Prevention of alcohol use in early adolescents: A joint venture of school and parents

More than half of the Dutch adolescents start drinking before age 12 (Monshouwer et al., 2009). Early drinking is related to several developmental risks and to later alcohol and drug abuse (Behrendt et al., 2009). A Dutch alcohol prevention program (PAS) targets early adolescents and their parents in the first three years of high school, until adolescents turn 15. In a cluster randomized trial, a total of 19 high schools, including nearly 3000 adolescents and their parents were followed for a period of four years. Parents and adolescents are advised to postpone drinking until at least the age of 16 by targeting strict parenting in parents and healthy attitudes and self-control in adolescents. The Dutch alcohol prevention program (PAS) showed to be effective in postponing the onset of (heavy) drinking in early adolescents (Koning et al., 2009), but only when both parents and adolescents were targeted. Targeting either of them was not effective. The brief school-based intervention targeting adolescents and their parents reduced the onset of weekly drinking at 22 months by 10%, and at 34 months, when adolescents were 15 years old, by 11%. Even at the age of 16, adolescents receiving the combined intervention drank a lower number of glasses of alcohol compared to those receiving no intervention. As expected, the behaviors that were targeted by the PAS intervention accounted for the delay in onset of drinking. That is, the increase in strict rule setting in parents and in the level of self-control in adolescents caused the effect of the combined PAS intervention on the delay of drinking. Moreover, we demonstrated that mainly the high risk groups had most beneficial effects of the combined intervention. For example, adolescents in lower levels of education, those with a low level of self-control and those with lenient parents at baseline had more favorable effects of the combined intervention. So far, these findings indicate the importance of parents, mainly via strict rule setting, in tackling adolescents’ drinking. Part two of the thesis further underlines this. We demonstrated that strict rule setting is of importance throughout adolescence and is most effective when this is combined with a good and frequent quality of communication about alcohol. Moreover, also parental worries about their child affect their parenting behavior and adolescents’ subsequent drinking. In sum, this thesis demonstrated the relevance of targeting parents as well as adolescents in alcohol prevention aiming at delaying the onset of drinking. Moreover, the PAS intervention is an effective method to postpone the onset of (heavy) drinking up to age 16 by increasing parental strict rule setting and adolescents’ level of self-control. The importance of parents in understanding adolescents’ drinking has been established throughout adolescents, from age 12 to 16