Psychosocial Risk and Protective Factors for Adolescent Problem Drinking in Estonia

Background and Purpose: Heavy alcohol consumption among adolescents living in Estonia is a widespread problem. The latest national prevalence rates of past month heavy episodic drinking and drunkenness among 15- to 16-year-old Estonian students were 49% and 41%, respectively. These figures place Estonia among the European nations with one of the highest proportions of heavy drinking students (Hibell et al., 2004). Despite the high and growing rates of problem drinking, little is known about factors that increase or decrease the risk of alcohol misuse for adolescents living in this region of the world. The goal of this study was to examine how a wide range of psychosocial factors within individual, peer, family, school, and community context relate to heavy episodic drinking and drunkenness in Estonian adolescents.

Methods: Using a cross-sectional survey design, a convenience sample of 486 ninth-grade students (51% male; average age 15.1 years) from 12 rural and 8 urban public schools located in south-central Estonia filled out a modified version of the Communities That Care Youth Survey (Arthur et al., 2002). Collection of data took place in a classroom setting during the fall of 2007. Relationships between risk and protective factors, and two types of past month problem drinking (i.e. heavy episodic drinking and drunkenness) were examined using binary logistic regression analyses.

Results: The prevalence of past month heavy episodic drinking and drunkenness in this sample of Estonian adolescents was 49% and 27%, respectively. Analyses revealed that higher exposure to the majority of the 24 individual, peer, family, school, and community risk factors, and 12 protective factors assessed in this study was significantly associated (at p < .05) with both types of past month problem drinking in the expected direction. Early initiation of substance use and personal attitudes favoring substance use emerged as the strongest shared risk factors for both types of problem drinking. Personal involvement in prosocial activities, low neighborhood attachment, community disorganization, and opportunities and rewards for prosocial community involvement were not significantly related to heavy episodic drinking or drunkenness.

Conclusions and Implications: With a few notable exceptions pertaining to general community characteristics, the results of this study show that the majority of psychosocial risk and protective factors identified in prior research with youth from other countries are similarly related to problem drinking in Estonian adolescents. Findings of this study have direct implications for the development of more effective alcohol use prevention and intervention strategies in Estonia. Implications for future research are also discussed.