Parental pro-drinking practices and alcohol drinking in Hong Kong adolescents

Background: Although parental drinking is associated with adolescent drinking, the impacts of parental alcohol-related actions were controversial. The present study aims to 1) examine the prevalence of parental pro-drinking practices (PPDPs), 2) examine the association between PPDPs and parental drinking, 3) identify the factors associated with PPDPs among adolescents with drinking parents, 4) examine the association between PPDPs and adolescent drinking, and 5) explore the experience of PPDPs and alcohol use in adolescents and parents qualitatively. Methods: A cross-sectional survey was conducted among 2200 secondary 1 to 6 students from 4 randomly selected local schools. Students were asked if they have experienced each of 9 PPDPs including 1) saw parents drank and being drunk; 2) heard parents saying benefits of drinking and certain alcohol tasted good; 3) helped parents buy alcohol, open bottle and pour alcohol; and 4) parental action in encouraging drinking and training of drinking capacity. Logistic regression was used to compute the adjusted odds ratios (AORs) and 95% confidence interval (95% CI) of each PPDP by the number of drinking parents, and the drinking frequency of each parent adjusting for socio-demographic variables. Moreover, correlates of PPDPs were identified among students with at least one drinking parent. Furthermore, the AORs and 95% CI of student drinking and drinking intention by each PPDP were computed. A total of 40 families (33 student-parent pairs, 6 students and 1 parent) were then selected for telephone interview. Results: Overall, 67.5% of students experienced at least 1 PPDP with the prevalence of PPDPs ranging from 9.3% for hearing the benefits of drinking to 51.0% for seeing parents drank. The prevalence of PPDP increased dramatically with the number of drinking parents (none 38.8%, either 81.6%, both 89.0%). PPDPs were associated with parental drinking frequency and various socio-demographic factors. For instance, adolescent girls (AOR: 2.28) were more likely to have received parental training of drinking capacity than boys. Frequent paternal and maternal drinking were most strongly associated with helping parents buy alcohol (AOR: 6.55) and training of drinking capacity (AOR: 5.14), respectively. In general, most PPDPs were significantly associated with ever drinking and monthly drinking in students. Both ever and monthly drinking in adolescents were strongly associated with parental training of drinking capacity with AORs of 6.20 and 8.20, respectively. Similarly, each PPDP was significantly associated with adolescent drinking intention with AORs ranging from 1.50 for helping parents buy alcohol to 3.53 for being encouraged by parents to drink. Consistent with quantitative data, the interviews revealed that almost half the students reported PPDPs (N=17/39) and it was common for students to see parents drink (N=7). Of the 17 families reporting involvement in PPDPs, all had at least one drinking parent. Conclusions: Most students experienced PPDPs and its prevalence increased with the number of drinking parents. In drinking parents, PPDPs were associated with socio-demographic factors and parental drinking frequency. Most PPDPs were associated with adolescent drinking and intention to drink. These results suggested that parents should avoid PPDPs to prevent adolescent drinking.published_or_final_versionPublic HealthMasterMaster of Philosoph