Charles University Prague (Czech Republic) University of Tartu (Estonia) Free University of Berlin/University of Hildesheim/ University of Hildesheim (Germany) University of Genoa (Italy) Ghent University (Belgium) Effective Environmental Strategies for the Prevention of Alcohol Abuse among Adolescents in Europe Majone Steketee

Objective of AAA-prevent Alcohol consumption among youngsters is rising in Europe (younger, heavier). What are the facts? What is done? What could be done? Underage drinking is a serious public health concern, as demonstrated by epidemiological data and results from studies investigating the social, health and economic consequences of drinking by children and adolescents. In particular, it should be reminded that: alcohol is the drug most commonly used by youths (Johnston et al., 2008; Hibell et al., 2009); adolescents who indulge in drinking are more likely to engage in risky behaviours, such as drinking and driving (Hingson et al., 2005); underage drinking contributes to both unintentional and intentional injury deaths among adolescents (Rehm et al., 2004); adolescents who drink heavily are at increased risk of short and long term health problems (Hingson et al., 2006; Squeglia et al., 2009) and behavioural problems (Spoth et al., 2006).

Prevention of alcohol (mis)use This study focuses on different contexts and their influence on alcohol use at an early age. Overall, youngsters mainly grow up in four different context Family School Peers / leisure time Neighbourhood Within these contexts we look at specific factors that can increase of decrease risky behaviour such as alcohol. Problem behaviours hardly ever spontaneously develop from one day to the other. Instead, these behavioural patterns generally develop over time with differences but also similarities between them in which genes, social experiences, life course as well as social circumstances play an interactive role (Jonkman, 2012; Marmot, 2000). The social position is affected by what adolescents experienced earlier in life (conception, birth, early life and childhood), as is their social response to social circumstances. We know that alcohol use in early adolescence is strongly influenced by social and familial environmental factors (Kendler, Schmitt, Aggen & Prescott, 2008). This study focuses on different contexts and their influence on alcohol use at an early age. Overall, youngsters mainly grow up in four different contexts wherein they interact with others on a daily basis over a longer period of time. These contexts include their: family, school, peer group and neighbourhood, and it is within these contexts where specific factors can be identified which either increase or decrease the likelihood of risk behaviours such as alcohol use (risk factors, protective factors).

Knowledge about prevention Prevention science has identified two different types of groups of predictors in terms of individuals and their social environments. First those factors which increase the likelihood of problems: risk factors. Secondly factors which moderate and mediate exposure to risk, which in effect will decrease the likelihood of problems: protective factors. There is also overwhelming evidence that the development of alcohol use is often intertwined with one or more other problem behaviours (Jonkman, 2012; REF). Severe alcohol use, for example, is associated with other substance use (Hawkins et al., 2002). A significant correlation between alcohol use and crime has also been recognized in scientific studies (Gatti &Verde, 2012, Steketee, 2011). The intertwining of different problem behaviours prompted the idea of simultaneously addressing underlying factors strongly associated with problem behaviours (Catalano et al.,2012). Over time, several longitudinal and experimental studies identified various risk and protective factors as underlying factors of the problem behaviours (IOM, 2009; Hawkins, Catalano & Miller, 2002). These factors can be found in the daily contexts in which children and youngsters are raised: family, school, peers and communities. Subsequently, these factors have become the building blocks of prevention strategies for children and youngsters.

In this study we used structural factors (besides risk factors), which are defined as higher-level country factors, such as policies (for example laws, prices and collective action), the social and economical system (including wealth, wealth distribution and employment) as well as cultural factors (beliefs, customs). These factors are important, as it is the larger circle of societal constraints and possibilities which may infl uence youngsters’ alcohol behaviour. We have sufficient knowledge concerning the infl uence of risk factors on our behaviour, but know less about the influence of these larger structural factors.

Cross-national analysis and preventive possibilities Understanding: patterns of alcohol use the influence of risk factors in daily life of young adolescence the influence of the country where you grow up Use of effective prevention programs and policies in Europe.

Conceptual framework Building Block 1 Building Block 2 Comparitive data of 25 European countries Science based research on problems and determinants Multilevel analyses of data on youth and countries Analyses of prevention policies in countries Possible effective strategies for the future at EU, national and local levels Building Block 5 Building Block 4 Building Block 3

Data International Self-Report Study of Delinquency (ISRD) (2006; see Junger-Tas et al., 2009; 2012) 57.771 youngsters 25 European countries Age 12-16 years Substance use, delinquency, school, family, leisure time

General questions What are the differences of adolescent alcohol and drug use between European countries? And are there patterns of consumption of alcohol use of young people betweeren the countries? What are the factors associated with patterns of alcohol use of young people? What are the effective policies, programmes and interventions to reduce the levels of risk factors and adolescent substance use? What are possible effective strategies for the future at EU, national and local levels.

Team members Harrie Jonkman Jessica van den Toorn Claire Aussems Nicole Vettenburg   Hans Berten Renate Soellner   Astrid-Britta Bräker Kristin Göbel   Majone Steketee Herbert Scheithauer Uberto Gatti Alfredo Verde   Gabriele Rocca, Anna Markina Kristjan Kask Jiri Burianek Zuzana Podaná

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