The prevalence of adolescent alcohol consumption and its association with the availability of alcohol and drugs and the community laws and norms: A cross-national comparison of Mumbai, India; Melbourne, Australia; and Seattle, USA

Introduction: India’s emergence as a rapidly growing economic power has brought with it forces of modernization and globalization that could have adverse implications for youth.  With an adolescent population of 243 million the stakes for India are very high. Mumbai is one of the fastest modernizing cities in India. Previous cross-national comparative papers from the present study have reported lower rates of alcohol use in Mumbai adolescents, relative to matched samples in Seattle, in the US, and Melbourne, in Australia. This present paper will extend prior findings by cross-nationally comparing potentially modifiable influences in the areas of alcohol and drug availability and laws and norms.

Methods: A representative sample of 4770 students in school years equating with US and Australia Grade 5, 7 and 9 were surveyed in 2010 using a sample designed to be representative of Mumbai, India. Sampling methods, survey procedures and instruments were matched to enable cross-national comparison with matched age and gender cohorts surveyed in Washington State, U.S., and Victoria, Australia in 2002. Analyses compared the prevalence of alcohol and drug use and risk and protective factors in urban segments of Washington State (Seattle N = 1,779) and Victoria (Melbourne, N = 1,577). Associations were examined between rates of alcohol use and risk factors related to alcohol and drug availability and laws and norms.

Results: Prevalence rates alcohol use was much lower in Mumbai, intermediate in US and highest in Melbourne. The results showed lower rates of alcohol, tobacco and other drug use in Mumbai. For example amongst Grade 5 boys (av age 11 years) rates of lifetime alcohol use were 4.1% (95% Confidence Interval [CI:] 2.4 - 6.9%) in Mumbai; 57.3% (CI: 51.4 - 62.9%) in Melbourne and; 25.4% (CI: 21.1 - 30.3%) in Seattle. Based on preliminary analyses, the results showed that the levels on risk factors for alcohol and drug availability and laws and norms were lowest in Seattle and highest in Mumbai, with Melbourne intermediate between these extremes. Associations between alcohol and drug use and risk factors related to alcohol and drug availability and laws and norms tended to be weaker in Mumbai compared to Seattle and Melbourne.

Conclusions: These analyses are discussed with reference to differing policy options for adolescent alcohol and drug availability that are adopted in Mumbai, Seattle and Melbourne. The findings have implications for scientific understanding of adolescent development and for planning international prevention programs.