Teen Alcohol Use Affected by Expected Enjoyment and Understanding of Health Messages, Study Finds

July 24, 2014

Teens with the best understanding of health messaging may also be the most susceptible to messages that make alcohol use look appealing and fun — like television ads for beer or liquor — according to a study published this week in the journal Patient Education and Counseling. This is a key finding for educators to be able to better prevent alcohol use among teens, which can predict problem drinking in adulthood. Study researchers at Nationwide Children’s Hospital and their collaborators also determined that teens with a good understanding of health-related information and messaging may be persuaded to either use or avoid alcohol based on their expected outcomes from drinking.

When the researchers set out to measure the connection between alcohol use and health literacy (a person’s ability to find, understand and apply health information), they expected to find that teens with a high level of understanding would be less likely to use alcohol. Instead, they found that these teens between the ages of 14 and 19 were probably more likely to understand — and be influenced by — both positive and negative messages about alcohol use.

Whether those messages gave them good expectations about alcohol use (e.g., increased sociability, increased bravery, stress reduction) or negative expectations (e.g., cognitive impairment, taking foolish risks) predicted whether or not those teens were likely to have had at least one drink within the six months prior to the survey. Nearly half of the study’s 293 teens reported at least some alcohol use in that time period.

Researchers must continue searching for the best ways to prevent alcohol use among teens of all levels understanding. However, there is still something every parent can do to help their teenage children refrain from alcohol, according to Deena J. Chisolm, PhD, director of the Patient-Centered Pediatric Research Program at Nationwide Children’s and first author on the recently published paper.

“Parents should monitor and, whenever possible, limit teen exposure to information designed to create positive beliefs about alcohol use,” said Dr. Chisolm, who also is a principal investigator in the Center for Innovation in Pediatric Practice at The Research Institute. “At the same time, parents should try to maximize exposure to negative messages about alcohol use.”

This is one case in which parents of kids with an advanced understanding of health and risk aren’t off the hook, so to speak. “A young person’s high health literacy does not necessarily protect them from high risk behaviors. It may even put them at increased risk of alcohol use,” Dr. Chisolm said. “Parents should be aware that no matter how intelligent their teen may be and how well they understand the pros and cons of alcohol use and misuse, they’re still just as likely to engage in the risky behavior of underage drinking.”

This is because higher literacy teens are just as likely to understand and act on positive alcohol messages (‘I’ll have more fun,’ ‘I’ll be more relaxed,’) as they are negative messages (‘I’ll get in trouble,’ ‘Something bad will happen’), Dr. Chisolm explained.

“But high literacy teens may also be able to more easily understand positive alcohol messages that are aimed at adults,” said Dr. Chisolm, who also is an associate professor of pediatrics at The Ohio State University. “Their beliefs that alcohol use would have good outcomes led to higher alcohol use, and their beliefs that alcohol would have bad outcomes led to lower alcohol use. In lower literacy teens, however, the link between beliefs and actual alcohol use was much weaker.”

The fact that expectations affect teens differently depending on how well they understand and process health-related information suggests that no one-size-fits-all approach for alcohol prevention is going to work with teens, Dr. Chisolm suggested. “More research is needed to understand what messages are most effective for each level of teens’ understanding, so that we can tailor interventions to the populations that we serve.”

About Nationwide Children's Hospital

Named to the Top 10 Honor Roll on U.S. News & World Report’s 2020-21 list of “Best Children’s Hospitals,” Nationwide Children’s Hospital is one of America’s largest not-for-profit freestanding pediatric health care systems providing wellness, preventive, diagnostic, treatment and rehabilitative care for infants, children and adolescents, as well as adult patients with congenital disease. Nationwide Children’s has a staff of more than 13,000 providing state-of-the-art pediatric care during more than 1.6 million patient visits annually. As home to the Department of Pediatrics of The Ohio State University College of Medicine, Nationwide Children’s physicians train the next generation of pediatricians and pediatric specialists. The Abigail Wexner Research Institute at Nationwide Children’s Hospital is one of the Top 10 National Institutes of Health-funded freestanding pediatric research facilities. More information is available at NationwideChildrens.org.