Alcohol consumption and consequences in adolescents in 68 low and middle-income countries - a multi-country comparison of risks by sex

Janni Leung; Vivian Chiu; Jason P Connor; Amy Peacock; Adrian B Kelly; Wayne Hall; Gary C K Chan

doi:10.1016/j.drugalcdep.2019.06.022

Alcohol consumption and consequences in adolescents in 68 low and middle-income countries - a multi-country comparison of risks by sex

Drug Alcohol Depend. 2019 Dec 1:205:107520. doi: 10.1016/j.drugalcdep.2019.06.022. Epub 2019 Oct 25.

Authors

Janni Leung¹, Vivian Chiu², Jason P Connor³, Amy Peacock⁴, Adrian B Kelly⁵, Wayne Hall⁶, Gary C K Chan⁷

Affiliations

¹ School of Psychology, Brisbane, The University of Queensland, QLD 4067, Australia; National Drug and Alcohol Research Centre, Sydney, University of New South Wales, NSW 2031, Australia; Centre for Youth Substance Abuse Research, Brisbane, The University of Queensland, QLD 4067, Australia; Institute for Health Metrics and Evaluation, University of Washington, WA 98121, United States. Electronic address: j.leung1@uq.edu.au.
² School of Psychology, Brisbane, The University of Queensland, QLD 4067, Australia; National Drug and Alcohol Research Centre, Sydney, University of New South Wales, NSW 2031, Australia; Centre for Youth Substance Abuse Research, Brisbane, The University of Queensland, QLD 4067, Australia. Electronic address: vivian.chiu@uq.net.au.
³ Centre for Youth Substance Abuse Research, Brisbane, The University of Queensland, QLD 4067, Australia. Electronic address: jason.connor@uq.edu.au.
⁴ National Drug and Alcohol Research Centre, Sydney, University of New South Wales, NSW 2031, Australia. Electronic address: amy.peacock@unsw.edu.au.
⁵ Institute of Health and Biomedical Innovation, Queensland University of Technology, QLD 4059, Australia. Electronic address: a.kelly@qut.edu.au.
⁶ Centre for Youth Substance Abuse Research, Brisbane, The University of Queensland, QLD 4067, Australia; King's College London, London, WC2R 2LS, United Kingdom. Electronic address: w.hall@uq.edu.au.
⁷ Centre for Youth Substance Abuse Research, Brisbane, The University of Queensland, QLD 4067, Australia. Electronic address: c.chan4@uq.edu.au.

PMID: 31707267
DOI: 10.1016/j.drugalcdep.2019.06.022

Abstract

Aims: Alcohol use is a leading risk factor for disease burden among youth. This study estimated sex differences in the prevalence of alcohol use and consequences among adolescents living in low and middle-income countries (LMIC).

Design: Multi-staged cross-sectional international standardized self-report questionnaires administered in the classroom.

Setting: The Global school-based student health survey (GSHS) comprised adolescents from 68 LMIC between 2003-2014.

Participants: 271,156 students aged 13-17 years old.

Measurements: Alcohol measures included: past month alcohol consumption, history of intoxication and alcohol-related problems. Regions were based on the World Health Organization definitions: Africa, America, Eastern Mediterranean, Europe, South-east Asia, and Western Pacific.

Findings: Overall, males had higher odds of alcohol use (OR = 2.38 [1.91-2.96]), a history of intoxication (OR = 2.64 [2.11-3.31]), and alcohol-related problems (OR = 1.72 [1.41-2.10]) than females. All regions recorded overall greater odds of alcohol use by males versus females; five regions (excluding Europe) recorded greater odds of intoxication in males; and three regions (America, South-east Asia, and Western Pacific) recorded greater odds of alcohol-related problems amongst males. However, there were country-level differences - in some countries, adolescent drinking rates and consequences were comparable by sex. Countries with the highest odds of alcohol use among males compared to females were Indonesia, Myanmar, Cambodia, Tuvalu, Morocco, Senegal, Kiribati, and Thailand.

Conclusions: Among adolescents living in LMIC, males had on average two-fold higher odds of drinking alcohol and experiencing adverse consequences. Growing affluence and improvements in sex equality in societies may increase the future prevalence of hazardous drinking in females in LMICs.

Keywords: Adolescents; Alcohol consumption; Alcohol drinking; Binge drinking; Drinking behavior; Low-income population; Sex; Teenage.

Publication types

Comparative Study
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Alcohol Drinking / economics
Alcohol Drinking / epidemiology
Alcohol Drinking / psychology
Cross-Sectional Studies
Developing Countries / economics*
Female
Global Health / economics*
Health Surveys / methods
Humans
Male
Poverty / economics*
Poverty / psychology
Risk Factors
Sex Factors
Underage Drinking / economics*
Underage Drinking / psychology
World Health Organization