Canada's National Youth Council defines "youth" as those who are 15-24 years of age. Compared to adults 25 years and older, youth are the population mostly likely to engage in risky drinking patterns typically characterized by the consumption of high quantities of alcohol per occasion (Stockwell, Zhao , & Thomas, 2009) and are more likely to experience acute alcohol-related harms, such as injuries and poisonings (Makela and Mustonen, 2000). Further, research comparing risk of injury for a given dose of alcohol by age shows that when consuming the same amount of alcohol as older adults, youth are more likely to experience alcohol-related harm (e.g. Keall, Frith, & Patterson, 2002; Peck Gebers, Voas, Romano, 2008; Cherpital, Tam, Midanik. Caetano, Greenfield, 1995). This evidence marks youth as a particularly vulnerable population.
This vulnerability stems from developmental changes including greater sensitivity to ethanol-related brain impairments (Clark, Thatcher, & Tapert, 2008), lower tolerance, and increased propensity for risk taking as a result of increased sensation seeking and delay maturation of self-regulatory competence (Steinberg, 2008). Together this evidence demands we consider carefully what can be defined as "low-risk" or "too much" alcohol for youth and design health messages that are realistic and specific to this age group.
Of some 34 countries who have issued low-risk drinking guidelines, Canada is the first to acknowledge this heightened vulnerability and offer lower detailed quantitative recommendations for youth, including distinct recommendations for those from the legal drinking age to 24 years. These recommended "low-risk" levels come from recent studies that showed the risk of acute alcohol-related harms, including physiological (e.g. passing out, sexually transmitted infections, self-harm, injuries), psychological (e.g. doing something you regretted, relationship problems), behavioural (e.g. drinking and driving, risky sexual behaviour, polysubstance use) and legal problems (e.g. getting into trouble with the law) increased considerably for youth when alcohol consumption exceeded 1-2 drinks per occasion (Thompson, Stockwell, & MacDonald, 2012; Gruenewald, Johnson, Ponicki, & LaScala, 2010).
However, it is important to acknowledge that the guidelines offer different messages for those at different ends of the youth age spectrum. Before the legal drinking age, the guidelines encourage delayed onset of drinking, but if it is initiated, guidelines recommend no more than one or two drinks, no more than once or twice a week to reduce drinking risks.
Once youth reach the legal drinking age, the guidelines suggest daily limits of no more than 2 drinks per occasion for women and 3 for men (more stringent limits than the adult guidelines). Further, the guidelines go beyond recommendations about the numbers of standard drinks and also provide advice about how to alter the context of drinking (e.g. drink slowly, eat while drinking, parental supervision). Thus abiding by the numeric and the contextual recommendations is likely to reduce youth's alcohol-related risks further.
The guidelines should not be perceived as encouragement of youth alcohol consumption and "low-risk" does not imply "no risk". The guidelines are intended to be an educational tool that provides specific information necessary for youth to make informed choices about their drinking and reduce their alcohol-related risks.The challenge is that few youth (particularly those between 19-24 years) are currently drinking at these recommended levels. However, with appropriate dissemination these guidelines could be helpful in shaping young people's attitudes and drinking behaviour, and contribute to a shift in cultural norms about drinking patterns.
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