Parents and pediatricians should talk to children as young as nine years old about the dangers of binge drinking, long before they take their first sip, experts say.
The clinical report "Binge Drinking," co-authored by Dr. Lorena Siqueira, in this week's issue of Pediatrics says the topic of alcohol use by children needs to be approached differently, compared to the approach for adults, because of their smaller bodies, lack of experience and the serious consequences of binge drinking that include vehicle collisions and cancer.
"The more young people are exposed to alcohol advertising and marketing, the more likely they are to drink, and if they are already drinking, this exposure leads them to drink more," Siqueira and her team said. "Therefore, it is very important to start talking to children about the dangers of drinking as early as nine years of age."
For youth, the Canadian guidelines suggest drinking should be delayed at least until the late teens and follow local legal drinking age laws. Once a decision to start drinking is made, it should occur in a safe environment, under parental guidance and at low levels — one or two standard drinks once or twice per week.
From legal drinking age — in Canada, it's 18 or 19 depending on the province — to 24 years, it's recommended women never exceed two drinks per day and men never exceed three drinks in one day.
Siqueira's report provides doctors with a summary of the harms and latest research related to alcohol use by young people, and suggests short screening questions every adolescent should be asked.
'I didn't pay all this money to drink my years away.' - Anthony Manella, Ryerson University student
In British Columbia, doctors may bill for the service, but few do so, said Tim Stockwell, director of the Centre for Addictions Research of BC.
Adolescents also tend to visit the doctor less frequently than children, said Dr. Joanna Henderson, a psychologist at the Centre for Addiction and Mental Health's child, youth and family program in Toronto. Schools may provide a better opportunity for youth to access screening services, Henderson suggested in an email.
Henderson called the report in Pediatrics thorough, and applauded its emphasis on the impact of alcohol on neurodevelopment. The adolescent brain is more vulnerable to to alcohol-induced brain damage than the adult brain, the researchers said. Binge drinking may also eventually lead to liver disease, hypertension, heart disease, stroke, and breast and other cancers.
Several of the policy recommendations in the Pedatrics report are in place somewhere across Canada. Mostly they aren't, said Stockwell, who reviews provincial alcohol policies.
"Pricing policy is done moderately well in some parts of Canada. It's the most effective and the most powerful tool, especially for young people," said Stockwell, who is also a psychology professor at the University of Victoria.
"The average price might be quite high, but it's the rock-bottom price where heavier drinkers go, where young people gravitate."
In August, Stockwell published a study in the Canadian Journal of Public Health that suggests rates of high-risk consumption are hugely underestimated. As many as 60 per cent of 18- to 24-year-olds in Canada consistently drink above daily consumption guidelines, he estimated.
"There's a difference between numbers going down and how high they are," he said. "A few years ago, it's like Everest and now it's like K2."
Since alcohol use is such as ubiquitous part of life, it's awkward and unpopular to say anything about it, Stockwell said.
But parents should talk to their children about alternative activities to drinking, encourage moderate alcohol use and even delaying use until young adulthood, he suggested.
Watching alcohol use on campus
Andrea Bartlett, president of Ryerson University students' union in Toronto, wasn't surprised about the underreporting of binge drinking, which she calls "a problem, especially during these first few weeks of school when students are moving out, living on their own for the first time."
Both the university and students' union are committed to ensuring students are well informed about alcohol consumption on campus, she said.
At an orientation event at Ryerson, first-year student Anthony Manella said he'll have a glass of wine here and there. His priority is academics, not the bars.
"I didn't pay all this money to drink my years away."