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Addiction Research & Theory

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A typology of alcohol consumption among youngpeople – A narrative synthesis

Martin P. Davoren, Mary Cronin, Ivan J. Perry, Jakob Demant, Frances Shiely& Karl O’Connor

To cite this article: Martin P. Davoren, Mary Cronin, Ivan J. Perry, Jakob Demant, Frances Shiely& Karl O’Connor (2015): A typology of alcohol consumption among young people – A narrativesynthesis, Addiction Research & Theory, DOI: 10.3109/16066359.2015.1121244

To link to this article: http://dx.doi.org/10.3109/16066359.2015.1121244

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ADDICTION RESEARCH & THEORY, 2015http://dx.doi.org/10.3109/16066359.2015.1121244

REVIEW ARTICLE

A typology of alcohol consumption among young people – A narrativesynthesis

Martin P. Davorena, Mary Cronina, Ivan J. Perrya, Jakob Demantb, Frances Shielya and Karl O’Connorc

aDepartment of Epidemiology and Public Health, University College Cork, Cork, Ireland; bDepartment of Sociology, University ofCopenhagen, Copenhagen, Denmark; cSchool of Criminology, Politics and Social Policy, University of Ulster, Antrim, Northern Ireland, UK

ABSTRACTBackground Currently, alcohol consumption levels are significantly higher among younger agegroups. However, previous research has noted the diversity of motivations and patterns. Thesepatterns of drinking have yet to be synthesised into a typology. The aim of the current study was tosynthesise information from studies that produced types of alcohol consumption among youngpeople. Method Quantitative and qualitative literature investigating the different types of drinkersamong young people [aged 12–24 years], published in peer reviewed journals, were eligible forinclusion in this systematic review. MEDLINE, PsychInfo and CINAHL were systematically searchedfor relevant articles published between January 1st 2000 and December 31st 2014. Included paperswere critically appraised. A narrative synthesis approach was employed based on guidance fromthe UK Economic and Social Research Council. Results In total, 13 studies were eligible forinclusion: 11 quantitative, one qualitative and one mixed methods. Six classes of drinkers wereformed within this typology. Abstainers reported no alcohol consumption. Light drinkers reporteddrinking small amounts of alcohol infrequently. In comparison, social and hedonistic drinkers drankmost in social situations and to have fun. Heavy and harmful consumers reported increased volumeand frequency of consumption including harmful consequences. Conclusion Currently, policymakers are attempting to combat the high levels of harmful alcohol consumption among youngpeople. The current typology provides guidance for targeted interventions in addition to a practicalanalytic tool in future research.

ARTICLE HISTORY

Received 25 May 2015Revised 12 November 2015Accepted 13 November 2015Published online9 December 2015

KEYWORDS

Typology; alcohol;young people; narrativesynthesis; review

Introduction

Since the beginning of recorded history alcohol has beenconsumed for reasons of relaxation, enjoyment andsociability (Rehm et al. 2009). The World HealthOrganisation reported Europe and America as theheaviest drinking regions in the world (World HealthOrganization 2014). Previous research has observed thatas the mean consumption pattern of the countryincreases so too does the consumption pattern of theindividual (Skog 1985; Rose and Day 1990). Youngpeople (age 18–29) represent a unique sub-section ofsociety who exhibit elevated levels of alcohol consump-tion (Morgan et al 2009). In 2015, the OECD reportedthat harmful drinking is on the rise among young people(Sassi 2015). Compounding this, it was recently reportedthat two-thirds of university students are hazardousalcohol consumers (Davoren et al. 2015) and betweenone in five (Sassi 2015) and two in five (Murphy et al.2015) second-level students (age 16–18) report bingedrinking. In a recent review of drinking cultures ahomogenisation of drinking cultures in Western societies

was noted (Gordon et al. 2011). This is supported bysimilar industry lobbying (Miller and Harkins 2010),technological advances, alcohol advertising (Andersonet al. 2009), alcohol policies (Brand et al 2007) andcultural factors (Gordon et al. 2011) across Westernsociety. Within this culture, research highlights theheterogeneous nature of alcohol consumption as youngpeople exhibit varying consumption patterns. Among thevarious consumption patterns identified in the literatureare young people who abstain from alcohol (O’Connorand Colder 2005). Research also highlights light andmoderate levels of alcohol consumption (Hersh andHussong 2006) in addition to heavy/binge drinkers(Steinhausen and Metzke 2003; Deshpande and Rundle-Thiele 2011) and problem alcohol consumers (Reboussinet al. 2006; Dauber et al. 2009). Public health policymakers have attempted to tackle population consump-tion throughout the past number of decades usingmarketing and supply restrictions (Babor and Caetano2005). However, alcohol remains a major cause of globalsuffering.

CONTACT Mr. Martin Davoren m.davoren@ucc.ie Department of Epidemiology and Public Health, University College Cork, 4th Floor Western GatewayBuilding, Western Road, Cork, Ireland

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Most recently, typologies have been hypothesised as apertinent public health tool (Eriksson et al. 2007). Theadvantage of a typology approach is that it enhances ourunderstanding of a societal phenomenon while making itpossible to note patterns across societies. Results fromprevious research outputs have yet to be synthesised toproduce a typology of drinkers. Furthermore, the rangeof types is not usually considered in policy developmentand implementation (Berg 2009).

Aim of the study

The current study aims to conduct a systematic review ofprevious literature in order to develop a typology ofalcohol consumption among young people from researchin Western countries.

Methodology

A narrative synthesis approach was chosen as it allowedfor the inclusion of a broad range of research designs(Popay et al. 2006). The narrative synthesis was under-taken using steps outlined in the guidance, developed byPopay et al. (2006) for the UK Economic and SocialResearch Council (ESRC). This guidance was developedafter the Cochrane Collaboration highlighted that‘systematic reviews adopting a narrative approach tosynthesis are prone to bias, and may generate unsoundconclusions leading to harmful decision’ (Popay et al.2006). Thus, these guidelines aim to ‘promote transpar-ent reporting and assessment of the robustness of theresults’ (Marshall et al. 2012). The guidelines structurethe narrative synthesis as follows: (1) identifying atheory, (2) identifying the review process, (3) identifyingstudies to include in the review, (4) extracting informa-tion and completing quality appraisal of included studiesand (5) synthesising this information together (Popayet al. 2006).

Identifying a theory

Skog’s theory of the ‘Collectivity of Drinking Cultures’(Skog 1985) is utilised as a framework for this narrativesynthesis. This theory assumes that an individual’s peergroup and the culture in which they live impact on anindividual’s drinking. In addition, it suggests that anindividual’s alcohol consumption increases as the meanconsumption for the society in which they live increases.Skog illustrated that factors influencing an individual’sdrinking tend to combine multiplicatively and thatindividual drinking behaviours are regulated by directand indirect social influences on the individual fromtheir peers and other social and cultural networks

(Skog 1985, 2001). Due to these influences, changes indrinking habits are typically seen as a group phenom-enon (Landberg 2010).

Identifying the review process

Quantitative and qualitative literature, published in peerreviewed journals, investigating the different types ofdrinkers, among a young adult population (aged 12–24years) were eligible for inclusion in this review. Forquantitative research, articles must have employedfactor/cluster analysis to investigate the type of alcoholconsumer. These complementary methods are under-pinned by an underlying logic of classification, attempt-ing to uncover homogeneous units (Krebs et al. 2000).MEDLINE, PsychInfo and CINAHL were searched forrelevant articles separately by quantitative and qualitativeresearch from January 2000 up until December 31st2014. Full details of the MESH terms and qualitativespecific terms (McKibbon et al. 2006) used are outlinedin Appendices 1 and 2. No language limits were placedon the inclusion of articles.

Identifying studies to include in the review

Completed searches were initially title and abstractsearched by one reviewer (MPD) and any clearlyirrelevant titles were excluded. All papers, which werereferred to the research question, were downloaded andfully reviewed. At this point, a final selection was madeand any duplicates from the databases were removed.Reference mining was conducted on all included articles.A flow diagram of this is displayed separately forquantitative (Figure 1) and qualitative (Figure 2)findings. English translation of abstracts for relevantpapers was available but no full text of a non-Englishpaper was required. References for all included articleswere managed in EndNote, a reference package, to keeptrack of paper selection.

Quality appraisal of included studies

Included papers were quality assessed using a modifiedversion of the Effective Public Health Practice Projecttool for quality assessment of quantitative studies. Theappraisal dealt with four main areas: selection bias, studydesign, data collection methods and analysis. As outlinedby Armijo-Olivo et al., sections were rated as strong (3points), moderate (2 points) or weak (1 point) and anappraisal score out of 12 was defined (Armijo-Olivo et al.2012). Higher appraisal scores indicated better qualitystudies. The RATS (Relevance, Appropriateness,Transparency, Soundness) checklist was used for

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Database

Number of ar�clesretrieved from

�tle/abstract search

Number of ar�clesretrieved and read in full

Total[A�er duplicates across

searches were removed]

PsychInfo = 809 MEDLINE = 328 CINAHL = 827

12 8 7

9 6 2

1

Total Total = 1,964

Figure 2. Number of articles retrieved in qualitative research.

Database

Number of ar�clesretrieved from

�tle/abstract search

Number of ar�clesretrieved and read in full

Total[A�er duplicates across

searches were removed]

PsychInfo = 235 MEDLINE = 416 CINAHL = 270

36 29 22

20 21 18

12

Total Total = 921

3 ar�cles retrievedfrom referencesearches of includedar�cles

Figure 1. Number of articles retrieved in quantitative research.

ADDICTION RESEARCH & THEORY 3

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qualitative studies. This checklist comprised of 25questions about appropriateness of the method andsoundness of the approach. As previously described byLeamy et al., each question was dichotomised into yes (1point) or no (0 points) giving a scale which ranged frompoor quality, zero, to high quality, 25 (Leamy et al. 2011).Information regarding the target population, sample size,study methodology and main results were extracted fromall included studies (see Table 1). Two authors reviewedarticles for quality. Discrepancy in score was discussedwith all co-authors to obtain concordance.

Synthesising the information

Complete results sections from each included articlewere extracted for analysis. Using NVivo 10, types ofdrinking behaviour were synthesised from includedstudies using an inductive approach to content analysis,as it is ‘a systematic and objective means of describingand quantifying phenomena’ (Elo and Kyngas 2008).Prevalence of specific types from individual papers wasexcluded due to the methodological and contextualdifferences among the studies.

Results

In total, 13 articles were included in the review; 11quantitative, one qualitative and one mixed methodsstudy (see Figures 1 and 2). Table 1 details an overviewof each included study in this synthesis. The six maintypes of alcohol consumer identified within this narrativesynthesis were Abstainers, Light drinkers, Social drin-kers, Hedonistic drinkers, Heavy alcohol consumers andProblem alcohol users. No distinct differences in typesreported were observed between countries.

Abstainers

Young people in this group reported no alcoholconsumption either currently (current non-drinkers) orin their lifetime (lifetime abstainers). These individualsreported complete abstention from alcohol. In total, fiveof the included papers reported a type of drinker whorefrained completely from alcohol use (Steinhausen andMetzke 2003; Dauber et al. 2009; Mathijssen et al. 2012;van Lettow et al. 2013; Cleveland et al. 2013). In general,younger people were more likely to be abstainers thanolder people (Dauber et al. 2009). Three of the includedpapers excluded non-drinkers as their aim was toinvestigate drinking styles (Stewart and Power 2002;Reboussin et al. 2006; Comasco et al. 2010).

Light drinkers

Most studies reported light alcohol users along withyoung people who have only experimented or sippedalcohol (Stewart and Power 2002; O’Connor and Colder2005; Reboussin et al. 2006; Percy and Iwaniec 2007;Dauber et al. 2009; Demant & Torronen 2011; Craigset al. 2012; Mathijssen et al. 2012; Cleveland et al. 2013;van Lettow et al. 2013; Jackson et al. 2014). Individualswho reported light levels of alcohol consumption drinksmall amounts of alcohol and have few alcohol-relatedproblems. These people may be likely to report alcoholconsumption but were unlikely to report risky behav-iours. Others in this cluster reported sipping alcohol intheir lifetime and were unlikely to have three or moredrinks on one occasion. This group reported low,infrequent amounts of alcohol consumption. Moreover,individuals in this group were more likely to be youngerin age (van Lettow et al. 2013) and female (van Lettowet al. 2013; Jackson et al. 2014) when compared to heavydrinkers. They were described as ‘consciously sober’ byMathjssen et al. (2012) and were characterised ascautious, unadventurous and family orientated. Lightdrinkers reported no instances of heavy drinking.

Social drinkers

Alcohol facilitates group interactions, meeting newpeople and feeling a sense of belonging in a group(Comasco et al. 2010; Demant and Torronen 2011;Jackson et al. 2014). Drinking for social reasons was aclear type of alcohol consumption among these youngpeople (Stewart and Power 2002; Steinhausen andMetzke 2003; Reboussin et al. 2006; Comasco et al.2010; Demant and Torronen 2011; Mathijssen et al.2012). Social drinkers noted drinking at parties withother individuals made them feel more outgoing andsocial (Comasco et al. 2010). Furthermore, they refer todrinking at bars and other social events in groups withfriends (Power et al. 2005) where they drank alcohol dueto social expectation.

Social drinking occasions can occur during a socialevening away from home, at home or at a friend’s house.A sense of mutual solidarity surrounds group drinking,underpinning this type of consumption (Demant andTorronen 2011). Alcohol consumption facilitates anatmosphere for social activities and feelings of inclusion.Their drinking habits are distinct due to their motivationto consume alcohol being driven by peer influence. Thiscomplements Skog’s theory which stated that an indi-vidual’s drinking habits are strongly influenced by thedrinking habits of an individual’s peers or social network(Skog, 1985, 2001). Social drinkers were more likely to be

4 M. P. DAVOREN ET AL.

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ADDICTION RESEARCH & THEORY 7

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female when compared to heavy drinkers (Steinhausenand Metzke 2003) and were older when compared toabstainers (Steinhausen and Metzke 2003; Mathijssenet al. 2012). Individuals in this group report moderatelevels of alcohol consumption. This type of drinking wasreported in 12 of the included papers.

Hedonistic drinkers

The majority of the included papers portrayed ahedonistic approach to alcohol use (Stewart and Power2002; Reboussin et al. 2006; Dauber et al. 2009; Comascoet al. 2010; Demant and Torronen 2011; Craigs et al.2012; Mathijssen et al. 2012; Cleveland et al. 2013; vanLettow et al. 2013). Hedonism is the view that pleasure isthe only good thing in life and can be defined by viewing‘pleasure as the only possible object of desire, because allmotivation is based on the prospect of pleasure’(O’Shaughnessy and O’Shaughnessy 2002). An integralpart of hedonistic drinking is the use of alcohol tochange one’s mood, for enjoyment, to enhance socialsituations, to reduce inhibitions and to get intoxicatedand experiment (Comasco et al. 2010). These individualsenjoyed being drunk and drank to feel pleasure (vanLettow et al. 2013). This style of drinking is associatedwith impulsive drinking behaviours and drinking largeramounts of alcohol with the intention of having fun andenjoyment (Stewart and Power 2002). This group ofdrinkers are distinct from social drinkers in their self-indulgent motivation to consume alcohol. Instead ofbeing motivated by peers and social groups, hedonisticdrinkers are driven by their personal need to feelpleasure, overcome reservations and enjoy themselves.These individuals are more likely to be older than lightdrinkers (Craigs et al. 2012), and less likely to be femalethan other groups (van Lettow et al. 2013).

Heavy drinkers

The majority of included papers (12) discussed patterns ofheavy alcohol consumption among young people. Heavyalcohol consumption ranged in name from ‘weekend riskydrinker’ to ‘habitual drinkers’; describing individuals whowould consume harmful levels alcohol on a regular basis.Individuals who fell within heavy alcohol consumptiongroups would report heavy drinking, high rates ofconsequences due to alcohol consumption, high riskdrinking behaviours and regular patterns of alcoholconsumption (Stewart and Power 2002; Steinhausen andMetzke 2003; O’Connor and Colder 2005; Reboussin et al.2006; Percy and Iwaniec 2007; Dauber et al. 2009;Comasco et al. 2010; Demant and Torronen 2011;Craigs et al. 2012; Mathijssen et al. 2012; Cleveland et al.

2013; Jackson et al. 2014). This group would consumehigher amounts of alcohol and consume alcohol morefrequently than their peers who report light drinking orsocial levels of drinking. Heavy drinkers were associatedwith early initiation into alcohol consumption, drinkingto intoxication and binge drinking (Stewart and Power2002; Reboussin et al. 2006; Demant and Torronen 2011;Cleveland et al. 2013). Adverse consequences for this typeof alcohol consumer are reported in the literature,including hangovers, blackouts, getting sick, feelingdepressed, losing control and having an outburst ofanger. In general, men (Reboussin et al. 2006; Sacco et al.2009) and those at the upper age limit of this study(Steinhausen and Metzke 2003) were more likely to reportheavy drinking.

Problem alcohol users

Problem alcohol users and the negative aspects associatedwith this type of alcohol use were described in 11 of the 13included studies (Stewart and Power 2002; Reboussinet al. 2006; Percy and Iwaniec 2007; Dauber et al. 2009;Comasco et al. 2010; Demant and Torronen 2011; Craigset al. 2012; Mathijssen et al. 2012; Cleveland et al. 2013;van Lettow et al. 2013; Jackson et al. 2014). Problemalcohol users are described as individuals who reportedsolitary drinking, drinking in the morning, individualswho drink on a daily basis and those who reportconsuming alcohol and driving (Stewart and Power2002; Dauber et al. 2009; Cleveland et al. 2013). Anumber of papers also reported their drinking patternplacing them in unwanted sexual situations or regrettingsex (Dauber et al. 2009; Cleveland et al. 2013). Problemalcohol users are described as such because of the negativeoutcomes associated with their alcohol consumption.

In addition, a number of studies highlighted thatproblem drinkers are fuelled by negative emotions and awish to change or improve mood through heavy alcoholconsumption. Physiological and pharmacological side-effects among problem alcohol users are frequent. Theydescribe drinking ‘to think of something else/to forgetmy worries, my problems’ (Comasco et al. 2010).Compared to abstainers/light drinkers this group isolder (Jackson et al. 2014) and predominantly male(Percy and Iwaniec 2007; Jackson et al. 2014).

Discussion

Alcohol consumption is a leading cause of suffering insociety (World Health Organization 2009). Reports fromdifferent countries reveal that young people today drinkmore, with increasing emphasis on binge drinking anddrunkenness than earlier generations (McCabe 2002;

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Carey et al. 2007; Murphy and Murphy 2010). This issaid to have increased over the last 45 years. Authorshave previously hypothesised this as the ‘psychoactiverevolution’ and by the 1990s, a decade defined by a ‘newculture of intoxification’ had manifested, peaking in 2001(Jarvinen and Room 2007). This cultural shift is furthercompounded by the fact that young adult consumptionlevels remained steady for the 1970s and 80s but doubledin the 1990s (Jarvinen and Room 2007). The currentresearch describes a synthesis of previously publishedtypologies of alcohol consumption identified in youngpeople living in Western society. Systematic reviewsfurnish policy makers with the entire range of relevantfindings from research on a particular topic, ensuringthey are not misguided by the results of one or twostudies (Akobeng 2005). The authors believe this reviewwill be a robust analytic tool in future research inaddition to providing novel information for public policymakers when tailoring health promotion interventions.

Abstainers and light drinkers may serve as protectiveand moderating factors when socialising among peers.Recently, an Australian report mooted that these individ-uals could be described as controlled and conscientious(VicHealth 2013). These individuals look out for otherswhen socialising. Health promotion practitioners haverecommended that these individual’s drinking attitudesshould be ‘encouraged and supported as the ideal drinkingattitude’ (VicHealth 2013). The protection peers offereach other against engagement in excessive alcoholconsumption should be emphasised (Quinn and Bussey2015). This can be achieved by ‘challenging society’snegative image of moderate drinking and empoweringpeople to abstain or drink less’ (VicHealth 2013).

As previously noted, ‘the classes of drinking occasionswhen heavy drinking occurs are of special interest fromthe preventive perspective’ (Mustonen et al. 2014). Skogemphasises, ‘egos drinking is very strongly influenced byalter’s drinking in group sessions’ (Skog 1985) highlight-ing the importance of an individual’s peer group andculture on their drinking pattern (Skog 1985). Thiscomplements the current research where the influence ofpeer drinking is evident. Young people highlight theirmotivators in terms of ‘house parties’, excessive drinkingand enjoyment which is apparent in social, hedonisticand heavy consumers. These correspond to the previ-ously described motives: ‘social’ and ‘enhancement’(Stewart et al. 1996; Quinn and Bussey 2015).

Individuals anticipate more arousal from risky behav-iours (Katz et al. 2000), complementing our finding ofhedonistic drinking. Hedonistic drinking has previouslybeen noted as a culture of alcohol consumption amongour society (Hurlbut and Sher 1992; Gordon et al. 2011).It is sustained by a technological era of instant

gratification to which young people have been exces-sively exposed. As outlined by Gordon, ‘rules governingdrinking behaviours vary and are often informal, sociallynegotiated and acquired via the socialisation process’(Gordon et al. 2011). It is these social cultures, whichgovern and reflect attitudes toward alcohol. For example,Germany tends to value individuals who can hold one’sdrink while the UK appears to celebrate intoxication andhigh levels of alcohol consumption. Gordon defines thesevariations in ‘levels of drinking and drunkenness as the‘‘hedonism’’ dimension to drinking cultures’ (Gordonet al. 2011). These cultural norms represent an importantway of regulating drinking behaviour.

Recommendations for policy & health promotionstrategies

Public policy makers have attempted to combat alcoholuse with a number of legislative measures. Despite this,consumption levels have continued to increase (Davorenet al. 2015). This typology gives us further insight intothe drinking patterns of young people. For example,abstainers give insight into their reasons for notconsuming alcohol (Steinhausen and Metzke 2003;Dauber et al. 2009; Mathijssen et al. 2012), while lightdrinkers give insight into a form of conscious experi-mentation which occurs as young people explore alcoholconsumption while remaining conscious and in controlof their bodies (Hersh and Hussong 2006; Reboussinet al., 2006; Dauber et al. 2009; Huang et al. 2011;Mathijssen et al. 2012). These consumption patterns arealso observed in comparatively older populations (Saccoet al. 2009), and in other risk taking activities (Fountainet al. 1999). Although, harms caused by these drinkingstyles are negligible, national policy and health promo-tion strategies aimed toward education, taxation andrestrictions on opening hours remain crucial to ensuringthese individuals do not transition to heavier patterns ofalcohol consumption. In addition, the socio-culturalnorms and practices upheld by these groups are useful inthe tailoring positive health promotion strategies, aimedat altering the negative image of abstinence and lightdrinking among young people (Quinn and Bussey 2015).

In the past decade a surge in predrinking has beenobserved with adolescents predrinking before parties orbefore going out (Kuntsche and Gmel 2013). This wasobserved in a typology which was formed almost50 years ago (Park 1967). This is being fuelled by theavailability of cheap alcohol through off-sales and thecurrent phenomenon of the ‘house party’ (Wells et al.2009). The most effective measure to reduce the harmscaused by this style of drinking is minimum unit pricing.This measure would increase the price of off-licence sales

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thus reducing the consumption among hedonisticdrinkers (The Scottish Government 2013). A reductionin the density of outlets surrounding colleges, univer-sities and schools would also reduce consumption andpatterns of harm. Culturally, a ban on the alcoholindustry providing sports sponsorship would break theview of alcohol as a cultural artefact (McGee 2013).However, for young people reporting problem drinkingand addictive tendencies, their motives for drinking arecentred on coping (Comasco et al. 2010). Individualstrategies will be required among these individuals, suchas brief intervention therapy, support structures andclear pathways of referral to addiction clinics.

Many screening tools employed by health profes-sionals define young people as either hazardous or non-hazardous drinkers. The protection of this vulnerablepopulation would benefit from the development of ascreening tool which incorporated the typology pre-sented in this synthesis. This typology would aid thehealth professional to tailor brief interventions andadvice, thus improving patient care (Winograd et al.2012). In addition, health promotion practitionersshould employ the current review to understand theculture of alcohol consumption further by tailoringeffective health promotion strategies to influence thesespecific groups and reduce consumption (Santos 2013).

Strengths and limitations

This synthesis has a number of strengths. A range ofdatabases were reviewed to obtain the breath of literatureavailable researching drinking types. Relevant articles,regardless of language were considered. No previoustypology had been developed. As studies assessingdrinking type had utilised quantitative and qualitativeresearch, a robust process was used to reduce theweaknesses of a narrative syntheses approach (Popayet al. 2006).

However, the synthesis is limited to the published datawhich tends to range in quality. Most of the includedstudies were cross-sectional. Moreover, the synthesis wasconstrained by the broad age limits used in previousresearch. Those aged less than 18 will report a distinctlydifferent alcohol consumption compared to their peersaged 18 years and older. Furthermore, policy implicationsfor those above and below the legal drinking age will bedistinctly different. Research questions in the includedarticles were distinct across each study. The impact of thisis difficult to control. Finally, answers may be influencedby recall and/or social-desirability bias due to participantsdisclosing a range of risk-taking behaviour.

A typology itself can be described as a ‘systematicmethod for classifying similar events, actions, objects,

people or places into distinct groupings’ (Berg 2009).The main objective of a typology is to provide additionalinformation on the material to the reader. This isexecuted by attempting mutually exclusive categories,making sure all elements have been accounted for andensuring the categories make theoretically meaningfulappraisals of the literature. However, the idea of atypology can be a reductionist one, loosing nuances fromdata which may better describe the different aspects ofalcohol consumption. Many argue this is the beauty ofthe method as it ‘permits the researcher to present thedata in an organised and simple fashion, allowing thereader to better understand the explanations offered’(Berg 2009).

Conclusion

The current synthesis outlines a typology of alcoholconsumption among young people in Western societies.It displays a varied prevalence of reported alcohol use forspecific groups of young people implying that the needfor alcohol interventions is not uniform. Thus, publicpolicy should address the specific needs of each of thetargeted groups (Francis et al. 2014) through a mix ofpopulation-level and individual measures. Future publicpolicy should consider this typology when developingalcohol interventions, screening tools and tailoringmotivational interventions.

Declaration of interest

The authors declare that there are no competing interests.

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Appendix 1. Search terms from PsychInfo [Quantitative].

Search termNumber ofarticles retrieved

S14 S12 AND S13 190S13 MM ‘Alcohol Drinking Attitudes’ OR MM ‘Alcohol Drinking Patterns’ OR MM ‘Alcohol Abuse’ OR MM ‘Alcohol

Intoxication’ OR MM ‘Social Drinking’26,196

S12 S6 AND S11 14,077S11 S7 OR S8 OR S9 OR S10 669,066S10 MM ‘Students’ OR MM ‘Business Students’ OR MM ‘Classmates’ OR MM ‘College Students’ OR MM ‘Dental

Students’ OR MM ‘Elementary School Students’ OR MM ‘Graduate Students’ OR MM ‘High SchoolStudents’ OR MM ‘International Students’ OR MM ‘Junior High School Students’ OR MM ‘KindergartenStudents’ OR MM ‘Law Students’ OR MM ‘Medical Students’ OR MM ‘Postgraduate Students’ OR MM‘Preschool Students’ OR MM ‘Reentry Students’ OR MM ‘Seminarians’ OR MM ‘Special Education Students’OR MM ‘Transfer Students’ OR MM ‘Vocational School Students’

100,965

S9 Student 491,276S8 Youth 67,771S7 Adolescent 181,497S6 S1 OR S2 OR S3 OR S4 OR S5 45,897S5 ‘cluster analysis’ 7344S4 ‘factor analysis’ 36,938S3 ‘latent class analysis’ 1106S2 MM ‘Factor Analysis’ OR MM ‘Item Analysis (Statistical)’ OR MM ‘Statistical Rotation’ 9344S1 MM ‘Cluster Analysis’ 1894

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Appendix 2. Search terms from PsychInfo [Qualitative].

Search termNumber ofarticles retrieved

S10 S4 AND S5 AND S9 809S9 S6 OR S7 OR S8 399,366S8 youth 68,413S7 adolescen* 208,259S6 DE ‘Students’ OR DE ‘Business Students’ OR DE ‘Classmates’ OR DE ‘College Students’ OR DE ‘Dental Students’

OR DE ‘Elementary School Students’ OR DE ‘Graduate Students’ OR DE ‘High School Students’ OR DE‘International Students’ OR DE ‘Junior High School Students’ OR DE ‘Kindergarten Students’ OR DE ‘LawStudents’ OR DE ‘Medical Students’ OR DE ‘Postgraduate Students’ OR DE ‘Preschool Students’ OR DE‘Reentry Students’ OR DE ‘Seminarians’ OR DE ‘Special Education Students’ OR DE ‘Transfer Students’ ORDE ‘Vocational School Students’

168,625

S5 DE ‘Alcohol Drinking Attitudes’ OR DE ‘Alcohol Drinking Patterns’ OR DE ‘Alcohol Abuse’ OR DE ‘AlcoholIntoxication’ OR DE ‘Social Drinking’

30,844

S4 S1 OR S2 OR S3 382,805S3 experiences 371,601S2 DE ‘Interviews’ OR DE ‘Intake Interview’ OR DE ‘Interview Schedules’ OR DE ‘Job Applicant Interviews’ OR DE

‘Psychodiagnostic Interview’9841

S1 DE ‘Qualitative Research’ 3916

Appendix 4. Search terms from CINAHL [Qualitative].

Search termNumber ofarticles retrieved

S10 S4 AND S5 AND S9 566S9 S6 OR S7 OR S8 205,214S8 Youth 12,723S7 MH ‘Adolescence+’ 193,078S6 (MH ‘Students, College’) OR

(MH ‘Students, High School’)15,801

S5 MH ‘Alcohol Drinking’ 11,518S4 S1 OR S2 OR S3 142,547S3 MH ‘Audiorecording’ 26,162S2 MH ‘Qualitative Studies+’ 113,690S1 MH ‘Interviews+’ 64,969

Appendix 3. Search terms from MEDLINE [Qualitative].

Search termNumber ofarticles retrieved

S10 S4 AND S5 AND S9 434S9 S6 OR S7 OR S8 1,572,139S8 youth 40,199S7 MH ‘Adolescent’ 1,542,922S6 MH ‘Students’ 32,110S5 MH ‘Alcohol Drinking’ 48,505S4 S1 OR S2 OR S3 138,689S3 experiences 371,601S2 MH ‘Qualitative Research’ 9841S1 MH ‘Focus Groups’ 3916

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