Understanding the patterns of alcohol use among adolescents in a Peri-urban historically disadvantaged community in the Western Cape province, South Africa

Magister Public Health - MPHBackground: Alcohol consumption among adolescents is increasing due to the general availability of alcohol in many community settings. Binge drinking (defined as drinking 5 or more drinks per occasion) (Parry, 2000) is considered the most common type of harmful alcohol consumption among young people. The United States Youth Risk Behaviour Surveillance report proposes that patterns of health risk behaviours are established during youth (Centre for Disease Control and Prevention,2006). The abovementioned report highlights behaviours such as alcohol misuse, drug use and risky sexual behaviour that have the potential to undermine the health and development of youth. Adolescent developmental theories recognise risk behaviours as central to normal adolescent development but there are complex predisposing risk factors that can cause these behaviours to compromise the healthy development of our youth. In order to design and implement effective intervention schemes, we need to understand the dynamics of alcohol use among local youth better, as these play out in their specific social environmental and personal contexts.Aim: The aim of this study was to gain an understanding of what influences the patterns of alcohol use among adolescents in a peri-urban historically disadvantaged community in the Western Cape. The study identified some of the factors that promote and inhibit drinking within the study community from the perspective of the adolescents themselves and a few of the adults who work with adolescents. The study also determined some of the harmful consequences to drinking as described by the adolescents.Method: This was an exploratory study using qualitative research methods. Four focus group discussions were conducted with adolescents aged between 14 and 19 years that were both attending and not attending school. Three key informant interviews with adults who were involved with the youth were conducted.Convenience sampling was used for the non-school attending participants and snowball sampling was used for the school attending youth. The adults in the study were purposively sampled. The study was conducted within the study setting during March and April 2009. Thematic and content analysis was used to interpret the data.The descriptive data was coded and categorised according to themes that emerged during analysis.Results: In general the youth of this study are drinking on weekends. They spend their time on the streets and access alcohol from the many illegal taverns in their neighbourhood. Some of the reasons why adolescents drink include just for the fun of it and because their friends drink and to cope with stress or boredom (risk factors for problem behaviour). Those who don’t drink generally have strong parental role models, have observed some of the harmful effects of alcohol use and seem able to resist peer pressure (protective factors for problem behaviour). There were no significant differences between the perceptions of male and female adolescents regarding alcohol consumption. The black adolescents in general appeared to be more affected by poverty than the coloured adolescents, a factor that influenced their choices around alcohol use. Risky sexual behaviour, rape and fighting seem to be some of the harmful consequences to drinking that are described by the youth of this study. The social environment in which the adolescents of this study live seemed to play a significant role in their attitudes toward drinking. Factors such as a lack of infrastructure for leisure, poverty and a tolerance for public drunkenness are community factors that affect these adolescents but over which they have little or no control.Conclusion: The potential for problem behaviour as perceived by the participants is determined by the balance of risk and protective factors that emanate from their social environment, the community itself and their own personality. Those fortunate enough to have cohesive families with interested adults around them are more likely to be protected from problem behaviour due to drinking.Recommendations: Recommendations from this study include engaging with the youth directly when designing intervention programmes; using peer-led programmes to effect change and to help adolescents to clarify their values; equip them with skills to plan for the future in order to develop their self-efficacy to make the right choices when it comes to alcohol consumption. It is also recommended that intervention programmes address relationships within the community itself such as strengthening parent-child communication; building positive adult role models and empowering community members to challenge issues such as illegal tavern owners serving alcohol to minors