Parents Who Supply Sips of Alcohol in Early Adolescence: A Prospective Study of Risk Factors

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Parents Who Supply Sips of
                                     Alcohol in Early Adolescence: A
                                     Prospective Study of Risk Factors
                                     Monika Wadolowski, PhD,a Delyse Hutchinson, PhD,a,b Raimondo Bruno, PhD,a,c Alexandra Aiken, BS,a Jackob
                                     M. Najman, PhD,d Kypros Kypri, PhD,e Tim Slade, PhD,a Nyanda McBride, PhD,f Richard P. Mattick, PhDa

BACKGROUND: Parents are a major supplier of alcohol to adolescents, often initiating use with                                                   abstract
sips. Despite harms of adolescent alcohol use, research has not addressed the antecedents
of such parental supply. This study investigated the prospective associations between
familial, parental, peer, and adolescent characteristics on parental supply of sips.
METHODS: Participants were 1729 parent–child dyads recruited from Grade 7 classes,
as part of the Australian Parental Supply of Alcohol Longitudinal Study. Data are from
baseline surveys (Time 1) and 1-year follow-up (Time 2). Unadjusted and adjusted logistic
regressions tested prospective associations between Time 1 familial, parental, peer, and
adolescent characteristics and Time 2 parental supply.
RESULTS: In the fully adjusted model, parental supply was associated with increased parent-
report of peer substance use (odds ratio [OR] = 1.20, 95% confidence ratio [CI], 1.08–1.34),
increased home alcohol access (OR = 1.07, 95% CI, 1.03–1.11), and lenient alcohol-specific
rules (OR=0.88, 95% CI, 0.78–0.99).
CONCLUSIONS: Parents who perceived that their child engaged with substance-using peers
were more likely to subsequently supply sips of alcohol. Parents may believe supply of a
small quantity of alcohol will protect their child from unsupervised alcohol use with peers.
It is also possible that parental perception of peer substance use may result in parents
believing that this is a normative behavior for their child’s age group, and in turn that
supply is also normative. Further research is required to understand the impacts of such
supply, even in small quantities, on adolescent alcohol use trajectories.

aNational Drug and Alcohol Research Centre, Faculty of Medicine, University of New South Wales, Sydney, New
                                                                                                                   WHAT’S KNOWN ON THIS SUBJECT: Adolescent
South Wales 2052, Australia; dQueensland Alcohol and Drug Research and Education Centre, University of             alcohol use is associated with major long-term
Queensland, Brisbane, Queensland 4072, Australia; eCentre for Clinical Epidemiology and Biostatistics, School of
Medicine and Public Health, University of Newcastle, Newcastle, New South Wales 2308, Australia; and fNational
                                                                                                                   harms. Parents are a major supplier of alcohol to
Drug Research Institute, Curtin University, Perth, Western Australia 6845, Australia bSchool of Psychology,        adolescent children, often initiating their child’s
Faculty of Health, Deakin University, Burwood, Victoria, Australia cSchool of Psychology, Faculty of Health,       alcohol use with sips. However, no research has
University of Tasmania, Hobart, Tasmania, Australia                                                                addressed the antecedents of such supply.
Dr Wadolowski contributed to the conceptualization and design of the study, contributed to the                     WHAT THIS STUDY ADDS: Parental factors (parental
design of the data collection instruments, coordinated and supervised data collection, wrote the                   perception of substance-using peers, home alcohol
statistical analysis plan, conducted and interpreted the statistical analyses, drafted and revised                 access, lenient alcohol-specific rules, and initial
the manuscript, and approved the final draft of the manuscript; Dr Hutchinson contributed to
                                                                                                                   parental supply of alcohol sips) and previous child
the conceptualization and design of the study, contributed to the design of the data collection
                                                                                                                   sipping predicted subsequent parental supply of
instruments, critically reviewed the manuscript, and approved the final draft of the manuscript;
Asst Prof Bruno contributed to the conceptualization and design of the study, coordinated and                      alcohol sips.
supervised data collection, assisted with analysis planning, contributed to the interpretation
of the statistical analyses, critically reviewed the manuscript, and approved the final draft of
the manuscript; Ms Aiken coordinated and supervised data collection, critically reviewed the                        To cite: Wadolowski M, Hutchinson D, Bruno R, et al.
manuscript, and approved the final draft of the manuscript; Prof Najman contributed to the                           Parents Who Supply Sips of Alcohol in Early Adolescence:
                                                                                                                    A Prospective Study of Risk Factors. Pediatrics. 2016;
                                                                                                                    137(3):e20152611

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PEDIATRICS Volume 137, number 3, March 2016:e20152611                                                                                                             ARTICLE
Early adolescent alcohol initiation         supply of sips. The lack of such                 from parent–child dyads. Of these
is associated with increased risk           prospective research runs the risk               1896 dyads, complete data were
of: delinquent behavior1; physical          that the reasons for supply provided             available for 1840 adolescent and
injury2; poor adolescent health             by parents are post hoc explanations             1870 parent T1 surveys, resulting in
and well-being3,4; and alcohol-             and may obscure some antecedents                 a total of 1808 parent–child dyads
use disorders.1 Alcohol use often           of supply.                                       with complete data. Data were
commences with a sip(s)/taste(s)            Our aim was to comprehensively                   imputed for T1 surveys in 15 cases,
of alcohol, rather than consuming           investigate how parental supply of               using the PRELIS application in the
whole drinks.5–7 By age 13, up to           sips of alcohol to adolescent children           LISREL program.26 When a case was
60% of adolescents have had a               at age 14 years was prospectively                missing a single item on a scale, the
sip/taste of alcohol5,8–14; sipping         associated with a range of: (1)                  dataset was searched for the same
is more prevalent than drinking             familial, parental, and adolescent               pattern of responses on that specific
in this age group.5,6,10,15 Sipping         demographic characteristics; (2)                 scale within other cases. When
is associated with increased risk           parent behaviors including alcohol               multiple response patterns matched
of early adolescent drinking and            consumption, alcohol availability,               in the dataset, a reliability estimate
binge drinking,12,16 but the area of        alcohol-specific rules, and parenting            was generated. Only imputations
sipping is under-researched. Despite        practices; (3) peer substance use and            with high reliability (0.999, ie, a
recommendations that parents avoid          alcohol attitudes; and (4) individual            LISREL variance ratio = 0.001)
providing alcohol to children,15            adolescent psychological behaviors.              were accepted. This in turn assured
parents remain a major supplier             These factors were selected based                confidence in the accuracy of the
of alcohol to adolescent children,          on several theoretical perspectives              imputed data.27 This provided a total
including sips.17,18 Reasons for this       identifying their importance in                  of 1823 parent–child dyads at T1. Of
early supply are particularly poorly        understanding adolescent alcohol                 these 1823 dyads, 1752 adolescents
studied, with a recent exception,9          use, including problem behavior                  and 1746 parents (87.0% were
where 60% to 70% of mothers                 theory, socialization theory, the                mothers) returned follow-up surveys
disagreed that supplying access to          social development model, and social             1 year later (Time 2 [T2]), resulting
sips was beneficial. Those authors          learning theory.24,25                            in 1729 (94.8% of dyads with
note9 that what remains unstudied                                                            complete data at T1) T2 dyads, the
are the antecedents associated                                                               sample used in the present analyses.
with parental supply of sips.               METHODS
Understanding these reasons may                                                              The sample was similar to the
inform on ways to advise parents            Sample                                           Australian population on important
about reducing alcohol access.              Grade 7 adolescents and 1 parent                 demographic factors. Males
                                            were recruited for the Australian                comprised 55% of the adolescent
Although the characteristics                Parental Supply of Alcohol                       sample (51% of 12- to 13-year-
predicting parental supply of alcohol       Longitudinal Study, and methods                  olds in the Australian adolescent
are poorly documented, some                 are described elsewhere.15 Families              population),28 and 81% of children
observers suggest parents supply            came from 49 Independent (49.0%),                lived in 2-parent households
sips to inoculate their children            Government (38.8%), and Catholic                 (80.0% of 2-parent households in
against heavy drinking,19 while also        (12.2%) secondary schools across 3               the Australian population),29 and
acknowledging that little is known          states: New South Wales, Tasmania,               socioeconomic status (SES)30 showed
about the antecedents of children           and Western Australia. A total of                our sample was very similar to the
sipping.6,8,20 Recent research on why       2017 families expressed interest                 Australian population.31 Rates of
parents provide alcohol suggests it is      in the study, but 90 families were               alcohol use in our sample (parents
to decrease consumption and teach           ineligible, as 16 adolescents were not           and adolescents) were also similar
children to resist peer pressure.9          in Grade 7 and 74 parents did not                to those in Australian population
However, the limited research on            sign informed consent, yielding 1927             surveys. In a school-based population
factors associated with parental            eligible parent–adolescent dyads. Of             survey, any lifetime alcohol use
supply has focused on parental              the surveys sent, 1910 adolescents               was reported by 67.3% of 12- to
attitudes, used only cross-sectional        (99.1%; mean age = 12.9-years-                   13-year-olds,32 compared with 67.8%
designs, or focused on supply of            old, SD = 0.5), and 1913 parents                 of adolescents in our sample at T1
whole drinks.9,21–23 There are no           (99.3%) returned baseline surveys                (mean age = 12.9 years). Parents
prospective studies investigating           (Time 1 [T1]), which included                    reported the following frequencies
what parent and adolescent                  written consent. Of the returned                 of T1 alcohol use: 2.7% daily, 48.5%
characteristics predict parental            T1 surveys, 1896 (98.4%) were                    weekly, 39.2% less than weekly,

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2                                                                                                                    WADOLOWSKI et al
and 9.6% not in the past 12 months.              scoring 10% of areas.30 For the                   Adolescents responded to 10 items
This was similar to the Australian               analyses, deciles were collapsed into             on their parents’ rules about drinking
population aged >18-years-old: 7.7%              3 categories: low SES (deciles 1–3),              and binge drinking frequency and
daily, 41.7% weekly, 33.0% less than             medium SES (deciles 4–7), and high                quantity, and whether drinking
weekly, and 7.7% not in the past                 SES (deciles 8–10). Parent religiosity:           was permitted in supervised and
12-months.33                                     One item asked how important                      unsupervised contexts.36 Family
                                                 religion was to them (very important,             conflict: Parents responded to 3
Families completed surveys either
                                                 pretty important, and not/only a                  items about the frequency of family
via paper hardcopy or online. To
                                                 little important).                                disagreements.37 Positive family
maintain privacy, all paper surveys
                                                                                                   relations: Parents responded to
were sent individually to parents                Parental Alcohol Use                              another 3 items regarding family
and adolescents, and each survey
                                                 Consumption was based on the                      relationship quality.37 Parental
included its own reply-paid envelope
                                                 Alcohol Use Disorders Identification              monitoring: 6 items assessed
for returning surveys. Where
                                                 Test short-form scale, AUDIT-C:                   adolescent report of monitoring,
available, links to online surveys
                                                 quantity, frequency, and heavy                    such as whether parents knew about
were e-mailed directly to parents
                                                 episodic use.34 Seven responses                   their peers, plans with peers, and
and adolescents. Participants were
                                                 measured quantity, ranging from 1–2               unsupervised activities.38 Parenting
reimbursed 10 AUD for their time
                                                 drinks to 13 or more drinks. These                consistency: Parents responded to
completing each survey. Paper and
                                                 options were then collapsed into 5                10 items assessing the consistency of
online surveys each had 3 reminders,
                                                 categories: 1–2 drinks to 10 or more              using discipline and enforcing rules.39
including resending surveys and
                                                 drinks. Frequency of alcohol use was
telephone calls. Approval to conduct                                                               Peers
                                                 measured with 8 categories, which
this research was received by the
                                                 were collapsed into: never, less often            Substance-using peers: Parents
University of New South Wales
                                                 (than monthly), monthly or less, 2–4              were asked whether they thought
Human Research Ethics Committee
                                                 times a month, 2–3 times a week, and              their child’s friends: had tried
(approval number 10144), and
                                                 4 or more times a week. Frequency                 alcohol; drank alcohol regularly;
this study is registered at www.
                                                 of heavy episodic use (more than                  and drank to get drunk. Adolescents
clinicaltrials.gov (identification
                                                 four standard drinks on a single                  also reported peer alcohol and
number NCT02280551).
                                                 occasion) was measured with 8                     tobacco use, responding to 6 items,
Variables                                        categories, collapsed into: never, less           including whether their friends
                                                 than monthly, monthly, weekly, daily              smoked cigarettes, drank alcohol,
Outcome Variable: Parental Supply of a
                                                 or almost daily. These 3 items were               and the frequency of drunkenness.40
Sip at T2
                                                 then summed, with higher scores                   Peer disapproval of substance use:
At both T1 and T2, parents were                  indicating increased parental alcohol             Four items asked adolescents about
asked: “In the last 12-months, did               use. Cronbachs α for this measure,                whether their friends disapproved of
you/your partner give your child a               and the other scales and variables                tobacco use and alcohol use.40
sip or taste of alcohol?” The response           included in the analyses, are available
option was a dichotomous yes or no.              elsewhere.6                                       Individual Adolescent Behaviors
                                                                                                   Alcohol use: Adapted from the
Familial Demographics                            Parenting Practices                               Australian National Drug Strategy
Household composition: Adolescents               Context of parental suppy: If parents             Household Survey, adolescents were
were asked whether they lived                    had supplied a sip, they were also                asked: “In the last six months, on a
in 1- or 2-parent households                     asked “In the last 12 months, when                day that you have an alcoholic drink,
(including step-parents). SES:                   you/your partner have given your                  how many standard drinks do you
Family geographical locations were               child alcohol, how many times have                usually have?” There were 7 response
categorized into deciles from a                  you provided it in these situations…”             options, including a sip/taste of
standardized Australian population               with response options being: with                 alcohol. At T1, 14.1% of adolescents
measure, the Index of Relative                   family on a holiday or special                    reported sipping and 5.5% reported
Socioeconomic Advantage and                      occasion; with family at dinner; and              consuming a whole drink. At T2,
Disadvantage. The deciles were                   at parent-supervised parties. Home                sipping increased to 25.2%, whereas
distributed between 10 equal groups,             alcohol access: Parents completed 5               7.8% of adolescents reported
with the first decile representing the           items about access and availability of            drinking. The 7 response options were
lowest scoring 10% of Australian                 alcohol in the family home, such as               collapsed into 3 categories: abstainer,
geographical areas, and the tenth                whether they kept track of, or locked             sipper (only sip[s]), and drinker (at
decile representing the highest                  up, alcohol.35 Alcohol-specific rules:            least 1 whole drink). Externalizing

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PEDIATRICS Volume 137, number 3, March 2016                                                                                              3
behaviors: Adolescents completed the         TABLE 1 Descriptive Statistics for Time 2 Parental Supply by Time 1 Familial, Parental, Adolescent
rule-breaking and aggressive behavior                   and Peer Characteristics (N = 1729)
subscales from the Achenbach youth                       Time 1 Characteristics (Score Range)                         Time 2 Parental Supply Mean (SD) or %
self-report.41 Internalizing behaviors:                                                                             No Supplya (n = 1279)          Supplyb (n = 450)
Adolescents also completed the
                                             Familial demographics
withdrawn-depressed and anxious-               Age (years)                                                                  12.4 (0.5)                    12.5 (0.6)
depressed subscales from the youth             Adolescent sex, %
self-report.41                                    Male                                                                         75.2                          24.8
                                                  Female                                                                       72.6                          27.4
Data Analyses                                  Household composition, %
                                                  Two-parent household                                                         74.1                          25.9
Planned logistic regression                       One-parent household                                                         73.4                          26.7
analyses first tested for unadjusted           Importance of religion, %
associations between T1 variables                 Very important                                                               76.4                          23.6
                                                  Pretty important                                                             76.2                          23.8
and T2 parental supply of a sip. A
                                                  Not, or only a little, important                                             73.0                          27.0
multivariate, logistic regression              Socioeconomic status, %
analysis, adjusting for all T1                    High                                                                         75.6                          24.4
covariates (regardless of the                     Medium                                                                       74.3                          25.7
significance of their associations with           Low                                                                          67.4                          32.6
                                             Parental supply of sips of alcohol, %
T2 supply), was then conducted to
                                               Noa                                                                             86.1                          13.9
test for associations with T2 supply.          Yesb                                                                            43.2                          56.8
The adjusted model also controlled           Parent alcohol use
for clustering at the school level and         Total consumption (Score: 0–12)                                               3.8 (2.2)                     4.3 (1.9)
tested for multicollinearity. Analyses       Parenting practices
                                               Home alcohol access(P) (Score: 6–30)                                         16.8 (3.7)                    17.7 (3.3)
were conducted in Stata/SE 11.2,42
                                               Alcohol-specific rules(A) (Score: 10–50)                                      49.6 (1.3)                    48.9 (2.2)
using logistic and cluster commands.           Family conflict(P) (Score: 3–6)                                               3.7 (0.9)                     3.8 (0.9)
                                               Positive family relations(P) (Score: 3–6)                                    5.9 (0.5)                     5.9 (0.4)
                                               Parental monitoring(A) (Score: 6–30)                                         27.8 (3.0)                    27.5 (3.4)
RESULTS                                        Parenting consistency(P) (Score 5–25)                                        21.4 (2.7)                    21.3 (2.7)
                                             Adolescent peers
Descriptive Analyses                           Peer substance use(P) (Score: 3–15)                                           4.3 (1.3)                     5.0 (1.4)
                                               Peer substance use(A) (Score: 6–30)                                           7.9 (2.6)                     8.9 (3.0)
Supply was reported by 24.4% of                Peer disapproval of substance use(A) (Score: 4–12)                           10.9 (1.9)                    10.5 (2.1)
parents (95% CI, 22.3826.43) at T2.          Adolescent behaviors
Supply typically occurred in familial          Adolescent alcohol use(A), %
contexts, such as holidays and                    Abstainerc                                                                   80.8                          19.2
                                                  Sipperd                                                                      41.8                          58.2
special occasions (68.0%, 95% CI,
                                                  Drinkere                                                                     56.8                          43.2
63.53–72.16), family dinners (50.0%,           Externalizing behaviors(A) (Score: 0–60)                                      5.3 (5.9)                     6.2 (6.3)
95% CI, 45.38–54.62), and parties              Internalizing behaviors(A) (Score: 0–40)                                      4.3 (5.1)                     4.6 (5.5)
(10.4%, 95% CI, 7.93–13.64). Table 1         (A), Adolescent report; (P), parent report.
presents the means and proportions           a Parent, and/or their partner, did not supply sips of alcohol in the past six months.
                                             b Parent, and/or their partner, supplied sips of alcohol on at least one occasion in the past 6 months.
of T2 supply in relation to T1 familial,     c Did not consume any alcohol in the past 6 months.
parental, peer, and individual               d Consumed only a sip(s) of alcohol.

adolescent characteristics.                  e Consumed at least a whole drink in the past 6 months.

Unadjusted Analyses                          associated with decreased T1 reports                             increases, and in turn become more
Compared with no supply, T2 supply           of: parental alcohol-specific rules                              pronounced when examining larger
was associated with increased T1             (OR = 0.73, P < .001); and perceived                             increases in the respective scales.
reports of: parental alcohol use (OR =       peer disapproval of substance use
1.12, P < .001), home access to alcohol      (OR = 0.91, P < .001). Notably, T2 supply                        Adjusted Analyses
(OR = 1.08, P < .001), perceived peer        had no unadjusted associations with                              The multivariate logistic model was
substance use among both parents             parenting factors such as monitoring,                            significant (χ2(22) = 1158.40, P < .001)
and adolescents (parent-report OR =          parenting consistency, relationship                              (Table 2). Notably, in adjusting for all
1.37, P < .001; and adolescent-report        quality, family conflict, or household                           familial demographic, parental, peer,
OR = 1.13, P < .001), and externalizing      composition. While some of these ORs                             and individual adolescent factors,
problems (OR = 1.02, P = .009) (Table        appear small, ORs for scales represent                           only a few T1 variables retained
2). Conversely, T2 supply was also           differences based on single unit                                 significant associations with T2

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4                                                                                                                                                      WADOLOWSKI et al
supply. Compared with no supply,                 TABLE 2 Unadjusted and Adjusted Associations Between Time 2 Parental Supply and Time 1 Familial,
these factors were: increased home                          Parental, Adolescent, and Peer Characteristics (N = 1729)
alcohol access (OR = 1.07, P < .001),            Time 1 Characteristics                                          Time 2 Parental Supply of Sips of Alcohol
the effect of which did not change from                                                                          Unadjusted                           Adjusted
unadjusted analyses; increased parent
                                                                                                            OR               95% CI              OR               95% CI
perception that their child engaged
                                                 Familial demographics
with substance-using peers (OR =
                                                   Adolescent age                                           1.26*          1.05–1.52            0.98             0.82–1.17
1.20, P < .001); and decreased parental            Adolescent sex
alcohol-specific rules (OR = 0.88, P =                Male                                                  1.00a             —                 1.00a               —
.033). Adjusting for the type 1 error                 Female                                                1.14           0.92–1.42            1.25             0.97–1.62
rate (Bonferroni adjusted α = 0.05/28              Household composition
                                                      Two-parent household                                  1.00a             —                 1.00a               —
= 0.0018), the association of alcohol-
                                                      One-parent household                                  1.04           0.79–1.37            0.92             0.69–1.23
specific rules was no longer significant,          Importance of religion
but the other associations remained                   Very important                                        1.00a             —                 1.00a               —
significant at
externalizing problems, peer alcohol          access and lenient parental alcohol              be relevant, but we have conducted
use, and alcohol use approval by              rules (which was nonsignificant                  a comprehensive adjustment
peers.8,11,14 In our unadjusted               after adjusting for capitalization on            using variables known to predict
analyses, externalizing problems,             chance). Although parental alcohol               drinking, so the effect of unmeasured
adolescent perception of substance-           use predicted parental supply in                 unobserved covariates is likely to be
using peers, and parent perception            unadjusted analyses, this association            small. Fourth, we have not been able
of substance-using peers, each                disappeared in the adjusted model. It            to assess the long-term associations
predicted subsequent parental supply.         is possible that home alcohol access             of early exposure to sips, which is a
However, after adjusting for a wide           and lenient alcohol rules accounted              matter for our ongoing work on this
range of familial, parental, peer, and        for parental alcohol use. In previous            cohort and not the focus of this paper.
adolescent factors, only parent factors       studies8,9,12 and our present sample,
(parental perception of substance-            parental supply occurred mostly in
using peers, home alcohol access, and         familial social contexts. To this end,
lenient alcohol-specific rules) retained      parental alcohol use may provide                 CONCLUSIONS
significant predictive associations.          access and opportunity for parents
Compared with parents who did not             to introduce alcohol to their child in           The findings of this study are
supply alcohol, parents were more             supervised, familial contexts. Likewise,         important because we identify
likely to supply it if they perceived that    the associations between lenient                 prospective predictors of parental
their child was mixing with substance-        alcohol rules and home alcohol access            supply of sips of alcohol, one of the
using peers and were more lenient             on parental supply may increase                  first stages of drinking. The results
about alcohol access. This result is          adolescent perception of parental                show that parental perceptions of
consistent with recent longitudinal           alcohol permissiveness, which                    whether their child engages with
findings, where the strongest                 increases the risk of early drinking             substance-using peers are a significant
antecedents of sipping were parenting         initiation.16                                    predictor of parental supply of
factors, whereas child psychosocial                                                            sips, along with home access and
proneness (such as externalizing)             This study has a number of strengths.            lenient alcohol rules. Parents may be
had no association.10 It seems                The sample comprised a large-scale               supplying sips of alcohol in response
parents may supply a sip of alcohol in        cohort of young adolescents and 1 of             to believing their child will be exposed
response to perceiving that their child       their parents, recruited across a range          to unsupervised alcohol use with their
has substance-using peers and are             of sites, and Australia is a multicultural       peers. However, they may be wrong in
motivated to inoculate their children         country increasing generalizability of           their belief, and may be prematurely
from the potential risk of unsupervised       the results. The prospective design              introducing their children to a
alcohol use and binge drinking with           accounted for a wide range of different          behavior that may have marked risks.
peers.9 In that regard, parents may be        parent and child characteristics,                Replication is needed, and research
reacting to a perceived risk of their         using both adolescent- and parent-               is required on whether supply of
adolescent child’s peers’ likelihood of       report. Some limitations should                  sips quickly transitions to supply of
drinking, which may not be manifest;          be considered. First, participants               whole drinks, and whether predictors
they may be trying to inoculate against       were not randomly selected from                  of supply differ with increasing
a nonexistent threat.                         the population, increasing the risk              adolescent age and alcohol experience.
                                              of self-selection and nonresponse                Turning from the transitions of
Parental supply of sips may be                biases. However, as outlined earlier             parental behaviors to the transitions
motivated by the belief that smaller          and elsewhere,15,28,29,33 the sample             in actual adolescent drinking, it is also
quantities will protect their child           reported many similarities on a                  necessary to better understand how
from unsupervised alcohol use with            range of demographic and alcohol                 parental supply, even sips, relates to
peers and associated harms, such as           use variables with the Australian                the trajectories of adolescent from
binging.9 Sipping has been associated         population, suggesting selective                 sipping to drinking and to binging.
with parental alcohol socialization           nonresponse biases were minimized.
and lenient alcohol rules,8,10,11,14 and      Second, self-report of parental supply
described as an opportunistic behavior        may have resulted in social desirability           ABBREVIATIONS
for parents to introduce alcohol in           bias, where parents may have under-
                                                                                                 CI: confidence interval
supervised contexts.8 Consistent with         reported supply, fearing negative
                                                                                                 OR: odds ratio
these notions, the only parenting             social consequences, but this should
                                                                                                 SES: socioeconomic status
practices associated with supply in           reduce associations, so the results
                                                                                                 T1: time 1
the present unadjusted and adjusted           found are likely to be robust. Third,
                                                                                                 T2: time 2
analyses were increased home alcohol          other unmeasured covariates may

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6                                                                                                                        WADOLOWSKI et al
conceptualization and design of the study, contributed to the design of the data collection instruments, critically reviewed the manuscript, and approved the final
draft of the manuscript; Prof Kypri contributed to the conceptualization and design of the study, contributed to the design of the data collection instruments,
critically reviewed the manuscript, and approved the final draft of the manuscript; Asst Prof Slade contributed to the conceptualization and design of the study,
contributed to the design of the data collection instruments, critically reviewed the manuscript, and approved the final draft of the manuscript; Dr McBride
coordinated and supervised data collection, critically reviewed the manuscript, and approved the final draft of the manuscript; and Prof Mattick contributed
to the conceptualization and design of the study, contributed to the design of the data collection instruments, coordinated and supervised data collection,
contributed to revising the manuscript, and approved the final draft of the manuscript.
This trial has been registered at www.clinicaltrials.gov (identifier NCT02280551).
Dr Bruno’s current affiliation is School of Psychology, Faculty of Health, University of Tasmania, Hobart, Tasmania, Australia.
DOI: 10.1542/peds.2015-2611
Accepted for publication Dec 2, 2015
Address correspondence to Dr Monika Wadolowski, National Drug and Alcohol Research Centre, Faculty of Medicine, University of New South Wales, Sydney, New
South Wales 2052, Australia. E-mail: m.wadolowski@unsw.edu.au.
PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275).
Copyright © 2016 by the American Academy of Pediatrics
FINANCIAL DISCLOSURE: The authors have no financial relationships relevant to this article to disclose.
POTENTIAL CONFLICT OF INTEREST: The authors have no potential conflicts of interest to disclose.
FUNDING: Supporteded by: a 2010–2014 Australian Research Council Discovery Project grant (DP:1096668) to Prof Mattick, Prof Najman, Prof Kypri, Asst Prof
Slade, and Dr Hutchinson; an Australian Rotary Health Mental Health Research grant to Prof Mattick, Dr Wadolowski, Prof Najman, Prof Kypri, Asst Prof Slade, Dr
Hutchinson, and Asst Prof Bruno; an Australian Rotary Health Whitcroft Family PhD Scholarship Mental Health Research Companion grant to Dr Wadolowski; a
University of New South Wales Australian Postgraduate Award to Dr Wadolowski; a National Health and Medical Research Council Principal Research Fellowship
grant to Prof Mattick (APP1045318) and Prof Kypri (GNT0188568, APP1041867); National Health and Medical Research Council project grants to Prof Mattick for the
Longitudinal Cohorts Research Consortium (GNT1009381 and GNT1064893); and a Research Innovation grant from the Australian Foundation for Alcohol Research
and Education to Prof Mattick, Prof Najman, Prof Kypri, Asst Prof Slade, Dr Hutchinson, Asst Prof Bruno, and Dr Wadolowski. The National Drug and Alcohol
Research Centre at the University of New South Wales Australia (Dr Wadolowski, Dr Hutchinson, Asst Prof Bruno, Ms Aiken, Asst Prof Slade, and Prof Mattick) is
supported by funding from the Australian Government under a Substance Misuse Prevention and Service Improvements grant.

REFERENCES
  1. Ellickson PL, Tucker JS, Klein DJ.                        sipping and drinking distinct? Alcohol                   through adolescence. J. Adolesc.
     Ten-year prospective study of                             Clin Exp Res. 2015;39(9):1805–1813                       Health. 2013;53(4):453–459
     public health problems associated
                                                           7. Donovan JE. The burden of alcohol use:               13. Ward BM, Snow PC. Factors affecting
     with early drinking. Pediatrics.
                                                              focus on children and preadolescents.                    parental supply of alcohol to underage
     2003;111(5):949–955.
                                                              Alcohol Res. 2013;35(2):186–192                          adolescents. Drug Alcohol Rev.
  2. Hingson RW, Zha W. Age of drinking                                                                                2011;30(4):338–343
     onset, alcohol use disorders,                         8. Donovan JE, Molina BSG. Children’s
     frequent heavy drinking, and                             introduction to alcohol use: sips                    14. Jackson KM, Barnett NP, Colby SM,
     unintentionally injuring oneself and                     and tastes. Alcohol Clin Exp Res.                        Rogers ML. The prospective association
     others after drinking. Pediatrics.                       2008;32(1):108–119                                       between sipping alcohol by the sixth
     2009;123(6):1477–1484                                                                                             grade and later substance use. J Stud
                                                           9. Jackson C, Ennett ST, Dickinson DM,
                                                                                                                       Alcohol Drugs. 2015;76(2):212–221
  3. Gore FM, Bloem PJN, Patton GC, et al.                    Bowling JM. Letting children sip:
     Global burden of disease in young people                 understanding why parents allow                      15. Aiken A, Wadolowski M, Bruno R, et al.
     aged 10-24 years: a systematic analysis.                 alcohol use by elementary school-aged                    Cohort profile: The Australian parental
     Lancet. 2011;377(9783):2093–2102                         children. Arch Pediatr Adolesc Med.                      supply of alcohol longitudinal study
                                                              2012;166(11):1053–1057                                   (APSALS) [published online ahead of
  4. Patton GC, Coffey C, Cappa C, et al.
                                                                                                                       print May 6, 2015. Int J Epidemiol.
     Health of the world’s adolescents:                   10. Kypri K, Dean JI, Stojanovski E.
     a synthesis of internationally                           Parent attitudes on the supply of                    16. Donovan JE, Molina BSG. Childhood risk
     comparable data. Lancet.                                 alcohol to minors. Drug Alcohol Rev.                     factors for early-onset drinking. J Stud
     2012;379(9826):1665–1675                                 2007;26(1):41–47                                         Alcohol Drugs. 2011;72(5):741–751
  5. Wadolowski M, Bruno R, Aiken A,                      11. Jackson C, Ennett S, Dickinson                       17. Henderson H, Nass L, Payne C, Phelps
     et al. Sipping, drinking, and early                      D, Bowling JM. Attributes that                           A, Ryley A. Smoking, drinking and drug
     adolescent alcohol consumption: a                        differentiate children who sip alcohol                   use among young people in England in
     cautionary note. Alcohol Clin Exp Res.                   from abstinent peers. J. Youth Adolesc.                  2012. London: NHS Information Centre
     2015;39(2):350–354                                       2013;42(11):1687–1695                                    for Health & Social Care; 2013
  6. Wadolowski M, Hutchinson D, Bruno R,                 12. Donovan JE, Molina BSG. Types of                     18. White V, Bariola E. Australian
     et al. Early adolescent alcohol use: Are                 alcohol use experience from childhood                    secondary school students’ use

                                    Downloaded from www.aappublications.org/news by guest on February 9, 2021
PEDIATRICS Volume 137, number 3, March 2016                                                                                                                      7
of tobacco, alcohol, and over-the-            27. Joreskog K, Sorbom D. LISREL 8:                  an effective brief screening test
        counter and illicit substances in                 Structural equation modeling with the            for problem drinking. Ambulatory
        2011. Melbourne, Victoria: Centre for             SIMPLIS command language. Chicago,               Care Quality Improvement Project
        Behavioural Research in Cancer, The               IL: Scientific Software International Inc;        (ACQUIP). Alcohol Use Disorders
        Cancer Council Victoria; 2012                     1993                                             Identification Test. Arch Intern Med.
                                                                                                           1998;158(16):1789–1795
    19. Donovan JE. Really underage drinkers:         28. Australian Bureau of Statistics.
        the epidemiology of children’s alcohol            Australian demographic statistics,           35. Komro KA, Maldonado-Molina MM,
        use in the United States. Prev Sci.               June quarter 2012: Australian                    Tobler AL, Bonds JR, Muller KE. Effects
        2007;8(3):192–205                                 demographic statistics tables.                   of home access and availability of
                                                          Canberra, Australian Capital Territory:          alcohol on young adolescents’ alcohol
    20. Donovan JE, Molina BSG. Antecedent                                                                 use. Addiction. 2007;102(10):1597–1608
        predictors of children’s initiation of            Australian Bureau of Statistics; 2012
        sipping/tasting alcohol. Alcohol Clin                                                          36. van der Vorst H, Engels RCME, Meeus
                                                      29. Australian Bureau of Statistics. Family
        Exp Res. 2014;38(9):2488–2495                                                                      W, Deković M, Van Leeuwe J. The
                                                          characteristics, Australia, 2009-10:
                                                                                                           role of alcohol-specific socialization
    21. Jones SC, Magee C, Andrews K. ‘I                  Households, families and persons,
                                                                                                           in adolescents’ drinking behaviour.
        think other parents might. …’: Using              selected characteristics by state.
                                                                                                           Addiction. 2005;100(10):1464–1476
        a projective technique to explore                 Canberra, Australian Capital Territory:
        parental supply of alcohol. Drug                  Australian Bureau of Statistics; 2011        37. Ary DV, Duncan TE, Duncan SC, Hops
        Alcohol Rev. 2015;34(5):531–539                                                                    H. Adolescent problem behavior: the
                                                      30. Pink B. Information paper: An                    influence of parents and peers. Behav
    22. Jackson KM, Colby SM, Barnett NP,                 introduction to Socio-Economic Indexes           Res Ther. 1999;37(3):217–230
        Abar CC. Prevalence and correlates of             for Areas (SEIFA) 2006. Canberra,
                                                          Australian Capital Territory: Australian     38. Small SA, Kerns D. Unwanted sexual
        sipping alcohol in a prospective middle
                                                          Bureau of Statistics, Commonwealth of            activity among peers during early
        school sample. Psychol Addict Behav.
                                                          Australia; 2008                                  and middle adolescence: Incidence
        2015;29(3):766–778
                                                                                                           and risk factors. J Marriage Fam.
    23. Kaynak Ö, Winters KC, Cacciola                31. Australian Bureau of Statistics. Socio-          1993;55(4):941–952
        J, Kirby KC, Arria AM. Providing                  economic Indexes for Areas (SEIFA),
                                                                                                       39. Stice E, Barrera M Jr, Chassin L.
        alcohol for underage youth: what                  Data cube, 2006. Canberra, Australian
                                                                                                           Prospective differential prediction of
        messages should we be sending                     Capital Territory: Australian Bureau of
                                                                                                           adolescent alcohol use and problem
        parents? J Stud Alcohol Drugs.                    Statistics; 2008
                                                                                                           use: examining the mechanisms
        2014;75(4):590–605                                                                                 of effect. J Abnorm Psychol.
                                                      32. White V, Smith G. Australian secondary
    24. Donovan JE. Adolescent alcohol                    school students’ use of tobacco,                 1998;107(4):616–628
        initiation: a review of psychosocial              alcohol, and over-the-counter and            40. Johnston LD, Bachman JG, O’Malley PM.
        risk factors. J Adolesc Health.                   illicit substances in 2008. Melbourne,           Monitoring the Future: Questionnaire
        2004;35(6):529.e7–529.e18                         Victoria: Centre for Behavioural                 responses from the nation’s high
                                                          Research in Cancer, The Cancer                   school seniors, 2011. Ann Arbor,
    25. Windle M, Spear LP, Fuligni AJ, et
                                                          Council Victoria; 2009                           MI: Institute for Social Research,
        al Transitions into underage and
        problem drinking: Developmental               33. Australian Institute of Health &                 University of Michigan; 2013
        processes and mechanisms                          Welfare. 2010 National Drug Strategy         41. Achenbac-h TM. Manual for the
        between 10 and 15 years of age.                   Household Survey report. Canberra,               youth self-report and 1991 profile.
        Pediatrics. 2008;121(suppl 4):                    A: Australian Institute of Health &              Burlington, VT: University of Vermont;
        S273–S289                                         Welfare; 2011                                    1991
    26. LISREL 8.8 for Windows [computer              34. Bush K, Kivlahan DR, McDonell MB,            42. Stata/SE 11.2 for Windows [computer
        program]. Skokie, IL: Scientific                   Fihn SD, Bradley KA. The AUDIT alcohol           program]. College Station, TX:
        Software; 2006                                    consumption questions (AUDIT-C):                 StataCorp LP; 2012

                                       Downloaded from www.aappublications.org/news by guest on February 9, 2021
8                                                                                                                                  WADOLOWSKI et al
Parents Who Supply Sips of Alcohol in Early Adolescence: A Prospective Study
                              of Risk Factors
Monika Wadolowski, Delyse Hutchinson, Raimondo Bruno, Alexandra Aiken, Jackob
 M. Najman, Kypros Kypri, Tim Slade, Nyanda McBride and Richard P. Mattick
                            Pediatrics 2016;137;
   DOI: 10.1542/peds.2015-2611 originally published online February 26, 2016;

Updated Information &          including high resolution figures, can be found at:
Services                       http://pediatrics.aappublications.org/content/137/3/e20152611
References                     This article cites 29 articles, 3 of which you can access for free at:
                               http://pediatrics.aappublications.org/content/137/3/e20152611#BIBL
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                               Substance Use
                               http://www.aappublications.org/cgi/collection/substance_abuse_sub
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Parents Who Supply Sips of Alcohol in Early Adolescence: A Prospective Study
                              of Risk Factors
Monika Wadolowski, Delyse Hutchinson, Raimondo Bruno, Alexandra Aiken, Jackob
 M. Najman, Kypros Kypri, Tim Slade, Nyanda McBride and Richard P. Mattick
                            Pediatrics 2016;137;
   DOI: 10.1542/peds.2015-2611 originally published online February 26, 2016;

  The online version of this article, along with updated information and services, is
                         located on the World Wide Web at:
           http://pediatrics.aappublications.org/content/137/3/e20152611

 Pediatrics is the official journal of the American Academy of Pediatrics. A monthly publication, it
 has been published continuously since 1948. Pediatrics is owned, published, and trademarked by
 the American Academy of Pediatrics, 345 Park Avenue, Itasca, Illinois, 60143. Copyright © 2016
 by the American Academy of Pediatrics. All rights reserved. Print ISSN: 1073-0397.

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