Put that beer down!
Civitas, 29 January 2009
On the basis of a report by the CMO, Sir Liam Donaldson, the government has recommended that no child should drink before the age of 15; and that children between the 15-17 years should only drink under the supervision of adults.
Aside from the wider, libertarian, critique of such an announcement that has been entered into elsewhere on this blog concerning public health issues, and the implied lack of trust in the ability of parents to do what’s best for their children, the basis for this announcement is unclear.
The key reference here is chapter 5 of the CMO’s report, an ‘Epidemiological review of harms to children’ through the use of alcohol.
First, it is only heavy drinking in children that is linked to an adverse effect on brain development and other physiological processes; as well as crime and what is termed ‘risky behaviours’ (drugs, unprotected sex etc.).
Second, while many studies have found a positive correlation between starting to drink at an earlier age and the subsequent development of alcohol abuse, there are caveats. In one study, for example, the odds of lifetime alcohol dependence and abuse were reduced by 14% and 8%, respectively, with each increasing year of age at first use. This sounds like a fantastic decrease, but it should be remembered that, here, risk reduction is expressed in relative terms. In absolute terms the difference is much less marked: the prevalence of alcohol dependence was greater than 40% among participants who initiated alcohol use before the age of 15, but still 39% for those who started drinking at 15 years and 31% for those that started drinking at 16 years. There are many children who did drink before the age of 15 and have not suffered from alcohol abuse.
Moreover, most of the studies cited are from the U.S., a different social context, where drinking in most states is banned until the age of 21.
Third, as the report acknowledges, there are a huge number of factors underlying both alcohol abuse and alcohol abuse in children that are independent of age: impulsive and aggressive personality traits, depression, anxiety, psychiatric diagnoses of conduct disorder, school-related problems, family breakdown, parental and/or peer alcohol abuse and parental attitudes. Maybe the lower binge drinking in many European countries compared with the UK, for example, has to with a more mature attitude to drinking on the part of parents? In fact, at least two studies cited in the CMO’s report have shown that young drinkers who are supplied alcohol by their parents are likely to drink less than those who obtain it from friends or older siblings.
Alcohol abuse is a complex social problem; a problem that issuing strong guidance against children drinking a watered-down shandy on their 14th birthday is not likely to tackle. Again, the government persists on a quick fix rather than a meaningful analysis of root causes.