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Abstract
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There is a growing literature on the declining trend in adolescent drinking in many countries. With their recent article, Caluzzi and colleagues [1] provide an important contribution to this literature by discussing concepts and processes underlying this trend. One key point in their article is that the process of normalization of non-drinking implies that abstinence comes to be seen as a normal and accepted practice. In addition to this, I will argue that normalization of non-drinking may be regarded as a process in which non-drinkers also become a less deviant group, not only in the statistical sense. The implications for alcohol epidemiology are highly important.
In populations where drinking is the norm and only a small minority are non-drinkers, abstainers tend to deviate from their drinking peers by having poorer social network and/or poorer mental health [2-6]. Whether or not this association reflects causality in one direction or another remains unclear. On one hand, it is suggested that those with small social networks and weak ties are less influenced by the drinking norms of the large majority and therefore less likely to drink [7]. In other words, a poor social network may cause non-drinking, due to lack of someone to drink with and lack of social occasions where drinking occurs. On the other hand, it is also suggested that abstinence may lead to a weaker social network and that the cost of being abstinent could be social isolation [8]. In either case, this association seems to reflect the co-occurrence of socially deviant and low-prevalence phenomena, much in line with the idea of individual clustering of problem behaviours [9].
What about populations where non-drinking is normalized and prevalent, which is currently the case for young people in many high-income countries? Here, we may expect that abstainers do not differ from their moderate-drinking peers with regard to social integration and mental health, simply because co-occurrence of marginal phenomena does not apply. There is some empirical evidence to support this expectation. An association between abstinence and loneliness was observed among adults in three countries where abstinence was low prevalence, whereas no such association was found in another country where abstinence was more common...
Language: en |