1. Young people, alcohol and
health
Dr. Jean-Pascal
Assailly, psychologist, researcher
and expert for the World Bank

3. Sources
• ESPAD Study: www.espad.org
• HBSC Study: www.hbsc.org/
• ESCAPAD Study (french only):
www.ofdt.fr/BDD/publications/docs/eisxstra.pdf
• YOUNG PEOPLE AND
ALCOHOL, trends, causes, consequences and strategies
of prevention, Dr. Assailly
• WHO Global status report on alcohol and health, 2011 :
www.who.int
1.Alcoholism - epidemiology. 2.Alcohol drinking -
adverse effects. 3.Social control, Formal - methods.
4.Cost of illness. 5.Public policy. I.World
Health Organization.

4. Sociological, medical and
psychological aspects

5. Differences young
men/women
GIRLS
 DRINK LESS ALCOHOL
 FEWER ALCOHOL RELATED PROBLEMS
 DRINKING FOLLOWS THE AGENDA OF FEMINISM
 HIGHEST VOLUME IN NORDICS COUNTRIES
BOYS
 HIGHER CONSUMPTION ON THEIR MOST RECENT
DRINKING DAY THAN GIRLS
 BINGE DRINKING DURING THE PAST 30 LAST DAYS
MORE COMMON AMONG BOYS THAN GIRLS
General Trends

6. Differences young
men/women
General Trends
GIRLS AND BOYS
 SIGNIFICANT DIFFERENCES
FOUND IN ALL COUNTRIES
 HIGHER INTOXICATION SCORE IN
A COUNTRY  GIRLS ARE
FOLLOWING THE BAD EXAMPLE
OF BOYS
GENDER DIFFERENCES
 DRINKING AS A MARKER OF
MASCULINITY

7. Differences young
men/women
Beverage type: beer and spirits
GIRLS
 33% OF GIRLS’ CONSUMPTION: SPIRITS
BOYS
 50% OF BOYS’ CONSUMPTION: BEER
Causes of alcohol misuse
GIRLS
 NEGATIVE INTERNAL STATE
 FAMILY CONFLICTS
BOYS
 PEER PRESSURE
 SOCIAL EXPECTANCIES

8. Differences young
men/women
Consequences
GIRLS
 CONSEQUENCES OF HEAVY ALCOHOL USE OR
USE DISORDERS MORE NEGATIVE FOR
WOMEN
• MORE PHYSICAL HARM AND SEXUAL
ASSAULT
• RANGE OF REPRODUCTIVE PROBLEMS

9. Alcohol-related brain damage
Young ‘at-risk’ drinkers: vulnerability markers?
Definition
Alcohol-related brain damage (ARBD) is a result of
chronic excessive alcohol misuse

10. Alcohol-related brain
damage
Specific drinking patterns in young people
Critical period in brain development
particularly vulnerable to alcohol misuse
Influence of substance use on mental
health: vulnerability
Early prevention and treatment
1
2
3
4

11. Is alcohol use a risk factor or a risk marker?
Age of onset of regular
drinking
CONSEQUENCES
 Immediate consequences of alcohol use (blackouts, hangovers)
 Brain deficits
 School failure
 Alcohol dependency
 Traffic accidents (related to alcohol) and violations
 Delinquency and antisocial behavior
Individuals who start regular alcohol at 14 years and
before are at increased risk of developing alcohol use
disorders

12. →Positive consequences at least as strongly associated
with drinking as negative consequences.
→Possible role of Fun/Social consequences in the
escalation and maintenance of high-risk drinking.
The types of the
consequences of drinking
 Fun/social
 Relaxation/coping
 Positive image
 Physical
 Behavioral
 Driving

13. The beliefs of students
about drinking
Copying with
internal state
(anxiety)
Copying with
external state (social
situation)
Enhancement of
internal positive
state (pleasure)Enhancement of
external positive state
(friendship)
Positive global
effects
Reduction of
negative emotional
states
Activation and
agression
Activation and sexual
pleasure
Relaxation and
tension
reduction

14. The “false” consensus
Overestimation by students of the extent of their fellow students' alcohol
consumption
 Campaigns measuring and communicating the real prevalence have
produced positive effects on binge drinking, changing the perceived social
norm (20% instead of 80% !!)
Definition
Overestimation of the prevalence of drinking on the
campus

15. Peers influences on drinking
behavior
Important role models of friends and siblings
Strong similarity in drinking between best
friends and adolescents but best friends are
not permanent!
Ambivalent value of popularity among peers
Importance of alcohol in peer-selection
processes

16. Drink and driving
Presence of alcohol in 30% of fatal traffic accidents of
young people: first cause of death of young people,
important cause of license suspension
Driver designation: no data on students about this impact
Mobility offers: no data on students about the impact of
alcohol consumption

17. Second hand” and
environmental effects”
Direct impacts of campuses with many binge drinkers
 Having sleep or study interrupted
 Having to take care of a drunken student
 Being insulted or assaulted
 Being the victim of unwanted sexual advances
 Having personal property vandalized
Impacts on universities
 More alcohol outlets within a mile, lower socioeconomic status
environment, lowered quality of neighborhood life
Impacts of alcohol outlets
 Importance of the number of nearby alcohol outlets mediating the
relationship between universities

18. Effects and impacts of drinking

19. Consequences of drinking on
health
SHORT TERM CONSEQUENCES
Acute alcohol intoxication
Young people less body mass than
adults and more likely to lose control
and to take risks
Young people more vulnerable than
adults
Sedative effect of alcohol less important
for young adults compared to adults
Blackouts or loss of memory due to an
episode of heavy drinking
Alcohol myopia

20. Consequences of drinking on health
FOCUS ON TWO CONSEQUENCES
BLACKOUT MYOPIA
 25% of university students who
drank reported blackouts during
the school year.
 Incidence doubled (54%) among
frequent binge drinkers.
 Blackout for girls with an average
of only 5 drinks. Males averaged 9
drinks per occurrence.
 More blackouts and forgetting
events among young people than
adult drinkers
 Intoxication
 Underestimation of the possible
negative consequences of
decisions and overestimation of
the positive consequences
 Applied to all types of decision-
making
 Conjunction with pre-existent
individual characteristics, type of
relationship with the partner and
motivations

21. Consequences of drinking on
health
LONG TERM CONSEQUENCES
SLEEP DEPRESSION
ACADEMIC PERFORMANCE SOCIAL RISKS TAKING (unprotected sex)
FRIENDSHIP

22. What is moderate and what is
excessive?

23. How to define what is moderate
and excessive drinking?

24. No more than 4 drinks in one occasion
Being able of abstinence one day
Daily use not excess 20 g of pure alcohol
How to define what is moderate
and excessive drinking?
MODERATE?
WOMEN
no more than 2 units
per day
MEN
no more than 3 units
per day

25. How to define what is moderate
and excessive drinking?
BUT…
No consistent definitions of moderate or heavy drinking
Underestimations of the volume of alcohol included in standard drinks
Inconsistencies in research reports about the relative benefits and harms of different
types of alcoholic beverages
Differences in the way self-reported “drinks” different across different countries, within
countries, and between different beverage types and in different drinking settings
1
2
3
4

26. THANK YOU FOR YOUR ATTENTION!
Questions welcome…but answers not guaranted!!

27. And what about you? do you feel concern? …Let’s go
further together with Responsible Party