Alcohol misuse: tackling the UK epidemic - London

when they are under the influence of alcohol. There is a strong link between alcohol and substance misuse
and mental health problems. Overall there is a strong correlation between psychiatric disorders, substance
misuse and risky sexual behaviour. Health problems in adolescence can compound one another. For
example, mental health problems may act as a potent risk factor for substance misuse and such substance
misuse can contribute to existing mental health disorders. 9
Although many health behaviours are common to adolescents, risk factors for more acute problems are
identifiable. Socio-economic group, family and peer influences, and an adolescent’s environment all
influence health behaviours and mental and sexual health. Additional influences include youth offending,
truancy, school exclusion, family problems, homelessness and deprived communities.
Social disadvantage plays an important role in adolescent health. Smoking, drinking and drug use are all
more likely among adolescents who have been in trouble with the police, suspended from school or who
have poor academic performance and low future expectations. Low educational attainment is also
associated with early motherhood.
It becomes clear that, while many health concerns are common to all adolescents, it is possible to identify
several especially vulnerable groups who are more likely to experience health problems.
Interventions in adolescent health
Governments throughout the UK use health education to improve adolescents’ nutrition and sexual
health, and to discourage the use of alcohol, tobacco and drugs. In addition, they are seeking to improve
adolescent health through increasing access to healthy food and decreasing access to alcohol, tobacco and
drugs. UK governments are also working on improving addiction and sexual health services for
adolescents. Current strategies involve targeting drug and sexual health services to groups of adolescents
most at risk.
Evidence for the effectiveness of many interventions in adolescent health is equivocal. However, it is
possible broadly to evaluate intervention strategies in adolescent health. A number of approaches emerge
which could be adopted to improve adolescent health: a full list is included at the end of this report.
Early intervention and targeted intervention are valuable approaches in all aspects of adolescent health.
Health education offers some potential benefits but needs to be approached in the right way. School-based
education will not reach all adolescents and does nothing to tackle environmental influences on
adolescent health. Across all areas of adolescent health, more could be done to make structural and
environmental influences more positive. Improving access to services is vital if adolescent health is to be
improved: this involves ensuring not only adequate resources but also age appropriate, welcoming
environments and the provision of information and support to service users. Multifaceted interventions in
adolescent health (those using several different types of approach) are a useful way of countering the
many different influences on adolescents. Similarly, multiprofessional approaches (those involving several
services) are useful because of the interrelation between different areas of adolescent health and between
health and other aspects of adolescents’ lives.
British Medical Association Adolescent health 3