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Is Drinking Contagious? An Analysis of the Collectivity of Drinking Behavior Theory Within a Multilevel Framework

Aims
To analyze the effect of behavioral contagion regarding problematic adolescent alcohol use among countries with varying prevalence of problematic drinking.


Methods
Nested data from 48,215 12 to 16-year olds from seventh to ninth grade of 25 European countries (48.5% male, M = 13.83 years) were studied using hierarchical general linear modeling sequences. Finally, an intercept-as-outcome model was built to test the main hypothesis.


Results
Multilevel analyses validated the significant effects of the individual risk factors of being older (OR = 2.02), being male (OR = 1.41) and being native born (OR = 1.32) on becoming a problematic alcohol user. Regarding the aggregated country-level predictor 'proportion of problematic alcohol users', the effect of behavioral contagion was also confirmed (OR = 1.05).


Conclusions
The contagion effect regarding alcohol use behavior calls for a focus on environmental prevention efforts. By decreasing the public acceptance of (adolescent) alcohol use, the average proportion of problematic adolescent alcohol users in European countries may be reduced.