This is a repository copy of Why is adolescent drinking declining? A systematic review and narrative synthesis.

Background: In the early 2000s, alcohol use among young people began to decline in many western countries, especially among adolescents (ages between 12-17 years old).These declines have continued steadily over the past two decades, against the backdrop of much smaller declines among the general population.Argument: Hypotheses examining individual factors fail adequately to provide the necessary 'big picture' thinking needed to understand declines in adolescent drinking. We use the normalisation thesis to argue that there is strong international evidence for both processes of denormalisation of drinking and normalisation of non-drinking occurring for adolescents in many western countries.Conclusions: Research on declining adolescent drinking provides evidence of both denormalisation of alcohol consumption and normalisation of non-drinking. This has implications for enabling policy environments more amenable to regulation and increasing the acceptability of non-drinking in social contexts. Normalisation theory (and its various interpretations) provides a useful multi-dimensional tool for understanding declines in adolescent drinking.

Young people's drinking has declined markedly in Australia over the past 15 years, and this may be linked to changing norms and values around health. We take the view that healthism-a discourse that privileges good health and renders people personally responsible for managing healthhas become pervasive, creating new pressures influencing young people's alcohol practices. Through interviews with 50 young light drinkers and abstainers, we explored these notions of health and alcohol. Although health was not the only reason that participants abstained or drank lightly, many avoided drinking to minimise health risks and to pursue healthy lifestyles. Their understanding of health came from multiple sources such as the media, schools, parents-and often reinforced public health messages, and healthist discourse. This discourse influenced how participants perceived health norms, engaged with health in everyday life and managed their alcohol consumption.Because the need to be healthy incorporated bodily health, mental health and social wellbeing, it also created tensions around how young people could drink while maintaining their health. This highlights the importance of health as a key consideration in the alcohol practices of light drinking and abstaining young Australians, which could help explain broader declines in youth drinking.

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