As many know, drinking alcohol in a licensed premise under the age of 18 is against the law in the UK, however those aged 16 or 17 and accompanied by an adult can drink but not buy beer, wine, or cider with a meal. However, with relatively high alcohol use among children and young people in the UK, is the flexibility of this law one of many factors contributing to heavy episodic drinking among this population?
Youth drinking
According to Truque et al. (2023), 25% of adolescents in Europe begin to consume alcohol as early as the age of 13, and depending on region and gender, the prevalence of weekly alcohol consumption from adolescents is anywhere from 2%-33%. In 2021, NHS England found that the proportion of 15-year-olds who reported drinking at least once a month was 36%, with 14% saying at least weekly. Specifically in England, the World Health Organization found that the proportion of 13-year-olds who had consumed alcohol was far higher than the Health Behaviour in School-aged Children (HBSC) average – which covers 44 countries – and in Scotland and Wales.
Several factors influence children and young people’s alcohol use. One of the primary reasons young people give for why they drink at a young age is because of their peers. Drinking interest stems from failure to miss out, pressure to drink, and an attempt to improve their social status.
There are also some non-consensual factors, particularly outdoor advertising, but also advertising in magazines and television, that could be fuelling underage drinking because of its appeal to younger audiences. Children and young people do not ask to be exposed to these advertisements, and they cannot always filter the advertisements that they see through these mediums.
Despite regulatory efforts and codes that have been in place to protect children from alcohol marketing, researchers believe that attempts to protect children through the regulatory system and codes are failing. Several councils across the UK have taken the initiative to establish local policies that restrict advertisements of unhealthy commodities, including alcohol. If more local authorities follow suit in creating policies to restrict alcohol advertising, it would protect children and young people from exposure and potential alcohol-related harms.
Effect on the adolescent brain
Although youth drinking is slowly decreasing across the UK, heavy episodic drinking and its health impact is still a concern amongst adolescents, especially the effect alcohol has on the adolescent brain. Research on the effect alcohol has on the adolescent brain is limited. Research has typically focused on the impact alcohol has on the adult brain and the relationship between alcohol dependence and increased risk of dementia and other chronic diseases.
Before diving into the specific impact alcohol has on adolescent brains, it is important to lay out the process of how alcohol even travels through the body. So envision this: you take your first sip, and the alcohol makes its way through the stomach and into your bloodstream through the walls of your small intestine, where the blood will take the alcohol throughout the rest of your body. Alcohol then makes its way quickly to your brain, kidneys, lungs, and liver via the bloodstream. The way these parts of the body act is also contingent on the amount of alcohol that is in the bloodstream. For the brain, alcohol can impact your thought processes, emotions, memory, and coordination.
For an adolescent, alcohol moves through the body and breaks down slower than other age groups. The brains of adolescents have an increased likelihood of being negatively impacted compared to adult brains, according to the National Institute on Alcohol Abuse and Alcoholism. For young heavy episodic drinkers, brain development, structure, and function could possibly be altered compared to young non-heavy episodic drinkers, as seen through neuroimaging.
This impact on the brain has been noted to significantly affect the executive function of the adolescent brain. Executive function is defined as the mental processes that help an individual set and carry out their goals. Scientific evidence shows that weakened executive functions cause young people to make more errors and struggle with their shifting abilities (i.e., the ability to adapt). In the long run, this can follow young heavy episodic drinkers to adulthood.
In more technical terms, adolescent heavy episodic drinking is associated with a greater risk of reductions in grey matter during adolescence and disrupts white matter integrity, impacting neurocognitive functioning, according to Chikritzhs et al. (2024). In simple terms, the brain’s grey matter that helps individuals control movement, memory, and emotions is reduced, and white matter that allows the brain to exchange information and gives the ability to concentrate and learn is disrupted.
With these types of tissues being impacted by alcohol at a young age, there is research that has highlighted some of the risk factors that have come to disturb the lives of young heavy episodic drinkers when they become adults. A study including about 488,000 Swedish men found that heavy episodic drinking in adolescence was one of the strongest risk factors for developing early-onset dementia in adulthood.
As adolescence is a critical phase of development, more protective measures are put in place to reduce alcohol use among adolescents and, as a result, reduce alcohol-related harm to their brains. These protective measures usually include regulation of youth’s access to alcohol and alcohol advertising.
As we know, alcohol marketing is causally linked to young people drinking more and at an earlier age, and much of this marketing is non-consensual. To protect children’s rights, ‘the state must do all it can, through passing legislation and creating administrative systems, to promote and protect children’s rights’, according to the United Nations Convention on the Rights of the Child.
The brain is a vital organ to the body, and adolescent brain health is critical. With alcohol being accessible to children and young people in the UK, a ban on alcohol marketing should be taken into consideration. In addition, the normalisation of alcohol use among young people has to be put to an end, and that may start in the home with parents reshaping how they communicate alcohol use with their children and not encouraging drinking behaviour. Furthermore, future research should look at the differences between light to moderate and heavy drinking among adolescents to see if the effects on the brain are drastically different.
Written by Ania Wellere, Master of Public Health Candidate, UNC Gillings School of Global Public Health.
All IAS Blogposts are published with the permission of the author. The views expressed are solely the author’s own and do not necessarily represent the views of the Institute of Alcohol Studies.