Abstract
Background:
Sipping alcohol during adolescence is a risk factor for later alcohol-related outcomes, but relatively little is known about the context in which sipping occurs. Prior work has primarily examined parental supply of alcohol or sipping as a dichotomous variable without considering the potential heterogeneity in early sipping experiences. Contextual variables related to sipping alcohol may act as important moderators for later risk.
Methods:
This study examined the ecology of sipping alcohol in a community sample of early adolescents (n = 260, mean age = 11.93). Lifetime sipping, contextual variables related to the first sip experience, sipping with/and or without parental permission, and future intentions to use alcohol were examined.
Results:
40% of adolescents in this sample reported ever sipping alcohol and 62.5% of these adolescents reported sipping alcohol with parental permission only. Sipping without permission appeared to primarily involve accidental rather than intentional sipping. Most commonly, sipping occurred at social gatherings in the adolescent’s or someone else’s home, and the alcoholic beverage belonged to a parent, but adolescents reported sipping alcohol in a variety of heterogeneous contexts. Contextual variables generally did not differ across those who sipped with versus without permission, but subsequent sipping behavior did, with adolescents who sipped both with and without permission most likely to be offered or ask for future sips. Consistent with prior work, adolescents who had sipped reported higher future intentions to use alcohol.
Conclusion:
It is important to educate parents about the risks associated with allowing sipping, as they appear to be the primary drivers of early sipping behavior. The prevalence of accidental sipping warrants further research and may indicate the need for supervision of children and adolescents in contexts where alcohol is available.
Introduction
Parental supply of alcohol, even in the form of sipping or tasting alcohol, has been identified as a risk factor for later alcohol-related outcomes, including increased frequency and quantity of alcohol use and alcohol-related problems in young adulthood.1-4 Despite these findings, relatively little is known about the context in which early sipping of alcohol takes place (see Jackson et al 5 and Murphy et al 6 for exceptions). Prior work has primarily examined sipping as a dichotomous variable(e.g.,7,8), or under the broader rubric of alcohol use with parental permission(e.g.,2) or parental supply of alcohol(e.g.,1). Contextual variables surrounding sipping may act as important moderators for later risk. Better understanding the ecology of sipping in early adolescence may provide insight into the different contexts in which adolescents are first directly exposed to alcohol and aid in identifying specific patterns of sipping that may be most risky.
The context of sipping alcohol may be important in shaping attitudes and beliefs about alcohol such as alcohol expectancies or perceived parental approval, which may in turn promote subsequent sipping occasions and even increase motivation to sip/taste alcohol without parental permission/supervision.6,9 Whether adolescents continue to drink the beverage after the first sip, or furtively sip may be indicative of sensation-seeking or differences in physiological reactions to alcohol, both markers of a risk trajectory.10,11 Other contextual factors may be protective. For example, some researchers have suggested that sipping in a religious context may not confer the same risk given the highly structured setting in which such sipping occurs.2,12 Restrictive community norms regarding underage drinking may similarly be protective. For example, laws regarding underage alcohol consumption vary (e.g., some states allow minors to drink alcohol in bars/restaurants when accompanied by a parent and others do not 13 ). The degree to which parents/caregivers use sipping experiences as an opportunity to communicate with adolescents about alcohol use (i.e., use sipping as a teaching moment) is likely also important.
This study aims to characterize the ecology of sipping in a community sample of early adolescents and examine potential differences in contextual variables for those who have sipped alcohol with versus without parental permission. The goal is to inform future research to consider the context of parental supply of alcohol in the form of sipping/tasting to better understand potential risky and protective aspects of sipping contexts.
Methods
Participants and Procedure
Reports of contextual variables surrounding the first occurrence of sipping alcohol were obtained from a community sample of 260 adolescents aged 11 or 12 as part of a larger longitudinal project examining parental communication about alcohol use. Adolescents and 1 parent or caregiver were recruited via flyers, social media, and word of mouth. Inclusion criteria included residence in the county of interest, fluency in English, and no developmental or other disabilities that would preclude the adolescent from completing questionnaires and other study procedures. If more than 1 child in a household was within the target age range, only 1 child was able to participate.
Data for the current study was taken from the baseline visit (follow-up data collection is ongoing). Caregivers and adolescents completed study procedures in-person at university research offices for the baseline visit. Caregivers and adolescents provided consent and assent respectively, then were taken to separate rooms and completed questionnaires on computers. Assent and consent procedures explicitly stated that we would not share any of the adolescent’s answers with the parent. Adolescents were read all questions by research assistants to ensure comprehension but selected answers independently. Families were compensated $120 for their participation. All study procedures were approved by the university IRB.
The mean age of adolescents was 11.93 years (SD = 0.56), 49.62% identified as male, 59.23% were White, and 9.62% were Hispanic or Latino. Additional demographic information for adolescents and the participating caregiver is provided in Table 1 for the full sample, as well as by sipping groups. We also include behavior problem scores from the Strengths and Difficulties Questionnaire (SDQ) to further characterize the sample. Borderline clinical range (95th percentile) for clinical problems corresponds to scores of 6 or greater for emotional problems, 5 or greater for conduct problems, and 8 or greater for hyperactivity/inattention. As shown in Table 1, mean scores across groups fell well below these cutoffs, as would be expected in a normative sample.
Sample Demographics and Characteristics.
Measures
Sipping Prevalence and Contextual Variables
The iSay Sip Inventory was used to assess sipping. 5 Adolescents were asked if they had ever sipped/tasted alcohol and if they responded yes, they were asked additional questions about the first occasion where they sipped/tasted alcohol, including age, type of alcoholic beverage, whether they continued to drink the beverage after the first sip, whether the beverage belonged to someone of legal drinking age, whose beverage it was, how the beverage was obtained, where the sipping took place, whether they remembered the occurrence, and whether they had been offered, asked for, or intentionally took sips of parents’ or other adults’ beverages following this first sip.
Sipping With and Without Permission
Following questions about the first occasion of sipping, adolescents were asked to report the number of times in their life that they had sipped alcohol with parental permission and the number of times in their life that they had sipped alcohol without parental permission. Responses to these questions were dichotomized (yes/no) and were used to create 3 subgroups of adolescents: those who had sipped only with parental permission, those who had sipped only without parental permission, and those who had sipped both with and without parental permission.
Intentions to Use Alcohol
To assess future intentions to use alcohol without parental permission, adolescents were asked whether they think they will drink alcohol without their parent’s permission in the next year and whether they think they will drink alcohol without their parent’s permission 5 years from now using a 1 to 5 scale (1 = Definitely will not, 5 = Definitely will). 14
Demographics
Adolescents self-reported on their current gender identity. All other demographic characteristics (adolescent age, caregiver gender, adolescent race and ethnicity, caregiver education, annual household income, receipt of public assistance) were reported by the participating caregiver.
Behavioral Problems
Caregivers reported on their adolescent’s behavioral problems using the Strengths and Difficulties Questionnaire (SDQ) 15 using a scale of 0 (Not true) to 2 (Certainly true). Scale scores were calculated for emotion, conduct, and hyperactivity/impulsivity problems (5 items per scale).
Data Analysis
Frequencies and means of contextual variables were examined and differences between sipping subgroups in the context of their first sip, instances of subsequent sipping, and future intentions to use alcohol were tested using t-tests, ANOVA, and χ2 analysis. All analyses were conducted using SAS statistical software (version 9.4).
Results
A large group of adolescents (n = 104, 40%) reported having ever sipped/tasted alcohol, which is a similar prevalence as reported in prior work.2,8 Of these adolescents, 65 (62.5%) reported sipping alcohol with parental permission only, 18 (17.31%) reported sipping alcohol without parental permission only, and 7 (6.73%) reported sipping alcohol both with and without permission. A small number of adolescents (n = 14) reported having sipped alcohol (i.e., responded yes to the question “have you ever sipped/tasted alcohol”) but responded 0 times to the frequency of sipping questions. This may have occurred due to adolescents’ sipping/tasting by accident and hence they may not have viewed the behavior as occurring with or without permission. Indeed, sipping by accident was common among first sipping experiences (see below).
Responses to questions about the context of sipping are presented for all those who endorsed sipping as well as the 3 subgroups (with and without permission, and both with and without permission) to examine potential group differences (Table 2). Those who reported lifetime sipping but then reported sipping with and without permission 0 times are included only in the total sipping group. Of note, these sipping subgroups were constructed based on lifetime sipping with or without permission, although some context questions assessed only the first instance of sipping.
Contextual Sipping Variables.
Groups are based on reported lifetime frequency of sipping with or without parental permission. Participants were asked how many times they had ever sipped/tasted alcohol with parental permission and how many times they had ever sipped/tasted alcohol without parental permission. The iSay Sip inventory does not distinguish whether first sip occurred with or without parental permission. Participants were given the option to select “Prefer not to answer” for all questions, but it is only included as a response option in the table when at least 1 participant selected it for that question.
First Sipping Experience
As can be seen in Table 2, although sipping most occurred when adolescents were offered alcohol (48.08%, n = 50), a substantial proportion of adolescents reported that their first sip of alcohol occurred accidentally (37.50%, n = 39). Adolescents who reported sipping only without parental permission almost universally endorsed sipping accidentally, indicating that this group may be more representative of accidental sipping than intentional sipping without permission. Intentionally taking the alcoholic beverage was rare (5.77%, n = 6).
First sip was most common at age 10 or later (54.81%, n = 57). Accordingly, most adolescents (80.77%, n = 84) remembered when their first sip occurred (vs were told about it later). The most common types of alcoholic beverages sipped were wine/champagne (38.46%, n = 40) or beer (29.81%, n = 31). Very few adolescents (1.92%, n = 2) reported continuing to drink the beverage after the first sip. The alcoholic beverage almost always belonged to someone of legal drinking age (93.27%, n = 97) and typically belonged to a parent (mother: 43.27%, n = 45; father: 21.15%, n = 22). The greater proportion of adolescents reporting that it was their mother’s drink may be due in part to a higher proportion of single mother versus single father families in the sample, with 27.88% (n = 29) of adolescents who sipped alcohol belonging to single parent families. Sipping most frequently occurred at a formal or informal social gathering (46.15%, n = 48), either at the adolescent’s or someone else’s home. The next most common location was at a home under other circumstances (26.92%, n = 28). Other locations, including sipping in a religious context (5.77%, n = 6), were infrequent.
Sipping groups were compared on contextual variables and results for these comparisons are provided in Table 3. Sipping groups differed on the age at first sip (F2, 88 = 6.61, P = .002, η2 = .13) with those who sipped without permission only reporting a lower age at first sip than those who sipped only with permission or both with and without permission. Sipping groups did not differ on the type of beverage (χ2(2) = 5.75, P = .06, Cramer’s V = 0.26), whose beverage it was (χ2(4) = 1.84, P = .77, Cramer’s V = 0.10), or the location of the sipping (χ2(6) = 2.34, P = .89, Cramer’s V = 0.11).
Sipping Group Comparisons.
Some percentages do not add up to 100 as adolescents selected “prefer not to answer.” For type of beverage, liquor includes shots of distilled spirits/drinking out of the bottle, mixed drinks; non-liquor includes beer, wine cooler/beer substitute, wine/champagne. For location, social gathering includes at a party/social gathering at my house/someone else’s home; special events/religious ceremonies includes at a special occasion, at a religious ceremony.
P < .05; **P < .01.
Subsequent Sipping Experiences
Relatively few adolescents reported being offered sips or asking for sips of alcoholic beverages following the first occurrence of sipping. Following the first sip, most adolescents reported that their parents had not offered them sips of their beverage (73.08%, n = 76) and they had not asked their parents for a sip of their beverage (81.73%, n = 85). Even fewer adolescents reported being offered or asking for sips from other adults. Intentionally sipping alcohol without parents knowing was almost nonexistent (0.96%, n = 1).
Later offers of sips differed significantly across groups (χ2(2) = 13.68, P = .001, Cramer’s V = 0.40; see Table 3). Adolescents who reported sipping without permission only did not report being offered future sips and adolescents who sipped both with and without permission were more likely to report later offers than those who sipped with permission only. The same pattern emerged for asking for subsequent sips (χ2(2) = 9.40, P = .009, Cramer’s V = 0.33) with those who sipped without permission least likely to report asking for sips, followed by those who sipped with permission only and those who sipped both with and without permission being most likely to ask for sips.
Of adolescents who sipped alcohol with permission, the greatest proportion reported 1 or 2 instances of sipping (65.28%, n = 47) and relatively few adolescents reported sipping with permission more than 3 times (13.89%, n = 10). Similarly, adolescents who sipped alcohol without permission primarily had done so one time (72.00%, n = 18) with no adolescents reporting more than 3 occasions of sipping without permission.
Intentions
In terms of intentions to use alcohol without parental permission in the future, adolescents who had sipped reported higher intentions to use in the next year (M = 1.34, SD = 0.68) than those who had never sipped alcohol (M = 1.11, SD = 0.49; t249 = 3.05, P = .003, Cohen’s d = 0.38). Adolescents who had sipped also reported higher intentions to use alcohol in 5 years (M = 2.22, SD = 1.07) than those who had never sipped (M = 1.46, SD = 0.83; t250 = 6.37, P < .001, Cohen’s d = 0.80).
Sipping groups did not differ on intentions to use in the next year (F2, 88 = 1.67, P = .19, η2 = .04), but they did differ on intentions to use in 5 years (F2, 88 = 3.54, P = .03, η2 = .08). Adolescents who reported sipping alcohol both with and without parental permission were more likely to endorse plans to use alcohol in the next 5 years than adolescents who sipped only with permission or those who sipped only without permission (see Table 3 for means).
Intentions were also compared for those who first sipped accidentally compared to those who first sipped because the beverage was offered to them. Intentions did not significantly differ across these groups for next year use (t86 = 1.80, P = .08, Cohen’s d = 0.39) or for use in 5 years (t87 = 1.80, P = .08, Cohen’s d = 0.38). Although these comparisons did not meet conventional criteria for statistical significance, the effect sizes suggest a potentially meaningful trend. With caution, we offer that the mean trends suggested lower intentions for those who sipped accidentally (see Table 3 for means).
To further interrogate predictors of intentions to drink in the next 5 years, we regressed intentions on sipping location (at a social gathering vs other) and whose beverage it was (mother/father/other guardian vs someone else), controlling for demographic variables (parent education, income, race) and prior use of alcohol without parental permission. Five-year drinking intentions were selected for this analysis due to greater variability in response compared to 1-year drinking intentions. Results of this regression are presented in Table 4. Location of sipping, whose beverage it was, and demographic variables were not associated with 5-year intentions. Prior use without permission was positively associated with 5-year intentions, but this association did not meet conventional cutoffs for statistical significance.
Regression Coefficients Predicting 5-Year Drinking Intentions.
Model R2 = .08. Race was dichotomized as non-Hispanic White versus other race. Sipping location was dichotomized as social gathering versus other location. Whose beverage was dichotomized as mother/father/other guardian versus someone else.
Discussion
Conclusions
Although the majority of this 11 to 12-year-old sample of adolescents reported having never sipped/tasted alcohol, a substantial proportion (40%, n = 104) reported having sipped/tasted alcohol in their lifetime. The first instance of sipping alcohol occurred most commonly in the home environment with alcohol belonging to a parent. Non-accidental first sips are primarily a function of parents or other adults offering alcohol. Very few instances of first sipping were driven by an adolescent requesting to try alcohol or intentionally sipping. That parents and adults are the primary drivers of first sips suggests the importance of informing parents and other caregivers about the risks associated with allowing their children to sip alcohol. Also notable in our findings is that accidental/unintentional sipping of alcohol was surprisingly prevalent, indicating a need to better track and limit access to alcohol and provide careful supervision of children and adolescents in contexts where alcohol is available.
Contextual variables surrounding the first instance of sipping generally did not differ across sipping subgroups, and there were no significant differences found in terms of type of beverage, whose beverage it was, or the location of the sipping. However, adolescents who had sipped only without permission reported a younger age at first sip. As this group primarily represent accidental sipping, it appears that this accidental sipping is happening at various ages, likely because it occurs at random, while sipping with permission occurred most often at older ages, with parents being more likely to offer alcohol to older children.
Subsequent sipping behavior did differ across subgroups, with those who sipped both with and without permission being most likely to be offered future sips and to ask for future sips. Additionally, those who sipped both with and without permission reported having the highest intentions to use alcohol in 5 years, indicating that this may be a particularly at-risk group. Adolescents in this group may represent those who have progressed along a risk pathway from use with permission to use without permission and may therefore be more likely to continue to use alcohol without permission, including in greater quantities, in the future. Early sipping may shape perceived norms, such as perceived parental approval, and expectancies about alcohol. This may be particularly relevant for adolescents in this group given their multiple sipping experiences. However, given the small group size, these results should be interpreted with caution.
Consistent with prior work, adolescents who had sipped alcohol reported higher intentions to use alcohol in the next year and in the next 5 years than those who had never sipped. The mechanisms through which sipping confers risk for later alcohol-related outcomes are not well understood, although some work has indicated that changes in alcohol expectancies may partially mediate this association. 9 Perceptions of parental approval may also be an important pathway through which sipping confers risk, particularly given that sipping was most commonly initiated by parents. This may signal to adolescents that their parents approve of underage alcohol consumption and may lead to increased likelihood of future unsupervised use.
Limitations and Future Directions
There are several limitations to this study that should be acknowledged. As noted, it is unclear what adolescents’ interpretation of sipping without permission entails. An obvious interpretation is that this entails volitional sipping without permission, however our data suggests that sipping without permission primarily encompassed accidental sipping in this sample. Some adolescents may not have construed accidental sipping as sipping without permission. This is an important distinction to make explicit in future work given the high prevalence of accidental sipping. Future work would additionally benefit from further exploration of accidental sipping and the specific circumstances in which it occurs.
Although the iSay Sip Inventory provides detailed contextual information, the focus of the measure is on the first instance of sipping, which limits our understanding of subsequent sipping behavior. For adolescents who sip alcohol multiple times, it is unclear how consistent the context of sipping is, and this could have important implications for later risk. For example, it is possible that sipping across multiple contexts could be riskier than sipping that occurs consistently in one specific context. More work is needed to understand contextual variables beyond the first sipping experience.
There may also be concerns related to accurate recall of events, as adolescents reported retrospectively on the first occurrence of sipping. This may be particularly important for those who reported that they did not remember the occurrence and had been told about it later, as well as those who reported sipping at early ages. Although most adolescents reported that they remembered their first sip, 19.23% (n = 20) did not, indicating that they were told about it at a later time and were reporting on this second-hand information. Other limitations associated with self-report measures, such as underreporting of certain behaviors due to social desirability, should also be considered when interpreting these results.
An important direction for future work is to consider the ecology of sipping in other cultural contexts. As this data was collected from a northeastern North American sample and the measure used was developed by North American researchers, it is unclear how translatable these findings may be cross-culturally. Allowing adolescents to sip alcohol is common in many European and other non-North American countries, and it is possible that there are important differences in the prevalence of sipping, the contexts in which it occurs, and its associations with later alcohol-related outcomes. Laws regarding consumption of alcohol by minors also vary across countries (e.g., Germany allows legal consumption of alcohol with parental permission beginning at age 14; several European countries allow legal purchase and/or consumption of alcohol at age 16). Less restrictive cultural contexts may have implications for the role of early sipping. Research conducted in Australia has found similar prevalences of sipping and risk effects of parental supply of alcohol, including sips,1,16 indicating that there may be some cross-cultural similarities. Additional research looking at sipping in other non-North American countries will be important for determining the generalizability of existing findings.
It is also important to note that there is considerable cultural diversity in the United States. Although our sample was broadly representative of the county in which data was collected, apart from a higher average level of education and a higher proportion of Black/African American families due to oversampling, there are likely regional differences across different populations within the United States and other North American countries. Within the present sample, use of alcohol by adults was generally accepted, with only 6.80% (n = 17) of caregivers reporting that alcohol use is not ok regardless of age, and 11.07% (n = 28) reporting that alcohol use is never allowed in their home. Other populations may have different cultural norms regarding the acceptability of sipping and alcohol use more broadly for a variety of reasons, including regional differences in norms, differing levels of religiosity, and prevalence of immigrant families who may have retained cultural practices from their native countries. It would be informative for future research to collect more exhaustive demographic data that may be relevant to attitudes and practices surrounding alcohol, such as immigrant status and acculturation or religious affiliation and participation. Other characteristics of caregivers and adolescents may also be relevant to sipping, such as parental drinking/drug use, attitudes about alcohol, and presence of psychopathology.
No sample size/power analysis was conducted for this study and, considering the small cell sizes for some sipping subgroups (i.e., sipping both with and without permission), a larger sample size would likely be helpful to further examine differences in contextual variables across such groups. Given the low rates of endorsement for behaviors that may indicate problematic sipping (i.e., continuing to drink the beverage after the first sip, asking for subsequent sips of beverages, intentionally sipping without permission) in this early adolescent sample, associations between such variables and intentions were not examined. However, even with the relative rarity of such behaviors, any sipping was associated with increased intentions to use alcohol without permission in the next year and in 5 years. This indicates that sipping may be risky regardless of the frequency or the contexts in which it occurs.
It would be beneficial to examine associations between potentially problematic sipping behaviors at older ages, as prior work suggests that sipping increases in the early adolescent years. 17 Additionally, it will be important to consider such variables when examining risk for later alcohol-related outcomes. The prevalence of accidental sipping of alcohol is of particular note and indicates a need for increased parental awareness of the accessibility of alcohol.
Supplemental Material
sj-docx-1-sat-10.1177_29768357261423808 – Supplemental material for Ecology of Sipping Alcohol in Early Adolescence
Supplemental material, sj-docx-1-sat-10.1177_29768357261423808 for Ecology of Sipping Alcohol in Early Adolescence by Samuel A. Levy, Craig R. Colder and Christopher J. Hopwood in Substance Abuse: Research and Treatment
Footnotes
Ethical Considerations
All study procedures were approved by the University at Buffalo IRB (STUDY00007348).
Consent to Participate
Written parent/guardian consent and child assent were obtained from all participants included in the study.
Author Contributions
Funding
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by a grant from the National Institute on Alcohol Abuse and Alcoholism (NIAAA; R01AA030988). NIAAA had no role in the study design, collection, analysis or interpretation of data, writing the manuscript, or the decision to submit the paper for publication.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Data Availability Statement
The data that support the findings of this study are openly available through the NIAAA NDA, project number C4884.
Supplemental Material
Supplemental material for this article is available online.
References
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