Alcohol Abuse and Addiction

Adolescence is the stage of life where people gain more independence and make new experiences in their social environment, where peer influence might encourage and provide opportunities to come into contact with alcohol, potentially leading to the development of an addictive behavior toward the substance. As the social environment is now composed of two realities, online and offiine, it is crucial to understand the contribution of social media in fostering, maintaining, or conveying contents related to substances. Studies on drinking behavior among teenagers and social media use highlight that online platforms like Facebook might represent a helpful tool to detect problematic alcohol use (25, 33, 34, 92, 93), or advertise for healthy behavior in settings such as popular alcohol-related events and parties (24). A higher number of alcohol-related posts has been shown to be linked to greater drinking conduct and approval from friends, although heavier consumers seem to tend to post less over time compared to light drinkers (56). A longitudinal study revealed that in the Facebook profiles of individuals identified as dependent alcohol users, alcohol references increased and half of those identified referenced intoxication or problematic drinking after 1 year (25), while another longitudinal study indicated that alcohol references at a first stage can predict binge drinking later in time (27). With regard to alcohol-related attitudes, binge drinkers appear to be more prone to use social media excessively (42). Moreover, posts containing references to alcohol predict the number of weekly substance consumption (93), the risk of developing an addiction, and alcohol cravings (92). In order to predict drinking conduct, Marczinski and colleagues have developed the Alcohol-Related Facebook Activity (ARFA) questionnaire (33) based on a sample

of college students. The preference for the virtual environment as a platform to share alcohol-related experiences has been studied by Moreno and colleagues, who report that students owning a profile on both Facebook and Twitter tended to post more alcohol references on Facebook compared to Twitter (34), as they were entertaining more social connections on the former site. Online social networks often include connections with offiine friends; therefore, the exposure to a friend’s drinking pictures or posts can be associated with higher alcohol consumption (28, 30). Risky alcohol behavior can differ according to the country; a cross- cultural study examined the relationship between daily usage of popular social media platforms and alcohol consumption among youths in the United States, Spain, Finland, and South Korea. In the targeted countries, the different platforms were correlated with greater hazardous alcohol usage as follows: Facebook and Instagram in Spain, Finland, and South Korea, YouTube in South Korea, and Twitter in Spain (55). These results suggest that specific social media sites might play an attractive or inspiring role in risky alcohol consumption but, on the other hand, they could also turn out to contribute greatly to online-based interventions. According to a study on nicotine, alcohol, and marijuana consumption in high school, being friends on Facebook with one’s own parents and not hiding contents can represent a protective factor against substance use
(37). Parental inclusion on social media interactions, without undermining autonomy and privacy of youths, can depict an important element in substance use prevention targeted toward youths.