Reducing Underage Drinking A Collective Responsibility (2004) / Chapter Skim
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2 Social, Health, and Economic Consequences of Underage Drinking--Ralph Hingson and Donald Kenkel
2 Social, Health, and Economic Consequences of Underage Drinking--Ralph Hingson and Donald Kenkel
Pages 351-382
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From page 351... ...
This was a reversal of an earlier policy trend: In the wake of the 1972 constitutional amendment that extended the right to vote to 18-year-olds, 29 states had also lowered their legal drinking ages. Higher traffic fatalities and other problems experienced in those states were part of the impetus for the national drinking age of 21.
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From page 352... ...
Finally, we present a brief discussion and conclusion about the program and policy implications of the social and economic consequences of underage drinking. UNDERAGE ALCOHOL CONSUMPTION Despite the legal drinking age of 21 in all states, according to the 2001 National Household Survey on Drug Abuse (NHSDA)
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From page 353... ...
Epidemiologic research comparing drivers in single-vehicle fatal crashes with drivers operating motor vehicles at similar times on the same roadways who were not involved in fatal crashes has revealed that each 0.02 percent increase in blood alcohol level nearly doubles the risk of single-vehicle fatal crash involvement and that the risk of death increases with each drink
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From page 354... ...
. A more recent national analysis found that in all age and gender groups, there was at least an 11-fold increased risk of single-vehicle fatal crash involvement at a blood alcohol level of 0.08 percent (the legal limit for intoxication for adults in most states)
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From page 355... ...
revealed that the percentage of nontraffic unintentional injury deaths that test positive for alcohol closely corresponds to the percentage of motor vehicle deaths that are alcohol related: 38 percent versus 40 percent. Among persons under age 21, 34 percent of unintentional traffic deaths (2,956/8,797)
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From page 356... ...
Of course, none who never drank drove after drinking, while 41 percent of frequent heavy drinkers did so. Twenty-two percent of respondents said they rode on a motorcycle and 63 percent on a TABLE 2-1a Traffic Risks According to Frequency of Drinking 5+ Drinks on an Occasion in the Past 30 Days Never Drank Drank Not 5+ 1 2 3-5 6+ N = 7,228 2,187 1,248 840 845 891 Of Motorcyclists Never Wear a Helmet 27% 29% 33% 36% 42% 45% Of Bicyclists Never Wear a Helmet 73% 81% 86% 88% 89% 92% SOURCE: Youth Risk Behavior Survey (YRBS)
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From page 357... ...
Forty-four percent of frequent heavy drinkers carried a weapon and 22 percent a gun in the past 30 days. Not only were the frequent heavy drinkers more likely to carry weapons and TABLE 2-2a Weapons and Violence According to Frequency of Drinking 5+ Drinks on an Occasion in the Past 30 Days Never Drank Drank Not 5+ 1 2 3-5 6+ N = 7,228 2,187 1,248 840 845 891 Carry Weapon 10% 18% 22% 26% 28% 44% Carry Gun 3% 4% 8% 8% 11% 22% Weapon at School 3% 6% 9% 10% 13% 20% In a Fight Past Year 23% 35% 43% 46% 52% 62% Injured in a Fight Past Year 2% 4% 7% 6% 7% 13% SOURCE: Youth Risk Behavior Survey (YRBS)
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From page 358... ...
. TABLE 2-4c Substance Use According to Frequency of Drinking 5+ Drinks on an Occasion in the Past 30 Days Never Drank Drank Not 5+ 1 2 3-5 6+ N = 7,228 2,187 1,248 840 845 891 Ever Inject Drugs <1% 1% 2% 4% 5% 13% Past Year Offered Drugs at School 19% 32% 37% 42% 48% 57% SOURCE: Youth Risk Behavior Survey (YRBS)
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From page 359... ...
2001. TABLE 2-5c Sexual Risk Behaviors According to Frequency of Drinking 5+ Drinks on an Occasion in the Past 30 Days Past 30 Days Drank Never Drank Not 5+ 1 2 3-5 6+ N = 7,228 2,187 1,248 840 845 891 Birth Control Last Sex 83% 85% 88% 86% 83% 82% Been/Gotten Someone Pregnant 5% 7% 7% 11% 11% 19% Used Condom Last Sex 63% 61% 64% 62% 57% 54% SOURCE: Youth Risk Behavior Survey (YRBS)
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From page 360... ...
. Tobacco and Illicit Drugs Compared to nondrinkers, frequent heavy drinkers were more likely to have used tobacco products: cigarettes (94 percent versus 46 percent)
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From page 361... ...
Sexual Behaviors According to the National Youth Risk Behavior Survey (Grunbaum et al., 2002) , frequent heavy drinkers relative to nondrinkers were also more likely to have had sexual intercourse (87 percent versus 34 percent)
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From page 362... ...
As we will discuss later in this chapter, if alcohol use contributes to poorer academic performance in adolescence, the economic consequences may extend into adult life. Age of Drinking Onset and Alcohol-Related Health Risks Not only are adolescents who drink heavily more likely to engage in behaviors that pose a risk to their health, but the younger adolescents are when they begin drinking alcohol, the more likely they are to experience alcohol related problems both during adolescence and in adulthood, including a higher frequency of drinking (Samson, Maxwell, and Doyle, 1989; Gruber, DiClemente, Anderson, and Lodico, 1996)
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From page 363... ...
Analyses of the National Longitudinal Alcohol Epidemiology Survey (NLAES) have revealed that those with a younger age of drinking onset are more likely to experience alcohol dependence as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM IV)
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From page 364... ...
2001. Ever Injured under the influence of 35 34 alcohol In a motor vehicle crash 30 29 because of drinking 27 In a physical fight after 25 24 drinking 22 20 20 Percent 19 15 14 14 14 14 11 13 10 8 8 9 5 5 5 7 5 4 4 4 3 3 2 0 2 Age Started <14 14 15 16 17 18 19 20 21+ Drinking N = 1,130 850 1,507 3,155 2,861 5,693 2,213 2,078 7,315 P<0.001 FIGURE 2-1 Ever experienced alcohol related problems according to age started drinking.
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From page 365... ...
first drank to intoxication, the more likely they were to experience alcohol dependence (Figure 2-3) and frequent binge or heavy drinking -- 5 or more drinks for a man and 4 or more for a woman on a single occasion (Figure 2-3)
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From page 366... ...
. College students age 19+ who drank past year N = 9,693 18 16.8 16 14 13.4 12 9.6 Dependent 10 8.6 8 6 5.3 Percent 4 3.1 2 0.3 0 Age First Intoxicated 12 13-15 16 17 18 19+ Never N = 281 1,973 1,828 1,400 1,733 1,514 1,036 Missing Data N = 120 FIGURE 2-4 Alcohol dependence according to age first drunk: 1999 college alcohol survey.
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From page 367... ...
The increased rates of driving after drinking, driving after 5+ drinks, injuries, and unplanned and unprotected sex after drinking among college students persisted after further controlling for alcohol dependence and frequency of consuming 5 or more drinks on an occasion in the past 30 days (Figures 2-6 and 2-7)
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From page 368... ...
. 4.0 3.5 Intervals 3.0 2.8 2.5 2.1 2.3 2 Confidence 2.0 and 1.5 1.5 Ratio 1.0 1 0.5 Odds 0.0 12 13-15 16 17 18 19+ Age First Intoxicated FIGURE 2-7 Past 30 days binged according to age first intoxicated: 1999 college alcohol survey.
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From page 369... ...
In a longitudinal study (Chassin et al., 2002) , parents with a history of alcohol dependence and antisocial personality were found to have children who begin binge drinking at younger ages and who binge at least once per week at ages 19 to 20.
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From page 370... ...
The second need for additional research is to examine why, even when diagnosis of alcohol dependence and measures of frequency of lifetime and past-year heavy drinking are controlled, persons who began drinking at an earlier age are more likely after drinking to place themselves in situations that pose risk of injury. Several explanations are possible.
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From page 371... ...
The life-course consequences occur if underage drinkers invest in less human capital, which reduces the standard of living they enjoy over their entire life-course. There are additional life-course consequences to the extent underage drinkers are more likely to suffer drinking problems later in life.
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From page 372... ...
Expenditures for medical consequences related to alcohol abuse by underage drinkers are estimated based on medical expenditures related to traffic crashes that involved an underage drinking driver.
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From page 373... ...
They estimated that controlling for other factors, students who spend their high school years in states with relatively high beer taxes and minimum legal drinking ages are more likely to graduate college. Using data from the 1993 College Alcohol Study, Wolaver (2002)
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From page 374... ...
Other evidence suggests that the earnings losses may be even larger for those underage drinkers who continue to abuse alcohol as adults. A long line of economics research examines the extent to which current alcohol problems reduce the earnings of working adults (for example, Rice et al., 1990; Mullahy and Sindelar, 1989; 1993, 1994; Kenkel and Ribar, 1994; and National Institute on Drug Abuse and National Institute on Alcohol Abuse and Alcoholism [NIDA/NIAAA]
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From page 375... ...
Part of the reason progress has been made in reducing alcohol related traffic deaths in the past two decades is that most drivers who die in traffic crashes are tested for alcohol. This allows comparison of states before and after new drunk driving and other alcohol regulations with states that do not make those changes to assess whether the regulations produce reductions in fatal crashes involving alcohol.
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From page 376... ...
Furthermore, results on age or drinking onset reinforce the need for policies that reduce adolescent drinking, such as the minimum legal drinking age of 21. That law has been found to reduce drinking, alcohol related traffic deaths, and deaths from unintentional injuries under the age of 21 (U.S.
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From page 377... ...
and alcohol related traffic crashes and assault injuries (Holder, Gruenwald, Ponick et al., 2000)
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From page 378... ...
. Age of onset of alcohol use and its association with DSM IV alcohol abuse and dependence: Results from the National Longitudinal Alcohol Epidemiologic Survey.
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From page 379... ...
. Age of drinking onset, driving after drinking and involvement in alcohol related motor vehicle crashes.
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From page 380... ...
. Effects of minimum drinking age laws on alcohol use, related behavior and traffic crash involvement among American youth.
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From page 381... ...
. A multistage social learning model of the influences of family and peers upon adolescent substance abuse.
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From page 382... ...
. Alcohol related involvement in fatal crashes according to age and gender.
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