Esposito Susanna, Campana Beatrice Rita, Argentiero Alberto, Masetti Marco, Fainardi Valentina, Principi Nicola
Pediatric Clinic, Department of Medicine and Surgery, University of Parma, Parma, Italy.
Università degli Studi di Milano, Milan, Italy.
Front Public Health. 2025 Jul 7;13:1598175. doi: 10.3389/fpubh.2025.1598175. eCollection 2025.
Underage alcohol consumption remains a critical global public health concern, contributing to a wide spectrum of short- and long-term health risks. Despite age-based legal restrictions, alcohol persists as the most commonly used psychoactive substance among minors, outpacing tobacco, cannabis, and other drugs. Early initiation of alcohol use is strongly associated with heightened risks of addiction, impaired brain development, mental health disorders, and engagement in high-risk behaviors such as unintentional injuries, violence, and academic underperformance. Most research has focused on adolescents, while data on younger children remain scarce. Moreover, methodological inconsistencies in defining and measuring alcohol use across countries complicate international comparisons and the evaluation of policy interventions.
This narrative review synthesizes contemporary literature on the epidemiology, determinants, and consequences of underage alcohol use. It examines genetic predispositions, family dynamics, peer influence, socioeconomic context, mental health, and exposure to alcohol-related media and advertising. It also evaluates the effectiveness of intervention strategies, including parental engagement, school-based education, extracurricular activities, community-level regulation, and professional health services.
Evidence highlights significant variability in the prevalence of underage drinking across regions, influenced by cultural, legal, and socioeconomic factors. Parental modeling, permissive attitudes, and weakened family structures are major contributors, while peer pressure and media exposure further normalize early alcohol use. Although various prevention strategies have demonstrated short-term benefits (particularly those involving active parental involvement and skill-based school programs), long-term effectiveness is limited due to inconsistent implementation, lack of standardization, and inadequate policy enforcement. Community-level interventions, such as increasing the legal drinking age and conducting compliance checks, have shown measurable success, but are underutilized in many regions.
Addressing underage drinking requires a coordinated, multifactorial strategy. Broader investment in early prevention, standardized assessment tools, and targeted research on younger populations is essential. Strengthening policy enforcement and cross-sector collaboration will be critical to mitigate this growing public health challenge.
未成年人饮酒仍然是一个至关重要的全球公共卫生问题，会导致一系列短期和长期健康风险。尽管有基于年龄的法律限制，但酒精仍是未成年人中最常用的精神活性物质，超过了烟草、大麻和其他毒品。过早开始饮酒与成瘾风险增加、大脑发育受损、心理健康障碍以及参与意外伤害、暴力和学业成绩不佳等高风险行为密切相关。大多数研究都集中在青少年身上，而关于年幼儿童的数据仍然很少。此外，各国在定义和衡量饮酒方面的方法不一致，这使得国际比较和政策干预评估变得复杂。
本叙述性综述综合了关于未成年人饮酒的流行病学、决定因素和后果的当代文献。它研究了遗传易感性、家庭动态、同伴影响、社会经济背景、心理健康以及接触与酒精相关的媒体和广告。它还评估了干预策略的有效性，包括家长参与、学校教育、课外活动、社区层面的监管和专业医疗服务。
证据表明，受文化、法律和社会经济因素影响，各地区未成年人饮酒的流行率存在显著差异。父母的示范作用、宽容的态度和弱化的家庭结构是主要因素，而同伴压力和媒体曝光进一步使早期饮酒正常化。尽管各种预防策略已显示出短期益处（特别是那些涉及家长积极参与和基于技能的学校项目的策略），但由于实施不一致、缺乏标准化和政策执行不力，长期效果有限。社区层面的干预措施，如提高法定饮酒年龄和进行合规检查，已显示出可衡量的成功，但在许多地区未得到充分利用。
解决未成年人饮酒问题需要采取协调一致的多因素策略。对早期预防、标准化评估工具和针对年幼儿童的针对性研究进行更广泛的投资至关重要。加强政策执行和跨部门合作对于应对这一日益严重的公共卫生挑战至关重要。
