title: An exploration of adolescents' decisions to abstain or refrain from alcohol consumption in Australian social settings: a qualitative systematic review.
abstract: BACKGROUND
  A significant number of Australian adolescents consume alcohol, with almost two thirds of them doing so at risky levels. This is continuing to increase despite recent National Health and Medical Research Council (NHMRC) guidelines stipulating that no alcohol is the safest option. Measures initiated to reduce and prevent alcohol consumption by adolescents have limited effectiveness. Consumption of alcohol by Australian adolescents is a national concern because of the deleterious effects of alcohol consumption on adolescents' social, physical and neurological development, as well as other short- and long-term health risks, and the negative impact of alcohol-related violence and injury on the community. Understanding adolescents' decisions to abstain or refrain from alcohol consumption may provide valuable insights to assist in dealing with this significant social and health issue, more particularly about the mechanisms used by adolescents or their ability to make decisions about resisting or abstaining from alcohol consumption when exposed to alcohol in their social setting(s).
  
  
  OBJECTIVE
  The review aimed to synthesize the best available qualitative evidence on the decisions made or mechanisms used by adolescents who abstain or refrain from consuming alcohol in any social setting where alcohol is available.
  
  
  METHODS
  Adolescents aged between 14 and 19 years who reside in Australia.The phenomenon of interest was abstinence from or resistance to alcohol consumption when exposed to alcohol in social situations.This review considered studies that focused on qualitative data, including, but not limited to,designs such as phenomenology, grounded theory, action research and exploratory studies.
  
  
  METHODS
  A three-step search strategy was used. An initial search to identify keywords only was undertaken in Medline and CINAHL. This was followed by an expanded search using all identified keywords and index terms specific to each included database. The reference lists of included papers were then searched for any other relevant studies.
  
  
  METHODS
  No studies met the inclusion criteria sufficiently to progress to critical appraisal.
  
  
  METHODS
  No studies progressed to data extraction.
  
  
  RESULTS
  Data synthesis was not undertaken as no study met the inclusion criteria.
  
  
  RESULTS
  Although a number of studies retrieved indicated they had qualitative elements to their studies, the qualitative data was not reported.
  
  
  CONCLUSIONS
  Although a number of studies met some aspects of the inclusion criteria there was insufficient reporting of the phenomenon of interest. Due to the lack of studies meeting the inclusion criteria, no conclusions can be drawn for clinical practice. A lack of qualitative data on this topic has been identified. Thus there is a great need for qualitative research to understand and know more about what enables an adolescent to abstain or refrain from consumption in order to inform or formulate effective interventions, policies or plans to prevent or reduce the volume of alcohol consumed by Australian adolescents.
authors.affiliation: 1School of Nursing, University of Adelaide, Australia2Centre for Evidence-based Practice South Australia: an Affiliate Center of the Joanna Briggs Institute3Discipline of General Practice, University of Adelaide, Australia.
authors.forename: Sue
authors.initials: S
authors.lastname: Sharrad
authors.forename: Charlotte
authors.initials: C
authors.lastname: de
authors.forename: Paul
authors.initials: P
authors.lastname: Aylward
authors.forename: Rick
authors.initials: R
authors.lastname: Wiechula
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D064829:Alcohol Abstinence / Q000523:psychology*; D000428:Alcohol Drinking / Q000523:psychology*; D001315:Australia; D005260:Female; D006801:Humans; D008297:Male; D036301:Qualitative Research; D012919:Social Behavior; D000066608:Underage Drinking / Q000523:psychology*; D055815:Young Adult