerable to the long-lasting effects of alcohol use. Cognitive impairments have been found in young, heavy alcohol-users weeks after they stop drinking (1) .

2. Increased risk of harm from intoxication

A range of factors make young people more vulnerable to increased risk of harm from drinking: being physically smaller and lighter; lack of experience of drinking and its effects; lower tolerance to alcohol; and a tendency to risk taking behaviour common in adolescence (3) . Injuries involving accident and violence, risky sexual behaviour and death by alcohol overdose are of particular concern among young drinkers. Inexperienced young drinkers can become intoxicated on relatively small amounts of alcohol. The Australian Drinking Guidelines (3) recommend that young people under the age of 18 years keep any drinking to a minimum, and where alcohol is available to them, should be supervised by adults at all times. Teenagers who choose not to drink should be supported in this decision.

3. Early alcohol use increases risk of later problems with alcohol and other drugs

A recent review of the research literature (4) indicates there is a higher incidence of substance use associated with an early introduction to alcohol.

There is also an established association between the early commencement of alcohol consumption and the development of more frequent use of alcohol. Such patterns generally increase the risk of problems with alcohol later in life.

Higher levels of use of alcohol at age 14 or 15 has been shown to increase the risk of progressing to frequent cannabis use.

4. Link with early alcohol use and other problems

Some follow-up studies have associated adolescent alcohol use with developmental progression to crime and delinquency (4) . One New Zealand study linked higher quantity and frequency of alcohol use at age 15 with predicted progression to crime at age 16.

Some commonly asked questions by parents

Won’t allowing teenagers to drink help them learn how to drink safely?

Due to the effect of alcohol on the developing brain, teenagers under 16 years of age should avoid alcohol. Older than this it can be good practice if they are allowed small amounts of alcohol in supervised settings, e.g. at family meals. Young people do not need to drink to learn how to use alcohol safely. Most important is the example set by parents and others on how, where and why they use alcohol.

Should I give my teenagers alcohol to take to a party so I know what they are drinking?

If under 16 years of age then it is not advisable, for the reasons given. Providing alcohol like this is no guarantee that this will be the only alcohol consumed. Ideally parties for this age group should be supervised by responsible adults and be alcohol free. Hosting a party carries a duty of care to make it a safe event otherwise the host may find themselves liable for any harm an intoxicated young person may do themselves or others.

What about older teenagers?

For older teenagers (16 and over), it is reasonable to supply low alcohol beverages at a party or to take to a party if the following precautions are taken to avoid an uncontrolled drinking environment.

• you have discussed and negotiated this with your teenager,
• there is appropriate adult supervision at the party,
• this is the only alcohol that will be available, and
• it is OK with the other parents

Is it illegal to supply alcohol to under-18 year olds?

Laws differ between states and territories, and depend on where the alcohol is being supplied and consumed. Generally it is not an offence for an under-18 year old to consume alcohol in a private home but, for example, in NSW, you are committing an offence if you supply or buy alcohol for a minor without being authorised to do so by the minor’s parents or guardian. Local by-laws may prohibit any alcohol being supplied in public places or hired halls. You need to check your local and state laws.

References

(1) White AM (2003) Substance abuse and adolescent brain development: an overview with a focus on alcohol. Youth Studies Australia , 22:1.

(2) Spear, L.P. (2000) The adolescent brain and age –related behavioral manifestations. Neurosci Biobehav Rev 24: 417-463

(3) National Health & Research Medical Council (2001) Australian Alcohol Guidelines: health risk and benefits. Commonwealth of Australia.

(4) Toumbourou, J.W. (2003) What are the risks and protective factors predicting harmful youth substances and what are the policy implications? Paper presented ta the International Research Symposium, “Preventing substance abuse, risky use and harm: What is evidence based policy?” Perth , February 2003.