Peer Pressure and Alcohol: a Difficult Combination for Many Teens

However, teens can also experience feelings of doubt and may lack self-esteem. For these reasons, they are particularly susceptible to peer pressure: an overwhelming desire to fit in and do "what everyone else is doing," even if it means participating in such high-risk activities as drinking, smoking and sex.

It's all part of a teenager's efforts to try to separate from his or her parents and establish a personal identity.

To help teens and their families cope with peer pressure, The Health Alliance on Alcohol (HAA), a national education initiative established to address the issues of underage consumption of alcohol that includes members Heineken USA, New York Presbyterian Healthcare System and White Plains Hospital Center, has developed a booklet entitled "Facts & Conversations: Peer Pressure."

Written by adolescent health experts at Columbia University Medical Center and The Morgan Stanley Children's Hospital of NewYork-Presbyterian, "Facts & Conversations: Peer Pressure" answers some common questions:

1. What exactly is peer pressure?

"Peer pressure" is a term used to describe how an adolescent's behavior is influenced by other adolescents. While most parents think of peer pressure as negative, not all peer pressure is bad. Teens may be influenced by their peers to study, to compete in athletics or to attend a religious function. However, when fellow teens are drinking or engaging in other risky activities, peer pressure can lead to problems.

2. Are there different types of peer pressure?

Peer pressure can be divided into active and passive peer pressure, and studies have shown that both strongly influence teen drinking.

Active pressure may be in the form of an explicit offer to drink alcohol or a verbal criticism for refusing to drink. Other forms of direct pressure include invitations to participate in drinking games or ordering of rounds of drinks while at a bar.

Passive pressure is based on a teen's desire to fit in and adopt the values and practices of fellow teens. Passive social pressures can be further divided into social modeling of alcohol use ("everyone's doing it") and perceptions regarding peers' alcohol use. Although many teens do drink alcohol to an alarming degree, teens invariably overestimate the rates at which their friends drink. This false sense that all teens drink can lead teens to feel that they have to drink to fit in. By eighth grade, nearly half of all adolescents report having had at least one drink and one in five report having been "drunk."

3. Are all teens affected by peer pressure the same way?

No. An adolescent with a healthy self-esteem and strong sense of self will be better able to resist both active and passive pressures to drink. In contrast, teens who are depressed or insecure are more likely to succumb to peer pressure. Fortunately, parents can help their teenage children resist the pressures to drink. By staying involved, parents can lessen the impact of peer pressure.

4. Does peer pressure change as teens get older?

Yes. While rates of adolescent emotional development vary and transitions are not necessarily smooth, the role of peers and peer pressure changes as teens progress through early, middle and late adolescence.

5. Is peer pressure the only factor leading to underage drinking?

No. Other important influences on teen drinking include relationships with parents, parental drinking, sibling drinking, participation in religious activities and the media.

"Underage drinking is often influenced by peer pressure," said Karen Soren, HAA expert/M.D., Associate Clinical Professor of Pediatrics and Public Health at Columbia University College of Physicians and Surgeons. "By knowing the facts, you can better prepare yourself to address peer pressure in conversations with your teen. Remember, these conversations need to be ongoing, and topics will often need to be revisited as the teen matures both physically and psychologically."

By: Adam Johnes