Dott.ssa Sabrina Vici YOUTH AND ALCOHOL WHAT PREVENTION? WHAT PREVENTION?

Dott.ssa Sabrina ViciDott.ssa Sabrina Vici

YOUTH AND ALCOHOLYOUTH AND ALCOHOL

WHAT PREVENTION?WHAT PREVENTION?

The European Region has the highest alcohol consumption in the world with a consumption that is the double of the world average rate per person. The alcohol is the third most important risk factor of death and disability in Europe, and the main risk among the young people. The alcohol diseases in the European Region are the double of the world average rate.

Framework for alcohol Policy in the WHO European Region

The subject of this experience is particularly important, because it emphasizes society’s deadly complacency about drinking.Why is public opinion so quick to react 8 sometimes rightly, sometimes in an exaggerate way) against any threat to health, yet it is hardly worried al all when, week after week, ten thousands of children and adolescents die as a result of drinking( more than 57 000 each year in the European Region)?Why is alcohol treated almost everywhere as a normal consumer product, widely advertised and available in major retail outlets, yet its consumption by young people increasingly mirrors patterns of drug use?Why is it that few studies into the positive health effects of alcohol are widely reported , yet the many others pointing up its dangers are often ignored? Who is aware, for instance, of the fact that one in four death among young men aged 15-29 years is due to alcohol?Why do we continuing pretending that there are two totally different and opposing types of drinking: the good way, which gives pleasure and eases social revolution, and a bad, which leads to alcohol abuse? We now realize that the boundary between moderate and excessive drinking in a fluid one, and that people often move from one to the other without acknowledging the fact.

Marc Danzon: Direttore Generale per l’Europa dell’OMS

Stoccolma 19 febbraio 2001

we can not speak about youth and alcohol without inserting this problem on a more general context of the community culture.

“Alcohol policies directed at young people should be part of a broader societal response, since drinking among young people to a large extent reflects the attitudes and practices of the wider adult society. “

WHO Young People and Alcohol Stockholm 21 Feb 2001

WHO and EU documents on Young people and Alcohol

• European Charter on Alcohol Paris 2005 All children and adolescents have the right to grow up in an environment

protected from negative consequences of alcohol consumption and, to the extent possible, from the promotion of alcoholic beverages

• European Commission “Drinking of children and adolescents” Luxembourg 2001

Raise awareness of the effects of alcohol, in particular among young people Minimize the risk connected to the alcohol consumption among young people

and his social an health impact. Press the manufacturers for paying attention on packaging and distribution of alcoholic beverages, not targeting alcohol products at young people

• Alcohol and Young People conference February 2001 Stockholm Set the following targets that should be achieved by the year 2006:1. reduce substantially the number of young people who star consuming alcohol;2. delay the age of onset of drinking by young people;3. increase education for young people on alcohol;4. minimize the pressures on young people to drink, especially in relation to alcohol

promotions, free distribution, advertising, sponsorship and availability, with particular emphasis on special events;

5. increase young people’s involvement in youth health-related policies, especially alcohol –related issues.

•More and more adolescents, above all girls, consume alcohol

•About 900,000 (ISTAT data) young people under 16 usually drink alcoholic beverages; young drinkers have risen from 781,000 in 1998 to 870,000 in 2002

•In Italy young people between 11 and 12 years of age start drinking; it is the lowest average age in Europe where the first approach to drinking is around 14 years

•Rise in the practice of highly risk consumptions such as “binge drinking”( 5 alcoholic beverages in a row to get drunk) and the assumption of psychoactive substances together

•There are obvious connections between alcohol, tobacco and illegal drugs

NATIONAL FRAMEWORK OF CONSUMPTIONNATIONAL FRAMEWORK OF CONSUMPTION

San Benedetto del tronto CitySan Benedetto del tronto City

Alcohol Health Call ServiceAlcohol Health Call Service

Social ServiceSocial Service

800-239220800-239220

Città di San Benedetto del TrontoCittà di San Benedetto del TrontoSERVIZIO RISPOSTE ALCOLOGICHESERVIZIO RISPOSTE ALCOLOGICHE

Settore attività sociali Settore attività sociali

The research was developed during the school year 2005-06, The research was developed during the school year 2005-06, between January and February, among 459 students (217 between January and February, among 459 students (217 females and 242 males) of 12 and 16 years old, all attending females and 242 males) of 12 and 16 years old, all attending the last year of middle school in San Benedetto del Trontothe last year of middle school in San Benedetto del Tronto

The students answered to 23 questions on their The students answered to 23 questions on their acknowledge on the alcohol properties to draw a final acknowledge on the alcohol properties to draw a final evaluation of their and their family attitude on the evaluation of their and their family attitude on the consumption of alcoholic beveragesconsumption of alcoholic beverages

47,28%

52,72%

44,00%

46,00%

48,00%

50,00%

52,00%

54,00%

female male

Sex

Città di San Benedetto del TrontoCittà di San Benedetto del Tronto SERVIZIO RISPOSTE ALCOLOGICHE SERVIZIO RISPOSTE ALCOLOGICHE Settore attività sociali Settore attività sociali

EFFCTS FOR ALCOHOLEMIC EXCESS

53%

27%

10%

4,6%

3%

2,8%

0% 10% 20% 30% 40% 50% 60%

Slow reflexes and sightdamage

Giddy f its and stomach-ache

I do not know w hatalcoholimia is

Everything seems easier

Makes you easy

Na

53,81%41,18%

1,74% 3,27%

0,00%10,00%

20,00%

30,00%40,00%

50,00%

60,00%

Yes it dependson quantity

no do notknow / na

A person who drinks alcoholic beverages before driving, rises the risk of car accidents

Città di San Benedetto del TrontoCittà di San Benedetto del TrontoSERVIZIO RISPOSTE ALCOLOGICHESERVIZIO RISPOSTE ALCOLOGICHE Settore attività sociali Settore attività sociali

The initiationThe initiation

23,5%

17,40%

58%

1,10%

0,0%

10,0%

20,0%

30,0%

40,0%

50,0%

60,0%

never once more thanonce

na

Have you ever drun an alcoholic beverage?


0,22%0,87%

2,83%3,05%

2,61%4,58%

5,23%

13,94%11,98%

19,61%

10,24%

1,09% 0,22%

0,00%2,00%4,00%6,00%8,00%

10,00%12,00%14,00%16,00%18,00%20,00%

two

four fiv

e six

seve

nhe

igt

nine te

n

elev

en

twel

ve

thirt

een

four

teen

fifte

en

Initiation age


48,40%

18,72%

3,92%8,06%

20,90%

0,00%5,00%

10,00%15,00%20,00%25,00%30,00%35,00%40,00%45,00%50,00%

wine/

cham

pagn

ebe

er

lique

ur/ s

uper

alco

holic

...

baca

rdi b

reez

er na

First alcoholic beverage drunk


1,09%

61,44%

17,21% 20,26%

0,00%

20,00%

40,00%

60,00%

80,00%

alone w ith myfamily

w ith friends na

Who were you with the first time you drank an alcoholic beverage?


31,59%

66,01%

0,00%

10,00%

20,00%

30,00%

40,00%

50,00%

60,00%

70,00%

yes no/ do not know

Is alcoholic beverage tasteful?


42,70%

52,72%

4,58%

0,00%

20,00%

40,00%

60,00%

not drinkers drinkers na

Alcohol consumers in the last six months


61,87%23,09%

0,00%

20,00%

40,00%

60,00%

80,00%

yes do not know

I like an alcoholic beverage in particular


12,20%

21,57%

5,23%

22,88%

0,00%

5,00%

10,00%

15,00%

20,00%

25,00%

w ine beer liqueur bacardibreezer

Favourite alcoholic beverage


59,04%

28,10%

0,00%

10,00%

20,00%

30,00%

40,00%

50,00%

60,00%

With family w ith friends

Consumption context


Consumption occasions

21,13%

35,95%

11,10%

6,54%

5,45%

4,36%

3,92%

2,83%

2,61%

1,53%

1,53%

3,05%

Never

To celebrate with family

To celebrate with family, in a restaurant

To have fun with friends

To celebrate with family, during meals

To celebrate with family, if I am sad

In a pub or in pizzeria

To have fun with friend in a pub

To celebrate with family, enjoy with friends

To have fun with friends during meals

To celebrate with family, pub, restaurant

Na

11,33%

85,84%

0,00%

50,00%

100,00%

yes no

Have you ever got drunk?


8,71%

2,61%

0,00%

5,00%

10,00%

In special occasions often

When did it happen?


68,85%

19,39%

4,79% 1,96%

0,00%

10,00%

20,00%

30,00%

40,00%

50,00%

60,00%

70,00%

None someone most of thetime

alw ays

Frequency of drinks at the weekend


17,65%20,70%

7,84%

0,00%

5,00%

10,00%

15,00%

20,00%

25,00%

w ine beer liqueurs

favourite beverage to exaggerate


64,71%

58,82%

18,08%

13,29%

3,70%

3,27%

11,11%

21,57%

2,40%3,05%

0,00%

10,00%

20,00%

30,00%

40,00%

50,00%

60,00%

70,00%

sometimes only atweekend

more timesduring the

week

never na

I usually go to pub or pizzeria w ith….

Parents

friends


45,32%

15,03%

39,65%

0,00%

20,00%

40,00%

60,00%

yes no do not know /na

It is better to get drunk than to assume illegal psychoactive substances


Summing up…..Summing up…..

Young interviewees’ lifestyle is really Young interviewees’ lifestyle is really worryingworrying

Almost the half of the sample frequent pub Almost the half of the sample frequent pub or pizzeria with regularity, they seldom got or pizzeria with regularity, they seldom got drunk and occasionally have “drinks” at the drunk and occasionally have “drinks” at the weekendweekend

Both female and male young people of our Both female and male young people of our area do not respect the WHO advices area do not respect the WHO advices (Health 21, Target 12) according that the (Health 21, Target 12) according that the consumption should be equal zero for consumption should be equal zero for people under 16.people under 16.

The family is the main context in The family is the main context in which they start drinkingwhich they start drinking

The average age for the first The average age for the first drink is 10.4 years olddrink is 10.4 years old

The consumption happens above The consumption happens above all among familyall among family

The occasions that promote The occasions that promote drinking are family partiesdrinking are family parties

Bacardi breezer and beer are the Bacardi breezer and beer are the most favourite beveragesmost favourite beverages

Family

mainmain

resourceresource

Shocking pink

This survey was carried out during the school year 2005/06, between January and February, among 594 female students between 14 and 22 years of age, all attending high school in the city of San Benedetto del Tronto

Fonte: Servizio Risposte Alcologiche-Città di San Benedetto del Tronto-

At the moment I am attracted/ more attracted by….

touring clubs all the night

long32%

joining the fray in the disco

26%provoking

23%

High speed 14%

drinking5%


When do you usually drink alcoholic beverages?

59,43%

9,43%4,04% 5,72%

0,00%

10,00%

20,00%

30,00%

40,00%

50,00%

60,00%

70,00%

Duringweekends

meals out of meals both


Who have I drunk in the last three months with?

16,50%

76,23%

26,43%

10,61%

35,85%

5,39%

59,26%

4,21%7,74%

0,00%

10,00%

20,00%

30,00%

40,00%

50,00%

60,00%

70,00%

80,00%

90,00%

Family friends partner

beer

wine

super alcoholic drinks


Where have you drunk in the last three months?

55,89%

9,43%

85,19%

8,08%

24,58%

46,30%

1,85%

48,82%

31,82%

0,00%

10,00%

20,00%

30,00%

40,00%

50,00%

60,00%

70,00%

80,00%

90,00%

At home in pubs outside

beer

w ine

super alcoholic drinks


Has it happened that you drank too much without getting drunk?

28,62%

16,16%

3,03%

49,83%

0,00%

10,00%

20,00%

30,00%

40,00%

50,00%

60,00%

Never

once

, twice

thre

e tim

es o

r mor

e

do n

ot kno

w, na

Has it happened that you drank too much without getting drunk in the last

three months?

47%

53%

yes

no


Has it happened that you drank too much till getting drunk?

14,81% 7,24% 1,68%

74,41%

0,00%10,00%20,00%30,00%40,00%50,00%60,00%70,00%80,00%

neve

r

once

, twice

thre

e tim

es o

...

do n

ot k

now, n

a

Has it happened that you drank too much till getting drunk in the last three months?

22,05%

74,41%

yes

no


A tuo giudizio quanto bevono i tuoi amici più stretti 55,9

A tuo giudizio quanto bevono le tue amiche più strette 50,6

Come giudichi il tuo consumo di alcol (0= basso, 100= alto) 51,3

Secondo te, bere è……… (0= spiacevole, 100= piacevole) 51,1

Quanto consideri pericoloso l’alcol? 65,9


In your opinion: how much do your closer friends drink?

In your opinion: how much do your closer female friends drink?

How do you judge the alcoholic beverages consumption (0= low, 100= high)

In your opinion: drinking is…… (0=disagreeable , 100= agreeable)

How dangerous do you think alcohol is?

After drinking, has it ever happened to you to…

0,00%

10,00%

20,00%

30,00%

40,00%

50,00%

60,00%

70,00%

80,00%

90,00%

have

gre

at t

ime

feel

em

barra

ssed

with

the

other

s

feel

bet

ter a

mong

frien

ds

feel

gui

lty

laug

h m

ore

thin

k it is

the

last

t ime

be d

emon

stra

tive

be a

ggress

ive

feel

qui

et

atte

mpt

a s

exua

l inte

rcou

rse

be e

uphor

ic

be a

nxious

never

sometimes

often


What about being a passenger in a car or on a motorbike driven by someone who had drunk too much?

18,35%

6,40%

72,73%

0,00%

20,00%

40,00%

60,00%

80,00%

Once-twice three or more times no

Have you ever thought to a trick not to get in a car driven by people who had drunk too much?

26%28%

30%

1%3%

12%

0%

5%

10%

15%

20%

25%

30%

35%

decide not togo out

get in anothercar

convince thedriver not to

drink

phoneparents,

brothers orsisters

f ind a housenearby to

sleep

convincesomeone else

to drive

How much do you think to use one or more of these tricks?

29,63%

22,73%36,36%

0,00%

10,00%

20,00%

30,00%

40,00%

little enough a lot


Have you ever seen fights ( quarrels, rows,…) among people who had drunk too much?

16,16%20,37%

62,63%

0,00%

10,00%

20,00%

30,00%

40,00%

50,00%

60,00%

70,00%

never sometimes often


Have you ever had easier sexual intercourses after drinking?

5,39%9,43%

82,32%

0,00%

10,00%

20,00%

30,00%

40,00%

50,00%

60,00%

70,00%

80,00%

90,00%

never sometimes often


• The style of consumption of the female adolescents do not differ from the male adolescents one

• Alcoholic consumption is characterised by the reach of the pleasure and amusement

• Drinking is seen as a positive attitude

• The low perception of risks and the poor information on the proprieties of the substance supports the reach of an easy gratification on drinking

• We must arise the awareness on the risks, in particular on alcohol and sexuality, with sensitisation interventions to this stated target

Summing upSumming up The family has a key role on their children’s future The family has a key role on their children’s future

behaviourbehaviour A National Health Service survey, based on ISTAT A National Health Service survey, based on ISTAT

data 1998-203, says the proportion of teetotal data 1998-203, says the proportion of teetotal children varies in relation with the type of children varies in relation with the type of consumption adopted by the head of the familyconsumption adopted by the head of the family

The children who live with a drinker head of the The children who live with a drinker head of the family have a higher risk (26%) to become family have a higher risk (26%) to become drinkers, with the respect of teetotal head of the drinkers, with the respect of teetotal head of the familyfamily

All scientific evidences first of all underline the All scientific evidences first of all underline the role of the family with respect to precocious role of the family with respect to precocious alcohol consumption and to future children alcohol consumption and to future children drinking attitudesdrinking attitudes

Consequently, it is fundamental to considerate Consequently, it is fundamental to considerate those facts and to involve the family to start a those facts and to involve the family to start a health promotion interventionhealth promotion intervention

The knowledge of the drinking risks in the youth The knowledge of the drinking risks in the youth should favour the family’s knowledge on the should favour the family’s knowledge on the main role the have in supporting healthy main role the have in supporting healthy lifestyleslifestyles

To realize the Health To realize the Health Promotion Activities among Promotion Activities among youth some considerations youth some considerations should be done:should be done:

HEALTH PROMOTIONHEALTH PROMOTIONFOCUS ON HEALTH AND INDIVIDUALFOCUS ON HEALTH AND INDIVIDUAL

““The health promotion is a process that lets The health promotion is a process that lets people increase the control on their health and people increase the control on their health and improve it”improve it”

““The health is a positive concept that gives value The health is a positive concept that gives value to personal and social resources, together with to personal and social resources, together with physic capacities”physic capacities”

OTTAWA CHARTER – W.H.O. 1986OTTAWA CHARTER – W.H.O. 1986

11) ….I giovani, gli adolescenti non sono molto inclini per natura al conformismo; agevolare tale inclinazione e incoraggiare in questo caso un sano anticonformismo….i giovani a volte hanno bisogno di essere provocati sulla sbandierata capacità giovanile di prendere la vita e le scelte nelle proprie mani. Se tutti bevono dov’è l’originalità….

Dieci suggerimenti ai genitori per favorire una scelta responsabileE. Scafato e R. Russo Istituto Superiore di Sanità

….Young people, adolescents are not conformist of their own; facilitating such inclination and encouraging a healthy anti –conformism….sometimes young people need to be provoked on the boasted youthful capacity to take life and choices in their own hands. If everybody drinks, where the originality is …..

3) ….3) ….Parlare ai giovani fin da quando sono Parlare ai giovani fin da quando sono bambini dei danni e dei rischi legati all’alcol bambini dei danni e dei rischi legati all’alcol e e delle conseguenze che errate abitudini di consumo delle conseguenze che errate abitudini di consumo possono arrecare sia in termini di salute che in possono arrecare sia in termini di salute che in termini socialitermini sociali può contribuire ad evitare che le può contribuire ad evitare che le indicazioni poste dai genitori si ammantino di un indicazioni poste dai genitori si ammantino di un valore “integralista” o di divieto….valore “integralista” o di divieto….


…Speaking with young people since they are little children on the damages and the risks connected to alcohol and the consequences that dangerous consumption behaviours can bring on health and social terms can contribute to avoid false families’ integrities..


9) Offrire la casa agli amici dei figli e coinvolgere i 9) Offrire la casa agli amici dei figli e coinvolgere i figli nell’organizzazione di una festa o di un figli nell’organizzazione di una festa o di un semplice incontro può essere l’occasione per semplice incontro può essere l’occasione per dimostrare che ci si può divertire e ottenere un dimostrare che ci si può divertire e ottenere un clima spensierato e allegro anche con clima spensierato e allegro anche con l’accompagnamento di bevande analcolichel’accompagnamento di bevande analcoliche : : l’alcol non è indispensabile per raggiungere questi l’alcol non è indispensabile per raggiungere questi risultati e nel corso dell’adolescenza risultati e nel corso dell’adolescenza l’esperienza l’esperienza di una di una convivialitàconvivialità “analcolica”“analcolica” e la disponibilità e la disponibilità di alternative alle bevande alcoliche può agire da di alternative alle bevande alcoliche può agire da supporto per l’adozione di stili di vita sani del supporto per l’adozione di stili di vita sani del gruppo oltre che dell’individuo. gruppo oltre che dell’individuo.

Hosting at home and involving our children’s friends to organize parties or meetings can be a good opportunity to demonstrate we can enjoy ourselves and live in a thoughtless environment also with soft drinks: we do not need alcohol to have these results and during the adolescence a “soft drinks” friendship and the supply of soft drinks could be a support on the adoption of healthy lifestyles of the group besides the individual subject

10) Vigilare sui giovani….situazioni spesso reputate tranquille possono essere causa di conseguenze impreviste per i giovani.

Nel corso di una serata in pizzeria con gli amici, specie se raggiunta con il motorino, c’è la possibilità che i giovani ricevano bevande alcoliche (è vietato per legge al disotto dei 16 anni ma non sempre la norma è applicata).

*************************************************Infine, il fattore chiave per incrementare i livelli di protezione della salute dei giovani è mantenere aperti e attivi i canali di comunicazione, privilegiando l’ascolto e dedicando un tempo ben definito all’analisi delle esigenze e dei loro problemi.


Supervising young people….. circumstances we think calm could have unexpected consequences among young people

During a party in pizzeria with friends, above all if they drive a motorbike, there is the possibility that young people have alcoholic beverages ( It is forbidden selling alcoholic beverages under 16 , but this law is always disregarded)

Moreover, the key point to rise the youth’s protection levels is to keep opened the communication channels, listening and devoting a specific time to the analysis of their needs and problems

FinallyFinally We should organize sensitization events connected We should organize sensitization events connected

alcohol risks in all the school, starting from primary alcohol risks in all the school, starting from primary school, with the help of the families who represent school, with the help of the families who represent the key factor to reinforce young people’s the key factor to reinforce young people’s knowledge on alcohol before they start drinkingknowledge on alcohol before they start drinking..

It is important a sensitization action on young It is important a sensitization action on young people on alcohol effects to promote health against people on alcohol effects to promote health against alcohol and its risks at school.alcohol and its risks at school.

Programs, according to different ages, should Programs, according to different ages, should increase youth’s critical capacities through suitably increase youth’s critical capacities through suitably trained teachers’ supporttrained teachers’ support

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Dott.ssa Sabrina Vici YOUTH AND ALCOHOL WHAT PREVENTION? WHAT PREVENTION?