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An examination of the role of changes in country-level leisure time internet use and computer gaming on adolescent drinking in 33 European countries

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posted on 2024-01-09, 04:51 authored by Rakhi VashishthaRakhi Vashishtha, J Holmes, Amy PennayAmy Pennay, Paul DietzePaul Dietze, Michael LivingstonMichael Livingston
Introduction: Adolescent alcohol consumption has been declining in many high-income countries since the turn of this century. Research investigating the plausible explanations for these declines has been mostly based on individual-level studies, which are largely inconclusive. Changes in leisure time internet use and computer gaming (referred to in this article as ‘computer activities’) have been hypothesised to play a role in declining adolescent alcohol consumption at a country-level. The aim of this study was to examine the association between country-level changes over time in computer activities and adolescent drinking in 33 European countries. Methods: This is a multi-level repeated cross-national study examining the role of changes over time in country-level and individual-level computer activities on regular drinking. We utilised four waves of the European School Survey Project on Alcohol and Drugs (ESPAD) from 2003, 2007, 2011 and 2015. At an individual-level the primary exposure of interest was daily engagement in computer activities and aggregated means were used to measure country-level daily computer activities in each included country. Data were analysed using three-level hierarchical linear probability methods. Results: In the fully adjusted model, for between individual effects, we found significant positive association between daily computer activities and regular drinking (β = 0.043, p-value <0.001 and 95% CI = 0.033–0.054). However, at a country-level, we did not find any association between within-country changes in daily computer activities and regular drinking (β = 0.031, p-value = 0.652 and 95% CI = -0.103–0.164. Conclusion: Findings from this study suggest that broad cultural shifts towards increased computer-based activities among adolescents has played a little or no role in declining adolescent drinking. Future research should be directed towards examining other high-level cultural changes which may have influenced cross-national reductions in adolescent drinking.


This research was supported under the Australian Research Council's Discovery Projects funding scheme (project number DP160101380). AP is supported by an Australian Research Council Discovery Early Career Researcher Award (DE190101074). ML is supported by an NHMRC Career Development Fellowship (1123840). PD has received investigator initiated funding from Gilead Sciences, an untied educational grant from Indivior and is an unpaid member of an Advisory Board for Mundipharma for work unrelated to this study.


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International Journal of Drug Policy



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© The Authors 2022. This manuscript version is made available under the CC-BY-NC-ND 4.0 license

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