1. www.ulb.ac.be/esp/sipes Nathalie Moreau Anne Hublet Alcohol use in 15-18 year olds in Belgium. Results from the Health Behaviour in School-aged Children study.

2. Content Aim and background of the study Methodology Results Descriptives Alcohol drinking during last 30 days Early alcohol experimentation Drunkenness in last 30 days Early drunkenness experimentation Binge drinking (FWB) Conclusions Strengths and weaknesses

3. Aims To improve the understanding of young people's health and well-being, health behaviours and their social context To support actors in youth health promotion with useful data: regional (Flemish and French governments/communities, Flemish Institute for Health Promotion,...) and international (WHO, Unicef,...) To facilitate planning, development and evaluation of policies

4. Background HBSC initiated in 1982 by Norway, Finland and England 1983-1984 : 1 st survey (5 countries) 2009-2010 : 8 th survey (43 countries/regions in Europe and North America) 2013-2014 : 9 th survey (in full preparation now) A collaborative project between national research teams, in partnership with WHO Surveys every 4 years using standard international protocol in all countries

5. Overview of countries in 2009/2010 1983/841985/861989/901993/941997/982001/022005/062009/10 1 England 2 Finland 3 Norway 4 Austria 5 Denmark* 1 Finland 2 Norway 3 Austria 4 Belgium (French) 5 Hungary 6 Israel 7 Scotland 8 Spain 9 Sweden 10 Switzerland 11 Wales 12 Denmark* 13 Netherlands* 1 Finland 2 Norway 3 Austria 4 Belgium= 5 Hungary 6 Scotland 7 Spain 8 Sweden 9 Switzerland 10 Wales 11 Denmark* 12 Netherlands* 13 Canada 14 Latvia* 15 N Ireland* 16 Poland 1 Finland 2 Norway 3 Austria 4 Belgium (French) 5 Hungary 6 Israel 7 Scotland 8 Spain 9 Sweden 10 Switzerland 11 Wales 12 Denmark 13 Netherlands 14 Canada 15 Latvia 16 N Ireland 17 Poland 18 Belgium (Flemish) 19 Czech Republic 20 Estonia 21 France 22 Germany 23 Greenland 24 Lithuania 25 Russia 26 Slovak Republic 1 Finland 2 Norway 3 Austria 4 Belgium (French) 5 Hungary 6 Israel 7 Scotland 8 Spain 9 Sweden 10 Switzerland 11 Wales 12 Denmark 13 Canada 14 Latvia 15 N Ireland 16 Poland 17 Belgium (Flemish) 18 Czech Republic 19 Estonia 20 France 21 Germany 22 Greenland 23 Lithuania 24 Russia 25 Slovak Republic 26 England 27 Greece 28 Portugal 29 Rep. of Ireland 30 USA 1 Finland 2 Norway 3 Austria 4 Belgium (French) 5 Hungary 6 Israel 7 Scotland 8 Spain 9 Sweden 10 Switzerland 11 Wales 12 Denmark 13 Canada 14 Latvia 15 Poland 16 Belgium (Flemish) 17 Czech Republic 18 Estonia 19 France 20 Germany 21 Greenland 22 Lithuania 23 Russia 24 Slovak Republic 25 England 26 Greece 27 Portugal 28 Rep. of Ireland 29 USA 30 Macedonia, tfyr 31 Netherlands 32 Italy 33 Croatia 34 Malta 35 Slovenia 36 Ukraine 1 Finland 2 Norway 3 Austria 4 Belgium (French) 5 Hungary 6 Israel 7 Scotland 8 Spain 9 Sweden 10 Switzerland 11 Wales 12 Denmark 13 Canada 14 Latvia 15 Poland 16 Belgium (Flemish) 17 Czech Republic 18 Estonia 19 France 20 Germany 21 Greenland 22 Lithuania 23 Russia 24 Slovak Republic 25 England 26 Greece 27 Portugal 28 Rep. of Ireland 29 USA 30 Macedonia, tfyr 31 Netherlands 32 Italy 33 Croatia 34 Malta 35 Slovenia 36 Ukraine 37 Bulgaria 38 Iceland 39 Luxembourg 40 Romania 41 Turkey 1 Finland 2 Norway 3 Austria 4 Belgium (French) 5 Hungary 6 Israel 7 Scotland 8 Spain 9 Sweden 10 Switzerland 11 Wales 12 Denmark 13 Canada 14 Latvia 15 Poland 16 Belgium (Flemish) 17 Czech Republic 18 Estonia 19 France 20 Germany 21 Greenland 22 Lithuania 23 Russia 24 Slovak Republic 25 England 26 Greece 27 Portugal 28 Rep. of Ireland 29 USA 30 Macedonia, tfyr 31 Netherlands 32 Italy 33 Croatia 34 Malta 35 Slovenia 36 Ukraine 37 Bulgaria 38 Iceland 39 Luxembourg 40 Romania 41 Turkey 42 Albania 43 Armenia

6. International structure 1.International Coordinating Centre 2.Scientific Development Group 3.Methodology Development Group 4.Policy Development Group

7. Methodology Standard international protocol Sampling Questionnaire (content, translation and sections/questions order) Survey administration Data coding and entering Strict quality controls at each stage

8. Sampling Target population : school-aged children Sampled population : 11, 13 & 15 years old in countries where school system makes it possible All school-age children from the 5 th grade in primary to the last grade in secondary schools in French-speaking Community and Flanders In French-speaking Community: Sample built in proportion with population size (Provincial level) and school networks (French community, province, municipalities and catholic education network) In Flanders: probability proportional to size (PPS) = size of schools taken into account. Every pupil has the same chance to be included.

9. Questionnaire Core questions : Compulsory (basis of international data) Optional packages: In-depth specific areas Opportunity to insert local questions (not in the protocol) Self-administered in class under supervision of a school staff

10. RESULTS HBSC 2010

11. Results Alcohol drinking in last 30 days Type of alcoholic drink Alcohol initiation Drunkenness in last 30 days Drunkenness initiation Binge drinking (only FWB)

12. HBSC 2010 - Sample FWBFlanders n%n% Gender43714645 Boy47,450,2 Girl52,649,8 Age43714645 15 y27,627,7 16 y29,630,2 17 y25,428,8 18 y17,413,3 Family Affluence Scale40584167 High25,6 Mean51,054,8 Low23,419,6

13. FWBFLANDERS n%n% Life satisfaction42064515 ≥683,789,8 Health perception42504568 Excellent/good76,272,8 Alcohol last 30 days42474564 At least once70,375,7 Alcohol experimentation35673967 ≤13 y39,842,6 Drunkenness last 30 days42204559 At least once28,131,5 Drunkenness experimentation24582535 ≤13 y15,812,5

14. FWBFLANDERS n%n% Binge drinking last 30 days4251- At least once57,7- Smoking status now43504586 Daily/weekly21,319,0 Cannabis experimentation (lifetime)43024586 Yes33,928,5 Early sexual intercourse14681891 <16 y57,237,2

15. ALCOHOL DRINKING DURING LAST 30 DAYS- RESULTS HBSC 2010

16. Alcohol drinking during the last 30 days

19. Type of drinking at least once a week

20. ASSOCIATED FACTORS ALCOHOL DRINKING DURING THE LAST 30 DAYS :

21. Alcohol drinking during the last 30 days

26. EARLY ALCOHOL EXPERIMENTATION- RESULTS HBSC 2010

27. Alcohol initiation

28. ASSOCIATED FACTORS EARLY ALCOHOL EXPERIMENTATION:

29. Early alcohol initiation (≤13 year old)

34. DRUNKENNESS - RESULTS HBSC 2010

35. Drunkenness during the last 30 days

38. ASSOCIATED FACTORS DRUNKENNESS DURING THE LAST 30 DAYS:

39. Drunkenness during the last 30 days

45. EARLY DRUNKENNESS EXPERIMENTATION- RESULTS HBSC 2010

46. Drunkenness initiation

49. ASSOCIATED FACTORS EARLY DRUNKENNESS EXPERIMENTATION:

50. Early drunkenness experimentation (≤13 year old)

55. BINGE DRINKING DURING THE LAST 30 DAYS - RESULTS HBSC 2010

56. Binge drinking

57. ASSOCIATED FACTORS BINGE DRINKING DURING THE LAST 30 DAYS:

58. Binge drinking during the last 30 days in FWB

59. Binge drinking during the last 30 days

61. Conclusions High frequency of alcohol use (70% in last 30 days in FWB and 76% in Flanders) A substantial amount of adolescents also engage in risky alcohol use (such as early experimentation and drunkenness) This last group are more likely boys, are older, have a higher family affluence, have a poor health and life satisfaction and engage in other risky behaviours

62. Strengths and weaknesses + Unique study on this topic and with this methodology Large scale study Validity of questionnaire Repeated measures (time trends) International comparisons - No information on absents (e.g. sick children, truancy), dropped-out pupils Decline of participation rate (school level)

63. HBSC : some results International overview reports (www.hbsc.org)

64. More information International: www.hbsc.orgwww.hbsc.org Flanders: www.jongeren-en-gezondheid.ugent.be www.zorg-en-gezondheid.be French Community: www/ulb.ac.be/esp/sipes http://www.sante.cfwb.be/publications-et- periodiques/promotionsante-prevention http://www.sante.cfwb.be/publications-et- periodiques/promotionsante-prevention