BACKGROUND: Despite legislation and enforcement activities to prevent underage access to alcohol, underage individuals continue to be able to access alcohol and to do so at levels which put them at significant risk of alcohol-related harm.

METHODS: An opportunistic survey of 15-16 year olds (n = 9,833) across North West England was used to examine alcohol consumption, methods of access and related harms experienced (such as regretted sex). Associations between these were analysed using chi square and logistic regression techniques.

RESULTS: Over a quarter (28.3%) of 15-16 year old participants who drank reported having bought their own alcohol. One seventh (14.9%) of these owned at least one form of fake identification for which by far the most common purchase method was online. Logistic regression analyses showed that those who owned fake identification were significantly more likely to be male (AOR = 2.0; 95% CI = 1.7-2.5; P < 0.001) and to receive a higher personal weekly income (comparing those who received > pound30 with those who received < or = pound10: AOR = 3.7; 95% CI = 2.9-4.9; P < 0.001). After taking into account differences in demographic characteristics and personal weekly income, ownership of fake identification was significantly associated with binge drinking (AOR = 3.5, 95% CI = 2.8-4.3; P < 0.001), frequent drinking (AOR = 3.0, 95% CI = 2.5-3.7; P < 0.001) and public drinking (AOR = 3.3, 95% CI = 2.5-4.1; P < 0.001) compared with those who did not own fake identification. Further, those who reported owning fake identification were significantly more likely to report experiencing a variety of alcohol-related harms such as regretted sex after drinking (chi square, all P < 0.001).

CONCLUSIONS: Young people (aged 15-16 years) who have access to fake identification are at a particularly high risk of reporting hazardous alcohol consumption patterns and related harm. Owning fake identification should be considered a risk factor for involvement in risky drinking behaviours. Information on these hazards should be made available to schools and professionals in health, social and judicial services, along with advice on how to best to work with those involved.

BACKGROUND: The Chief Medical Officer for England has developed the first guidance in England and some of the first internationally on alcohol consumption by children. Using the most recent iteration of a large biennial survey of schoolchildren we measure the extent to which young people's drinking fell within the guidelines just prior to their introduction and the characteristics of individuals whose drinking does not; how alcohol related harms relate to compliance; and risk factors associated with behaving outside of the guidance.

METHODS: A cross-sectional survey was conducted utilising a self-completed questionnaire with closed questions. A total of 11,879 schoolchildren, aged 15-16 years, from secondary schools in North West England participated in the study. Data were analysed using chi square and conditional logistic regression.

RESULTS: Alcohol consumption is an established norm by age 15 years (81.3%). Acute alcohol related violence, regretted sex and forgetfulness were experienced by significantly fewer children drinking within the guidance (than outside of it). Over half of drinkers (54.7%) reported routinely drinking more heavily than guidance suggests (here >/= 5 drinks/session >/= 1 month), or typically drinking unsupervised at home or at a friend's home when parents were absent (57.4%). Both behaviours were common across all deprivation strata. Children with greater expendable incomes were less likely to consume within guidance and reported higher measures for unsupervised, frequent and heavy drinking. Although drinking due to peer pressure was associated with some measures of unsupervised drinking, those reporting that they drank out of boredom were more likely to report risk-related drinking behaviours outside of the guidance.

CONCLUSIONS: Successful implementation of guidance on alcohol consumption for children could result in substantial reductions in existing levels of alcohol related harms to young people. However, prolonged social marketing, educational and parental interventions will be required to challenge established social norms in heavy and unsupervised child drinking across all social strata. Policy measures to establish a minimum price for alcohol and provide children with entertaining alternatives to alcohol should also increase compliance with guidance.

The article reviews the history of the discussion concerning the effect of alcohol consumption on the national economy. The point of departure is a discussion prompted by the prohibitionists in the Nordic countries and US who succeeded in bringing a ban on alcohol into reality. It made sense in those circumstances to ask the question. Two different situations were compared, a society where alcohol was forbidden and one where it was not. After the prohibitionists' hope of an alcohol-free society became a lost cause in the 1930s, interest in these calculations waned for a spell. Interest was re-ignited in Finland, Norway and Sweden in the 1960s and '70s, however, spreading to North America and Australia in the 1980s and '90s. A set of international guidelines was issued on how to estimate the social costs attributable to alcohol consumption. In practice, there was a heavy bias in favour of costs, while the income side, with the exception of alcohol's presumed beneficial effect on cardiovascular diseases, was left out. Cost-of-illness studies were employed here, in which a contemporary society was compared with a fictive one, where alcohol had never existed. This article argues that such studies are not very meaningful in a research context and represent a capitulation to the desire of politicians to give political decisions a semblance of neutrality based on a common-sense approach to economics.

This paper reports on trends in alcohol consumption and related problems in the Republic of Ireland during the years 1990-2010, and on alcohol policy developments over this same period. Prior to the collapse of the Irish economy in late-2008, Ireland had enjoyed almost fifteen years of unprecedented economic growth, with commensurate increases in levels of personal disposable income. As predicted by economists, economic growth was accompanied by substantial increases in levels of alcohol consumption, with corresponding increases in all the main indicators of alcohol-related problems. Although numerous policy reports from the health sector advocated alcohol control strategies, due to the generally neo-liberal ethos of this era and active lobbying from the drinks industry, little or no implementation of such strategies occurred. Reflecting the current economic down-turn, levels of alcohol consumption have now stabilized. It is concluded, however, that implementation of comprehensive, top-down, alcohol strategies remains unlikely, and that bottom-up, community mobilization offers the best prospect for change in this sphere.

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