Adolescent girls’ lived experiences of alcohol access, exposure, and use in high-school settings: a phenomenological study

Early initiation of alcohol use during adolescence is associated with significant mental, social, and physical health risks. In societies where alcohol consumption is legally and culturally prohibited, such as Iran, adolescents’ engagement with drinking often occurs covertly and remains poorly understood. To design effective prevention strategies and improve health literacy among students, it is essential to explore the lived experiences of adolescents within their real sociocultural contexts, including the influence of school policies and peer networks. This study aimed to examine how adolescent girls perceive, access, and interpret alcohol use in high-school settings, and how families and schools respond to it. This qualitative study employed a descriptive phenomenological design to gain in-depth insights into the subjective meanings of alcohol use among adolescents. Fifteen female students aged 16–18 from both public and private high schools in Tehran were selected through non-probability snowball sampling, considering the sensitivity of the topic. Semi-structured interviews were conducted and analyzed thematically following Colaizzi’s seven-step method, using NVivo software for coding and theme development. Thematic analysis revealed three major themes: (1) Alcohol Consumption in School Settings—reflecting hidden and normalized practices of alcohol use through concealment in drink containers and consumption during school trips or in unsupervised areas; (2) Reactions of Parents and Schools—indicating inconsistent moral, emotional, and institutional responses characterized by denial, minimal guidance, and lack of preventive education or school policy enforcement; (3) Knowledge and Awareness—revealing misconceptions about alcohol’s risks and benefits, limited health literacy, and the influence of peers and social media as informal sources of information. The findings highlight how cultural taboos, peer influence, and institutional silence interact to shape adolescents’ covert drinking behaviors. These dynamics reflect not only individual experimentation but also a broader societal avoidance of open dialogue about alcohol. Addressing underage drinking in Iran requires culturally grounded, multi-level interventions involving schools, parents, and community stakeholders. Such programs should integrate accurate health education, parental empowerment, and structured school policies to reduce misinformation and promote healthier adolescent development.