Personal choice drives young adults to abstain from alcohol and turn to cannabis as a common alternative

In a recent study published in the journal Alcohol Clinical and Experimental Research, The researchers examined common purposes for drinking alcohol among young adults and their relationship with demographics, timing (weekday vs. weekend) and patterns of alcohol use. They used a questionnaire-based 14-day daily survey approach for their investigation to identify factors that could be used in future interventions against alcohol misuse. The study findings showed that “not being interested in drinking” was the most common reason for abstinence from alcohol (83.4%), followed by “not wanting to get drunk” (81.8%). Among individuals who took another drug in place of alcohol, cannabis was mentioned most frequently (81.8%).

Overall, these findings highlight that ‘personal decision’ accounts for a large proportion of the underlying reasons for alcohol abstinence in young adults, and identify situational barriers (e.g. financial concerns) as key points that clinicians and policy-makers could use for future alcohol-focused interventions in this at-risk population.

Study: Prevalence and correlates of reasons for daily level of non-drinking among young adults who consume alcohol. Image credit: AndreyCherkasov / Shutterstock

background

A study conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA, 2022) identified alcohol as the most common substance abuse among young adults (aged 18-25). Alcohol has a significant negative impact on this vulnerable age group, leading to an increase in road-related crashes, physical and sexual assaults, and physical trauma (e.g., liver cirrhosis).

Despite public health service interventions gradually decreasing alcohol use (and its associated disorders), alcohol consumption by young people is still significantly higher than most other age groups. As of 2022, reports from the National Institute on Alcohol Abuse and Alcoholism and others still find that 30.5% and 9.5% of young adults participate in binge- and high-intensity drinking (HID), respectively. Together, this literature highlights the need to understand the underlying motivations for and against alcohol consumption, an initial step toward curbing its global impact.

Decades of research have hypothesized and tested the role of 'reasons and motives' (coping, social enhancement and conformity) as proximal risk factors in substance abuse. Coping and conformity have been highlighted as the most frequently referenced reasons for drinking alcohol. Surprisingly, 'reasons for not drinking' are often overlooked in the literature, especially in everyday-level investigations. This leaves policy makers with little information about the perceived harms of drinking by the population. Furthermore, the effects of confounding variables such as demographics, alcohol use patterns and timing of drinking alcohol are still under-studied.

About the study

The present study aims to answer two main questions: 1. How often do young adults who drink alcohol regularly abstain from drinking, and what are their generally accepted reasons for doing so? 2. What is the role of confounding variables (demographics, timing, purpose and alcohol use behaviour) in altering the results for Question 1?

The group of participants was drawn from the Young Adult Daily Life (YADL) study (Year 4 – 2022 dataset). Of the 14,502 participants enrolled in the United States (US) nationally representative YADL study, 1,208 did not submit data, and 10,262 did not report past 30-day alcohol use (eligibility criteria) and were thus excluded from the current analysis. An additional 1,439 participants were lost during the four-year-long follow-up period. Data was collected via a baseline survey (30 minutes) and 14 daily questionnaire surveys (5–7 minutes), each consisting of 12 questions asking participants to rate their alcohol consumption on that particular day.

For confounding data analysis, participants’ drinking habits were assessed as regular drinking (<5 ड्रिंक्स लगातार), बिंज ड्रिंकिंग (किसी दिए गए दिन में 5 या उससे ज़्यादा ड्रिंक्स) और उच्च-तीव्रता वाले पीने (HID; किसी दिए गए दिन में 10 या उससे ज़्यादा ड्रिंक्स) में वर्गीकृत किया गया था। प्रतिभागियों के बिंज- या HID के कारणों/उद्देश्यों का मूल्यांकन करने के लिए पीने के उद्देश्यों प्रश्नावली (DMQ-R; 20 आइटम) का उपयोग किया गया था। प्रतिभागियों के लिंग, जातीयता और वर्तमान कॉलेज की स्थिति (कॉलेज शिक्षा के > YADL demographic data were examined for age (<4 years or 1 year). Statistical analyses included descriptive and multilevel logistic regression models to reveal day- and person-level predictors corrected for confounding variables.

Study findings

Of the 14,502 YADL participants initially included in the study and over 2,000 screened at baseline, only 765 completed the daily questionnaire and were included in the final analysis. Statistical evaluation revealed that “I was not interested in drinking” was the most frequently listed reason for abstaining from alcohol consumption (83.4% of days), with a nearly ubiquitous 97.2% of participants citing this reason at least once during the 14-day investigation. “I did not want to get drunk,” “I did not want alcohol to interfere with school/work,” and “I usually do not drink on weekdays” were other commonly referenced reasons for abstaining from alcohol (81.8%, 58.4%, and 58.7% of days, respectively).

72.6% of the participants, the majority of whom were women, highlighted the need for monetary help as a priority over alcohol as a reason for not drinking. Nearly 1/3^Third Of the participants (29.5%), 100 reported using a drug other than alcohol, with cannabis (81.8%) being the most frequently used alternative.

Demographic analyses revealed that women were more likely than their male counterparts to report abstaining from alcohol consumption for monetary-, hangover-, or interest-based reasons. Encouragingly, duration of college education was positively correlated with alcohol and drug abstinence, possibly due to the frequency of campus-based anti-substance abuse intervention programs. Surprisingly, binge- and HID had almost no statistically significant relationship with reasons for or against drinking, with the sole exception of “I recently had a hangover.”

…At the person level, heavy drinking (vs. moderate) and HID (vs. moderate) were associated with greater odds of endorsing “I recently had a hangover” and lower odds of endorsing “I don’t drink.” Those who endorsed more coping motives had greater odds of endorsing “I needed money for things other than alcohol” and “I annoy my family/friends when I drink.” Those who endorsed more enhancement motives had greater odds of endorsing “I used another drug instead of alcohol” and lower odds of endorsing “I don’t drink.” Those who endorsed more conformity motives had greater odds of endorsing “I didn’t have anyone to drink with,” “I annoy my family/friends when I drink,” and “I was quarantined or sick.”

conclusion

The findings of the current study help fill a persistent gap in motivational models of alcohol use risk—causes of use and abstinence. The study findings highlight that the motivation to abstain from drinking alcohol is primarily an individual decision influenced by monetary, coping, and conformity concerns. Encouragingly, comparisons between college-going and college-abstaining participants suggest that campus-based intervention programs can motivate young adults to quit not only drinking but also other drug use. Together, these findings highlight the need for increased informed and individualized intervention programs that can help reduce young adults' dependence on alcohol and its associated risky behaviors.