20 million units of alcohol are consumed weekly by 11 to 17 year olds in the UK. Starting to drink at a young age is associated with higher risks of alcohol dependence and other harms as an adult. An alcohol-free childhood is the healthiest option, but parental guidance can help reduce risks if 15 to 17 year olds do drink. Frequent or binge drinking should be avoided, and daily drinking limits for adults should not be exceeded. Parents have significant influence over children's drinking, so they require advice on appropriate monitoring and rule-setting regarding alcohol use. Support services are also needed for young people and parents dealing with alcohol-related problems.

2. Why are we worried? 20 million units of alcohol are consumed in a week by 11 to 17 year olds. That is the equivalent of 9 million pints of beer or 2 million bottles of wine. 500,000 young people aged 11 to 15 years were drunk in the previous four weeks. Starting drinking early is associated with higher trends of alcohol dependence in adulthood and a wider range of other adverse consequences.

3. 1 An alcohol-free childhood is the healthiest and best option

4. Rationale Alcohol consumption during any stage of childhood can have a harmful effect on a child’s development. Alcohol use during the teenage years is related to a wide range of health and social problems, and young people who begin drinking before the age of 15 are more likely to experience problems related to their alcohol use.

5. Evidence suggests: Children who start drinking alcohol at an early age are more likely to develop alcohol problems in adolescence and adulthood. Children who begin drinking at a young age drink more frequently and in greater quantities than those who delay drinking, and are more likely to drink and to get drunk. Beginning to drink before age 14 is associated with increased health risks, including alcohol-related injuries, involvement in violence, and suicidal thoughts and attempts. Significant changes in brain structure accompanying heavy drinking in young people with alcohol use disorders can affect brain functions related to motivation, reasoning and other processes.

6. 2 If young people aged 15 to 17 years consume alcohol, it should always be with the guidance of a parent or carer or in a supervised environment.

7. Rationale Whilst no alcohol consumption is the healthiest option for young people, in England by the age of 15 many children have already consumed alcohol and some drink on a weekly basis. How much alcohol young people drink is related to their ability to access alcohol, and the location in which they drink.

8. Evidence suggests: Parental monitoring, family standards and rules and close family relationships are important in delaying alcohol initiation in early adolescence. Alcohol consumption by young people, including heavy and regular drinking, increases as the amount of spending money young people have available to them increases. Young people may suffer high levels of harm if they begin drinking in parks, streets and other unsupervised settings.

9. 3 If 15 to 17 year olds do consume alcohol, they should do so infrequently and certainly on no more than one day a week. Young people aged 15 to 17 years should never exceed recommended adult daily limits.

10. Rationale Children and young people who drink frequently and binge drink are more likely to suffer alcohol-related consequences. Individuals vary in the way that they react to alcohol, and young people may have a greater vulnerability to certain harmful effects of alcohol than adults.

11. Evidence suggests: Binge drinking and heavy alcohol use in young people is associated with health risk behaviours including injury, sexual activity, fighting and drug use. Young people who binge drink in adolescence are more likely to be binge drinkers as adults and have an increased risk of developing alcohol dependence in young adulthood.

12. 4 The importance of parental influences on children’s alcohol use should be Communicated to parents, carers and professionals. Parents and carers require advice on how to respond to alcohol use and misuse by children.

13. Rationale Parents’ and carers’ own drinking behaviours can influence their children’s alcohol use. Parents can positively influence their children’s alcohol use by maintaining a close relationship with their children, establishing rules concerning alcohol and supervising their children’s drinking.

14. Evidence suggests: Parental use of alcohol increases the likelihood that children will also consume alcohol. Warm and supportive parent–adolescent relationships are associated with lower levels of adolescent alcohol use The use of incentives, setting limits and consequences for behaviour, and negotiating boundaries and rules for appropriate behaviour are associated with less alcohol use Peers play an important role in the onset of drinking behaviours

15. 5 Support services must be available for children and young people who have alcohol-related problems and their parents.

16. Rationale Policy makers and professionals need to ensure that all services are meeting the needs of young people and their parents that relate to alcohol.

17. Evidence suggests: Professionals need to be able to identify, assess and, where necessary, appropriately refer young people experiencing alcohol-related problems. Offering brief, one-to-one advice on the harmful effects of alcohol use, how to reduce the risks and how to find sources of support is an effective approach for tackling harmful drinking CBT and motivational-type brief interventions can be used as interventions, or to facilitate engagement with more structured substance misuse treatment Specialist substance misuse treatment interventions have been shown to be effective in reducing substance misuse among young people.

18. Implications from this advice

19. What parents and carers can do Parental influence on children’s alcohol use is most effective when there is a good parent–child relationship and consistent and appropriate monitoring and behaviour management.

20. Informing young people The Safe. Sensible. Social. Alcohol strategy local implementation toolkit recommends that all young people should receive information and education about the effects of alcohol on young people through schools.

21. Supporting parents and carers The Every Child Matters: Change for Children programme recognises that parents, carers and families are the most important influences on outcomes for children and young people.

22. Support for young people with alcohol-related problems Depending on a young person’s needs, they will be offered services at a universal, targeted or specialist level.

23. This presentation has been developed using the Chief Medical Officers advice which can be downloaded in full at: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_110258