Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia; Health Services and Systems Research, Duke-NUS Medical School, Singapore.
School of Health and Related Research, University of Sheffield, Sheffield, UK.
Int J Drug Policy. 2022 Feb;100:103508. doi: 10.1016/j.drugpo.2021.103508. Epub 2021 Oct 29.
Adolescent alcohol consumption has been declining in many high-income countries since the turn of this century. Research investigating the plausible explanations for these declines has been mostly based on individual-level studies, which are largely inconclusive. Changes in leisure time internet use and computer gaming (referred to in this article as 'computer activities') have been hypothesised to play a role in declining adolescent alcohol consumption at a country-level. The aim of this study was to examine the association between country-level changes over time in computer activities and adolescent drinking in 33 European countries.
This is a multi-level repeated cross-national study examining the role of changes over time in country-level and individual-level computer activities on regular drinking. We utilised four waves of the European School Survey Project on Alcohol and Drugs (ESPAD) from 2003, 2007, 2011 and 2015. At an individual-level the primary exposure of interest was daily engagement in computer activities and aggregated means were used to measure country-level daily computer activities in each included country. Data were analysed using three-level hierarchical linear probability methods.
In the fully adjusted model, for between individual effects, we found significant positive association between daily computer activities and regular drinking (β = 0.043, p-value <0.001 and 95% CI = 0.033-0.054). However, at a country-level, we did not find any association between within-country changes in daily computer activities and regular drinking (β = 0.031, p-value = 0.652 and 95% CI = -0.103-0.164.
Findings from this study suggest that broad cultural shifts towards increased computer-based activities among adolescents has played a little or no role in declining adolescent drinking. Future research should be directed towards examining other high-level cultural changes which may have influenced cross-national reductions in adolescent drinking.
自本世纪初以来，许多高收入国家的青少年饮酒量有所下降。研究这些下降现象的合理原因的大部分研究基于个体层面的研究，这些研究结果基本没有定论。人们推测，闲暇时间互联网使用和电脑游戏（在本文中称为“电脑活动”）的变化可能在国家层面上对青少年饮酒量的下降起到了一定作用。本研究旨在检验 33 个欧洲国家的国家层面和个体层面的电脑活动随时间变化与青少年饮酒之间的关系。
这是一项多水平重复的跨国研究，旨在检验国家层面和个体层面的电脑活动随时间变化对定期饮酒的影响。我们利用 2003 年、2007 年、2011 年和 2015 年四次欧洲学校毒品和酒精调查项目（ESPAD）的数据。在个体层面，主要暴露因素是每天参与电脑活动，使用聚合均值来衡量每个纳入国家的日常电脑活动。使用三级层次线性概率模型进行数据分析。
在完全调整后的模型中，对于个体间效应，我们发现每天使用电脑与定期饮酒之间存在显著正相关（β=0.043，p 值<0.001，95%CI=0.033-0.054）。然而，在国家层面，我们没有发现国内日常电脑活动变化与定期饮酒之间存在任何关联（β=0.031，p 值=0.652，95%CI=-0.103-0.164）。
本研究结果表明，青少年中普遍向基于电脑的活动转变的文化转变在青少年饮酒量下降中作用较小或没有作用。未来的研究应针对可能影响跨国家青少年饮酒量减少的其他高级文化变化进行。
