Alcohol misuse: tackling the UK epidemic - London

2
heavier smoking, drinking and more problematic drug use are all more pronounced among lower
social groups
• in early adolescence, behavioural, emotional and relationship difficulties are more common among
those from lower social groups and lower income households
• socio-economic deprivation is associated with a greater risk of teenage pregnancy.
Gender
There are important gender differences in adolescent health:
• boys are more physically active from an early age and are significantly more likely to engage in
vigorous activity during adolescence. Girls are more likely than boys to be dissatisfied with their
body size and shape
• adolescent girls are more likely to be regular smokers than boys. The prevalence of drinking, the
amount drunk and the use of drugs is, however, slightly higher among boys. Gender differences in
lifestyle now appear to be diminishing, meaning that girls are increasingly at risk of substance use
and misuse 7
• there are pronounced differences in mental health by gender, although effects differ by type of
disorder
• girls are more vulnerable to STIs and are normally more affected by young parenthood.
Age
Physical activity declines with age. Throughout adolescence there is an increase with age in smoking,
drinking, drug use and mental and sexual health problems. Age also affects the drugs and alcohol which
adolescents are exposed to and the type of mental health problems experienced.
Family and peer influences
There is considerable evidence that both family and peer factors influence adolescent health. For
example, nutrition and exercise are related to family and peer modelling and support. The behaviour of
family and peers has also been found to influence adolescent smoking. Coming from a non-intact family,
and favouring peer opinion over that of the family, are risk factors for smoking, drinking and drug use.
Reliance on the peer group rather than the family for support may also increase adolescent vulnerability
to peer pressure to engage in substance abuse and risky sexual behaviour. 6
Mental health difficulties are more common in lone parent households than in two parent families. The
quality of family relationships, levels of parental stress and family type have all been linked to adolescent
mental health. A history of child abuse, parental substance misuse, mental illness, personality disorder and
marital disharmony can all influence the mental health of adolescents.
Environment
Individuals bear some responsibility for their own health, even during early adolescence. It is clear,
however, that health is subject to social and economic circumstances that are often beyond individual
control. 8
The social environment plays an especially important role in nutrition through social norms and
the availability of healthy food. Access to appropriate recreational facilities also influences adolescents’
physical activities.
Social and psychological circumstances can cause long-term stress. Continuing anxiety, insecurity, low
self-esteem and social isolation can have powerful adverse effects on health, and are associated with
emotional disorders such as depression and anxiety. 8
Co-morbidity
There is evidence that many of the health problems and risk taking behaviours of adolescents examined
in this report can influence and exacerbate one another. The likelihood of smoking, drinking or using
drugs is higher among adolescents who use another substance. Adolescents report having more risky sex
British Medical Association Adolescent health