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Review article: Biomedical intelligence

Vol. 143 No. 2930 (2013)

Alcohol consumption in late adolescence and early adulthood – where is the problem?

  • Emmanuel Kuntsche
  • Gerhard Gmel
Cite this as:
Swiss Med Wkly. 2013;143:w13826


Risky single-occasion drinking (RSOD) is more common in late adolescence and early adulthood (approximately between the ages of 16 and 30) than in any other period in life. This is also the age when young people in Switzerland and many other European countries are legally allowed to buy and drink alcohol, but they usually do not yet have adult responsibilities. This paper reviews evidence from the international literature and provides examples of studies conducted in Switzerland demonstrating that (a) RSOD is by far most prevalent on Saturday evenings followed by Friday evenings, usually because young people go out and do not have any work or study responsibilities the next day; (b) RSOD results from drinking in private before going out (“predrinking”) and accelerating the pace of drinking (i.e. increasing the number of drinks consumed per hour); (c) RSOD is often not accidental but purposeful,. to seek excitement, to have fun and to feel the effects of alcohol; (d) RSOD occurs predominantly outside the home, mostly in bars, pubs, discos or at special events and festivals; (e) RSOD often results in intended and unintended injuries and other acute consequences, which are leading risk factors for mortality and morbidity in this age group. Effective prevention strategies should include attempts to reduce opportunities to engage in heavy drinking as well as strategies to reduce its harmful consequences.


  1. Currie C, Zanotti C, Morgan A, Currie D, De Looze M, Roberts C, et al. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen: WHO Regional Office for Europe; 2012 [10.12.12]; Available from:
  2. Hibell B, Guttormsson U, Ahlström S, Balakireva O, Bjarnason T, Kokkevi AE, et al. The 2011 ESPAD Report – Substance Use Among Students in 36 European Countries. Stockholm: The Swedish Council for Information on Alcohol and Other Drugs (CAN); 2012.
  3. International Center for Alcohol Policies (ICAP). Policy Table: Minimum Age Limits Worldwide. Washington, DC ICAP; 2012 [10.12.2012]; Available from:
  4. Jessor R, Jessor SL. Problem Behavior and Psychosocial Development: A Longitudinal Study of Youth. New York: Academic Press; 1977.
  5. Allen JP, Leadbeater BJ, Aber JL. The development of problem behavior syndromes in at-risk adolescents. Dev Psychopathol. 1994;6(2):323–42.
  6. Kuntsche E. Progression of a general substance use pattern among adolescents in Switzerland? Investigating the relationship between alcohol, tobacco, and cannabis use over a 12-year period. Eur Addict Res. 2004;10(3):118–25.
  7. Enoch M-A. The influence of gene-environment interactions on the development of alcoholism and drug dependence. Current Psychiatry Reports. 2012;14(2):150–8.
  8. van der Zwaluw CS, Kuntsche E, Engels RCME. Risky alcohol use in adolescence: The role of genetics (DRD2, SLC6A4) and coping motives. Alcohol Clin Exp Res. 2011;35(4):756–64.
  9. Mackie CJ, Conrod PJ, Rijsdijk F, Eley TC. A systematic evaluation and validation of subtypes of adolescent alcohol use motives: Genetic and environmental contributions. Alcohol Clin Exp Res. 2011;35(3):420–30.
  10. Young-Wolff KC, Kendler KS, Prescott CA. Shared genetic contributions to early-onset drinking and drinking to cope motives. Addict Behav. 2012;37(10):1176–80.
  11. Steinberg L. A social neuroscience perspective on adolescent risk-taking. Dev Rev. 2008;28(1):78–106.
  12. Kuntsche E. Stellenwert der Gesundheit im Jugendalter. In: Kuntsche E, Delgrande Jordan M, editors. Gesundheit und Gesundheitsverhalten Jugendlicher in der Schweiz Ergebnisse einer nationalen Befragung. Bern: Verlag Hans Huber; 2012. p. 11–3.
  13. Bachman JG, O'Malley HM, Schulenberg JE, Johnston LD, Bryant AL, Merline AC. The Decline of Substance Use in Young Adulthood: Changes in social Activities, Roles, and Beliefs. Mahwah, NJ: Lawrence Erlbaum; 2002.
  14. Kuntsche S, Knibbe RA, Gmel G. Parents’ alcohol use: gender differences in the impact of household and family chores. Eur J Publ Health. 2012;22(6):894–9.
  15. Rehm J, Room R, Monteiro MG, Gmel G, Graham K, Rehn N, et al. Alcohol use. In: Ezzati M, Lopez AD, Rodgers A, Murray CJL, editors. Comparative quantification of health Risks Global and regional burden of disease attributable to selected major risk factors. Geneva: World Health Organization (WHO); 2004. p. 959–1108.
  16. Rehm J, Arminger G. Alcohol consumption in Switzerland 1987–93: adjusting for differential effect of assessment techniques on the analysis of trends. Addiction. 1996;91(9):1335–44.
  17. Kuntsche E, Rehm J, Gmel G. Characteristics of binge drinkers in Europe. Soc Sci Med. 2004;59(1):113–27.
  18. Gutjahr E, Gmel G. Defining alcohol-related fatal medical conditions for social-cost studies in Western societies: An update of the epidemiological evidence. J Subst Abuse. 2001;13:239–64.
  19. Gmel G, Kuendig H, Maffli E, Notari L, Wicki M, Georges A, et al. Suchtmonitoring Schweiz / Jahresbericht – Daten 2011. Bern: Bundesamt für Gesundheit (BAG); 2012 [13.12.2012]; Available from:
  20. Gmel G, Gaume J, Faouzi M, Kulling J-P, Daeppen J-B. Who drinks most of the total alcohol in young men – Risky single occasion drinking as normative behaviour. Alcohol Alcohol. 2008;43(6):692–7.
  21. Parker H, Williams L. Intoxicated weekends: Young adults’ work hard-play hard lifestyles, public health and public disorder Drugs Educ Prev Pol. 2003;10(4):345–67.
  22. Van Wersch A, Walker W. Binge-drinking in Britain as a social and cultural phenomenon: The development of a grounded theoretical model. J Health Psychol. 2009;14(1):124–34.
  23. Kuntsche E, Labhart F. Investigating the drinking patterns of young people over the course of the evening at weekends. Drug Alcohol Depend. 2012:319–24.
  24. Gmel G, Heeb J-L, Rezny L, Rehm J, Mohler-Kuo M. Drinking patterns and traffic casualties in Switzerland – Matching survey data and police records to design preventive action. Public Health. 2005;119(5):426–36.
  25. Wells S, Graham K, Purcell J. Policy implications of the widespread practice of “pre-drinking” or “pre-gaming” before going to public drinking establishments: Are current prevention strategies backfiring? Addiction. 2009;104(1):4–9.
  26. Pedersen ER, LaBrie JW. Partying before the party: Examining prepartying behavior among college students. J Am Coll Health. 2007;56(3):237–45.
  27. Labhart F, Graham K, Wells S, Kuntsche E. Drinking before going to licensed premises: An event-level analysis of predrinking, alcohol consumption, and adverse outcomes. Alcohol Clin Exp Res. 2013;37(2):284–91.
  28. Hughes K, Anderson Z, Morleo M, Bellis MA. Alcohol, nightlife and violence: The relative contributions of drinking before and during nights out to negative health and criminal justice outcomes. Addiction. 2008;103(1):60–5.
  29. Kuntsche E, Müller S. Why do young people start drinking? Motives for first-time alcohol consumption and links to risky drinking in early adolescence. Eur Addict Res. 2012;18(1):34–9.
  30. Cooper ML. Motivations for alcohol use among adolescents: development and validation of a four-factor-model. Psychol Assessm. 1994;6(2):117–28.
  31. Kuntsche E, Knibbe RA, Gmel G, Engels RCME. Who drinks and why? A review of socio-demographic, personality, and contextual issues behind the drinking motives in young people. Addict Behav. 2006;31(10):1844–57.
  32. Kuntsche E, Cooper ML. Drinking to have fun and to get drunk: motives as predictors of weekend drinking over and above usual drinking habits. Drug Alcohol Depend. 2010;110(3):259–62.
  33. Kuntsche E, Labhart F. Drinking motives moderate the impact of pre-drinking on a given evening and related adverse consequences – An event-level study. Addiction 2013 (in press).
  34. Treno AJ, Alaniz ML, Gruenewald PJ. The use of drinking places by gender, age and ethnic groups: an analysis of routine drinking activities. Addiction. 2000;95(4):537–51.
  35. Clapp JD, Reed MB, Holmes MR, Lange JE, Voas RB. Drunk in public, drunk in private: the relationship between college students, drinking environments and alcohol consumption. Am J Drug Alcohol Abuse. 2006;32(2):275–85.
  36. Knibbe RA, Oostveen T, van de Goor I. Young people’s alcohol consumption in public drinking places: Reasoned behaviour or related to the situation? British Jounal of Addiction. 1991;86:1425–33.
  37. Rehm J, Taylor B, Room R. Global burden of disease from alcohol, illicit drugs and tobacco. Drug Alcohol Rev. 2006;25(6):503–13.
  38. Gmel G, Kuntsche E, Rehm J. Risky single-occasion drinking: bingeing is not bingeing. Addiction. 2011;106(6):1037–45.
  39. Borkenstein RF, Crowther FR, Shumate RP, Ziel WB, Zylman R. The role of the drinking driver in traffic accidents (The Grand Rapids Study). Blutalkohol. 1974;11( Suppl. 1):1–131.
  40. Hurst PM, Harte D, Frith WJ. The Grand Rapids dip revisited. Accid Anal Prev. 1994;26(5):647–54.
  41. Gmel G, Bissery A, Gammeter R, Givel J-C, Calmes J-M, Yersin B, et al. Alcohol-attributable injuries in admissions to a Swiss emergency room – An analysis of the link between volume of drinking, drinking patterns and preattendance drinking. Alcohol Clin Exp Res. 2006;30(3):501–9.
  42. Usdan SL, Moore CG, Schumacher JE, Talbott LL. Drinking locations prior to impaired driving among college students: implications for prevention. J Am Coll Health. 2005;54(2):69–75.
  43. Graham K, Osgood DW, Wells S, Stockwell T. To what extent is intoxication associated with aggression in bars? A multilevel analysis. J Stud Alcohol Drugs. 2006;67:382–90.
  44. Wagenaar AC, Salois MJ, Komro KA. Effects of beverage alcohol price and tax levels on drinking: a meta-analysis of 1003 estimates from 112 studies. Addiction. 2009;104(2):179–90.
  45. Wicki M, Gmel G. Hospital admission rates for alcoholic intoxication after policy changes in the canton of Geneva, Switzerland. Drug Alcohol Depend. 2011;118(2-3):209–15.
  46. Stockwell T, Gruenewald PJ. Controls on the physical availability of alcohol. In: Heather N, Peters TJ, Stockwell T, editors. The International Handbook of Alcohol Dependence and Problems. Chichester, UK: Wiley; 2004.
  47. Popova S, Giesbrecht N, Bekmuradov D, Patra J. Hours and days of sale and density of alcohol outlets: Impacts on alcohol consumption and damage: A systematic review. Alcohol Alcohol. 2009;44(5):500–16.
  48. Glindemann KE, Ehrhart IJ, Maynard ML, Geller S. Alcohol front-loading among college students: exploring the need for prevention intervention. J Alcohol Drug Educ. 2006;50:5–13.
  49. Graham K, Jelley J, Purcell J. Training bar staff in preventing and managing aggression in licensed premises. J Subst Use. 2005;10(1):48–61.
  50. Homel R, McIlwain G, Carvolth R. Creating safer drinking environments. In: Heather N, Peters TJ, Stockwell T, editors. International Handbook of Alcohol Dependence and Problems – Part VI: Prevention of Alcohol Problems. Chichester: John Wiley & Sons Ltd.; 2001. p. 721–40.

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