Adolescents’ intention to reduce alcohol use: a health belief model approach to cancer prevention

Aims Alcohol consumption is a well-established risk factor for health problems such as cancer; yet, public health campaigns have shown mixed results in their effectiveness to reduce alcohol use. Drawing on the health belief model, this study examines adolescents’ self-reported alcohol consumption and explores drivers and barriers to abstaining from or reducing their alcohol consumption, with the ultimate goal of reducing alcohol-attributable cancers. Method A large-scale, cross-sectional and cross-national online survey was conducted in 2024 among N = 4054 adolescents between 12 and 18 years, chiefly recruited through schools, in eight European countries (Belgium, Cyprus, Greece, Italy, Romania, Slovenia, Spain, and Switzerland). Results Results indicate that 47.5% of adolescents reported never consuming alcohol. Alcohol use increased with age and country differences were observed, while we found no differences in gender. Among the 52.5% participants who reported drinking alcohol, the average intention to reduce consumption was moderate. Adolescents who drank more frequently were less inclined to reduce their alcohol use. Intention to reduce drinking decreased with age. Perceived benefits of alcohol reduction followed by self-efficacy were the strongest predictors of this intention. Conclusions The study’s results provide valuable insights into adolescent alcohol consumption across Europe, leading to the formulation of concrete guidelines for future prevention campaigns regarding target groups (e.g. age, country), messaging, and framing. Specifically, future alcohol prevention campaigns could emphasize long-term health benefits and aim to increase adolescents’ perceptions of self-efficacy to refrain from initiating or to reduce alcohol consumption.