Parent attitudes, family dynamics and adolescent drinking: qualitative study of the Australian parenting guidelines for adolescent alcohol use

Central for most of the parents we interviewed was a desire to maintain a good relationship with their child, and encourage communication. While each of the parents had their own approach to maintaining a good relationship with their child, in general, the approaches taken closely matched the suggestions made in the guidelines. For example, parents attempted to talk to their children, showed interest in their lives, and encouraged them to be open about the presence of alcohol at parties and in other social situations, in order to cultivate trust. These sentiments are reflected in the following comments:

"“its important to keep the communication lines open” and “the bottom line is that you have to trust them” (Mother of a 16 year-old girl);"

"“it happens anyway so I would rather they tell me” (Mother of a 14 year-old girl and 16 and 18 year-old boys); and"

"“We have a good relationship with their friends…we try to make it pretty cool for them to hang out at our place” (Mother of 13 year-old girl and 15 year-old boy)."

Several studies show that family relations and the strength of the parent-child bond can affect drug use, both directly and indirectly through an influence on the choice of friends [12‐14]. There is conflicting evidence on the impact of parental attachment on adolescent drinking. Van der Vorst et al. found that good attachment was not protective against adolescent alcohol consumption, but that strict parental control did have a protective effect [15]. Ryan et al. cited evidence that parental involvement is associated with delayed alcohol initiation but not with lower levels of later use, and the reverse for parental support i.e. there was no association with age of initiation but parental involvement was predictive of lower levels of later use [6]. Parent-child relationship quality is reportedly associated with both delayed alcohol initiation and reduced levels of later use [6].

Parental behaviour in relation to parental monitoring matched reasonably well with the guidelines. Parents generally attempted to know where their children were, and who they were with. Often, parents used dropping-off and picking-up children as a way of monitoring their whereabouts and behaviours. Many parents acknowledged that it is difficult to monitor what happens at parties and other events, but they focused on building a trusting relationship whereby their adolescent communicates with them about such events. One mothers’ comment “I want them to feel that they can talk to me” (Mother of a 17 year-old boy and 15 year-old girl) echoed the sentiments of many. A harm minimization approach was mentioned by several parents, ensuring their children could get home safely, discouraging drink driving, and making themselves “accessible 24-7” if needed. Messages such as “never get in a car with someone who has been drinking” (Mother of 13, 16 and 18 year-old boys) were common. One mother (of a 13 year-old girl and 16 year-old boy) talked about telling her children “No mucking around, if you are out of your depth, I can be there in a flash to pick you up”.

Previous research suggests that parental monitoring and supervision can prevent or delay the onset of adolescent substance use (including alcohol) [16]. In a longitudinal study of drug taking among year 8-10 students (aged 13-16) it was found that higher levels of monitoring were protective against the misuse of drugs, even when exposed to drug-using peers [17]. In relation to alcohol, Ryan et al. reported that greater parental monitoring is associated with earlier initiation, but lower levels of later alcohol use [6]. This result suggests that parental monitoring may occur in a context of early initiation to alcohol in the home, which is consistent with findings that early initiation of alcohol is likely to occur when children are allowed to drink at home [18, 19] or at family gatherings [20].

While some families did have rules that matched with those suggested in the guidelines, these rules were rarely planned or established through family discussion as the guidelines recommend. In further discordance with the guidelines, parents often expressed a reluctance or incapacity to punish their children, and consequences were rarely enforced if household rules were broken. Some parents reflected:

"“I feel like punishing him is a bit draconian, it is going to happen anyway…and I am trying to minimize the damage…”. (Mother of a 17 year-old boy)"

"“I don’t think I would punish her, I don’t think that would work, but I would let her know that I was really disappointed”. (Father of a 16 year-old girl)"

A number of parents recalled ‘one-off’ incidents where their child had come home drunk or been drunk when they were collected from a party. The most common reaction among parents in both groups was disappointment, with anger being secondary. Several parents also said their greater concern or reaction was in relation to their child’s dishonesty rather than the drinking itself. In cases where children had been drunk, parents commonly stated that punishment wasn’t necessary because the sense of shame and the hangover were enough to teach their child a lesson.

Some research suggests that parents who lack effective skills in family management have less capacity to protect their children from negative influence of peers [21]. Adolescents with poor family management are more likely to engage in heavy episodic drinking [22] and be exposed to risky situations such as socialising with peers who are drinking [23]. In contrast, Ryan et al. found no relationship between rules about alcohol and either early initiation or later drinking levels [6].

Several parents cited heavy drinking by their children’s fathers or step-parents as influences on divorce or separation. According to the parents, these behaviours had mixed impacts on their children. Some children expressed anger and were deterred from drinking by their parents’ or step-parents’ heavy drinking, others have become heavy drinkers themselves. This contrast is highlighted in comments such as “The oldest was never curious as a child – she was probably put off by seeing Dad come home drunk too often” (Mother of 14, and 16 year-old boys and an 18 year-old girl) and “the older boys don’t seem to have been put off at all by seeing their dad drunk so often – they both drink [on] most if not all weekends” (Mother of 15, 18 and 20 year-old boys and separated from what the mother described as an alcoholic husband). The influence of older siblings was also important for both parents and adolescents, which is consistent with evidence from large cohort studies [24, 25].

While there was some matching between parents’ behaviour and the guidelines (not getting drunk around children or modeling having a good time without alcohol), most parents discussed their own alcohol consumption as personal preference rather than a plan to model certain behaviour. In discordance with the guidelines, many parents cited associating having a drink with stress relief, or referred to the “need” for a glass of wine in conversation with their adolescent: “I just tell them that Mum’s had a stressful day and needs a wine” (Mother of 14 and 16 year-old boys and an 18 year-old girl), “I joke that I need a glass of wine to cope with them [children]” (Mother of a 14 year-old boy and a 16 year-old girl). Some parents also referred to asking older adolescents to pick them up when they had been drinking.

The varied influences of modeling and family of origin mirror the literature, with Ryan et al. citing mixed evidence, but reporting that overall, parental modeling of drinking is associated with early initiation to drinking and increased later use [6]. The influence of parental modeling of alcohol consumption though, is likely to be mediated by a range of other factors including parenting style and behaviour management, peer influence, and expectations associated with alcohol consumption [26‐28]. An inverse relationship has been demonstrated between normative alcohol use by parents (frequency and volume) and measures of positive parenting [29].

Many parents were careful to deliver clear messages to their children about alcohol, some presenting the context of use (e.g. drinking large amounts when in public and potentially exposed to violence or other risks) as the danger rather than the alcohol itself; “I do a lot of talking to about alcohol – it’s not cool to be drunk…the impact on the liver, the brain, etc etc” (Mother of 14 and 18 year-old boys and a 16 year-old girl). Others “wait until [their] children bring up the issue with [them]” and have only discussed alcohol in the context of their adolescent raising the issue. Several parents indicated that an incident with drinking or comment about others’ drinking was the initial trigger for discussions about alcohol and the household rules.

Several studies of alcohol-specific communication between parents and adolescents have reported complex associations with adolescent drinking behaviours. In a prospective cohort study, Van der Vorst et al. found that frequent discussions about alcohol were counterproductive to reducing heavy drinking among male adolescents [30]. However, this result should be interpreted in light of the possibility that discussions about alcohol typically occur after the child has started to drink [14]. Parental discussions and attitudes may also be influenced by parents’ own consumption patterns. A Dutch study found that parents who experienced alcohol-related problems were more likely to engage in alcohol-specific communication with their adolescent children, but that this did not significantly affect the risk of adolescent alcohol use or alcohol-related problems [31]. Ryan et al. reported insufficient evidence of a relationship with alcohol-specific communication, but strong evidence that good general communication is associated with both delayed alcohol initiation and lower levels of later use [6].

The guidelines recommend delaying the use of alcohol for as long as possible; not giving children any alcohol when they are under 15 years of age, and delaying their first drink for as long as possible. Overall, parents’ behaviour matched poorly with this suggestion. Most of the parents did not supply alcohol to their children for consumption outside the home, and reported making it clear to their children that they would not do so. Many, however, saw a certain inevitability that their children would be exposed, or gain access to alcohol prior to turning 18. One mother said “I can’t prevent the drinking, I have to accept that it will happen, but I won’t supply it”. Another who refused to supply her son with alcohol knew his older sister was giving it to him – “the transaction happens in front of me”. Parents’ sense of powerlessness to prevent alcohol consumption was common: “we do not supply alcohol to them…I know that my 17 year-old is drinking at parties, and he comes home smelling of alcohol…I can’t stop him” (Mother of a 17 year-old boy).

A sense of inevitability was also expressed by those parents who did supply their children with alcohol. One parent, reflecting on having provided her sons with a six pack of beer to take to parties from age 16 said “I don’t like doing it but I see it as a way of keeping a limit on it”. Even parents who claimed to have reasonably strict rules and close monitoring of their children admitted they would allow some drinking from around age 16 or 17; “I would let them drink with a small group of friends…in a safe environment. I wouldn’t want them to be social outcasts from their peer group” (Mother of a 15 year-old boy and younger girl). Other parents refer to their impression of the law and have adopted “you don’t drink until you’re 18” as their rule. However, many of these parents were also aware that their children were drinking from a younger age and expressed a sense of powerlessness to prevent it. One mother, when discussing drinking at a party with her 17 year-old son, told him “we won’t allow you, but we can’t stop you”.

The provision of sips or tastes of alcohol at home was generally regarded as quite separate to the provision of alcohol for consumption outside the home. Comments such as “we have given him half a glass of beer with us, but basically they are not allowed to drink” (Mother of 15 year-old boy) and “might be allowed to have a sip, but we never give them alcohol…I would never give them alcohol to take to a party” (Mother of a 13 year-old girl and 16 year-old boy) capture the views of many parents. Even some of the strictest parents, who regarded themselves as “disciplinary…not their friend” (Mother of 16 and 17 year-old boys) and report having strict household rules, have allowed their older adolescents to try “a little sip” of alcohol. Two main opposing views were expressed; one that children should not drink at all before they turn 18, and the other that a gradual, safe introduction would likely prevent excessive, harmful drinking later on. The latter view was articulated clearly by the father of a 16 year-old boy who explained “over the next two years we will be introducing him to alcohol. We don’t want him to be suddenly 18 and go on a rampage” (Father of a 15 year-old boy). Interestingly, one of the strictest proponents of the former view reported that her son “has indicated that he is going to have an 18 ^th and get drunk” (Mother of a 17 year-old boy), highlighting a potential desire for those who are deprived from trying alcohol to rebel when the opportunity arises.

Some parents said they provided their children with small amounts of alcohol from a young age to avoid demonising alcohol or fuelling curiosity that may lead to rebellion. This is consistent with reports of parents providing children with alcohol in order to control consumption and encourage safe use [11]. Views on the conditions under which parents would supply alcohol were consistent with research conducted in New Zealand where parents generally expressed responsible attitudes on the subject [4]. It should be noted that in that research, involving 872 teenagers aged 13-17 and 748 parents in the same school communities, there were large discrepancies between teenagers’ and parents’ reports concerning supply of alcohol for unsupervised drinking [32]. The authors suggested that the discrepancy may reflect differences in understanding of the survey questions but was more likely the result of socially desirable responses from parents.

Ryan et al. report associations of the provision of alcohol, with both early initiation and higher levels of drinking [6]. A US study examined permissibility of drinking at home during the senior year of school (aged 17-18) as a potential predictor of young women’s alcohol consumption early in their college careers. The study reported that those women who had been allowed to drink at home, whether during meals or with friends, reported more frequent heavy episodic drinking in their first semester of college, but those allowed to drink with friends drank more per drinking occasion [33]. Lundborg also reported that parents’ willingness to supply was not linked with more responsible drinking patterns in adolescents [34]. These results are in keeping with those of our recent study with high school students in Australia, in which parental supply under all conditions was associated with an increased probability of risky drinking [35]. Parental supply of alcohol for consumption when parents were present was no longer significantly associated with risky drinking once other confounders (including supply for consumption under other adult supervision, or no supervision, as well as peer-related variables) were controlled for. Those findings suggest that while some parents give their children alcohol to ensure a safe introduction, this type of supply may not protect young people from engaging in risky drinking. In another study with Australian adolescents, Dietze et al found that risky drinking was more likely among those supplied with alcohol from sources other than parents [36].

Parents expressed great difficulty in protecting their children from the influence of peers. Generally, parents viewed the choice of peer group as a significant influence upon their adolescents’ behaviours, but parents felt that they had minimal influence over these choices. One parent said of her 16-year-old son: “he’s probably more influenced by the pack leader than by us [parents] now”. Parents of adolescents who didn’t drink frequently cited close friendship groups that “just aren’t interested” or are “not into that”. Some parents commented on their children’s peer groups: “the circle of friends that he hangs with are all good kids” (Father of a 15 year-old boy), “the group are the same, they do not drink” (Father of a 16 year-old girl), “he is going through with a peer group that have been drinking for a couple of years” (Mother of a 17 year-old boy).

Those who chose not to drink or who had not yet begun experimenting with alcohol often commented on the behaviour of “other kids at parties and at their school” and expressed negative attitudes towards drunkenness among peers at age 14 to 16. One parent relayed her daughter’s description of drunken 14 year-olds as “disgusting and stupid”. A clear differentiation was made between close friendship groups and the wider group of ‘kids at school’. One parent discussed the dramatic positive change in the behavior of her two sons when they moved areas and therefore moved away from the peer groups that she perceived to be a bad influence on them.

Parents also frequently commented on personality differences between children and indicated that some children just weren’t interested; and even between siblings, differences often existed. Several parents recalled their children calling to be collected, or coming home early from parties where there was a lot of alcohol consumption because they felt uncomfortable. Discussions about perceptions of alcohol and drinking appeared to be more difficult for parents when they knew their child’s peers had engaged in alcohol consumption.

Recent work with Australian parents supports the sentiments that parents expressed in this study. Ward and Snow reported on parents’ intentions to supply their children with alcohol, suggesting that such behaviours may be a reflection of the normalization of alcohol use in Australia [37]. In another Australian study, parents cited peer influence as a major contributor to adolescent alcohol use, particularly among younger adolescents [38]. The strong influence of peer groups and normative beliefs [39] represents a great challenge for parents in influencing their adolescent’s perceptions toward alcohol and alcohol consumption.

Several parents described “making an effort” to know other parents. This was commonly referred to as an effort rather than something that happened naturally or easily. One parent whose son had started a new school in a new area in year 10 (age 15) discussed the fact that she knew very few of his friends or the parents of his friends, and that she felt “less comfortable with that”. It was a common theme among parents that they didn’t know many of the other parents, and it was not easy to change this situation. Most parents knew some of their children’s friends, but this was expressed more as a product of their child’s personality and extra-curricular activities than a deliberate effort. For example: “They have a community of kids…90% are elite athletes…most weekends we spend with these kids…do not drink at all because they are so focused on their goals”.

When asked if they would call parents they didn’t know to discuss alcohol being supplied at a party, parents had very mixed views. Some indicated that they would feel more comfortable doing so if they did not know the parents, others suggested that doing so would not be helpful with parents who obviously had differing values to their own, and others still put the responsibility on their adolescent children to make their own informed decisions and deal with the situation as they saw fit. The difficulty of engaging with other parents was evident in the following comments:

"“It can be who they hang around. I think it depends on the other parents’ morals. Some people are more liberal than others. I think with high school they mix with a lot of people that are not in your social circle…” (Mother of 16 year-old girl);"

"“If you ring the police…or confront them, it puts you in an awkward position…I think the best thing you can do is talk to your children and…just ask them to be sensible” (Mother of a 17 year-old boy)."

The guidelines recommend that parents ‘build a support network with other parents’, but this was not common among the parents in the study. Parents did refer to friends with older or similar aged children and were often influenced in their parenting decisions by strategies they had observed among their own peers. Interestingly though, it was often the pressure imposed by other parents’ behaviour that was often raised:

"“…my friend gave her 13 year-old a sip…and my daughter looked at me and asked the question…I probably would have told her ‘no’ if she was on her own but I didn’t want her to feel left out” (Mother of a 13 year-old girl)."

"“…all the parents were saying that they gave their kids alcohol” (Mother of a 17 year-old boy)."

"“I don’t want my child to miss out on things. We are teaching our children to be individuals but we, as parents have issues with the peer pressure” (Mother of a 13 year-old boy and a 16 year-old girl)."

The difficulties expressed by parents in this study reinforce the need for support which has been reported by parents [38] and recognized as a need in other Australian studies [37, 40]. It is expected that parents’ decisions about supplying their children with alcohol are likely to be influenced by their knowledge of the behaviours of other parents [41]. It seems however, that parents have limited contact with the parents of their children’s peers, and are therefore not likely to have an accurate understanding of their behaviours and attitudes. This represents a key opportunity to provide assistance to parents in reducing adolescent alcohol use.

Many of the comments parents made regarding their relationships with, and discipline of their children, referred to the developmental stage, or to different approaches or reactions depending upon the age of the child. A common pattern of change in children’s attitudes towards alcohol was described by most parents. When very young, their children were curious about alcohol and interested in tasting their parents’ drinks. In late primary school and early adolescence, many children adopt quite a negative attitude toward drinking and tend not to be interested in or to enjoy the taste of alcoholic drinks. At a point that appears to differ among children according to their personalities, peer groups and family experiences, they then develop an interest in drinking. This issue is highlighted by comments such as “I’m always telling them that being drunk is not cool but that message was taken on board more at 16 than at 17, nearly 18” (Mother of a 17 year-old boy). Further, when faced with hypothetical scenarios involving children of different ages, parents indicated that they felt they had more control of their children’s behaviour at 16 than at close to 18; “I couldn’t stop the 17 year-old but I’d be willing to say no at 16” (Mother of a 17 year-old boy).

These comments are in keeping with the concept of the social clock, which refers to the age at which it is considered acceptable in a particular society, to reach various milestones or transitional events [41]. The social clock is also reflected in comments about drinking at home. Many parents allowed their young children to have sips or tastes of alcohol from their own drinks but cited children’s lack of interest in late primary and early secondary school. Some parents clearly stated their children were not allowed to have a drink, whether it be a sip with a family meal or at a special occasion. Other parents had not faced this situation or even considered their ‘rules’ because their children had not expressed interest in drinking. This is in keeping with comments that adolescents “bypass the taste and drink to get drunk”. Many parents discussed the fact that their children didn’t enjoy the taste of alcohol, but would drink “lolly water” (alcopops) for the effect it gave. The influence of peers may exacerbate the social clock phenomenon, with peer groups seemingly progressing together past each milestone.