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Prevalence and associated factors of alcohol consumption in Albanian schoolchildren

BMC Public Health volume 25, Article number: 1510 (2025) Cite this article

Abstract

Background

Alcohol consumption among adolescents is a global public health challenge, with many children engaging in early drinking habits, affecting negatively growth and development. We aimed at assessing the prevalence and sociodemographic correlates of alcohol consumption among Albanian children.

Methods

A cross-sectional study was conducted in Albania in 2022, including a nationwide sample of 5454 schoolchildren aged 11, 13 and 15 years (N = 5454; ≈52% girls; response rate: 96%). Information on drinking habits and sociodemographic characteristics of schoolchildren was collected. Binary logistic regression was employed to assess the relationships of alcohol consumption indices with sociodemographic factors.

Results

The prevalence of alcohol indices was: 23% for lifetime alcohol consumption; 14% for current alcohol consumption; 13% for lifetime drunkenness; and 6% for current drunkenness. Independent positive correlates of alcohol consumption and/or drunkenness included male gender, age 15, and pertinence to more affluent families (all P < 0.01).

Conclusions

Our findings reveal that alcohol consumption and drunkenness are prevalent among Albanian adolescents. These results highlight the need for targeted prevention strategies addressing demographic factors that contribute to underage drinking in Albania.

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Introduction

According to the World Health Organization (WHO), alcohol consumption is an important risk factor for poor health and is responsible for a significant proportion of mortality and morbidity, along with social harm [1,2,3,4]. In 2019, alcohol consumption resulted in an estimated 2.6 million deaths (4.7% of all deaths) and 115.9 million disability-adjusted life years (DALYs) which constituted 4.6% of all DALYs, mainly due to noncommunicable diseases (NCDs), injuries and mental health conditions [1,2,3]. Furthermore, convincingly, the harmful consumption of alcohol hinders progress towards numerous sustainable development goals (SDGs), including also the goal of reducing or eliminating all forms of violence against children (SDG 16.2) [1, 5, 6].

The prevalence of alcohol consumption and the quantity (levels) of intake are higher among males than females in all WHO regions [1, 3]. These well-documented gender differences are also mirrored in the estimates of the disease burden due to alcohol consumption [1, 3].

In addition, according to WHO, substance use among adolescents, including alcohol consumption, continues to constitute an important public health problem, affecting negatively health statis, wellbeing, and life prospects of the children [7]. Consequences of substance use among children include an array of negative psychological and physical health outcomes, poor academic performance, violence and injury, accidents, and harmful effects on cognitive, emotional, and social development [7, 8]. Also, substance use, especially alcohol consumption, is frequently associated with other unhealthy behaviours, leading to multiple risky behaviours among adolescents [9,10,11].

Recent evidence from the Western Balkan countries indicates a relatively high prevalence of lifetime alcohol consumption among 15-year-old children (in Albania: 45% in boys vs. 36% in girls; in North Macedonia: 48% in boys vs. 50% in girls; in Serbia: 67% in boys vs. 64% in girls) [7]. Furthermore, the current prevalence of alcohol consumption (at least one drink in the last 30 days preceding the survey) among adolescents aged 15 years in the Western Balkan countries is seemingly high (in Albania: 29% in boys vs. 21% in girls; in North Macedonia: 34% in boys vs. 35% in girls; in Serbia: 50% in boys vs. 46% in girls) [7]. Additionally, worryingly, 14% of boys and 8% of girls aged 15 years in Albania had experienced drunkenness in the last 30 days preceding the survey [7]. For the North Macedonia these estimates are 13% and 10%, respectively [7].

Regarding the trends over the period 2014–2022, there is evidence of a slight decrease in the prevalence of current alcohol consumption in Albania and the North Macedonia among 15-year-old boys, but a slight increase in girls [7]. Conversely, in Serbia, there is a decrease in both 15-year-old genders, but an increase among younger girls (aged 11–13 years) [7].

However, current research on adolescent alcohol consumption exhibits several inconsistencies and limitations, including variations in self-reported data accuracy, differences in measurement methods across studies, and a lack of longitudinal data to assess long-term impacts [1]. Many studies rely on cross-sectional designs, limiting causal inferences, while others fail to account for cultural, socioeconomic, and policy-related factors that influence drinking behaviours [1]. Additionally, research often focuses on high-income countries, leaving significant gaps in understanding patterns in low- and middle-income settings including Albania and other countries in the Western Balkans.

The Health Behaviour in School-aged Children (HBSC) study is a large school-based survey carried out every four years in many countries worldwide in the past four decades [12,13,14]. The HBSC survey gathers useful data on health status and health behavioural characteristics among children aged 11, 13 and 15 years [12,13,14]. The last round of HBSC survey was conducted in 2021–2022 in 44 countries including Albania [12, 13], a post-communist country in Southeastern Europe. Among other aspects, the survey covered a set of questions assessing alcohol consumption among study participants [14]. The HBSC survey incorporates standardized and validated measures including alcohol indices across many countries (including understudied populations of the Western Balkan region) enhancing data reliability and comparability [14]. Investigation of adolescent alcohol consumption is crucial for informing targeted prevention and policy strategies tailored to the complexities of modern adolescent drinking behaviours.

The available evidence indicates a growing problem regarding alcohol use among Albanian teenagers [15]. Additionally, lifetime alcohol consumption has been reported as an independent positive correlate of lifetime physical abuse among Albanian schoolchildren aged 15 years [15].

In this framework, we aimed at assessing the prevalence and the associated sociodemographic factors of alcohol consumption among children in Albania, based on the information available from the last wave of HBSC survey conducted in 2022. This study conducted in Albania expands research beyond high-income countries, capturing cultural and socioeconomic variations that influence adolescent drinking behaviours, providing eventually essential, policy-relevant knowledge to guide effective interventions. Based on the findings of the previous rounds of HBSC survey, we hypothesized a higher prevalence of alcohol consumption among boys, older children, and those pertinent to more affluent families.

Materials and methods

This was a cross-sectional study carried out in the framework of the last round of HBSC survey in Albania, which took place in 2022, consisting of an internationally standardised instrument [14], already validated in Albania since 2009–2010 [15].

The targeted study sample was drawn according to the HBSC international protocol [14] consisting of a nationwide representative sample of 5700 schoolchildren aged 11, 13 and 15 years (stratified multistage cluster sampling with probability proportional to size [PPS]). Stratification was based on prefectures (regions) of Albania, ensuring a fair representativeness of the sample at a national level. Of 5700 schoolchildren targeted for inclusion, 246 children refused participation or provided considerably partial data. Therefore, the final study sample consisted of 5454 schoolchildren aged 11, 13 and 15 years (2844 girls, or about 52% of the overall sample), with an overall response rate of about 96%.

A self-administered and structured questionnaire included, among other aspects, measurement of alcohol consumption and sociodemographic data of schoolchildren. Measurement of alcohol indices included assessment of the frequency of alcohol consumption (lifetime and in the last 30 days preceding the survey) and assessment of drunkenness (also, lifetime and in the last 30 days preceding the survey) [14]:

  • Lifetime alcohol consumption: schoolchildren were asked how many days (if any) they had consumed alcohol in their lifetime. Potential responses were as follows: never, 1–2 days, 3–5 days, 6–9 days, 10–19 days, 20–29 days, and ≥ 30 days. In the analysis, lifetime alcohol consumption was dichotomized into: “No” (never) vs. “Yes” (≥ 1–2 days/lifetime).

  • Alcohol consumption in the last 30 days preceding the survey: schoolchildren were asked how many days (if any) they had consumed alcohol in the last 30 days preceding the survey. Potential responses were as follows: never, 1–2 days, 3–5 days, 6–9 days, 10–19 days, 20–29 days, and ≥ 30 days. In the analysis, this variable was dichotomized into: “No” (never) vs. “Yes” (≥ 1–2 days/last 30 days) and is referred to as “current alcohol consumption”.

  • Lifetime drunkenness: schoolchildren were asked how many times (if any) they had consumed so much alcohol that they had been really drunk in their lifetime. Potential responses were: never, once, 2–3 times, 4–10 times, and > 10 times. In the analysis, lifetime drunkenness was dichotomized into: “No” (never) vs. “Yes” (≥ once/lifetime).

  • Drunkenness in the last 30 days preceding the survey: schoolchildren were asked how many times (if any) they had consumed so much alcohol that they had been really drunk in the last 30 days preceding the survey. Potential responses were: never, once, 2–3 times, 4–10 times, and > 10 times. In the analysis, this variable was dichotomized into: “No” (never) vs. “Yes” (≥ once/last 30 days) and is referred to as “current drunkenness”.

Sociodemographic factors included gender (boys vs. girls), age (11, 13, 15 years), place of residence (urban vs. rural areas), mother’s and father’s current employment status (yes vs. no), and family affluence scale (a six-item composite measure whose summary score ranges from six [least affluent families] to 19 [most affluent families], which in the analysis was dichotomized based on the median score into: “less affluent families” [below median, scores: 6–11] vs. “more affluent families” [above median, scores: 12–19]) [14].

This study was endorsed by the Ethics Committee of Tirana Medical University (approval ID: No.700/1). Also, the data collection process was approved by the Albanian Ministry of Education and Sport. All schoolchildren were informed about the aim and objectives of the study and were explained in sufficient detail all aspects of the study, especially the anonymity of the survey and the following aggregated data analysis. Passive consent was sought from the parents through teachers from each respective school. All ethical issues were followed strictly according to the Helsinki Declaration.

Binary logistic regression was employed to assess the relationships of alcohol consumption indices with sociodemographic factors of schoolchildren. First, crude (unadjusted) models were run, based on which odds ratios (ORs) and their respective 95% confidence intervals (95%CIs) and p-values were calculated. Subsequently, multivariable-adjusted logistic regression models were run controlling simultaneously for all sociodemographic factors of schoolchildren (gender, age, residence, parental employment status, and family affluence). Accordingly, multivariable-adjusted ORs and their respective 95%CIs and p-values were calculated for each alcohol consumption index. To test for the appropriateness of the multivariable-adjusted logistic regression models used, the Hosmer-Lemeshow test, a goodness-of-fit test, was run and its significance was tested [16]. The Hosmer-Lemeshow test is based on the squared differences between the observed and predicted values, with a small observed significance level of the test indicating that the model does not fit well [16]. Hence, the greater the p-value, the better the model fits the data [16]. As a rule of thumb, p-values over 0.20 indicate that the logistic models are suitable (i.e. the models fit well the data) [16]. For all statistical tests used, P ≤ 0.05 was considered statistically significant. Statistical Package for the Social Sciences (SPSS, version 19.0) was employed for all the analyses.

Results

Approximately one in three of schoolchildren were aged 11, 13, or 15 years, respectively; almost one in three children was rural resident; one in three children reported unemployed mothers, while one in ten children reported unemployed fathers; and almost half of schoolchildren belonged to less affluent families (Table 1).

Table 1 Distribution of alcohol consumption by sociodemographic characteristics in a nationwide representative sample of schoolchildren in Albania in 2022
Full size table

Overall, the prevalence of lifetime alcohol consumption was 23.0% (Table 1). It was higher in boys than in girls (26.8% vs. 19.5%, respectively) and among children pertinent to more affluent families than in those from poorer families (25.6% vs. 20.4%, respectively). There were no significant differences regarding place of residence or parental employment status, but a graded positive relationship with age, with 15-year-old children reporting a considerably higher prevalence of lifetime alcohol consumption (39.9%) compared to the youngest children aged 11 years (8.8%). The overall prevalence of current alcohol consumption was 13.7%, a variable which was distributed in the same manner as the lifetime variable, with boys, children belonging to more affluent families and particularly 15-year-old children reporting a higher prevalence of current alcohol consumption. On the whole, the prevalence of lifetime drunkenness was 13.1%. It was higher in boys than in girls (14.5% vs. 11.9%, respectively), among urban children compared to rural children (14.0% vs. 11.4%, respectively), in children from more affluent families than in those from poorer families (15.2% vs. 11.2%, respectively) and, especially, among 15-year-old children compared to their 11-year-old counterparts (24.0% vs. 4.2%, respectively). The overall prevalence of current drunkenness was 6.0%, with a similar socio-demographic distribution as the lifetime drunkenness (Table 1).

In crude/unadjusted binary logistic regression models (Table 2), lifetime alcohol consumption was positively associated with male gender (OR = 1.5, 95%CI = 1.3–1.7) and particularly with older age of schoolchildren (OR = 6.8, 95%CI = 5.6–8.3) [upper panel]. On the other hand, there was an inverse relationship with maternal unemployment (OR = 0.9, 95%CI = 0.8-1.0) and a lower family affluence (OR = 0.8, 95%CI = 0.7–0.9) [lower panel]. Comparable sociodemographic associations were evidenced for current alcohol consumption (Table 2). Lifetime drunkenness was positively associated with male gender (OR = 1.3, 95%CI = 1.1–1.5), urban residence (OR = 1.3, 95%CI = 1.1–1.5) and especially with older age (OR = 7.2, 95%CI = 5.6–9.3) [upper panel], but inversely related to a lower family affluence (OR = 0.7, 95%CI = 0.6–0.8) [lower panel]. Similar sociodemographic correlates were evidenced for current drunkenness (Table 2).

Table 2 Association of alcohol consumption with sociodemographic characteristics of schoolchildren; results from unadjusted binary logistic regression models
Full size table

In multivariable-adjusted binary logistic regression models (Table 3), independent and significant correlates of lifetime alcohol consumption included male gender (OR = 1.7, 95%CI = 1.4–1.9), age 15 (OR = 6.9, 95%CI = 5.7–8.4) [upper panel], and belonging to less affluent families (OR = 0.8, 95%CI = 0.7–0.9) [lower panel]. Likewise, independent and significant correlates of current alcohol consumption consisted of male gender (OR = 1.7, 95%CI = 1.4-2.0), age 15 (OR = 7.5, 95%CI = 5.8–9.8) [upper panel] and pertinence to less affluent families (OR = 0.7, 95%CI = 0.6–0.8) [lower panel]. Additionally, independent correlates of lifetime drunkenness included male gender (OR = 1.3, 95%CI = 1.1–1.6), age 15 (OR = 7.3, 95%CI = 5.6–9.4) [upper panel] and belonging to less wealthy families (OR = 0.7, 95%CI = 0.6–0.9) [lower panel]. Also, independent and significant correlates of current drunkenness consisted of male gender (OR = 1.8, 95%CI = 1.4–2.3), age 15 (OR = 4.8, 95%CI = 3.3–6.8) [upper panel], mother’s unemployment (OR = 1.3, 95%CI = 1.0-1.7) and pertinence to less affluent families (OR = 0.7, 95%CI = 0.5–0.9) [lower panel].

Table 3 Independent sociodemographic correlates of alcohol consumption; results from multivariable-adjusted binary logistic regression models
Full size table

There was no evidence of a significant multivariable-adjusted age-gender interaction in the association with lifetime and/or current alcohol consumption (overall p-values of the age-gender interaction terms: P = 0.092 and P = 0.107, respectively), notwithstanding a remarkably higher lifetime and current prevalence of alcohol consumption among 15-year-old boys (45% and 29%, respectively) compared to the youngest (11-year-old) girls (about 6% and 2%, respectively) [data not shown in the tables]. Likewise, there was no evidence of a significant multivariable-adjusted age-gender interaction in the association with lifetime and/or current drunkenness (overall p-values of the age-gender interaction terms: P = 0.213 and P = 0.565, respectively), regardless of a considerably higher lifetime and current prevalence of drunkenness among 15-year-old boys (around 27% and 13%, respectively) compared to the youngest (11-year-old) girls (3% and 1%, respectively) [data not shown in the tables].

Discussion

According to our study involving a nationwide representative sample of Albanian schoolchildren aged 11–15 years, overall, the prevalence of alcohol indices was: 23% for lifetime alcohol consumption; 14% for current alcohol consumption; 13% for lifetime drunkenness; and 6% for current drunkenness. Independent positive and highly statistically significant correlates of alcohol consumption and/or drunkenness in our study sample included male gender, age 15, and pertinence to more affluent families.

WHO has recently published a multi-country report on the prevalence of substance use from all participating countries (including Albania) in the last HBSC round conducted in 2021–2022 [7]. According to this multi-country report, 18% of boys and 13% of girls aged 11 years reported drinking alcohol in their lifetime [7]. In our study, the prevalence of lifetime alcohol consumption among 11-year-old children was lower (12% in boys and 6% in girls) than the average estimate including 44 participating countries in the last wave of HBSC, as well as lower than in other Southeastern European countries including Serbia (24% in boys and 19% in girls), Croatia (23% in boys and 15% in girls), and Slovenia (26% in boys and 17% in girls) [7]. However, our estimates are comparable with the North Macedonia (14% in boys and 7% in girls) [7]. Additionally, the prevalence of lifetime alcohol consumption among 13-year-old children in our study was lower than the average estimate of the multi-country report (both genders: 20% vs. 33%, respectively) [7]. Regarding the Southeastern European region, Slovenia exhibited the highest prevalence among 13-year-olds (49% in boys and 43% in girls), followed by Serbia (42% in boys and 45% in girls) [7]. A similar finding was evident also for 15-year-old children (40% in our study vs. 57% in the multi-country report) [7]. The highest prevalence among 15-year-old children in Southeastern European countries was evidenced in Slovenia (71% in boys and 69% in girls), followed by Croatia (67% in boys and 71% in girls) and Serbia (67% in boys and 64% in girls) [7]. Therefore, our findings on the prevalence of lifetime alcohol consumption are considerably lower than the multi-country average estimates for all three age-groups included in the same type of study (that is HBSC survey) and employing the same measuring instrument [14]. The lower prevalence of alcohol consumption among adolescents in Albania compared to other European countries can be attributed to cultural norms and societal attitudes toward drinking, rather than stricter legal regulations. Albania has a predominantly conservative social structure, where family influence plays a crucial role in shaping adolescent behaviour. Alcohol consumption, particularly among young people, is often discouraged within families and communities, and there is less cultural acceptance of underage drinking compared to many Western European countries. Religious influences, considering that Albania is a predominantly Muslim country, may also contribute to lower alcohol use by promoting abstinence or discouraging excessive drinking. Additionally, social gatherings and recreational activities in Albania may be less centered around alcohol compared to Northern and Western European cultures. All these cultural factors may create an environment where adolescent alcohol consumption is less normalized, leading to lower prevalence among Albanian adolescents. Hence, notwithstanding the fact that legal regulations on alcohol are not exceptionally strict in Albania, we speculate that practical barriers such as lower affordability and family and community-based social control seemingly limit adolescent access and consumption more effectively than formal laws. On the face of it, we speculate that cultural norms can sometimes be more influential than legal regulations in determining youth alcohol consumption patterns.

As for the drunkenness, according to the HBSC 2021-22 multi-country report [7], the prevalence of at least two episodes of lifetime drunkenness was 2% in boys and 1% in girls aged 11 years, which is exactly similar with our study (data not shown) and estimates from several countries in the region including North Macedonia and Croatia; 5% among boys and girls aged 13 years (in our study: 4% in boys and 3% in girls; in North Macedonia: 3% in boys and 2% in girls; in Slovenia: 5% in both genders; in Croatia: 8% in boys and 6% in girls); and 20% among 15-year-old boys and girls (in our study: 16% in boys and 10% in girls; in North Macedonia: 12% in boys and 8% in girls; in Croatia: 28% in girls and 25% in boys; in Slovenia: 25% in boys and 21% in girls) [7]. Hence, the prevalence of at least two episodes of lifetime drunkenness in our study was similar or even lower among children of the three age-groups included compared to the estimates of the multi-country report, including countries of the Southeastern European region [7].

Regarding time trends, there is evidence of a similar prevalence of alcohol consumption and drunkenness in the current study (consisting of the last HBSC round conducted in 2022) compared with the previous rounds of HBSC conducted in Albania in 2017-18 and in 2013-14 (authors’ data– unpublished). For example, in the HBSC 2013-14, about 14% of schoolchildren reported lifetime drunkenness compared with 10% of those in HBSC 2017-18 and 13% of children in HBSC 2022. On the other hand, about 5% of the children reported 2–3 episodes of drunkenness in 2013-14 vs. 3% in 2017-18 and 4% in 2022. Conversely, about 1% of children reported drunkenness > 10 times in all three survey rounds (data not shown). On the other hand, according to the multi-country HBSC 2021-22 report, between 2018 and 2022, the prevalence of lifetime drunkenness did not change for 11- and 13-year-old boys, while decreasing for 15-year-old boys [7]. On the other hand, there was evidence of a significant increase in the prevalence of lifetime drunkenness among 13- and 15-year-old girls [7].

In our study, both alcohol consumption and drunkenness were more prevalent in boys and older children, a finding which is compatible with the multi-country HBSC 2022 report [7]. Furthermore, our findings on a higher prevalence of alcohol consumption and drunkenness among children from more affluent families are in line with the average estimate of the multi-country report [7]. We have obtained similar evidence in the same study sample regarding a positive association between family affluence and smoking [17], attributing this finding to a greater purchasing power of children belonging to more affluent families [17, 18]. Notably, the prevalence of all four alcohol indices measured in our study were remarkably the highest among boys from more affluent families, which is in line with recent reports from the other countries in the Southeastern European region [7]. Children from wealthier families may be more likely to engage in alcohol consumption due to several factors beyond their greater financial resources. For example, affluent adolescents may experience less parental supervision, as their caregivers often have demanding professional commitments, leading to greater autonomy in their social activities. Additionally, cultural norms in higher-income families may also normalize moderate drinking, making alcohol consumption more socially acceptable. Furthermore, wealthier adolescents often participate in recreational activities, parties, or peer groups where alcohol is commonly consumed. These combined factors may create an environment where alcohol use is more accessible, socially reinforced, and perceived as a normative behaviour among adolescents from affluent backgrounds [1].

The influence of commercial factors on alcohol consumption, associated harm, and the development and implementation of policies is widely recognized [1, 19]. As convincingly argued by WHO, the exposure of children and adolescents to attractive marketing and advertisements for alcoholic beverages is particularly worrisome [20], also when it implicates cross-border alcohol marketing and advertising [21].

On another aspect, treatment for children and adolescents with substance use disorders is particularly important for the management of co-occurring psychiatric disorders, and other mental health conditions [22, 23]. As a matter of fact, according to the WHO’s Global Survey on Progress with SDG health target 3.5, special treatment and care programmes and services for children and adolescents are not available in the majority of reporting countries [1].

Our study may have several limitations including lack of generalizability of the findings to all Albanian children aged 11, 13, and 15 years, as we did not include out-of-school children who might exhibit different alcohol consumption patterns; the likelihood of information bias concerning underreporting of alcohol consumption, recall bias (particularly for lifetime alcohol consumption, as children may have not remembered correctly infrequent alcohol intake occurring a long time ago); and the study design (cross-sectional) which does not enable judgments on causal relationships, making it impossible to determine the temporal sequence of events. Furthermore, alcohol consumption in adolescents is a multifactorial phenomenon, influenced by various moderating variables, such as personality dimensions, environmental factors, and macrosocial conditions. Since our study did not address all the variables that could influence alcohol consumption, it is important to acknowledge also this limitation.

Yet, our study provides useful information about the levels and sociodemographic distribution of alcohol consumption among schoolchildren in Albania, a country in the Western Balkans which has experienced rapid changes in the past three decades including changes in behavioural practices among children and adolescents [24]. Control and prevention of unhealthy behaviours among children and youths should constitute an important public health priority in Albania and all the other countries worldwide, as a recent report has indicated that over 60% of students exhibit two or more modifiable risk factors for non-communicable diseases including alcohol consumption [25].

Our findings carry significant political implications, emphasizing the need for policy action to curb underage alcohol consumption in Albania. The high prevalence of alcohol use among Albanian adolescents, particularly among older boys and those from more affluent backgrounds, suggests that current regulations and public health efforts in Albania may be insufficient. Therefore, policymakers in Albania and other similar settings should consider strengthening alcohol control laws, such as restricting youth access to alcohol through stricter enforcement of age limits and regulating marketing strategies targeting young individuals. Additionally, nationwide school-based prevention programs incorporating evidence-based education on the risks of early alcohol use should be implemented in the Albanian context. Community and family-based interventions, including parental guidance initiatives, should also be promoted to address the influence of socioeconomic factors on adolescent drinking behaviours. A multi-sectoral approach involving health authorities, educators, and policymakers is crucial to developing sustainable interventions that reduce alcohol consumption among Albanian adolescents and mitigate its long-term health and social consequences.

Overall, our findings provide crucial evidence for the formulation of public policies and prevention programs aimed at reducing adolescent alcohol consumption in Albania and similar countries. Policymakers in Albania should design targeted interventions that prioritize at-risk adolescents identified in our study including older boys and higher socioeconomic groups. Integration of the findings from our study into the Albanian national health strategy can enhance the effectiveness of prevention efforts by ensuring that resources are allocated to the most vulnerable adolescent groups. Indeed, public health authorities in Albania and elsewhere should translate research findings into concrete policy actions to ultimately foster healthier developmental outcomes for children and youths.

Conclusions

Our findings reveal that alcohol consumption and drunkenness are prevalent among Albanian adolescents. These results highlight the need for targeted prevention strategies addressing demographic factors that contribute to underage drinking in Albania and in other countries worldwide.

Data availability

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

This study was conducted by the Faculty of Medicine, University of Medicine, Tirana, Albania. We would like to thank all the participants as well the parents and the teachers who assisted in the process.

Funding

This research was funded by the following agencies: the United Nations Population Fund (UNFPA) Office in Albania, the United Nations Children’s Fund (UNICEF) Office in Albania, and the Swiss Development and Cooperation (SDC) Agency through the project “Schools for Health” implemented in Albania.

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Authors and Affiliations

  1. Faculty of Medicine, University of Medicine, Rr. “Dibres”, No. 371, Tirana, 8185, Albania

    Alketa Qosja, Ditila Doracaj, Iris Mone, Genc Burazeri, Eugena Tomini & Gentiana Qirjako

  2. Department of International Health, CAPHRI (Care and Public Health Research Institute), Maastricht University, Maastricht, 6200 MD, The Netherlands

    Genc Burazeri

  3. Department of Healthcare, Faculty of Public Health, University of Vlora, PBox, Vlora, 9401, Albania

    Enkeleint A. Mechili

  4. School of Medicine, University of Crete, PBox, Crete, 71003, Greece

    Enkeleint A. Mechili

  5. Institute of Public Health, Rr. “Aleksander Moisiu”, No. 80, Tirana, 8185, Albania

    Eugena Tomini & Gentiana Qirjako

Authors
  1. Alketa Qosja
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  2. Ditila Doracaj
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  3. Iris Mone
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  4. Genc Burazeri
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  5. Enkeleint A. Mechili
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  6. Eugena Tomini
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  7. Gentiana Qirjako
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Contributions

A.Q, has contributed to conceptualization, data preparation, analyses, and wrote the first draft. D.D, and I.M, have participated in the investigation, visualization and made comments to the first draft. G.B, has contributed to the conceptualization, methodology development, data preparation, data analysis and contributed to the development of the first draft. E.M, contributed to the preparation of the first draft, visualization of the article and addressed the comments of the co-authors. E.T, has contributed to the preparation of the first draft, in the visualization process and in the funding acquisition and needed resources. G.Q, has the supervision and project administration of the whole work. G.Q, contributed to the conceptualization and development of the methodology, in data analyses, in writing the first draft and in funding acquisition. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Genc Burazeri.

Ethics declarations

Ethics approval and consent to participate

The study was approved by the Ethics Committee of Tirana Medical University (approval ID: No.700/1) and the data collection process was also confirmed by the Albanian Ministry of Education and Sport. All schoolchildren were informed about the aim and objectives of the study and were explained in sufficient detail particularly the aspects related to the anonymity of the survey and the successive aggregated data analysis. Passive consent was sought from the parents through teachers from each respective school. All ethical issues were followed strictly according to the Helsinki Declaration.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

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Qosja, A., Doracaj, D., Mone, I. et al. Prevalence and associated factors of alcohol consumption in Albanian schoolchildren. BMC Public Health 25, 1510 (2025). https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s12889-025-22682-8

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  • DOI: https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s12889-025-22682-8

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BMC Public Health

ISSN: 1471-2458

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