La Trobe
1195570_Holmes,J_2022.pdf (818.11 kB)

Youth drinking in decline: What are the implications for public health, public policy and public debate?

Download (818.11 kB)
journal contribution
posted on 2022-09-26, 03:39 authored by J Holmes, H Fairbrother, Michael LivingstonMichael Livingston, PS Meier, M Oldham, Amy PennayAmy Pennay, V Whitaker
Youth drinking has declined across most high-income countries in the last 20 years. Although researchers and commentators have explored the nature and drivers of decline, they have paid less attention to its implications. This matters because of the potential impact on contemporary and future public health, as well as on alcohol policy-making. This commentary therefore considers how youth drinking trends may develop in future, what this would mean for public health, and what it might mean for alcohol policy and debate. We argue that the decline in youth drinking is well-established and unlikely to reverse, despite smaller declines and stabilising trends in recent years. Young people also appear to be carrying their lighter drinking into adulthood in at least some countries. This suggests we should expect large short- and long-term public health benefits. The latter may however be obscured in population-level data by increased harm arising from earlier, heavier drinking generations moving through the highest risk points in the life course. The likely impact of the decline in youth drinking on public and policy debate is less clear. We explore the possibilities using two model scenarios, the reinforcement and withdrawal models. In the reinforcement model, a ‘virtuous’ circle of falling alcohol consumption, increasing public support for alcohol control policies and apparent policy successes facilitates progressive strengthening of policy, akin to that seen in the tobacco experience. In the withdrawal model, policy-makers turn their attention to other problems, public health advocates struggle to justify proposed interventions and existing policies erode over time as industry actors reassert and strengthen their partnerships with government around alcohol policy. We argue that disconnects between the tobacco experience and the reinforcement model make the withdrawal model a more plausible scenario. We conclude by suggesting some tentative ways forward for public health actors working in this space.


This work was supported by the Wellcome Trust (208090/Z/17/Z) and an ARC Discovery Early Career Research Award to AP (DE190101074) .


Publication Date



International Journal of Drug Policy



Article Number








Rights Statement

© 2022 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (

Usage metrics

    Journal Articles


    No categories selected