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Young People and Alcohol the Role of Cultural Infl Uences Young People and Alcohol the Role of Cultural Infl Uences young people and people alcoholyoung • the role of cultural infl uences of role cultural the infl young people and alcohol the role of cultural infl uences young people and alcohol the role of cultural infl uences An examination of the cultural drivers of risk-taking behaviour and their effects on ‘low risk’, ‘risky’ and ‘high risk’ use of alcohol among 14-24 year old Australian drinkers Ann M. Roche, Petra Bywood, Joseph Borlagdan, Belinda Lunnay, Toby Freeman, Lisa Lawton, Amanda Tovell, Roger Nicholas Roche, A.M., Bywood, P.T., Borlagdan, J., Lunnay, B., Freeman, T., Lawton, L., Tovell, A. & Nicholas, R. (2007). Young People and Alcohol: The Role of Cultural Infl uences. National Centre for Education and Training on Addiction, Adelaide. ISBN 978-1-876897-13-0 © DrinkWise Australia Ltd 2008 This work is copyright. Apart from any use as permitted under the Copyright Act 1968, no part may be reproduced without prior written permission from DrinkWise Australia Ltd, available from 1/34 Queen Street, Melbourne 3000, Victoria, Australia. Any enquiries about or comments on this publication should be directed to: Professor Ann Roche National Centre for Education and Training on Addiction (NCETA) Flinders University of South Australia GPO Box 2100 Adelaide 5001 South Australia Australia Phone: +61 8 8201 7535 Email: ann.roche@fl inders.edu.au Website: http://www.nceta.fl inders.edu.au/ Published by DrinkWise Australia Ltd, ACN 112 783 114 Design and Layout by Inprint Design www.inprint.com.au The role of cultural infl uences Acknowledgements This work was commissioned by DrinkWise Australia Ltd with funding provided by DrinkWise Australia and the Australian Government Department of Health and Ageing. Thanks are extended to Dr Ken Pidd for his contribution to sections on work and culture. Dr Jo Lindsay and Dr Clarissa Cook are thanked for sharing their bibliographic resources with the research team. Tania Steenson and Amy Hallion contributed research assistance and editorial support. Stacey Appleton and Paula Wilson assisted with layout and formatting. The conclusions and opinions contained within this work are those of the authors. DrinkWise does not warrant the completeness or accuracy of any data or information contained in this work. Neither DrinkWise nor its members and directors will be liable to any person or entity for any legal liability for any errors in this work or for the use of or reliance upon the information contained in this work. i young people and alcohol ii The role of cultural infl uences Table of Contents List of Tables ...............................................................................................................ix List of Figures ..............................................................................................................xi PART ONE ....................................................................................................................1 1. Executive Summary ...............................................................................................3 2. Introduction ..........................................................................................................13 2.1. Rationale ....................................................................................................13 2.2. Background ................................................................................................14 2.2.1. Burden of disease ..........................................................................19 3. Aims and Research Questions .............................................................................21 4. Methods ...............................................................................................................23 4.1. Approach to literature review ......................................................................23 4.1.2. Search strategy ..............................................................................24 4.2. Critical appraisal and analysis ....................................................................27 4.3. Evidence base ............................................................................................28 4.4. Approach to secondary analyses of datasets ............................................28 4.5. Accuracy of NDSHS data ...........................................................................29 5. Patterns and Prevalence of Drinking ....................................................................31 iii 5.1. Age of initiation ...........................................................................................31 5.2. Risky alcohol consumption ...........................................................................33 young people and alcohol 5.2.1. Harms associated with risky consumption ....................................36 5.2.2. Risky alcohol consumption over time ............................................39 5.2.3. Prevalence of alcohol dependence among young people .............46 5.2.4. Young people’s alcohol-related healthcare utilisation ....................48 5.3. Patterns of consumption ............................................................................50 5.3.1. How young people obtain alcohol..................................................50 5.3.2. Types of alcohol consumed by young people ................................50 5.3.3. Places where alcohol is consumed by young people ....................53 5.3.4. Times when alcohol is consumed by young people ......................57 5.3.5. Adult supervision ............................................................................57 5.3.6. Young people’s understanding of standard drinks .........................58 5.4. At-risk groups .............................................................................................59 5.4.1. Homeless young people .................................................................59 5.4.2. Indigenous young people ...............................................................59 5.4.3. Young people in rural or remote areas ...........................................59 PART TWO ..................................................................................................................61 6. Role of Culture .....................................................................................................63 6.1. Culture .......................................................................................................63 iv 6.1.1. What is ‘culture’ .............................................................................63 6.1.2. Cultural change ..............................................................................64 The role of cultural infl uences 6.1.3. Consumer culture and the culture industries .................................65 6.1.4. Australian drinking cultures ...........................................................66 6.1.5. Drinking in a wider cultural context ................................................68 6.2. Youth ...........................................................................................................69 6.2.1. Defi ning ‘youth’ ..............................................................................69 6.2.2. Youth culture and generational change ..........................................72 6.2.3. Young people’s friendship groups and social networks .................73 6.2.4. Young people and technology ........................................................74 6.2.5. Drinking in the life course of young people ....................................75 6.2.6. Symbolic and interpretive context of drinking................................76 6.3. Pleasure, culture and identity .....................................................................78 6.3.1. The pursuit of pleasure ...................................................................78 6.3.2. Hedonism: calculated, controlled and bounded? ..........................79 6.3.3. Organising pleasure........................................................................80 6.3.4. Identity and the ‘consuming self’ ...................................................82 6.3.5. Youth identity in ‘risk society’ .........................................................83 6.4. Summary ....................................................................................................84 7. Social Trends and Interpersonal Factors ..............................................................85 7.1. Social trends ...............................................................................................85 v 7.2. Gender ........................................................................................................86 young people and alcohol 7.2.1. Changing roles of women .............................................................87 7.3. Family structure ..........................................................................................89 7.3.1. Single-parent families .....................................................................89 7.4. Religion .......................................................................................................91 7.5. Socioeconomic status ...............................................................................92 7.6. Transitions ..................................................................................................92 7.6.1. Leaving home .................................................................................92 7.6.2. Educational retention .....................................................................93
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