Untangling the Effects of Peer, Family, School and Neighborhood Influences on Underage Drinking

Background: Adolescent alcohol use is highly prevalent and relatively unchanged in most developed countries, suggesting the importance of innovative approaches to understanding this behavior. As most of the social network research on adolescent substance use falls back on examining solely peer relationships, the other spheres that influence the adolescent's life: family, school and neighborhood, are often excluded. This study is one of a few that concurrently examine the influence of each social network on adolescent drinking behaviors. Methods: With a sample of 10,796 youth, grades six through twelve, social network influences were measured through risk behaviors among peers and family, perceived disconnect in school, and a revised neighborhood efficacy measure. The outcome of alcohol use was modeled using binomial regression with the exposures of social network type, age, gender, gang affiliation and depression indicators. Results: While positive behaviors by peers and family each produced a 50% decrease in drinking when adjusting for other measured factors, it appears that family has the strongest influence on whether a child becomes a mild drinker (RR 1.64) while peer influence most predicts heavy drinking (RR 1.47) when adjusting for other measured factors. Alternatively school and neighborhood influence showed little to no independent effect and the influence of each social network on alcohol consumption further varied by age of the child. Conclusion: Understanding the concurrent influence of the various social networks in a child's life given the age of the child and the type of drinking behavior targeted is necessary when implementing alcohol prevention efforts.