Keywords
adolescent
socioeconomic determinants
public health
meta-analysis
How to Cite
Abstract
Introduction
Adolescent alcohol consumption is a major global public health issue due to its detrimental effects on physical, mental, and social health, as well as its association with long-term risk-taking behaviors. However, the determinants of this consumption remain multifactorial and strongly influenced by socioeconomic and cultural contexts.
Purpose
This study aimed to estimate the overall association between socioeconomic and cultural determinants and adolescent alcohol consumption, as well as the associated moderating factors.
Methods
We conducted a systematic review and meta-analysis in accordance with PRISMA guidelines. A comprehensive search was performed across PubMed, Scopus, Web of Science Core Collection, PsycINFO, the Cochrane Library, Cairn, and ScienceDirect. Seventy-four studies (cross-sectional, cohort, and case-control designs) published between 2016 and 2026 were selected, encompassing a total of 139,349 adolescents aged 10–19 years across four continents.
Results
Disadvantaged socioeconomic determinants and high-risk cultural factors were significantly associated with adolescent alcohol consumption (pooled Odds Ratio [OR] = 1.34, 95% Confidence Interval [CI]: [1.29, 1.39], p < .001), representing a 34% increased risk. Substantial heterogeneity was observed (I2 = 93.0%, p < .001). Regional subgroup analyses revealed stronger associations in Africa (OR = 1.70) and low-income countries (OR = 1.68). Associations were also pronounced among male adolescents (OR = 1.44) and for episodic heavy drinking (OR = 1.42). Moderating effects of geographic region, sex, income level, and consumption pattern were statistically significant (p < .001).
Conclusion
Socioeconomic and cultural determinants play a pivotal role in shaping adolescent alcohol use. These findings underscore the urgent need for targeted, context-sensitive public health interventions and structural policies tailored to regional socioeconomic realities.
Protocol registration: PROSPERO (CRD420261393518).
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