Abstract
Adolescent alcohol use has declined in many high-income countries, yet few studies have measured the impact on alcohol harm. We investigated whether declines in alcohol use among secondary school students in Aotearoa New Zealand were accompanied by declines in self-reported alcohol harm. We used data from the Youth2000 survey series (2007, N = 9098; 2012, N = 8487; 2019, N = 7311). We found alcohol use declined substantially on all indicators (lifetime, current, past month, and weekly alcohol use; past month binge drinking; typical consumption of 10 + drinks/session), with declines concentrated in the 2007-2012 period. Self-reported alcohol harm also declined markedly over the 2007-2012 period, e.g. the proportion reporting being injured declined from 22% to 16%; and/or doing something that could get them in serious trouble (e.g. stealing) declined from 19% to 12%. Despite declines, alcohol harm was common in 2012 with 33% of current drinkers reporting at least one indicator in the past 12 months. In conclusion, declines in adolescent drinking were accompanied by declines in self-reported alcohol harm. However, adolescent binge drinking remained prevalent in 2019 compared with similar countries. Addressing adolescent alcohol harm remains a pressing public health priority, and there is an urgent need to better monitor youth drinking and associated harms.