Alcohol consumption during adolescence poses long-term risks to physical health, brain development, and social well-being. A large national survey provides updated evidence on how common drinking remains among Chinese adolescents and how it varies by age, gender, and region. The study reveals a substantial proportion of middle and high school students have tried alcohol, with many initiating drinking at an early age. While severe intoxication is less frequent than alcohol use itself, notable disparities persist across sex, residence, and geographic regions. These findings highlight that underage drinking remains a widespread public health issue and underscore the need for targeted prevention strategies addressing early exposure, social contexts of drinking, and vulnerable subgroups.
Alcohol use during adolescence occurs at a critical stage of neurological and psychological development and is associated with injuries, risk behaviors, impaired learning, and long-term health outcomes. Although alcohol consumption among Chinese adults has shown mixed trends over recent decades, nationally representative data on adolescent drinking have been limited. Previous surveys were either outdated or restricted to specific regions, leaving uncertainty about current patterns at the national level. Understanding the alcohol consumption patterns among Chinese adolescents is essential for policies designing. Therefore, an in-depth, national-wide investigation was conducted, aiming to solve this crucial issue.
Researchers from the Chinese Center for Disease Control and Prevention and collaborating institutions reported new findings (DOI: 10.1007/s12519-025-00994-4) in World Journal of Pediatrics in December 2025, presenting results from a nationally representative school-based survey conducted in 2021. The study examined alcohol use among adolescents aged 12 to 19 years across mainland China. By analyzing drinking prevalence, age of initiation, beverage types, emotional motives, and drinking locations, the research offers the most comprehensive and up-to-date national patterns of adolescent alcohol consumption in China.
The survey shows that an estimated 44.1% of students reported having consumed alcohol at least once in their lifetime, while 32.7% drank in the past year and 11.2% in the past month. Although drunkenness was less frequent—affecting 12.1% over a lifetime and only 1.6% in the past month—it remains a significant concern, especially among specific subgroups. Boys consistently reported higher levels of drinking and intoxication than girls across all time frames.
Early exposure emerged as a key issue. Nearly one-third of students reported initiating alcohol use at age 13 or younger, and almost 7% experienced drunkenness at an early age. Drinking prevalence increased steadily with school grade, indicating cumulative exposure as adolescents grow older. Geographic disparities were also evident, with higher levels of drinking and drunkenness in rural areas and certain regions, particularly Central and Southwest China.
Beer and wine were the most commonly consumed beverages, while spirits were less frequent. Importantly, adolescent drinking often occurred in family settings and private homes, frequently without strong emotional motives. This pattern suggests that alcohol use is embedded in social and cultural contexts rather than driven solely by deliberate risk-taking.
"This national survey provides a clear reminder that underage drinking remains a widespread and socially embedded behavior," the researchers noted. They emphasized that although severe intoxication has declined compared with earlier surveys, early initiation and persistent exposure continue to pose long-term risks. The findings highlight the importance of parental influence, family environments, and social norms in shaping adolescent drinking behaviors. According to the authors, prevention efforts should move beyond individual education and address broader cultural and environmental factors that normalize alcohol use among young people.
The results offer valuable evidence for public health policy and prevention programs targeting underage drinking in China. By identifying early initiation, family-centered drinking occasions, and regional disparities, the study points to concrete opportunities for intervention. Strengthening parental guidance, improving enforcement of age restrictions, and tailoring strategies to high-risk regions and rural communities could reduce early alcohol exposure. More broadly, the findings support the need for sustained national monitoring and culturally sensitive prevention efforts. Addressing adolescent alcohol use early may help curb future health burdens and reduce the long-term impact of alcohol-related harm across the population.
