Family Structure in Association with Alcohol Use Among Adolescents: A Systematic Review and Meta-analysis

Context: It is proposed that family structure influences adolescent alcohol use; however, the findings are mixed, and no systematic review has been conducted to summarize the evidence. Objectives: We aimed to identify the association between family structures and adolescent alcohol consumption through a systematic review and meta-analysis of observational studies. Methods: PubMed, Scopus, and Google Scholar were searched until June 2017 for observational studies, which examined the relationship between family structure and adolescent alcohol use. A random-effects model was used to derive the overall odds ratio (OR) for the likelihood of alcohol use in different non-intact families compared with intact families (adolescents growing up with both biological parents). DerSimonian and Liard's random-effects model was used to conduct the meta-analysis. All analyses were performed using STATA software, version 11.2. Results: Fifty-seven articles met the eligibility criteria for the systematic review, and 29 were included in the meta-analysis. The meta-analysis revealed a significant increase in alcohol use among adolescents with non-intact families (OR = 1.27, 95% confidence interval: 1.19, 1.36) compared with adolescents with intact families in which both biological parents were present. Living with one biological parent, living in a divorced family, loss of parents, and other types of the non-intact family also significantly increased the odds of alcohol use in adolescents (P < 0.05). Conclusions: All types of the non-intact family were linked to adolescents' alcohol use. The family structure could have an essential role in reducing high-risk behaviors, including alcohol use and its consequences in adolescents.