Kuntsche E, Kuendig H, Gmel G
Swiss Institute for the Prevention of Alcohol and Drug Problems (SIPA), Research Department, PO Box 870, CH-1001 Lausanne, Switzerland.
J Epidemiol Community Health. 2008 Sep;62(9):811-6. doi: 10.1136/jech.2007.065367.
Perceived availability is commonly associated with adolescent alcohol use. Little is known about the factors which shape this perceived availability. The present study investigates (1) whether perceived alcohol availability is related to the characteristics of the adolescents' social environment and the per capita outlet density in the community and (2) whether adolescent alcohol use is related to perceived availability, social environment characteristics and outlet density.
Multilevel structural equation models were estimated based on data from a national representative sample of 6183 adolescents in the 8th and 9th grades of school (mean age 14.8 years) in 254 communities in Switzerland.
Social environment characteristics, that is, having peers and siblings who drink, going out without parental knowledge of the adolescents' whereabouts, drinking in public settings and the density of on-premises but not off-premises alcohol outlets, were related to perceived availability. Adolescent alcohol use increased with the permissiveness of social environment characteristics and with increasing perceived availability. Community-level perceived availability and the density of on-premises but not off-premises outlets were related to volume drinking but not to the frequency of risky drinking occasions.
Perceived availability and drinking volume appear to be shaped by the adolescents' social and physical environments. Adolescents who have a variety of opportunities to obtain alcohol might develop the impression that underage drinking is common and socially endorsed. Consequently, preventive actions to curb adolescent alcohol consumption should take into account the social acceptance of drinking and the physical availability of alcohol in the community.
感知可得性通常与青少年饮酒行为相关。对于影响这种感知可得性的因素，我们知之甚少。本研究调查了：（1）感知到的酒精可得性是否与青少年社会环境的特征以及社区内人均销售点密度有关；（2）青少年饮酒行为是否与感知可得性、社会环境特征及销售点密度有关。
基于瑞士254个社区中6183名八、九年级青少年（平均年龄14.8岁）的全国代表性样本数据，估计了多层次结构方程模型。
社会环境特征，即有饮酒的同龄人和兄弟姐妹、在父母不知道行踪的情况下外出、在公共场所饮酒以及店内而非店外酒精销售点的密度，与感知可得性有关。青少年饮酒行为随着社会环境特征的宽松程度以及感知可得性的增加而增加。社区层面的感知可得性以及店内而非店外销售点的密度与大量饮酒有关，但与危险饮酒场合的频率无关。
感知可得性和饮酒量似乎受到青少年社会和物理环境的影响。有各种机会获得酒精的青少年可能会形成这样的印象，即未成年人饮酒很普遍且得到社会认可。因此，遏制青少年酒精消费的预防行动应考虑到社区对饮酒的社会接受程度以及酒精的实际可得性。
