Heavy episodic drinking among French adolescents between 2005 and 2022: a gender perspective.

Background. Heavy episodic drinking (HED) among youth remains a major public health concern as well as a strong predictor of alcohol use disorders at later age. Understanding the mechanisms favouring or hindering HED remains an on-going challenge.

Method. We take advantage of a standardised, nationally representative survey representative of adolescents aged 17 living in France to provide a comprehensive overview of risks and protective factors of past month and repeated HED (3 times or more) between 2005 and 2022, with emphasis on gender differences.

Results. Alcohol consumption is still a male-dominated activity, however sex ratios have consistently narrowed over time. In a context of steady decline in alcohol use among French adolescents over the past two decades, heavy episodic drinking (HED) remains relatively high, concerning one-third of French 17-year-olds in 2022. The reduction in alcohol use is mainly supported by the increase of lifetime abstinence and conceals a diffusion of HED among occasional drinkers (<10 times a month). Whereas the prevalence rates of HED are still higher among males, the probabilities of past month/repeated HED among females are now similar to that of males, or even higher depending on the frequency of use. 

Conclusions. The diffusion of HED among occasional drinkers and the homogenisation of behaviour between genders constitute a strong call in favour of global prevention, rather than aimed at the most frequent or "at-risk" drinkers. Our results also question underage access to alcohol, despite increasing legal restrictions.