title: Drinking motives mediate cultural differences but not gender differences in adolescent alcohol use.
abstract: OBJECTIVE
  To test whether differences in alcohol use between boys and girls and between northern and southern/central Europe are mediated by social, enhancement, coping, and conformity motives.
  
  
  METHODS
  Cross-sectional school-based surveys were conducted among 33,813 alcohol-using 11- to 19-year-olds from northern Europe (Denmark, Estonia, Finland, Ireland, Poland, Scotland, and Wales) and southern/central Europe (Belgium, Hungary, Italy, Portugal, Slovakia, and Switzerland).
  
  
  RESULTS
  Particularly in late adolescence and early adulthood, boys drank more frequently and were more often drunk than girls. Instead of mediation, gender-specific motive paths were found; 14- to 16-year-old girls drank more because of higher levels of coping motives and lower levels of conformity motives, whereas 14- to 19-year-old boys drank more because of higher levels of social and enhancement motives. Geographical analyses confirmed that adolescents from southern/central European countries drank more frequently, but those from northern Europe reported being drunk more often. The strong indirect effects demonstrate that some of the cultural differences in drinking are because of higher levels of social, enhancement, and coping motives in northern than in southern/central Europe.
  
  
  CONCLUSIONS
  The results from the largest drinking motive study conducted to date suggest that gender-specific prevention should take differences in the motivational pathways toward (heavy) drinking into account, that is, positive reinforcement seems to be more important for boys and negative reinforcement for girls. Preventive action targeting social and enhancement motives and taking drinking circumstances into account could contribute to tackling underage drinking in northern Europe.
authors.affiliation: Addiction Switzerland, Research Institute, Lausanne, Switzerland; Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands. Electronic address: EKuntsche@suchtschweiz.ch.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Kuntsche
authors.affiliation: Addiction Switzerland, Research Institute, Lausanne, Switzerland.
authors.forename: Matthias
authors.initials: M
authors.lastname: Wicki
authors.affiliation: Addiction Switzerland, Research Institute, Lausanne, Switzerland.
authors.forename: Béat
authors.initials: B
authors.lastname: Windlin
authors.affiliation: Social Research and Information Division, Welsh Government, Cardiff, United Kingdom.
authors.forename: Chris
authors.initials: C
authors.lastname: Roberts
authors.affiliation: Health Promotion Research Centre, School of Health Sciences, National University of Ireland, Galway, Ireland.
authors.forename: Saoirse Nic
authors.initials: SN
authors.lastname: Gabhainn
authors.affiliation: Child and Adolescent Health Research Unit (CAHRU), School of Medicine, University of St. Andrews, St. Andrews, United Kingdom.
authors.forename: Winfried
authors.initials: W
authors.lastname: van der Sluijs
authors.affiliation: Chronic Disease Department, National Institute for Health Development, Tallinn, Estonia.
authors.forename: Katrin
authors.initials: K
authors.lastname: Aasvee
authors.affiliation: Department of International Health, Lisbon University, Lisbon, Portugal.
authors.forename: Margarida
authors.initials: M
authors.lastname: Gaspar de Matos
authors.affiliation: Health Psychology Unit, Institute of Public Health, Medical Faculty, PJ Safarik University, Kosice, Slovak Republic.
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Dankulincová
authors.affiliation: Department of Public Health, Ghent University, Ghent, Belgium.
authors.forename: Anne
authors.initials: A
authors.lastname: Hublet
authors.affiliation: Department of Health Sciences, Research Centre for Health Promotion, University of Jyväskylä, Jyväskylä, Finland.
authors.forename: Jorma
authors.initials: J
authors.lastname: Tynjälä
authors.affiliation: Department of Health Sciences, Research Centre for Health Promotion, University of Jyväskylä, Jyväskylä, Finland.
authors.forename: Raili
authors.initials: R
authors.lastname: Välimaa
authors.affiliation: National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
authors.forename: Pernille
authors.initials: P
authors.lastname: Bendtsen
authors.affiliation: Department of Developmental and Social Psychology, University of Padova, Padova, Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Vieno
authors.affiliation: Department of Child and Adolescent Health, Institute of Mother and Child, Warsaw, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Mazur
authors.affiliation: Department of Clinical Psychology and Addiction, Institute of Psychology, Eötvös Loránd University, Budapest, Hungary.
authors.forename: Judith
authors.initials: J
authors.lastname: Farkas
authors.affiliation: Department of Clinical Psychology and Addiction, Institute of Psychology, Eötvös Loránd University, Budapest, Hungary.
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Demetrovics
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D000428:Alcohol Drinking / Q000453:epidemiology / Q000208:ethnology*; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D003466:Cultural Characteristics; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D010379:Peer Group; D015995:Prevalence; D018570:Risk Assessment; D012309:Risk-Taking; D012737:Sex Factors; D012919:Social Behavior; D012925:Social Conformity
keywords: Adolescence; Alcohol use; Cross-cultural study; Drinking motives; Europe; Gender; Mediation