Have declines in the prevalence of young adult drinking in English-speaking high-income countries followed declines in youth drinking? A systematic review

Abstract

Background: Alcohol use in early adulthood is a significant public health concern. The prevalence of adolescent alcohol consumption has been declining in high-income English-speaking countries since the early 2000s. This review aims to examine whether this trend continues in young adulthood.

Methods: We systematically searched Medline, PsycInfo and CINAHL and the grey literature. Eligible records reported the prevalence of alcohol consumption amongst 18-25-year-olds over a minimum three-year time frame in the United States (US), Canada, the United Kingdom, the Republic of Ireland, Australia and New Zealand. Results were described using narrative synthesis. Quality assessment was undertaken using the Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies.

Results and conclusion: Thirty-two records from 22 different surveys were included. The prevalence of consumption amongst young adults fell in Australia, Ireland, and the United Kingdom and was stable in New Zealand and Canada. In the US, there was evidence of a decline in the prevalence of drinking among under-21s, but results for adults over the minimum purchase age were mixed. The prevalence of alcohol consumption in young adults appears to be broadly declining. This could lead to reduced rates of alcohol-related harms in the future. Further high-quality multinational surveys may help to confirm this trend.

Keywords: Alcohol drinking; adults; trends; underage drinking; young people.

Figure 1.

PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow diagram. ^aSeven surveys included data from two or more reports on a single wave or year (Australian Bureau of Statistics, , 2017–18; Bromley et al., ; Central Statistics Office, , ; Central Survey Unit, , ; Government of Canada, , ; Ministry of Health, ; Information Analysis Directorate, ; Schoenborn et al., , ; Scottish Health Survey, ; The Scottish Government, 2009). We treated these reports as a single record for synthesis purposes but as separate records for quality assessment.

Figure 2.

(a) The prevalence of alcohol consumption amongst 18–25-year-olds in the United States by consumption measure, 2000–2019 (Chen & Yoon, ; Dawson et al., ; Hasin et al., ; White et al., ; Schoenborn et al., , ; Schulenberg et al., ; Slater et al., ; Substance Abuse and Mental Health Services Administration, 2020). (b) The prevalence of alcohol consumption amongst 18–25-year-olds in Australia, New Zealand and the United Kingdom, by country and consumption measure, 2000–2019/20 (Australian Bureau of Statistics, , 2017–18; Australian Institute of Health and Welfare, ; Livingston, ; Ministry of Health, ; Ng Fat et al., 2018). Orange lines represent an increase in prevalence of consumption of > 5% over the survey time frame; blue lines represent a decrease in prevalence of consumption of > 5% over the survey time frame; and green lines represent a stable prevalence of consumption of (change of ≤5%) over the survey time frame. (a) MTF: Monitoring the Future; NESARC: National Epidemiological Survey on Alcohol and Related Conditions; NHIS: National Health Interview Survey; NSDUH: National Survey on Drug Use and Health. (b): ANHS: Australian National Health Survey; HSE: Health Survey for England; NDSHS: National Drug Strategy Household Survey; NZHS: New Zealand Health Survey.