title: Use of fake identification to purchase alcohol amongst 15-16 year olds: a cross-sectional survey examining alcohol access, consumption and harm.
abstract: BACKGROUND
  Despite legislation and enforcement activities to prevent underage access to alcohol, underage individuals continue to be able to access alcohol and to do so at levels which put them at significant risk of alcohol-related harm.
  
  
  METHODS
  An opportunistic survey of 15-16 year olds (n = 9,833) across North West England was used to examine alcohol consumption, methods of access and related harms experienced (such as regretted sex). Associations between these were analysed using chi square and logistic regression techniques.
  
  
  RESULTS
  Over a quarter (28.3%) of 15-16 year old participants who drank reported having bought their own alcohol. One seventh (14.9%) of these owned at least one form of fake identification for which by far the most common purchase method was online. Logistic regression analyses showed that those who owned fake identification were significantly more likely to be male (AOR = 2.0; 95% CI = 1.7-2.5; P < 0.001) and to receive a higher personal weekly income (comparing those who received > pound30 with those who received < or = pound10: AOR = 3.7; 95% CI = 2.9-4.9; P < 0.001). After taking into account differences in demographic characteristics and personal weekly income, ownership of fake identification was significantly associated with binge drinking (AOR = 3.5, 95% CI = 2.8-4.3; P < 0.001), frequent drinking (AOR = 3.0, 95% CI = 2.5-3.7; P < 0.001) and public drinking (AOR = 3.3, 95% CI = 2.5-4.1; P < 0.001) compared with those who did not own fake identification. Further, those who reported owning fake identification were significantly more likely to report experiencing a variety of alcohol-related harms such as regretted sex after drinking (chi square, all P < 0.001).
  
  
  CONCLUSIONS
  Young people (aged 15-16 years) who have access to fake identification are at a particularly high risk of reporting hazardous alcohol consumption patterns and related harm. Owning fake identification should be considered a risk factor for involvement in risky drinking behaviours. Information on these hazards should be made available to schools and professionals in health, social and judicial services, along with advice on how to best to work with those involved.
authors.affiliation: Centre for Public Health, Liverpool John Moores University, Fifth Floor, Kingsway House, Hatton Garden, Liverpool L3 2AJ, UK. m.j.morleo@ljmu.ac.uk
authors.forename: Michela
authors.initials: M
authors.lastname: Morleo
authors.forename: Penny A
authors.initials: PA
authors.lastname: Cook
authors.forename: Mark A
authors.initials: MA
authors.lastname: Bellis
authors.forename: Linda
authors.initials: L
authors.lastname: Smallthwaite
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000367:Age Factors; D000428:Alcohol Drinking / Q000191:economics / Q000453:epidemiology / Q000331:legislation & jurisprudence*; D000437:Alcoholism / Q000517:prevention & control; D003430:Cross-Sectional Studies; D008192:Deception; D004739:England; D005260:Female; D006801:Humans; D008297:Male; D012309:Risk-Taking; D012737:Sex Factors