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The Minimum Legal Drinking Age: History, Effectiveness, and Ongoing Debate.

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• Toomey TL 1
• Rosenfeld C 1
• Wagenaar AC 1

Alcohol Health and Research World , 01 Jan 1996 , 20(4): 213-218 PMID: 31798158  PMCID: PMC6876521

Abstract 

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The Minimum Legal Drinking Age

Minimum legal drinking age (MLDA) laws provide an example of how scientific research can support effective public policies. Between 1970 and 1975, 29 States lowered their MLDAs; subsequently, scientists found that traffic crashes increased significantly among teenagers. Alcohol use among youth is related to many problems, including traffic crashes, drownings, vandalism, assaults, homicides, suicides, teenage pregnancies, and sexually transmitted diseases. Research has demonstrated the effectiveness of a higher MLDA in preventing injuries and deaths among youth. Despite laws prohibiting the sale or provision of alcohol to people under age 21, minors can easily obtain alcohol from many sources. Increased MLDA enforcement levels and deterrents for adults who might sell or provide alcohol to minors can help prevent additional injuries and deaths among youth.

Science can play a critical role in developing effective policies to address health issues, including those focused on alcohol-related problems ( Gordis 1991 ). In an ideal world, public policy development would be based on the identification of a problem and the scientific evidence of the factors that are most effective in reducing that problem. In the real world, however, public policy results from economic and political forces, which occasionally combine with good science. Minimum legal drinking age (MLDA) laws provide an example of how scientific research can support effective public policies. This article shows how science has influenced MLDA policies in the past and summarizes research contributing to the ongoing debate on the MLDA.

• History of the MLDA

Following the repeal of Prohibition, nearly all State laws restricting youth access to alcohol designated 21 as the minimum age for purchasing and consuming alcohol ( Mosher 1980 ). Between 1970 and 1975, however, 29 States lowered the MLDA to age 18, 19, or 20. These changes occurred at the same time that minimum-age limits for other activities, such as voting, also were being lowered ( Wechsler and Sands 1980 ). Scientists began studying the effects of the lowered MLDA, particularly focusing on traffic crashes, the leading cause of death among teenagers. Several studies in the 1970’s showed that traffic crashes increased significantly among teenagers after the MLDA was lowered ( Cucchiaro et al. 1974 ; Douglass et al. 1974 ; Wagenaar 1983 , 1993 ; Whitehead 1977 ; Whitehead et al. 1975 ; Williams et al. 1974 ).

With evidence that lower legal drinking ages were associated with more traffic crashes among youth, citizen advocacy groups led a movement to restore the MLDA to 21 in all States ( Wolfson 1995 ). In response, 16 States increased their MLDA’s between September 1976 and January 1983 ( Wagenaar 1983 ). Many States, however, resisted pressure from these groups and ignored Government incentives to raise their MLDA’s ( King 1987 ). The Federal Government became concerned about the safety both of youth in States that had lower MLDA’s and of youth who lived in neighboring States. Persons who were below the MLDA in their own State could drive across State borders to purchase alcohol in a State with a lower MLDA and then return home, increasing the likelihood of being involved in traffic crashes.

Because the 21st amendment to the U.S. Constitution guaranteed States’ rights to regulate alcohol, the Federal Government could not mandate a uniform MLDA of 21. Instead, in 1984 the Federal Government passed the Uniform Drinking Age Act, which provided for a decrease in Federal highway funding to States that did not establish an MLDA of 21 by 1987 ( King 1987 ). Faced with a loss of funding, the remaining States returned their MLDA’s to age 21 by 1988.

• Effectiveness of the MLDA

Reductions in Drinking

Following the end of Prohibition, each State developed its own set of policies to regulate the distribution, sale, and consumption of alcohol. In addition to the MLDA, examples of other alcohol control policies include excise taxes, restrictions on hours and days of sales, and server training. Many of these other alcohol policies have only recently been evaluated (see Toomey et al. 1994 for a review of the research literature). Of all the alcohol control policies, MLDA policy has been the most studied. Since the 1970’s, at least 70 studies have explicitly examined the effects of either increases or decreases in the MLDA, with some studies using more robust research designs than others. MLDA policies may have been evaluated sooner and more often for a variety of reasons, including: (1) a growing concern about youth drinking and driving; (2) availability of archived, time-series data on traffic crashes; (3) the fact that many States first lowered, then raised, their MLDA’s; and (4) preliminary research showing the large effects of changes in MLDA’s. Thorough literature reviews by Wagenaar (1983 , 1993) , the United States General Accounting Office (1987) , and Moskowitz (1989) provide detailed summaries of many of these studies. MLDA laws have been evaluated mostly in terms of how changing the MLDA affects rates of alcohol use and traffic crashes among youth.

Methods used to study the effect of the MLDA on alcohol use have varied widely, contributing to differences in conclusions among studies. For example, some studies used convenience samples, such as students in introductory psychology classes, whereas other studies used sophisticated, random sampling designs to obtain nationally representative samples. Wagenaar (1993) concluded that studies employing strong research and analytical designs typically observed increases in alcohol use among youth following a lowering of the MLDA. In contrast, when many States raised the MLDA, alcohol use among youth decreased.

Beer is the alcoholic beverage of choice for most youth. As a result, reduced rates of alcohol use among youth after the MLDA was increased were primarily evident in decreased rates of beer consumption ( Berger and Snortum 1985 ). Rates of wine and distilled spirits use among youth did not change dramatically following the rise in the MLDA ( Barsby and Marshall 1977 ; Smart 1977 ).

Opponents of the age-21 MLDA theorized that even if a higher MLDA reduced alcohol use among minors, drinking rates and alcohol-related problems would surge among those age 21 and older. In other words, opponents believed that a “rubber band” effect would occur: When youth turned 21, they would drink to “make up for lost time” and thus drink at higher rates than they would had they been allowed to drink alcohol at an earlier age. A study by O’Malley and Wagenaar (1991) , however, refutes this theory. Using a national probability sample, O’Malley and Wagenaar found that the lower rates of alcohol use due to a high legal drinking age continued even after youth turned 21.

Although the MLDA’s effect on youth alcohol consumption is important, a key consideration is whether the MLDA ultimately affects the rates of alcohol-related problems. Alcohol use among youth is related to numerous problems, including traffic crashes, drownings, vandalism, assaults, homicides, suicides, teenage pregnancies, and sexually transmitted diseases. Alcohol use is reported in one-fifth to two-thirds of many of these problems ( Howland and Hingson 1988 ; Plant 1990 ; Roizen 1982 ; Smith and Kraus 1988 ; Strunin and Hingson 1992 ). As drinking rates increase or decrease, rates of alcohol-related problems may change in response.

Decreases in Traffic Crashes

Using various research methods, at least 50 studies have evaluated the effect of changes in the MLDA on traffic crashes ( Wagenaar 1993 ). Some studies assessed policy changes in only one State, whereas others analyzed the MLDA’s effect across multiple States. These studies evaluated the effect of MLDA changes on a variety of outcomes, including total traffic crash fatalities for youth; drinking-driving convictions; crashes resulting in injuries; and single-vehicle nighttime crash fatalities (the crashes most likely to involve alcohol).

Most studies on the effect of lowering the MLDA found an increase in traffic crashes and traffic deaths among youth ( Wagenaar 1993 ). Of the 29 studies completed since the early 1980’s that evaluated increases in the MLDA, 20 showed significant decreases in traffic crashes and crash fatalities. Only three clearly found no change in traffic crashes involving youth. The remaining six studies had equivocal results. Based on results from research studies such as these, the National Highway Traffic Safety Administration (NHTSA) estimated that in 1987 alone, 1,071 traffic crash fatalities were prevented because of the MLDA of 21 ( NHTSA 1989 ).

Since 1984 researchers have been investigating whether changes in the MLDA also affect other alcohol-related problems. Of the four studies conducted to date that focused on other social and health consequences of alcohol use, three found an inverse relationship between the MLDA and alcohol-related problems: A higher legal drinking age was correlated with a lower number of alcohol problems among youth. The New York State Division of Alcoholism and Alcohol Abuse (1984) found a 16-percent decrease in rates of vandalism in four States that raised the MLDA. In a study of an increase of the MLDA in Massachusetts, Hingson and colleagues (1985) did not find significant changes in the rates of non-motor-vehicle trauma, suicide, or homicide. Smith (1986) , however, found an increase in non-traffic-related hospital admissions following decreases in the MLDA in two Australian states. Jones and colleagues (1992) found lower rates of death caused by suicides, motor vehicle crashes, pedestrian accidents, and other injuries in States with higher MLDA’s. More research is needed to characterize the full effect of the MLDA on rates of alcohol-related injuries and on problems other than motor vehicle crashes.

• The Role of Enforcement

Research indicates that a higher MLDA results in fewer alcohol-related problems among youth and that the MLDA of 21 saves the lives of well over 1,000 youth each year ( NHTSA 1989 ; Jones et al. 1992 ). What is compelling is that the effect of the higher MLDA is occurring with little or no enforcement. A common argument among opponents of a higher MLDA is that because many minors still drink and purchase alcohol, an MLDA of 21 does not work. The evidence shows, however, that although many youth still consume alcohol, they drink less and experience fewer alcohol-related injuries and deaths than they did under lower MLDA’s ( Wagenaar 1993 ). A more appropriate discussion, therefore, is not whether the MLDA should again be lowered but whether the current MLDA can be made even more effective.

Despite laws prohibiting the sale or provision of alcohol to people under age 21, minors throughout the United States can easily obtain alcohol from many sources. Buyers who appear to be younger than 21 can successfully purchase alcohol from licensed establishments without showing age identification in 50 percent or more of their attempts ( Forster et al. 1994 , 1995 ; Preusser and Williams 1992 ). In addition, although many youth purchase alcohol themselves, most youth indicate that they generally obtain alcohol through social contacts over age 21 ( Wagenaar et al. 1996 b ; Jones-Webb et al. in press ). These social contacts—who include friends, siblings, parents, coworkers, and strangers approached outside of alcohol establishments—purchase alcohol and then either provide or sell it to minors.

Commercial establishments licensed to sell alcohol, as well as social sources, face potential criminal penalties, fines, license suspensions, and lawsuits for selling or providing alcohol to minors. So why do they still supply alcohol to youth? One reason is that policies are not actively enforced. For policies to deter specific behaviors effectively, people must believe that they have some chance of being caught and that they will face swift consequences for noncompliance ( Gibbs 1975 ; Ross 1992 ). Wolfson and colleagues (1996 b ) found that only 38 percent of the alcohol merchants they surveyed thought it was likely that they would be cited for selling alcohol to a minor. Further research is needed to determine whether social sources are aware of their legal liability for providing alcohol to youth and whether they perceive a high likelihood of facing penalties for doing so.

Laws prohibiting the sale and provision of alcohol to minors are not well enforced ( Wagenaar and Wolfson 1995 ), and systems for enforcing the legislation vary by State. Typically, however, enforcement systems use both State administrative agencies, usually called State Alcohol Beverage Control (ABC) agencies, and local law enforcement agencies, such as police departments and county sheriffs. Enforcement of MLDA laws has focused primarily on penalizing underage drinkers for illegal alcohol possession or consumption ( Wagenaar and Wolfson 1995 ), an unintended and unanticipated consequence of the MLDA ( Mosher 1995 ; Wolfson and Hourigan in press ). For every 1,000 minors arrested for alcohol possession, only 130 establishments that sell alcohol to them have actions taken against them, and only 88 adults who purchase alcohol for minors face criminal penalties. Wagenaar and Wolfson (1994) estimate that only 5 of every 100,000 incidents of minors’ drinking result in a fine, license revocation, or license suspension of an alcohol establishment.

An in-depth review of enforcement actions in 295 counties in 4 States (Kentucky, Michigan, Montana, and Oregon) showed that in a 3-year period, 27 percent of the counties took no action against licensed establishments for selling alcohol to minors, and 41 percent of those counties made no arrests of adults who provided alcohol to minors ( Wagenaar and Wolfson 1995 ). The States were selected for their diversity of alcohol-control systems and availability of data. Although the majority of counties took at least one action against alcohol establishments and adults who provided alcohol to youth, many did not take actions frequently.

As noted earlier, only a tiny proportion of incidents of minors’ drinking results in fines or other penalties for establishments that sell alcohol. Some reasons that enforcement agencies do not cite or arrest illegal providers include (1) perceived acceptance of underage drinking by community members, (2) lack of community encouragement to increase enforcement of the MLDA, and (3) lack of resources ( Wolfson et al. 1995 ).

Given the low level of enforcement activity, it is not surprising that many adults do not hesitate to sell or give alcohol to minors. To create a deterrent effect, we need to increase the likelihood of facing negative consequences for illegally selling or providing alcohol to youth. One approach is to encourage ABC and local law enforcement agencies to increase enforcement against illegal alcohol providers. Preusser and colleagues (1994) found dramatic reductions in alcohol sales to minors (from 59 percent at baseline to 26 percent 1 year later) following an enforcement campaign involving three “sting operations” in which underage males attempted to purchase alcohol.

In addition to increasing enforcement of the MLDA, other procedures and policies can be implemented to improve the effectiveness of MLDA laws. To ensure that adults do not sell or provide alcohol to minors, both public and institutional policies can be developed that complement MLDA laws ( Wagenaar et al. 1996 a ). Alcohol establishments, for example, can implement several policies and practices, including (1) requiring all alcohol servers to receive responsible service training on how to check age identification and refuse sales to teenagers, (2) establishing systems to monitor servers to prevent illegal sales to youth, and (3) posting warning signs ( Wolfson et al. 1996 a , b ). Wolfson and colleagues (1996 a , b ) found that establishments adhering to these policies were less likely to sell alcohol to young women who appeared to be under age 21 and who did not present age identification.

• The Ongoing MLDA Debate

Despite an abundance of research demonstrating the effectiveness of the age-21 MLDA at saving lives and reducing alcohol-related problems, several States are again considering lowering their legal age limits for drinking. Louisiana’s MLDA of 21 was recently challenged in court on the premise that it violates the State’s constitutional law regarding age discrimination. Louisiana’s State Supreme Court concluded, however, that “. . . statutes establishing the minimum drinking age at a level higher than the age of majority are not arbitrary because they substantially further the appropriate governmental purpose of improving highway safety, and thus are constitutional” ( Manuel v. State of Louisiana [La. 1996] ). In other words, because the MLDA was based on empirical evidence that such laws saved lives, the court decided that the law was not arbitrary and thus did not violate Louisiana’s constitution. Despite the Louisiana decision, the MLDA of 21 also may be challenged in other States.

The same arguments used to lower the MLDA 20 years ago are being used today (see sidebar , pp. 216–217). Despite ongoing debates about the MLDA, research demonstrates the effectiveness of a higher MLDA in preventing alcohol-related injuries and deaths among youth. As the MLDA’s were lowered, rates of injuries and deaths increased; when the MLDA’s were raised, injuries and deaths significantly decreased. The benefit of using environmental (i.e., external) approaches, such as the MLDA, is further supported by the fact that drinking rates were reduced even after youth turned age 21. In contrast, individual approaches (e.g., school-based programs) have generated only short-term reductions in underage drinking. This finding suggests that to create long-term changes in youth drinking and alcohol-related problems, strategies that change the environment should be used.

The Public Debate Over the MLDA

The public debate over reducing the legal drinking age has remained essentially unchanged since the minimum legal drinking age (MLDA) was first lowered in the 1970’s. Following are some frequently asked questions concerning the MLDA, along with answers based on the research findings to date.

Question: If States are the only entities that have the right to establish a minimum drinking age, does Federal legislation concerning this policy area infringe on State powers?

Answer: The initial movement to raise the MLDA to 21 was largely fueled by citizen action groups in several States, which raised their drinking ages before the Federal Government passed any legislation on the matter. Moreover, the Federal Government encouraged States to increase their MLDA’s to 21 to reduce traffic crashes caused by people driving to States that had lower MLDA’s. The Federal Government did not mandate the change. Polls continue to show strong public support for the drinking age of 21 ( Wagenaar 1993 a ).

Question: Many Europeans let their children drink from an early age, and European countries do not have the same alcohol-related problems that we do. Therefore, how can people claim that MLDA’s are a major factor in helping to prevent alcohol problems in the United States?

Answer: Research confirms that European countries do experience alcohol-related problems. For example, European countries have rates of alcohol-induced diseases, such as cirrhosis of the liver, similar to (or higher than) the United States ( Single 1984 ). Drunk driving among youth may not be as great a problem in Europe; compared with youth in the United States, European youth obtain their drivers’ licenses at an older age, are less able to afford automobiles, and more often use public transportation. Youth in Europe thus may be at lower risk of traffic crashes simply because they drive less frequently than their U.S. counterparts. Other alcohol-related problems are significant enough in Europe that those countries are examining the U.S. experience regarding MLDA policy and are initiating a debate over the most appropriate age for legal access to alcohol ( Wagenaar 1993 a ).

In reviewing another country’s success with a given policy, one cannot simply compare international rates of alcohol-related problems without assessing the role of factors that contribute to the problems. Many cultural, political, and social conditions, which differ from country to country, affect drinking rates. The most robust research, although conducted in the United States, has shown a strong inverse relationship between MLDA and alcohol consumption and its related problems: As MLDA increases, alcohol-related problems among youth decrease. As MLDA changes occur in Europe, researchers will be able to determine more accurately the effect of a higher MLDA on alcohol-related problems among European youth.

Question: If a person is old enough to serve in the military, how can he or she not be old enough to buy alcohol?

Answer: Different activities have different ages of initiation: A person can drive at age 16, vote in elections and serve in the military at age 18, and serve as President at age 35. These restrictions are based on the requirements of the specific activities (e.g., motor skills, capacity for judgment, and experience) and take into account the risks and benefits of participation at different ages ( Fell 1985 ). For example, research shows that at a given blood alcohol concentration, youth are more likely to be impaired than adults. Underage drinking is strongly related to serious public health problems, including injuries and death resulting from motor vehicle crashes, homicide, assault, and recreational injury. Consequently, policymakers and researchers have come to believe that risk both to youth and to society in general can be reduced by restricting people below age 21 from drinking.

Question: How can researchers be sure that the drop in rates of alcohol-related crashes among 19-and 20-year-olds following the increase in the MLDA to 21 was related to MLDA policy?

Answer: When the age-21 restriction was initiated, alcohol-involved highway crashes declined among 18- to 20-year-olds. This decline occurred with limited enforcement of the MLDA laws. The decline is therefore not attributable to drinking-driving enforcement and tougher penalties but directly results from lower consumption levels ( O’Malley and Wagenaar 1991 ).

Question: If people cannot legally drink until they are 21, will they just drink more when they reach the MLDA?

Answer: Research indicates that the opposite is true ( Wagenaar 1993 b ). In fact, early legal access to alcohol (i.e., at age 18) is associated with higher rates of drinking later in life. Research shows that when the MLDA is 21, people under age 21 drink less and continue to do so through their early twenties. Those who are inclined to drink do not “make up for lost time” after turning 21 ( O’Malley and Wagenaar 1991 ).

—Carolyn Rosenfeld

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Despite the MLDA of 21, minors still have easy access to alcohol from commercial and social sources. The observed benefits of the MLDA have occurred with little or no active enforcement; simply by increasing enforcement levels and deterring adults from selling or providing alcohol to minors, even more injuries and deaths related to alcohol use among youth can be prevented each year.

This research was funded in part by National Institute on Alcohol Abuse and Alcoholism grants R01AA10426 and R01AA09142 to Alexander C. Wagenaar.

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Why the drinking age should be lowered

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Why the drinking age should be lowered: an opinion based upon research.

Engs, Ruth C. (1997, 2014). “Why the drinking age should be lowered: An opinion based upon research. Indiana University: Bloomington, IN. Adapted from: IUScholarWorks Repository:  http://hdl.handle.net/2022/17594

The legal drinking age should be lowered to about 18 or 19 and young adults allowed to drink in controlled environments such as restaurants, taverns, pubs and official school and university functions. In these situations responsible drinking could be taught through role modeling and educational programs. Mature and sensible drinking behavior would be expected. This opinion is based upon research that I have been involved in for over thirty years concerning college age youth and the history of drinking in the United States and other cultures.

Although the legal purchase age is 21 years of age, a majority of college students under this age consume alcohol but in an irresponsible manner. This is because drinking by these youth is seen as an enticing "forbidden fruit," a "badge of rebellion against authority" and a symbol of "adulthood." As a nation we have tried prohibition legislation twice in the past for controlling irresponsible drinking problems. This was during National Prohibition in the 1920s and state prohibition during the 1850s. These laws were finally repealed because they were unenforceable and because the backlash towards them caused other social problems. Today we are repeating history and making the same mistakes that occurred in the past. Prohibition did not work then and prohibition for young people under the age of 21 is not working now.

The flaunting of the current laws is readily seen among university students. Those under the age of 21 are more likely to be heavy -- sometimes called "binge" -- drinkers (consuming over 5 drinks at least once a week). For example, 22% of all students under 21 compared to 18% over 21 years of age are heavy drinkers. Among drinkers only, 32% of under-age compared to 24% of legal age are heavy drinkers.

Research from the early 1980s until the present has shown a continuous decrease, and then leveling off, in drinking and driving related variables which has parallel the nation's, and also university students, decrease in per capita consumption. However, these declines started in 1980 before the national 1987 law which mandated states to have 21 year old alcohol purchase laws.

The decrease in drinking and driving problems are the result of many factors and not just the rise in purchase age or the decreased per capita consumption. These include: education concerning drunk driving, designated driver programs, increased seat belt and air bag usage, safer automobiles, lower speed limits, free taxi services from drinking establishments, etc.

While there has been a decrease in per capita consumption and motor vehicle crashes, unfortunately, during this same time period there was an INCREASE in other problems related to heavy and irresponsible drinking among college age youth. Most of these reported behaviors showed little change until AFTER the 21 year old law in 1987. For example from 1982 until 1987 about 46% of students reported "vomiting after drinking." This jumped to over 50% after the law change. Significant increase were also found for other variables: "cutting class after drinking" jumped from 9% to almost 12%; "missing class because of hangover" went from 26% to 28%; "getting lower grade because of drinking" rose from 5% to 7%; and "been in a fight after drinking" increased from 12% to 17%. All of these behaviors are indices of irresponsible drinking. This increase in abusive drinking behavior is due to "underground drinking" outside of adult supervision in student rooms, houses, and apartments where same age individuals congregate. The irresponsible behavior is exhibited because of lack of knowledge of responsible drinking behaviors, reactance motivation (rebellion against the law), or student sub-culture norms.

Beginning in the first decade of the 21st century, distilled spirits [hard liquor] began to be the beverage of choice rather than beer among collegians. Previously beer had been the beverage of choice among students. A 2013 study of nursing students, for example, revealed that they consumed an average of 4.3 shots of liquor compared to 2.6 glasses of beer on a weekly basis.

This change in beverage choice along with irresponsible drinking patterns among young collegians has led to increased incidences of alcohol toxicity - in some cases leading to death from alcohol poisoning. However, the percent of students who consume alcohol or are heavy or binge drinkers has been relatively stable for the past 30 years.

Based upon the fact that our current prohibition laws are not working, the need for alternative approaches from the experience of other, and more ancient cultures, who do not have these problems need to be tried. Groups such as Italians, Greeks, Chinese and Jews, who have few drinking related problems, tend to share some common characteristics. Alcohol is neither seen as a poison or a magic potent, there is little or no social pressure to drink, irresponsible behavior is never tolerated, young people learn at home from their parents and from other adults how to handle alcohol in a responsible manner, there is societal consensus on what constitutes responsible drinking. Because the 21 year old drinking age law is not working, and is counterproductive, it behooves us as a nation to change our current prohibition law and to teach responsible drinking techniques for those who chose to consume alcoholic beverages.

Research articles that support this opinion are found in the Indiana University Repository at: https://scholarworks.iu.edu/dspace/handle/2022/17133/browse?type=title

and https://scholarworks.iu.edu/dspace/handle/2022/17130/browse?type=title

Some material here also used in: Engs, Ruth C. "Should the drinking age be lowered to 18 or 19." In Karen Scrivo, "Drinking on Campus," CQ Researcher 8 (March 20,1998):257.

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(c) Copyright, 1975-2024. Ruth C. Engs, Indiana University, Bloomington, IN 47405

Has lowering the drinking age caused more crime? Despite ongoing concern, the evidence isn’t clear cut

Senior Research Fellow in Applied Labour Economics, Auckland University of Technology

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Senior Research Fellow, Auckland University of Technology

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It’s fair to say that drinking alcohol is popular among Kiwis, to the point of potential harm.

According to the latest New Zealand Health Survey , one in five adults – or 824,000 people – have an established drinking pattern that “carries a high risk of future damage to physical or mental health”.

In 2016, data showed heavy drinking sessions were much more common in New Zealand than in the UK, the US, Canada and even countries like Finland, Norway and Sweden.

Alcohol abuse is also a major contributor to crime. In 2010, the New Zealand Police estimated about one-third of all police apprehensions involved alcohol and half of serious violent crimes had alcohol as a contributing factor.

Dropping the purchasing age

However, in a landmark alcohol reform enacted in 1999, New Zealand reduced the minimum purchasing age from 20 to 18 years old.

Politicians in favour of the change argued that an 18-year-old could vote and marry and should therefore be given the chance to drink in a safe environment .

Since then, there has been an ongoing debate among social and political commentators, including health professionals, over whether the legal purchasing threshold should be raised back to 20.

Critics of the 1999 reform usually cite a potential increase in public health risks to support their point of view.

Last year, in an unprecedented move, the heads of the district health boards released a joint statement calling for the reform of the 2012 Sale and Supply of Alcohol Act.

The statement proposed numerous changes to reduce easy access to alcohol, including increasing the legal purchasing age from 18 to 20.

Does alcohol access cause a jump in crime?

In a recent study , researchers found monthly consumption jumped drastically when individuals turned 18 and could legally purchase alcohol.

The researchers used Statistics New Zealand’s integrated data infrastructure (IDI) to test whether this change in drinking behaviour prompted a corresponding spike in alcohol-related criminal behaviour among 18- and 19-year-olds.

The analysis also took advantage of the detailed crime register administered by the Ministry of Justice.

The spectrum of offences is broad, ranging from minor incidents, such as bringing alcohol into an alcohol banned area, to severe crimes like causing injury through excess alcohol.

The authors considered convictions a more accurate measure of crime than arrests, as not every arrest leads to a conviction.

Read more: College-age kids and teens are drinking less alcohol – marijuana is a different story

Researchers looked at the difference in alcohol-related criminal behaviour for ages just below the minimum legal purchasing age versus ages right above the mandated age threshold.

Put simply, the research compared the criminal outcomes of youths who had just gained the right to buy alcohol to those who were close to turning 18 and therefore unable to legally buy it.

There was a slight increase in traffic violations by drivers around the currently mandated age of 18. However, the analysis found little evidence that 18- and 19-year-olds committed more alcohol-related crimes after reaching the legal purchasing age.

From 2014 to 2018, the average number of alcohol-induced offences for those aged 17 years and 11 months stood at 53 convictions per 100,000 people and increased by four convictions in the month turning 18. This equals an increase of 8% but is not statistically significant.

However, similar to previous research, the analysis indicated that gaining easier access to alcohol was associated with an immediate spike in other crimes, particularly dangerous acts and property damage.

The average number of property damage convictions (per 100,000 people) where alcohol was involved increased from 40 to 51 (28%), and dangerous acts increased from 47 to 60 convictions (27%) in the month of turning 18.

Alcohol purchasing age of 20

The researchers also examined how criminal behaviour changed in the period between 1994 and 1998 when the legal alcohol purchasing age was 20.

They found that all alcohol-related convictions dropped from 203 to 163 (19%) in the month of turning 20.

This surprising pattern is caused by changes in the legal breath and blood alcohol limit, which takes place at the same age and permits higher blood alcohol levels for drivers aged 20 and above.

When removing those types of convictions, the researchers find no observable jump in alcohol-related crimes. That said, there was an increase in offences against public order and other traffic-related convictions.

Alcohol and crime in the US and Canada

These findings align with the data from the United States and Canada .

A US study looked at how crime rates changed around the minimum legal drinking age of 21 in the states where drinking and purchasing alcohol below the age of 21 is not permitted.

Read more: Binge drinking and blackouts: Sobering truths about lost learning for college students

The authors found individuals aged just over 21 were 5.9% more likely to be arrested than individuals just under 21. However, crime levels for this age group were substantially higher compared to New Zealand.

In Canada, where the minimum legal drinking age for most states sits at 18, and 19 in Alberta, Manitoba and Québec, a sharp increase of 7.6% in all crimes was observed – with a large jump of 29.4% for disorderly conduct.

As two decades of data shows, allowing younger people to drink has resulted in upticks in some types of crime, but not all of them. Understanding the impact of lowering New Zealand’s drinking age can inform the ongoing policy debate and offers decision makers an insight into how these sorts of thresholds can change society in unexpected ways.

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Events, news & press, underage drinking and the drinking age.

The Amethyst Initiative’s harmful remedy

T he problem of underage drinking on college campuses has been brewing for many years to the continued vexation of higher education administrators. In 2008 , John McCardell, president emeritus of Middlebury College, began to circulate for signature a public statement among colleagues titled “The Amethyst Initiative,” 1 which calls for elected officials to reexamine underage drinking laws. The project grew out of outreach efforts of a nonprofit organization he founded in 2007 called Choose Responsibility. The nonprofit advocates lowering the drinking age to 18 and licensing alcohol use for young people in much the same manner as driving — following coursework and an exam. Choose Responsibility also favors the repeal of the laws that set 21 as the mandatory minimum age for drinking (known as the “ 21 laws”) and encourages states at the least to adopt exceptions to the 21  laws that would allow minors to drink at home and in private clubs. It also favors social changes that shift the focus on alcohol use among youth to the home, family, and individual.

The Amethyst Initiative’s statement has been signed by 135 college presidents and chancellors at schools from Duke to Bennington. The majority is private; most are in the Northeast. The statement takes no formal position, unlike Choose Responsibility. It does, however, drop heavy hints as to where the debate ought to come out. The statement says “ 21 is not working” and asks “How many times must we relearn the lessons of Prohibition?” It draws comparisons to other age-of-majority rights conferred on 18 -year-olds, such as voting and serving in the military, and calls upon elected officials to consider “whether current public policies are in line with current realities.”

It seems that the presidents of 135 colleges, including elite schools, large universities, and small state schools find themselves so exasperated with the amount of alcohol guzzled by undergraduates — or more to the point, the trouble the undergraduates get into while inebriated — that they now beseech lawmakers to “rethink 21 ,” an elegant and rather roundabout way of saying: Let undergrads drink with the sanction of the law.

The primary argument made in the Initiative’s statement in favor of repealing the 21 laws is that the 21 laws make alcohol taboo, thus driving underage drinking underground and causing more binge drinking to take place than otherwise would, due to the allure of forbidden fruit and the need for secrecy. Hence, by lowering the drinking age, youth consumption would come out in the open and binge drinking would be largely reduced or even eliminated. The second salutary effect of lowering the drinking age, the Initiative argues, would be educational: Colleges would be allowed to have open, frank discussions about responsible drinking. In other words, institutions of higher education could teach young people how to drink responsibly. The Initiative makes vague references to the “unintended consequences” of 21 “posing increasing risks to young people,” and says that the original impetus for the 21  laws — reduction of highway fatalities by young drivers — has outlived its usefulness.

Since its launch, the Initiative has created a public dialog about the drinking age, resulting in media coverage and a hearing before the New Jersey state legislature in November 2008 . Despite its gravity as a public health problem, even among children younger than 18 , the topic of underage alcohol abuse has been underaddressed in the popular media and in public funding compared to illicit drug abuse. The Initiative is a welcome development insofar as it challenges us to examine whether 21 “is working.” The answer: It is not, as currently enforced. So should 21 be scrapped or salvaged? First, a look at how we got here, and why the 21  laws are broken.  

The 21 laws

A mericans generally have not allowed young people to drink. Older teens were allowed to drink legally during part of the 1970 s and early 1980 s — a blip on the American-history radar screen. Here is how it happened.

During the 19 th century, cultural and social norms prevented young people from drinking. The expense and limited availability of liquor also helped keep it out of youthful hands. After Prohibition, it was left up to the states to regulate alcohol, and most states made the legal drinking age 21 , the same as the age for voting and other adult rights. The issue remained largely untouched until the late 1960 s when protests over the Vietnam War raised the question of the national voting age. For the first time, the question of the draft age and the voting age were linked in the popular imagination, at least among the left. “If a boy is old enough to fight and die for his country, why isn’t he old enough to vote?” was the popular refrain.

The legal drinking age got swept up in the political upheaval of the era, as states generally reexamined their age-of-majority laws. Between 1970 and 1976 , 29 states lowered their age for drinking alcohol. The results were catastrophic. Highway deaths among teenagers and young adults skyrocketed. Almost immediately, states began raising the minimum drinking age again — years before Congress in 1982 and 1984 dangled the carrot of federal highway monies as an incentive. Between 1976 and 1984 , 24 of the 29 states raised the age back up again. By 1984 , only three states allowed 18 -year-olds to drink. Five states and the District of Columbia regulated various degrees of alcohol consumption among those 18 and over. The remaining states had a patchwork of minimum ages ranging from 19 to 21 . 2

While states experimented with age-of-majority laws, a cultural shift was taking place in how society regarded drunk driving. In 1980 , a 13 -year-old California girl named Cari Lightner was walking to a carnival when she was struck by a hit-and-run drunk driver and killed instantly. Her mother became enraged when she learned that drunk driving was not treated seriously in the American judicial system. What followed was one of the great stories of American grassroots activism. Together with a friend, Candace Lightner founded Mothers Against Drunk Driving ( madd ), which quickly garnered local and later national support in a campaign that focused on putting a human face on the damage done by drunk drivers. By 1982 , with madd 100 -chapters strong, President Reagan created a presidential commission to study drunk driving and Congress authorized highway funds to states that passed stiffer drunk driving laws. In 1984 , Congress passed the Uniform Drinking Age Act, which required states to have a minimum drinking age of 21 < for all types of alcohol consumption if they wanted to receive federal highway monies. The legal drinking age has stayed at 21  since then.

In most of the television debates about the Amethyst Initiative, the success or failure of 21 has been primarily linked to the issue of highway deaths, with the debaters arguing fatality statistics to prove whether the 21 laws should be shelved because of the advent of safer cars. But that suggests, wrongly, that the debate largely begins and ends with the question of teenage bodies splattered across the interstates. While drunk driving among underage drinkers remains a problem, unfortunately it is only one of several ways that underage drinking threatens young people. Time has not stood still since 1984 . American campuses and drinking patterns have changed, and not for the better.

Binge drinking

T he logic of the Initiative is that if we take away the allure of illegality, American youth will stop binging. That conclusion is wrong. Alcohol should be forbidden to 18 - to 20 -year-olds precisely because they have a propensity  to binge drink whether the stuff is illegal or not — especially males.

Henry Wechsler and Toben F. Nelson, in the landmark Harvard School of Public Health College Alcohol Study, or cas , which tracked college student drinking patterns from 1992 to 2001 , explained that binge drinking is five or more drinks on one occasion. Binge drinking brings the blood alcohol concentration to 0.08 gram percent or above (typically five drinks for a man or four for a woman within two hours). To understand just how drunk that makes a person, consider that it violates criminal laws to drive with a blood alcohol level of 0.08  gram percent or above.

To call alcohol taboo implies that drinking is done in secret and rarely. Yet college drinking is so common as to have lost all tinge of intrigue. Drinking greases the social wheels, and college life for many is saturated with popular drinking games that no doubt seem brilliant to the late-adolescent: Beerchesi, Beergammon, BeerSoftball, coin games like Psycho, Quarters, and BeerBattleship, and card and dice games linked to beer.

When undergraduates binge drink, they get into trouble — a lot of it. They endanger and sometimes kill their fellow students by setting fires. 3 They sexually assault their female companions (approximately 100,000 incidents annually). They get into fights with other young undergrads (some 700,000 assaults annually). On average 1,100 a year die from alcohol-related traffic crashes and another 300 die in nontraffic alcohol-related deaths. According to the cas , among the 8 million college students in the United States surveyed in one study year, more than 2 million drove under the influence of alcohol and more than 3 million rode in cars with drivers who had been drinking. Eight percent of students — 474,000 — have unprotected consensual sex each year because they have been drinking. 4  In short, college students do stupid, illegal, dangerous, and sometimes deadly things when they drink.

Moreover, the drinking doesn’t begin in college. More kids drink alcohol than smoke pot, which is the most commonly used illicit drug. A third of our youth taste their first drink before the age of 13 and have drinking patterns as early as 8 th to 10 th grade. In a pattern that continues in college, boys fall into binge drinking patterns in greater numbers than girls by 12 th grade. 5 The Pacific Institute for Research and Evaluation has estimated the social cost of underage drinking (for all youth) at some $ 53  billion. That includes only highway deaths and injuries and does not factor in brain damage associated with early adolescent drinking, or the array of other injuries and social problems such as opportunity costs that crop up when children drink.

The majority of those who binge drink in college started down that road long before they matriculated — they simply continue their drinking habits once they arrive on campus. Brett Sokolow, president of the consulting firm National Center for Higher Education Risk Management ( ncherm ), which counsels colleges on reducing “risk” through educational programs and institutional policies, said in an interview that based on his anecdotal experience, 60 to 70 percent of the students attending his on-campus alcohol seminars have had drinking experiences prior to attending college and about 40  percent have “deeply engrained drinking habits” by the time they get to college.

Consider the scope of college drinking. Among the general population in America, 15 percent of 18 - to 25 -year-olds binge drink, according to the Centers for Disease Control. Among college students, 80 percent reported drinking and of those, 40 percent binge drink once a month — that is more than twice the rate of their peers in the general population. 6 About one fourth drank in this way frequently — three or more times in a two week period. 7

If college life, with its basic structure and lack of privacy, forces drinking underground as the Amethyst Initiative posits, then one should see far less binge drinking among youth who are not in college. A study drawn on data from the National Household Survey on Drug Abuse, which looked at heavy episodic drinking among all 18 - to 24 -year-olds, comparing those in college to those outside the ivy-covered walls, does not bear out the Initiative’s theory. While 41 percent of those in college binge drank at least once a month, according to that study, so did 36  percent of other youth. And as we shall see, in the military and in countries where they may drink legally, the young guzzle apace.

U.S. military

T he initiative, as  well as students arguing in favor of the right to go to keggers, invoke the plight of the parched soldier — old enough to die for his country but not allowed to have a beer. The cascading images on Choose Responsibility’s Web site even include the wordless image of a young soldier.

Reality check: The U.S. Department of Defense takes substance abuse among military personnel very seriously and has been addressing drug and alcohol issues for many years. While it has made great progress against illicit drugs, it has found alcohol more intractable. dod devotes substantial resources to counseling and prevention programs. Heavy alcohol use is regarded as a drain on morale and productivity and a potential threat to unit readiness. dod in 2005  undertook a comprehensive study of health-related behaviors among active-duty military personnel that compared alcohol use among men and women in the four branches of the service and the civilian population.

It found high rates of binge drinking among young service members, especially men aged 18 to 25 . Binge drinking was especially high in the Army and the Marines, where binge drinking rates of young men were similar to those of male college students. The consequences of heavy alcohol use in the military can be severe, including being passed over for promotion and punishment under the Uniform Code of Military Justice.

Not all military drinking by young men and women is illegal, depending on where soldiers and sailors are stationed. Under federal law, military personnel must comply with the law of the jurisdiction in which their installation is located. Contrary to the lure-of-the-illicit theory, the dod study showed that soldiers drink more when it is legal . Among the entire military (all ages), 15 percent are heavy users of alcohol in the continental United States, while outside the United States, 25  percent are heavy users. The study found that one of the factors that made binge drinking less likely was being located in the United States.

This throws into doubt two fundamental assumptions of the Initiative: that young people drink because of the allure of forbidden fruit; and that enforcement does not work. Young men in the military, who clearly have a very strong propensity to drink, do less of it when stationed in the United States. While one can surmise that some of the decrease could be due to lower levels of stress, it is a comparison that bears further inquiry. There is something about young males being grouped together in bonding experiences, whether in college or in the military, that seems to lend itself to heavy drinking.  

The military experience of lower drinking levels in the U.S. could also mean that factors such as enforcement, fear of consequences, and difficulty in obtaining alcohol influences the amount of binge drinking. The Air Force has the lowest rate of binge drinking among the service branches and the Navy has made an effort to change the culture of sailors on liberty engaging in binge drinking. Clearly, drinking is influenced by organizational culture. The cas study came to similar conclusions: It found that drinking cultures differ among schools and states, sometimes depending on the level of binge drinking among adults  and the type of enforcement in the state. The environment in which young people are placed and the adult support systems and level of enforcement count.

Other settings bear comparison. American students studying abroad in France or Italy notice that college students there don’t drink like fish, and assume that is the case among young people everywhere in Europe. While many Americans cling to the belief that Europeans are better than us, studies of drinking habits across all of Europe show that their binge drinking problems are worse than ours in many countries, start at younger ages, and continue into adulthood.

The legal drinking ages in Europe generally range from 16 to 18 with varying rules as to when youth may purchase and consume alcohol. Serious binge drinking begins at age 15 in countries across the European Union. The highest rates are seen in the Nordic countries, Slovenia, Latvia, the uk , and Ireland. 8 Young teenagers, 15 - to 16 -year-olds, are drinking six drinks at a clip when they go out (even more in the uk and Ireland), and 18 percent of that age group is binge drinking three times a month. Things aren’t much better south of the equator. When New Zealand lowered its drinking age to 18 it experienced a “sharp increase in binge drinking among teenagers and young adults.” 9

The alcohol-sex cocktail

M an does not  live by drink alone. There is something else college students, far from the confines of home, like to do: have sex. And when we consider that the vast majority of binge drinkers are male and then factor in their role as the initiator in sexual adventures, the role of sex drive in campus alcohol abuse becomes clearer.

One of the results of the fall of in loco parentis in the early 1970 s was the rise of the ivory-towered Sodom and Gomorrah. Mind you, today we are not talking about dating as the Baby Boomer generation understands it. We are talking about “hooking up.” That means young people go out in groups and then pair off, have casual sex, and quite possibly never get together again. Alcohol, sadly, is directly linked to the hookup culture. It fuels casual and often dangerous sexual encounters on campuses. (The danger lies in unprotected sex and date rape.)

It’s important to think about the hookup culture as we weigh whether lowering the drinking age, coupled with education and licensing, would work. Picture this: A 19 -year-old male has heard the lectures and has an alcohol license in his hip pocket. Yet he knows that plying himself and his female companions with beer will vastly increase his chances that the evening will end with a hookup. Oh, and he’s at a bar selling 25 -cent beer pitchers. Care to wager how that night will turn out?

Brett Sokolow of ncherm said in an interview that the alcohol-related campus workshops he conducts grew out of sexual assault presentations he has done. In speaking with students and exploring how assault situations arose, he found that alcohol played an integral role. His anecdotal observations of the connection between alcohol and problematic sexual encounters on campus are reflected in research in the field. In 2001 , 474,000 college students had unprotected sexual intercourse as a result of their drinking. In the same year, more than 696,000 reported being assaulted or hit by another drinking student and of those episodes, 97,000 were alcohol-related sexual assault or date rape victims. 10

Sexual misconduct hearings are now “no longer rare occurrences on many college campuses,” Sokolow wrote in a white paper. The paper (available on the ncherm  website) provides painstaking guidelines for college administrators to follow in conducting disciplinary hearings to determine if the victim of an alleged assault was truly “incapacitated” or just plain “drunk,” “under the influence,” “intoxicated,” or “inebriated.” Parsing such terms is a job skill for today’s college administrator, since only “incapacitation” renders a victim unable to give consent to a sexual encounter.

Just another privilege?

T he initiative takes pains to refer to college students as “adults,” and argues that the 21 laws should be brought “into sync” with age-of-majority rights such as voting, military service, or contract. These are not apt comparisons because the basis of those rights is the doctrine of emancipation. Given the grave consequences of underage alcohol consumption, the legal test for emancipation is helpful in thinking about whether the typical American 18 -year-old is mature enough for the rights and responsibilities of legal drinking.

When a minor enters the military (with parental permission), he or she automatically  becomes emancipated in the eyes of the law. The law assumes that the military will only accept someone who demonstrates the necessary level of maturity for duty. In the event the military is wrong, it has an excellent system for weeding out mistakes: basic training. The military can discharge those not up to the challenge. For a minor to become emancipated under other circumstances, it’s a tougher process. He must show a court that he is self-supporting, can handle his own personal affairs, and understands what emancipation means.

Although a typical 18 -year-old is technically emancipated, it is the rare college student who could pass such a test. Rather than living a life of real emancipation like his married or enlisted counterparts, the college student exists in a strange netherworld suspended between adolescence and real adulthood. While college students demonstrate a good deal of independence in the sense that they live away from home, make friends, study, and do their own laundry, they are nonetheless dependent on their parents financially and demonstrate varying degrees of autonomy and good sense. They are often busy having the time of their lives. Indeed, a common suggestion for reigning in campus drinking is to hold classes on Friday mornings, thus preventing the weekend revelry from beginning on Thursday nights.

Alcohol consumption is unique among the rights conferred by age-of-majority laws because it alters brain chemistry, and the risk of conferring it on the wrong person can be immediate and violent. Bear in mind that under various provisions of state and federal law, even minors emancipated at an early age through marriage or military service see no change in their right to drink.

In addition, colleges are not the bastions of the hale and hearty they were for most of the 20 th century. Today, students attend college while managing chronic illnesses such as arthritis, diabetes, multiple sclerosis, asthma, depression and other psychiatric maladies, endocrine disorders, and attention deficit disorder. College populations even include cancer survivors in various stages of remission. “Two generations ago [ill students] would not have been mainstreamed,” said Patricia Fennell, head of Albany Health Management Associates and an expert on managing chronic health conditions. Now they are coping with chronic illnesses far from the watchful eyes of their parents — which means taking medicines and dealing with the temptations of college life — including alcohol.

Emancipation is not always desirable. Indeed, there is a tradition in the law to that effect. Many states have an express, statutory exception to age-of-majority emancipation rules. Exceptions usually relate to special rights conferred on the disabled, who are entitled to certain protections beyond the age of 18 . Many state and federal child poverty programs cover children through age  21 . Given the rates of binge drinking on campus and the number of deaths, injuries, and social costs associated with underage alcohol use, the emancipation-exception doctrines provide a useful perspective from which to think about the 21 laws. By delaying legal drinking, the 21 laws provide a valuable, partial exception to emancipation for 18 -, 19 - and 20 -year-olds on the grounds that when it comes to alcohol, they can benefit from society’s protection.

The question is not whether we should protect youth from alcohol, but why has society done such a lousy job of it by largely failing to enforce the 21  laws? The Initiative, in its rhetorical question about “repeating the lessons of Prohibition,” intimates that laws proscribing alcohol are simply doomed to failure. Are they?

Prohibition

I n the early 20 th century, the nation was a hodgepodge of “dry” and “wet” states. During the 1910 s, dry states became frustrated that liquor was entering their borders via railroad shipments to individuals under a legal loophole. The powerful Anti-Saloon League lobbied successfully for the Webb-Kenyon Act, which President Taft later vetoed. A court challenge followed in 1917 . The decision, Clark Distilling Co. v. Western Maryland Railway Co. , upheld the constitutionality of the Act, despite concerns that had been raised about it under the commerce clause of the Constitution. With power becoming centralized in Washington as World War I approached, the dry congressmen who dominated at the time saw their moment to take on the alcohol industry. Congress passed the 18 th Amendment, which was quickly ratified in January, 1919 . 11

The 18 th Amendment banned the manufacture, sale, and importation of “intoxicating liquors” for use as beverages. It gave “concurring jurisdiction” for enforcement to the federal and state governments. Congress soon passed the Volstead Act, which defined “intoxicating liquor” to include even light beer. The Volstead Act was far more draconian than many dry advocates anticipated and cost the movement supporters.

Prohibition’s impact was immediate: It lowered the rates of alcohol-related deaths, illnesses, and pathologies such as cirrhosis, alcoholism, and drunkenness arrests, and dramatically lowered the consumption of beer and liquor. So intense was the regulatory effort during Prohibition that 85 percent of distilleries went out of business, with the remainder producing mostly industrial alcohol. The social tradition of the male saloon vanished from American life. All of this was done at a substantial sacrifice to the national purse. 12

Nonetheless, the “concurring jurisdiction” clause wreaked havoc. The U.S. Supreme Court held in the National Prohibition Cases  that “concurring jurisdiction” meant that the federal government got to call the shots and enforce its teetotaling agenda under the Volstead Act even where local or state law was more lenient. That was a formula for hostility between state and federal governments and an invitation to subverting the law through illegal trafficking and speakeasies. Moreover, Southern states didn’t want Washington sticking its nose in their business — wet or dry. Consequently, Southern states put the kibosh on federal enforcement by making sure it was underfunded by Congress. Not surprisingly, the feds ended up doing most of the enforcement — underfunded — competing with overlapping, often uncooperative state entities, involved in their own local, wet-dry politics.

A combination of factors sank Prohibition, both social and political. In the end, however, it was the Great Depression that broke the back of Prohibition. By the late 1920 s, business titans such as Pierre DuPont, who had been dry advocates, felt pummeled by the taxman of the Roaring Twenties and suddenly were singing the praises of the British liquor tax system. Just one year after the election of the “wet” Roosevelt ticket in 1932 , ratifying conventions were held for the 21 st Amendment with the hope that the resurgence of the alcohol industry would replenish tax revenues and provide “relief to suffering families.” 13

There is much to learn from Prohibition. The 21 laws are not as sweeping as the Volstead Act. They are not a ban on an industry, nor are they a ban on the sale of all alcohol to all drinkers; they do not create a bootleg market or leave a void for organized crime. The political factions that undermined Prohibition enforcement are not a factor in underage drinking. The 21  laws ban alcohol for a small segment of society, extending the childhood ban on alcohol for only three years. Choose Responsibility argues that the violence and illegal excesses of Prohibition — the homemade booze that made people sick, the organized crime, the shootouts — bear a direct parallel to the secretive ways of today’s underage binge drinking.

This isn’t so. American youth don’t distill liquor in their dorm rooms, they aren’t involved in organized crime, they don’t shoot federal marshals or transport truckloads of bootleg spirits. We are faced with the opposite problem: Underage drinkers are surrounded by easily available alcohol and need expend no special efforts to obtain it. A phony id , an invitation to a party, or a 21 -year-old friend does the trick. There is no underground market in alcohol — they are buying their alcohol from neighborhood pubs and liquor stores or obtaining it from older buddies.

There already exist many laws relating to the sale of liquor to those under 21  that, if better enforced, could prevent underage drinking. Enactment of additional laws in some states would aid enforcement. For example, purchasing alcohol for underage drinkers or selling large quantities of beer or renting unregistered kegs are not illegal in some states — but should be. These types of state and local laws do not conflict with each other, nor do they overlap with federal enforcement efforts, which was a central point of policy contention that gave rise to criminality and weak enforcement during Prohibition. The federal Department of Education regulations that can penalize schools for failure to comply with federal alcohol-related campus policies do not overlap with local law enforcement powers to arrest, prosecute, or fine those who sell liquor to minors.

A fundamental change in outlook is required, because selling liquor to young people in the United States is big business. Underage drinkers account for 19.4 percent of alcohol revenues (about $ 22.5 billion). 14 The absurdly low price of beer near college campuses — it is not unusual for a pitcher of beer to cost 25 cents — creates temptations that are very hard for young people in college to resist. A discussion in the National Academy of Sciences report on underage drinking revealed that when alcohol is “readily accessible” to young people, it “represents a powerful message within the social environment that encourages youth consumption and undermines other messages regarding the risks alcohol poses to their well being.” 15 The low price of beer has been shown to be an important factor in underage drinking and the overall accessibility of alcohol to young people. During the decade from 1981 to 1992 , underage drinking declined because of intense public education, a shift in youth culture away from the 1970 s model of getting wasted, and — significantly — a lack of spending money available to young people. 16

Why not just educate?

C hoose responsibility would replace the 21 laws with alcohol education at home and on campus. But colleges already educate college students about drinking. Even though schools are required to have anti-underage drinking policies under federal law, there is nothing to prevent them from teaching moderation or techniques to prevent alcohol poisoning. Indeed, college students get alcohol education from numerous sources: official school policy and abstinence programs and alcohol moderation programs provided by colleges; moderation programs provided by outside consulting groups; an online program called AlcoholEdu that has reached almost a quarter of a million students on over 400 college campuses; and normative marketing programs. Sokolow estimates that 10 to 20  percent of colleges now have outside consultants come to campus to provide alcohol moderation programs.

A large role is also played by social-norms marketing programs in which “latent healthy norms” about college drinking are made known to students through posters, flyers, and other forms of high-profile communication on campus. In other words, messages on billboards and flyers all over campus model the way grown-ups drink. A program may present the idea that a typical young drinker consumes five or fewer drinks when he parties with friends. Such marketing programs carry a positive message and do not discuss the dangers of drinking. About half of all four-year residential colleges have conducted social-norms marketing programs for alcohol. 17

They are not necessarily a good idea. A study of alcohol-related social-norms marketing was done based on the data gathered in the Harvard cas that compared the 118  schools in the survey. The social-norms study included the schools that had experienced social-norms marketing programs and those that didn’t. The study showed that social-norms marketing did not reduce college drinking. In fact, in the schools that had the programs, drinking increased. In the schools without the programs, no change in drinking rates occurred.

The study did not show why drinking increased at schools with the programs, but it is a cautionary tale. The college drinking scene is a battleground with two fronts: coping with those who already are binge drinkers and fighting for the hearts and souls of the others. We know that about half of freshman classes enter with no history of alcohol use and can be lured into drinking. Hearing a message sanctioned by the college that some drinking is all right could tip the balance.

We do know that many environmental factors influence the likelihood of a nondrinking student continuing on that course, including diversity of the student body, the number of female students, the risk and cost of obtaining alcohol and the presence of “zero-tolerance” dorms. Much depends on the state and its culture of enforcement. Measures such as increasing prices, imposing excise taxes, and local laws that regulate the density of liquor-selling establishments close to campus can have a strong impact on underage drinking. 18

The Institute of Alcohol Studies in London looked at individual as well as meta-analyses of European, Australian, and American youth alcohol education efforts. It found that although there were “individual examples of the beneficial impacts of school-based education,” there was not enough evidence to conclude that education has an impact on binge drinking among young people. The Institute said it was not implying that education should not be done, but it “should not be seen as the answer to reduce the harm done by binge drinking.” Education, the Institute concluded, plays only a supportive role. 19

The Amethyst Initiative says, in essence, that the phenomenon of underage drinking is a tidal wave that society cannot stop. Our only hope is to ride the wave along with our children, give them an oar, and hope they don’t drown. That relies on the very big — and untested — assumption that their young minds have the capacity to listen when it comes to alcohol, no matter how badly they want to party, hook up, fit in.

Given the stakes, America should not throw in the towel on the 21 laws until we have actually enforced them as they were meant to be enforced — though it will require a clear dedication of political will. It can be done; a similar revolution occurred during the 1980 s with respect to driving under the influence laws. Disparities in enforcement do not mean that the laws are impossible to enforce. It signals that we have not gotten serious as a nation about using the laws we have — and improving them where needed.  

Carla T. Main writes often on law and society. She is the author of Bulldozed (Encounter Books, 2007), about an eminent domain battle in a small city in Texas.

1  The use of the word “amethyst” alludes to an ancient myth associating the stone with the ability to ward off drunkenness.

2  Richard J. Bonnie and Mary Ellen O’Connell, eds., Reducing Underage Drinking: A Collective Responsibility, Committee on Developing A Strategy to Reduce and Prevent Underage Drinking (National Academies Press, 2004 ), 25–26 .

3   Robert Davis and Anthony DeBarros, “Alcohol and Fire a Deadly Mix,” USA Today , Dec. 18, 2008 .

4  Ralph W. Hingson et al., “Magnitude and Morbidity Among U.S. College Students Ages 18–24 ,” Journal of Studies on Alcohol (March 2002 ); Ralph W. Hingson, et al., “Magnitude and Morbidity Among U.S. College Students Ages 18–24 : Changes from 1998 to 2001 , Ages 18–24 ,” Annual Review of Public Health ( 2005 ); and “The Surgeon General’s Call to Action to Prevent and Reduce Underage Drinking” (Office of the Surgeon General, 2007 ), available at http://www.surgeongeneral.gov/topics/underagedrinking/calltoaction.pdf (accessed May 4, 2009 ).

5  J.A. Grunbaum, et al., “Youth risk behavior surveillance — United States, 2003,” Morbidity and Mortality Weekly Report Summary  53:2 (May 21, 2004), and L.D. Johnston, et al., “Teen Drug Use Continues Down in 2006, Particularly Among Older Teens; but Use of Prescription-Type Drugs Remains High,” University of Michigan News and Information Services (2006).

6  “The Surgeon General’s Call to Action to Prevent and Reduce Underage Drinking.”

7  “Magnitude and Morbidity Among U.S. College Students Ages 18–24 .”

8  Bjorn Hibell., et al., “The espad Report 2003 : Alcohol and Other Drug Use Among Students in 35 European Countries” ( 2004 ).

9  Institute of Alcohol Studies, “Binge Drinking — Nature, prevalence and causes, ias Fact Sheet” ( 2006 ).

10  “Magnitude and Morbidity Among U.S. College Students Ages 18–24 : Changes from 1998 to 2001 , Ages 18–24 <.”

11  Thomas R. Pegram, Battling Demon Rum (Ivan R. Dee, 1998 ), 144 .

12  Jack S. Blocker Jr., “Did Prohibition Really Work? Alcohol as a Public Health Innovation,” American Journal of Public Health 26:2 (February 2006 ).

13  Blocker, “Did Prohibition Really Work? Alcohol as a Public Health Innovation.”

14  Bonnie and O’Connell, Reducing Underage Drinking , 23 .

15  James Mosher, et al., “Reducing Underage Drinking: The Role of Law,” Journal of Law, Medicine & Ethics 32:4 (Winter 2004 ).

16  Bonnie and O’Connell, Reducing Underage Drinking , 100 .

17  Henry Wechsler and Toben F. Nelson, “What We Have Learned From the Harvard School of Public Health College Alcohol Study: Focusing Attention on College Student Alcohol Consumption and the Environmental Conditions That Promote It,” Journal of Studies on Alcohol and Drugs (July 2008 ).

18  Robert Zimmerman and William DeJong, “Safe Lanes on Campus: A Guide for Preventing Impaired Driving and Underage Drinking” (Higher Education Center for Alcohol and Other Drug Prevention, 2003 ).

19  Peter Anderson, “Binge Drinking and Europe,” (Institute of Alcohol Studies, 2008 ).

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News & Events

National Institute on Alcohol Abuse and Alcoholism (NIAAA)

Digital health technology shows promise for efforts to address drinking among youth.

Wednesday, May 8, 2024

This article was first published in  NIAAA Spectrum   Volume 16, Issue 2 .

Underage drinking and alcohol misuse by young adults are serious public health concerns in the United States. The 2022 National Survey on Drug Use and Health (NSDUH) found that 15.1% of people ages 12 to 20 and 50.2% of people ages 18 to 25 reported drinking alcohol in the past month, with 8.2% of 12- to 20-year-olds and 29.5% of 18- to 25-year-olds reporting  binge drinking  in the past month. 1 , 2  Surveys also consistently find that young people are among the biggest users of the internet and mobile devices.

“There is an urgent need for innovative interventions to prevent alcohol misuse among our nation’s young people,” said National Institute on Alcohol Abuse and Alcoholism (NIAAA) Director George F. Koob, Ph.D. “Internet and mobile technologies have the potential to significantly expand our prevention efforts.”

In December 2023, NIAAA held a webinar, “ Harnessing Technology and Social Media to Address Alcohol Misuse in Adolescents and Emerging Adults ,” featuring NIAAA-supported research conducted by Maureen Walton, M.P.H., Ph.D., of the University of Michigan and Mai-Ly Steers, Ph.D., of Duquesne University.

In her talk titled “Optimizing Prevention of Alcohol Misuse and Violence Among Adolescents and Emerging Adults,” Dr. Walton discussed the importance of early interventions and how strategies that address multiple factors simultaneously may be more effective in preventing alcohol misuse over time. She also emphasized the potential benefits of more selective alcohol prevention interventions for youth at risk for binge drinking, as opposed to universal interventions that are designed to reach a broader age group.

Dr. Walton, Rebecca Cunningham, M.D., and colleagues previously developed  SafERteens . SafERteens is a single-session, motivational interview-based intervention delivered by a therapist to youth ages 14 to 18 during an emergency department visit for a medical illness or injury. The researchers found that alcohol-related consequences and severe aggression were reduced in the year following the intervention.

Dr. Walton’s team has expanded SafERteens to include digital boosters such as telehealth sessions with a health coach and text messages to reduce violence and alcohol misuse. Preliminary data from a recent study show that participants who received SafERteens plus digital boosters reduced their alcohol consumption, their involvement with violence, and the consequences associated with alcohol use and violence over the course of the study.

“Digital technology is an exciting and feasible way to extend interventions and prevention to youth in real time in their daily lives,” said Dr. Walton.

In her talk, “Social Media Use - Friend or Foe? How It Has Been Problematic Yet Holds Promise for Addressing College Drinking,” Dr. Steers discussed the relationship between social media and alcohol consumption, particularly among college students. Although much about social media’s influence on alcohol use is unknown, research has consistently found a link between young people’s exposure to alcohol-related social media posts and their alcohol consumption and related problems. Alcohol-related social media posts by young people have also been found to be robust predictors of alcohol consumption and problems.

Dr. Steers and her colleagues are examining factors that influence young people’s susceptibility to alcohol-related social media content and the individual differences that affect their drinking patterns. The researchers have found that some of the main reasons that college students who drink post alcohol-related content on social media are to obtain attention and approval from their peers and to convey status or popularity. In addition, exposure to other people’s alcohol-related content may normalize drinking and portray it as socially rewarding, both of which can in turn influence a student’s alcohol consumption.

Although social media is linked to increased alcohol misuse, it also holds promise for addressing alcohol misuse among college students. Dr. Steers and her team are working to develop novel interventions targeting students ages 18 to 26 who drink excessively and who are also avid social media users. As a step toward a more standardized measure for research, her team created an alcohol-related content and drinking scale in which students use their alcohol-related posting behavior to recall their drinking retrospectively. The researchers are using this tool within the context of personalized normative feedback−a brief intervention that corrects perceptions of normal behavior−by giving people feedback on their self-reported drinking and their perceptions of how much they think their peers drink.

“Given that we know for sure that social media is a major source of social influence, future research should really try to leverage it as a tool to promote the reduction of drinking,” said Dr. Steers.

Dr. Koob added, “Digital technology offers a path into people’s daily lives and can reach people where they are and on their terms. Therefore, it provides opportunities to reach broader segments of society, from people who are reluctant to get help for an alcohol problem to youth who may be at risk for initiating or escalating alcohol use.”

NIAAA also supports a variety of other studies that are leveraging social media and other technologies to develop novel alcohol prevention and treatment interventions for youth. Such studies include:

• Developing social media-inspired games to help reset perceptions of normal behaviors surrounding alcohol
• Expanding use of existing mobile phone-based apps to reduce alcohol-related sexual assault on college campuses as well as to reduce alcohol use and post-traumatic stress disorder after sexual assault
• Using virtual reality to provide insight into alcohol’s effects on behavior

References:

1  Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Behavioral Health Statistics and Quality. 2022 National Survey on Drug Use and Health. Table 2.27B—alcohol use in past month: among people aged 12 or older; by age group and demographic characteristics, percentages, 2021 and 2022. [cited 2023 Dec 8]. Available from:  https://www.samhsa.gov/data/sites/default/files/reports/rpt42728/NSDUHDetailedTabs2022/NSDUHDetailedTabs2022/NSDUHDetTabsSect2pe2022.htm#tab2.27b

2  SAMHSA, Center for Behavioral Health Statistics and Quality. 2022 National Survey on Drug Use and Health. Table 2.28B—binge alcohol use in past month: among people aged 12 or older; by age group and demographic characteristics, percentages, 2021 and 2022. [cited 2023 Dec 8]. Available from:  https://www.samhsa.gov/data/sites/default/files/reports/rpt42728/NSDUHDetailedTabs2022/NSDUHDetailedTabs2022/NSDUHDetTabsSect2pe2022.htm#tab2.28b

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Lowering Drinking Age in the United States Essay

Arguments supporting the set drinking age, arguments against the set drinking age, why should the minimum drinking age be lowered, works cited.

Alcohol use is characterized by various negative effects on people’s health and their social and private life. Underage drinking has been regarded as a serious public health problem that led to an adverse long-term impact on the health of those who consumed alcohol in their adolescence (Green et al. 118). At the same time, an increasing number of Americans claim that the existing policies and laws regarding the minimum drinking age are unable to address the issue and result in certain negative outcomes (Cary par. 11). A considerable bulk of evidence suggests that the current drinking age minimum is associated with negative consequences and does more harm than good. Therefore, it is necessary to follow the example of many western democracies and establish the limit at the age of 18 that was once employed in this country as well.

Several decades ago, the minimum drinking age in the USA was 18 years old. One of the major reasons for raising this age limit was its potential effect on drunken driving, and the Mothers Against Drunk Driving was one of the key players in the process (MADD) (Cary par. 4). According to the MADD, it has been estimated that “the law has saved about 900 lives a year” (Cary par. 4). It is believed that the established minimum drinking age prevents people younger than 21 from causing traffic accidents.

Apart from traffic issues, alcohol use is also linked to a significant effect on people’s criminal activity. For instance, Carpenter and Dobkin note that access to alcohol is related to a “statistically significant 5.9% increase in arrests… for assault, robbery, reckless driving, driving under the influence, drunkenness, and nuisance crimes” (522). Researchers assume that 21-year-olds get access to alcohol and are more likely to be involved in criminal activity (by almost 6%) compared to those under this age. The use of alcohol in adolescence harms people’s health since it is associated with a high chance of the development of addiction in adulthood (Green et al. 118). Teenagers and young adults who consume alcohol are at a higher risk of developing mental health issues, including addiction, and other problems such as cardiovascular disorders.

At the same time, the number of people who are against the current minimum drinking age is increasing. The opponents of the existing drinking age note that it can be lowered to 18 years old as people at that age can make responsible decisions. Moreover, it is found that younger people start drinking alcohol. According to Green et al., 50% of teenagers “report having had at least one drink by the time they reach 8th grade” and “20% of 8th graders have consumed alcohol in the past” several days (Green et al. 117). The abuse of drugs has also grown exponentially during the past decades, which is also linked to the minimum drinking age. Cary stresses that the rate of “college students abusing opioids like Vicodin and OxyContin jumped 343 percent and 450 percent for tranquilizers like Xanax and Valium (par. 6). In simple terms, instead of using alcohol, adolescents use drugs for recreational purposes, which has a considerably more harmful impact on their health.

The minimum drinking age should be lowered to prevent adolescents from using heavier substances with more serious consequences. Many adults agree that keeping an eye on children drinking beer during a party is much safer than being unaware of adolescents’ using drugs and drinking alcohol in concealed spots (Cary par. 11). The ban does not completely stop the use of alcohol as teenagers obtain fake IDs and buy as much alcohol as they wish. It is also necessary to note that the reduction of traffic accidents can hardly be completely dependent on the minimum drinking age.

Various policies have been introduced to achieve the goal, such as ignition interlock law or suspending the driving license for drunken driving. Numerous educational campaigns, as well as the focus on a healthy lifestyle, contribute to making adolescents more responsible and willing to live healthy lives. Therefore, lowering the minimum drinking age is unlikely to lead to an increase in alcohol use, but can potentially result in the reduction of drug abuse.

On balance, the minimum drinking age should be lowered to 18 years old as it can divert adolescents from using drugs and abusing prescribed drugs. Young people consume alcohol before they reach the established age as they break the law, use fake IDs, and take alcohol from their older friends or relatives. It is much more beneficial to enable these people to choose and make responsible decisions regarding their health and their behavior. Of course, it is also essential to continue educating adolescents and children raising their awareness of the negative impact of alcohol on health and people’s social life. Binge drinking is a serious problem to address, but the minimum drinking age is not an effective remedy, so it should be made similar to the standards set in other western countries.

Carpenter, Christopher, and Carlos Dobkin. “The Minimum Legal Drinking Age and Crime.” The Review of Economics and Statistics , vol. 97, no. 2, 2015, pp. 521–524.

Cary, Mary Kate. “Time to Lower the Drinking Age.” U. S. News , 2014, Web.

Green, Rivka, et al. “Underage Drinking: Does the Minimum Age Drinking Law Offer Enough Protection?” International Journal of Adolescent Medicine and Health , vol. 27, no. 2, 2015, pp. 117–128.

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• Peshtigo Fire, October 8th, 1871, Investigation
• Driving Under the Influence: US Policies
• Mothers Against Drunk Driving
• Feelings of Families Regarding Drug Dependence: In the Light of Comprehensive Sociology
• How Bingeing Became the New College Sports by Seaman
• Addiction in Adolescences: Factors and Treatments
• Narcotics Anonymous Group Observation
• “Psychological Factors of Drugs” by Alhyas et al.

Home — Essay Samples — Law, Crime & Punishment — Legal Drinking Age — The Benefits Of Lowering The Drinking Age In America To 18

The Benefits of Lowering The Drinking Age in America to 18

• Categories: Drinking Age in America Legal Drinking Age

About this sample

Words: 764 |

Published: Dec 16, 2021

Words: 764 | Pages: 2 | 4 min read

Works Cited 

• Glaser, Gabrielle. “You Must Be 21 to Drink?” The New York Times, The New York Times, 2018, www.nytimes.com/roomfordebate/you-must-be-21-to-drink/return-the-drinking-age-to-18-and-enforce-it.
• Carpenter, Christopher, and Carlos Dobkin. “The Minimum Legal Drinking Age and Public Health.” The Journal of Economic Perspectives : a Journal of the American Economic Association, U.S. National Library of Medicine, 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC3182479/.

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The Impact of the Minimum Legal Drinking Age on Alcohol Related Chronic Disease Mortality

Andrew d. plunk.

1 Eastern Virginia Medical School, Norfolk, VA, USA.

Melissa J. Krauss

2 Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.

Husham Syed-Mohammed

Patricia a. cavzos-rehg, laura j. bierut.

3 Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA.

Richard A. Grucza

Associated data.

The minimum legal drinking age (MLDA) of 21 has been associated with a number of benefits compared to lower MLDAs, including long-term effects, such as reduced risk for alcoholism in adulthood. However, no studies have examined whether MLDA during young adulthood is associated with mortality later in life. We examined whether individuals exposed to permissive MLDA (< 21) had higher risk of death from alcohol-related chronic disease compared to those exposed to the 21 MLDA. Because prior work suggests that MLDA affects college students differently, we also conducted conditional analyses based on ever having attended college.

Data from the 1990 through 2010 U.S. Multiple Cause of Death files were combined with data on the living population and analyzed. We included individuals who turned 18 during the years 1967 to 1990, the period during which MLDA varied across states. We examined records on death from several alcohol related chronic diseases, employing a quasi-experimental approach to control for unobserved state characteristics and stable time trends.

Individuals who reported any college attendance did not exhibit significant associations between MLDA and mortality for the causes of death we examined. However, permissive MLDA for those who never attended college was associated with 6% higher odds for death from alcoholic liver disease, 8% higher odds for other liver disease, and 7% higher odds for lip/oral/pharynx cancers ( OR = 1.06, 95% CI [1.02, 1.10]; OR = 1.08, 95% CI [1.02, 1.14]; OR = 1.07, 95% CI [1.03, 1.12], respectively).

Conclusions

The 21 MLDA likely protects against risk of death from alcohol-related chronic disease across the lifespan, at least for those who did not attend college. This is consistent with other work that shows that the long-term association between MLDA and alcohol-related outcomes is specific to those who did not attend college.

Introduction

The minimum legal drinking age (MLDA) in the United States determines the age at which individuals may legally purchase and possess alcohol in public. This policy varied by state after prohibition and many states reduced their drinking ages to as low as 18 during the Vietnam War era ( Wagenaar and Toomey, 2002 ). Following passage of the National Minimum Drinking Age Act of 1984 (23 USC §158) all states adopted an MLDA of 21, a process that was complete by 1988 (with the exception of the state of Louisiana, which maintained a lower de facto purchase age until 1995; Ponicki, 2004 ; Scribner and Cohen, 2001 ).

Many studies have shown that higher MLDAs are linked to lower rates of motor-vehicle fatalities, alcohol consumption, and numerous other adverse alcohol-related outcomes among teenagers and adults under the age of 21 (see DeJong and Blanchette, 2014 and Wagenaar and Toomey, 2002 for reviews of this extensive literature). A handful of studies have also shown that the effects of the MLDA may persist into the early 20s; that is, those who were restricted from drinking at ages 18-20 were less likely to report heavy drinking episodes after age 21 ( Cook and Moore, 2001 ; Moore and Cook, 1995 ; O'Malley and Wagenaar, 1991 ). Insofar as MLDA is a proxy for the age at which one has ready access to alcohol, this suggests that changes in access during late adolescence could have a persistent impact on one's drinking patterns.

The idea that the MLDA has persistent effects is intriguing because of neurobiological evidence that adolescence is a critical period during which vulnerability to substance use disorders are at their highest ( Chambers et al., 2003 ). Motivated by this theory, recent work from our group has suggested that higher MLDAs do appear to have long-term benefit. Birth cohorts who were legally restricted from drinking prior to age 21 are less likely to drop out of high school, have alcohol use disorder (AUD), and engage in binge drinking behaviors in later adulthood ( Norberg et al., 2009 ; Plunk et al., 2015 , 2013 ). A protective cohort effect of higher MLDA on risk of death by suicide and homicide among adult women has also been suggested ( Grucza et al., 2012 ). Others have shown that higher drinking ages appear to confer protection against fatal traffic accidents over the long term among men ( Kaestner and Yarnoff, 2011 ). These studies of the long-term consequences of the MLDA have built upon a large body of literature showing that early drinking is an important marker, though not necessarily a contributing cause, of adult alcohol use disorders ( DeWit et al., 2000 ; Grant and Dawson, 1997 ; Grucza et al., 2008 ; McGue et al., 2001 ; Prescott and Kendler, 1999 ; Ystrom et al., 2014 ). However, results of studies of the MLDA, which functions as a natural experiment of legally restricting access to alcohol during late adolescence, suggest that reductions in early drinking lead to decreased risk for alcohol problems well into mid-adulthood.

If ready access to alcohol at a younger age increases risk for alcohol use disorder and heavy drinking over the long term, then risk for alcohol-related chronic disease mortality should also be affected ( Plunk et al., 2014a ). In this work we undertake the first examination of the possible effects of the MLDA—and, by extension, changes in access to alcohol during a key developmental period—on alcohol-related chronic disease mortality. This is significant for several reasons. First, there are relatively few studies of the long-term consequences of permissive (i.e., < 21) MLDA ( DeJong and Blanchette, 2014 ). More specifically, if we find that the MLDA is associated with chronic disease mortality, it would show that MLDA policies protect not only adolescents and young adults from the harmful effects of alcohol, but that the influence of MLDA on health may last throughout the lifespan. Finally, this work is timely as debate about the minimum drinking age continues both in the U.S. and in other countries, where some argue that lower drinking ages will lead to safer drinking among youth and young adults (e.g., Christiansen, 2010 ; Cohan, 2014 ; Metherell, 2009 ; Paglia, 2014 ; Tracy, 2014 ; Young, 2012 ).

Our objective was to examine whether the ability to legally purchase alcohol prior to age 21 is related to increased chronic disease mortality later in life. We propose that permissive MLDA, a proxy for ready access to alcohol during the ages of 18-20, influences heavy drinking outcomes across the lifespan, which in turn influence mortality risk from chronic disease. Since this hypothesized association is indirect we expect to see significant findings only for diseases for which risk is substantially attributable to heavy alcohol use. We focused on mortality from the following chronic diseases that are in large part (> ~20%) attributable to alcohol: liver cirrhosis and other liver disease; cancers of the lip, oral cavity and pharynx; laryngeal cancer; and esophageal cancer ( Boffetta et al., 2006 ; Haas et al., 2012 ; World Health Organization, 2014 ).

In addition to the proportion of mortality attributable to alcohol, other factors are likely to influence the magnitude of any potential association between MLDA and risk of death that we will be able to observe. First, MLDA exposure is determined by a person's year of birth and state of residence between the ages of 18-21, but it is not possible to directly observe this from mortality data. Instead, we must rely on subject's state of residence at time of observation as a proxy ( Krauss et al., 2015 ; Norberg et al., 2009 ; Plunk et al., 2015 , 2013 ). To determine if this is a reasonable way to estimate policy exposure we conduct a separate set of analyses on “likely non-movers.” This subset of the study sample resided in their birth state at time of observation and are much less likely to have ever migrated between states. Second, some studies have suggested that college campuses may be insulated from the effects of drinking age policy; that is, that the mix of legal and non-legal drinkers on school campuses provides ready access to alcohol, making youth-access policies like the MLDA less effective ( Grucza et al., 2009 ; Johnston et al., 2015 ; Plunk et al., 2015 ; Wagenaar and Toomey, 2002 ). To ensure that we are capturing this potential campus insulation effect, we examine whether the potential impact of MLDA on chronic disease mortality is stronger among those who did not attend college. Thus, in the current study we use nationally representative mortality data to test three hypotheses: (1) MLDA is associated with increased risk for liver disease and alcohol-related cancers; (2) magnitudes of association are similar among likely non-movers, for whom we are less likely to misestimate MLDA policy exposure; and (3) the associations between MLDA and alcohol-related chronic disease mortality are stronger among individuals who never attended college.

Dependent variables and data sources

Our dependent variables were death due to: alcoholic liver disease; liver disease not specified as alcohol-related; cancers of the lip, oral cavity, and pharynx; esophageal cancer; and laryngeal cancer. Data on individual deaths in the U.S. were obtained from the Multiple Cause-of-Death files for 1990-2010, collected by the National Center for Health Statistics. These data are based on all death certificates filed in the U.S. by each state and the District of Columbia ( Miniño et al., 2011 ). Files containing individual-level data through 2004 were obtained through the National Bureau of Economic Research ( http://www.nber.org/data/multicause.html ). For years beyond 2005, state-level geographic identifiers are not included in public use files, so customized files including geographic data were obtained by request through the National Association for Public Health Statistics and Information Systems. From the complete set of death records, we selected individuals who died from one of the causes of interest based on ICD-9 codes for years 1990-1998 and ICD-10 codes for years 1999-2010. Codes for each outcome are listed in Table 1 . Each analysis included records from individuals for whom the cause of interest was listed as a contributing cause of death, alongside records from the living population, described below.

ICD Codes used to extract mortality records

To model the living population, we combined data from the annual American Community Survey (ACS) for the years 2001-2010, obtained from the Integrated Public Use Microdata Series maintained by the Minnesota Population Center ( Ruggles et al., 2010 ). Since the ACS was not administered annually prior to 2000 we used data from 1% samples of the 1990 and 2000 Census to estimate data for years 1991 through 1999 using a linear interpolation procedure fully described elsewhere ( Grucza et al., 2015 , 2009 ). Briefly, this was accomplished by creating a single record for each possible combination of covariate parameters in each Census data set (i.e., each combination of year, state, race/ethnicity, sex, age group and education) and assigning that record a weight corresponding to the population for that group. The weight for the corresponding record during non-observed years was estimated as: [(2000-year)*(1990 weight) + (year-1990)*(2000 weight)] / 10). We have shown elsewhere that this method is valid by comparing the results with U.S. Census Bureau estimates for intracensal years ( Grucza et al., 2015 ). All observed and estimated living population data were combined and sample weights were divided by the number of data years. The living population data were then combined with the mortality data to create the final data set. Because our analytical approach relies on differences in policy exposure within birth cohorts, we limited analyses to those who turned 18 during the years 1967 to 1990 (birth years 1949 to 1972), the period in which the MLDA was in flux.

Independent variable: MLDA exposure

MLDA policy data were coded as described in our previous studies (e.g., Norberg et al., 2009 ; Plunk et al., 2015 , 2013 ). We examined a period during which some states both increased and decreased their MLDAs, while others maintained a 21 MLDA throughout. Individuals who were legally permitted to purchase alcohol between the ages of 18-20 (i.e., those with “permissive MLDA exposure”) were contrasted with those who were restricted until age 21. Individuals who were exposed to an MLDA of 18, 19 or 20 were assigned a value of “1” and those who were unable to purchase alcohol before the age of 21 were assigned a value of “0.” This means that individuals from the same state could have different MLDA exposure, depending on when they were age 18-20.

MLDA coding for each state was based on year of change (i.e., when a change occurred, MLDA was assigned based on what the MLDA was changing to at any time during that year). State of residence at the time of survey administration or death was also used as a proxy for state of residence at the age of potential exposure. Since mortality and census records do not contain residence history between the ages of 18 and 21, we used state of residence at time of observation as a proxy for state of residence during time of exposure. While this introduces error due to misclassification, the most likely effect is to reduce the estimated magnitude of any true association (i.e., bias toward the null hypothesis, or type II error). We have shown elsewhere that migration-induced error is unlikely to bias estimates toward type I error unless there is a strong correlation between disease status and change in policy exposure upon emigration ( Grucza et al., 2012 ). Furthermore, the rate of misclassification is much lower than the rate of emigration since individuals may move to states with the same MLDA and thus migrate without changing their policy exposure. Elsewhere, using population migration data, we have estimated that misclassification to be approximately 11% ( Krauss et al., 2015 ).

Individual-level covariates extracted from mortality records included state of residence, year of birth, sex, age, race/ethnicity, educational attainment, and year of death. Race/ethnicity was coded as non-Hispanic White, non-Hispanic Black, Hispanic, and other. Because of the birth year inclusion criteria, age ranged from 28 to 61 years. Age categories corresponded to quartiles; ranges were 28-38, 39-44, 45-50, and 51-61 years old. Education was dichotomized such that those with no post-secondary education were coded as “no college” and those with one or more years of post-secondary education were classified as “any college.” We also included several time-varying state-level covariates to control for potential confounding due to factors that might have changed simultaneously with drinking age policies and might also influence alcohol-related mortality outcomes. These included a measure of citizen political ideology ( Berry et al., 1998 ) state per-capita income, state annual unemployment rate, state beer excise tax at time of observation, state beer excise tax at time the respondent/decedent was age 21, an indicator for privatization of wine and spirits sales, percent of state population affiliated with Judeo-Christian religious denominations, and state annual unemployment rate. Per-capita income and unemployment measures were obtained from the University of Kentucky Center for Poverty Research.(University of Kentucky Center for Poverty Research, Gatton College of Business & Economics. University of Kentucky, Lexington, KY., n.d.). Data on beer taxes were obtained from the Statewide Availability Data System and from the Alcohol Policy Information System (National Institute on Alcohol Abuse and Alcoholism., n.d.; Ponicki, 2004 ). Wine and spirits sales privatization data were based on earlier studies examining these policy changes ( Hahn et al., 2012 ; Wagenaar and Holder, 1995 ).

Stratification Variables

As previously discussed, one limitation of our analytical approach is that we do not know the state of residence of each individual during late adolescence, and so we approximate MLDA exposure using state of residence at observation (i.e., at time of survey or census for the living population and time of death for decedents). One way to examine whether this approximation induces bias into our estimates is to conduct additional analyses limited to “likely non-movers” (i.e., those who resided in their birth state at the time of observation). These individuals are less geographically mobile, and therefore more likely to have lived in their current state during the period in which they would have been subject to MLDA policies ( Plunk et al., 2014b ). All analyses conducted on the full data set were subsequently conducted on this subset. We also examined whether the relationship between MLDA and mortality status differed by educational attainment. As discussed earlier, MLDA may have less influence on college campuses, and therefore, MLDA-mortality associations may be stronger among those who did not attend college. Lower educational attainment is also associated with lower cross-state mobility, so migration-related error is also likely lower among this group ( Kaestner and Yarnoff, 2011 ).

Educational attainment was dichotomized as having any education beyond a high-school diploma vs. having no post-secondary education. Information on education was missing for 7.1% of decedents. Therefore, education was multiply imputed from other demographic variables for those observations. Five imputations were carried out. These data were used only for analyses stratified by education, and reported standard errors reflect the additional variance introduced by the imputation process.

Empirical Strategy

Our objective was to examine whether permissive MLDA exposure (<21) during adolescence is associated with increased likelihood of death from the selected alcohol-related chronic diseases in adulthood. Our quasi-experimental study design is based on the difference in differences approach, which models exposure to a policy change by comparing pre- and post-policy implementation differences in an outcome for exposed groups to those for unexposed comparison groups ( Wooldridge, 2010 ). In effect, we use changes in MLDA to reflect within-state variation in alcohol availability over time for individuals under the drinking age. This approximates an experimental design if there are no unobserved confounders related to both policy exposure and the outcome in question. The plausibility of this “exogeneity assumption” rests on whether or not the policy change came about independently of other factors that also influence the outcome; for example, MLDA has been used as an exogenous variable representing a change in availability by many researchers since MLDA changes were driven by national trends ( Dee and Evans, 2003 ).

Statistical analysis

We used logistic regression to model death due to the chronic diseases listed in Table 1 . Fixed-effects regression models were used to control for the impact of unobserved, time-invariant state factors and national secular trends. This is accomplished by including dummy variables for state and birth year in regression models ( Allison, 2009 ; Wooldridge, 2010 ). Final models included the primary independent variable (MLDA exposure), as well as state and birth-year fixed effects, participant demographics (sex, race, age category, year of observation, and education), and state-level variables selected as described previously (unemployment rate, per capita income, political ideology, beer excise taxes, wine and spirits privatization, and religious affiliation). Parameter estimates and clustered standard errors were calculated using the SAS (Version 9.2, SAS Institute, Cary, NC) procedure “surveylogistic” employing state as the clustering unit ( Angrist and Pischke, 2008 ; Arellano, 1987 ; Bertrand et al., 2004 ).

Table 2 describes the demographic characteristics of the sample broken down by mortality status for each of the causes of death analyzed. The number of decedents ranged from 8,397 for laryngeal cancer to 115,841 for alcoholic liver disease. Men were substantially over-represented among decedents for each outcome, comprising between 70.1 and 80.5% of decedents. Blacks were over-represented among deaths from lip/oral/pharynx cancer, laryngeal cancer and liver disease not specified as alcoholic, while Whites were over-represented among esophageal cancer decedents. Hispanics were under-represented among all types of cancers, but over-represented among liver disease decedents. The proportion of death from each cause was also higher for older individuals and those who resided in their state of birth at time of observation.

Demographic characteristics of the living population and decedents from alcohol-related chronic disease

Note: Individuals born in the U.S, 1949 through 1972; observations from 1990 through 2010.

Results of logistic regression analyses modeling risk for death from each cause as a function of permissive MLDA exposure are displayed in Table 3 (full models with estimates for all covariates are described in Tables S1-S5 ). Mortality risk was positive and statistically significant for alcoholic liver disease and for other liver disease (i.e., not specified as alcoholic); permissive MLDA exposure was associated with 5% and 6% greater odds of death from those two causes, respectively ( OR = 1.05, 95% CI [1.01, 1.10]; OR = 1.06, 95% CI [1.01, 1.12]). A significant association between higher risk of death and permissive MLDA was also observed for lip/oral/pharynx cancers ( OR = 1.05, 95% CI [1.01, 1.10]). The association between MLDA and esophageal and laryngeal cancers did not approach statistical significance. Analyses conditioned on sex did not suggest any meaningful between-groups differences. These analyses were then repeated for likely non-movers, for whom permissive MLDA was significantly associated with 6% greater odds of mortality from alcoholic liver disease ( OR = 1.06, 95% CI [1.01, 1.11]), but not with other outcomes. However, point estimates were largely similar to those observed in the full sample. As with the full-sample analyses, there were no notable between-groups differences when likely non-mover men and women were analyzed separately.

Mortality from selected alcohol-related chronic disease as a function of under 21 MLDA exposure

Note: All models include state and birth year indicators, age category, sex, race, education, year of observation, state unemployment rate, state per-capita income, citizen political ideology, state beer excise tax rate, state beer excise tax rate at the time the respondent was 21 years old, presence of state controlled liquor and wine sales at the time the respondent was 21 years old, and percent of state population affiliated with Judeo-Christian religious denominations. Likely non-movers are those who lived in the state in which they were born at time of observation.

Table 4 describes results from analyses conditioned on educational attainment. Individuals who reported any college attendance did not exhibit significant associations between permissive MLDA and any of the causes of death we examined (although deaths from laryngeal cancers approached nominal significance criteria for likely non-movers who had gone to college). However, individuals who reported not attending college exhibited significant associations between permissive MLDA and several causes of death in the full sample: 6% higher odds for death from alcoholic liver disease, 8% higher odds for other liver disease, and 7% higher odds for lip/oral/pharynx cancers ( OR = 1.06, 95% CI [1.02, 1.10]; OR = 1.08, 95% CI [1.03, 1.13]; OR = 1.07, 95% CI [1.03, 1.12]). Estimates based on the likely non-mover subsample did not differ significantly from those derived from the full sample.

Mortality from selected alcohol-related chronic disease as a function of under 21 MLDA exposure, conditioned on college attendance

Note: All models include state and birth year indicators, age category, sex, race, year of observation, state unemployment rate, state per-capita income, citizen political ideology, state beer excise tax rate, state beer excise tax rate at the time the respondent was 21 years old, presence of state controlled liquor and wine sales at the time the respondent was 21 years old, and percent of state population affiliated with Judeo-Christian religious denominations. Likely non-movers are those who lived in the state in which they were born at time of observation.

Our findings suggest that individuals who were legally permitted to purchase alcohol prior to age 21 had modest, but statistically significant, increased risk of death from alcoholic liver disease, other liver disease, and lip/oral/pharyngeal cancers relative to those who were not permitted to purchase alcohol until age 21. These apparent policy effects were driven by individuals without any college education—those who reported having attended college did not exhibit increased mortality risk related to permissive MLDA exposure.

These findings are consistent with earlier studies from our group suggesting that permissive MLDA exposure during adolescence and young adulthood is related to increased risk of alcohol misuse later in life ( Norberg et al., 2009 ; Plunk et al., 2013 ). The finding that MLDA only seems to have impacted alcohol-related mortality for non-college educated individuals is also consistent with our past work. It may be that the 21 drinking age confers protection against heavy drinking among non-college educated individuals, but not among those who attended college ( Grucza et al., 2009 ). If life-long drinking habits are formed during these years, MLDA-related differences may extend into adulthood ( Plunk et al., 2013 ).

The idea that college attendance could be associated with decreases in the effectiveness of the MLDA is also consistent with other research. For example, binge drinking has decreased in the general population, but is more common on college campuses, where the campus environment likely insulates against policies aimed at curbing underage drinking due to easy access to alcohol coupled with a culture that promotes drinking to excess ( Grucza et al., 2009 ; Johnston et al., 2015 ). Other researchers have noted that underage college students report being able to obtain alcohol very easily and that legal-age drinkers are their primary source ( Wagenaar et al., 1996 ; Wechsler et al., 2002 ). Further, most legal-aged college students also report frequently providing alcohol to underage peers ( Brown et al., 2009 ). Our current findings are consistent with this proposed campus insulation effect: the MLDA seems to be less effective on college campuses, where underage drinkers have ready access to alcohol.

It is also possible that the positive impact of college education on health could be moderating the negative effects of permissive MLDA exposure on the outcomes we examined. However, regardless of the exact mechanism involved, our findings suggest that the long-term impact of lowering the drinking age as a response to risky college drinking would primarily be experienced by those without a college education.

Based on current death rates, and assuming that the effects documented above are generalizable to the current population, we estimate that the 21 drinking is preventing 900 deaths per year from alcoholic liver disease, 1,000 deaths per year from liver disease not specified as alcoholic, and 400 deaths annually from lip/oral/pharynx cancers. These effects were observed only among individuals who never attended college. Based on U.S. Census Bureau estimates, as of 2014 there were approximately 62 million adults age 25 and over in the U.S. without any form of post-secondary education (roughly 30% of the adult population). Further, while heavy drinking has declined across the population, there are still important between groups differences based on college attendance. According to Monitoring the Future data, college student heavy drinking (5+ drinks in a row sometime in the prior two weeks) has declined nine percentage points (from 44% to 35%) from 1980 to 2014. Heavy drinking declined by 12 percentage points (from 41% to 29%) during the same period for non-college respondents ( Johnston et al., 2015 ). These differences suggest that adolescents and young adults who do not attend college likely continue to benefit from the 21 MLDA.

Limitations and conclusion

We make several assumptions which could bias our results if violated and thus represent potential limitations of our study. First, we assume that MLDA did not change because of unobserved confounding factors that varied by state, but rather came about due to national trends. This assumption is supported by past research suggesting that MLDA laws are suitable exogenous predictors of alcohol use ( Dee and Evans, 2003 ). We also assume that any error introduced by retrospectively estimating policy exposure was essentially random. While we do introduce error by estimating exposure, bias toward false positive associations would require that other factors related to increased risk of death from the outcomes we examined were correlated with the with the decision to move to states with permissive MLDAs. Our conditional analyses for likely non-mover and individuals who did not attend college, two sub-groups less likely to migrate between states, suggest that this is not the case. To the degree that our assumptions are reasonable, our results represent the average effect of MLDA exposure in addition to these other unmeasured factors.

Even in light of these limitations, our findings suggest that the long-term effects of permissive MLDAs—which represent increased access to alcohol at an earlier age—extend to alcohol-related chronic disease. We also offer additional evidence that increases in the MLDA significantly protected individuals who did not attend college, which would need to be addressed by those who argue that lower drinking ages are justified because of the prevalence of heavy drinking on college campuses. These analyses have focused only on diseases with a high degree of alcohol-attributable mortality. The 21 drinking age likely protects against other chronic diseases as well, and thus represents a major protective factor against alcohol-related morbidity and mortality in the United States.

Supplementary Material

Supp table s1-s5, acknowledgements.

NIH R01DA031288 (RAG, ADP), R01AA01744401 (RAG), NIH K01DA025733 (PCR), NIH R01DA032843 (PCR), NIH P01 CA89392 (LJB).

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Example Of Lowering US Drinking Age To 18 Research Paper

Type of paper: Research Paper

Topic: Law , Family , Teenagers , Alcoholism , Education , Parents , Criminal Justice , Alcohol

Words: 1900

Published: 12/14/2019

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Lowering US Drinking Age to 18

The problem of teenage crimes have rapidly caused concerns in the government, private sector and even in the communities for the past couple of years due to the increasing severity of these crimes. Police records and investigations show that many of these crimes are done under the influence of alcohol. For the United States, the legal drinking age is set to 21 years old. Despite this law, teenagers under 21 could gain access to alcohol with or without guardians and easily purchase alcohol without any warning. Talks of changing the legal drinking age in the country to 18 years old are dominating various discussion boards and even the two legislative branches of the US government, arguing the pros and cons of approving such change. However, it cannot be denied that there is a need for a more sustainable and detailed law that would enforce strict guidelines for teenagers to resist the temptation of drinking.

Supporters to changing the drinking age to 18 pointed out some advantages to the idea of allowing 18 year old teenagers drink alcohol. Most groups such as the National Youth Rights Association argue that the reduction of the drinking age to 18 with the addition of accepting moderate drinking in society would reduce the phenomenon known as the “forbidden fruit”, which is normally done by teenagers once they wish to try out something illegal and find out why it is being regulated. According to Smith and Brogan (2008) the Association believes that teaching only about the risks, policies, and showing that alcohol is an evil substance, it would only cause teenagers to be curious. Like any other activity in life, drinking is something that must be learned by one’s self and the responsibilities attached to it. The Association believes that the government is denying teenagers this healthy way to learn about life’s many activities and entice temptation . Youngerman and Kittleson (2005) supported Smith and Brogan’s argument by quoting Ruth Engs, a professor of Applied Health Sciences at Indiana University, who is known as a major supporter for reducing the legal drinking age. According to Engs, the main reason why many young teenagers start drinking and drink irresponsibly is because drinking is seen as an enticing “forbidden fruit”, a means to rebel against adults and authority; and a symbol of initiation to adulthood. If the drinking age is reduced or changed, the policy would enable adults to regulate teenage drinking habits as it would be done under their supervision and guidance until they reach their maturity .

For Peck (2009), lowering the drinking age would shift the responsibility away from the state to the parents, who should be the ones to handle teenager’s drinking habits and guide them. With parents’ supervision, children can grow up into fine adults and understand the risks involved in alcohol consumption and drinking moderately. According to Radley Balko, a known libertarian journalist, it is better letting children, and teenagers learn how to drink moderately with the supervision of their parents rather than learn it on their own and far from their parents. Drinking without supervision is one of the major causes of teenage-related accidents and casualties, which is why a lowered drinking age would give parents enough leverage to influence their children. In another position noted by Peck by quoting Marc Fisher, Fisher wrote two possible benefits of lowering the drinking age. The first benefit is pushing drinking into a more private context which normally is supervised by adults and the second benefit eliminates the taboo that adults would not regulate the younger generation on their drinking. Instead, adults would be able to entice teenagers and adolescents to drink moderately under their supervision and with reason .

White and Rabiner (2011) pointed out that the current Minimum Legal Drinking Age Law is ineffective and has served as a deterrent for alcohol consumption. Both authors quoted John McCardell’s position over the issue of college drinking with McCardell noting that alcohol is a way of life for many American teenagers. Restraining them from drinking alcohol would only entice them to find ways to acquire alcohol illegally. McCardell also explains that with alcohol as a common factor in American life, it should not be denied and legislated. There would also be a rift between those teenagers ages 18 to 20 to those teenagers already 21 as the regulation separates their legal rights under the law .

Opponents to the age change for alcohol drinking to 18 contradict the supporter claims that it would entice parents to monitor their children’s drinking habits can control teenage alcohol abuse. The main argument that is being raised with regards to the lowering of drinking age to 18, as noted by Maisto, Galizio, and Conners (2010) is that there is no clear proof that it would lower the chances of teenage binge drinking. There is a possibility that college students would be most likely drink more now that they can drink at an earlier age, especially in the beginning of their college schooling. Teenagers currently under the age 18 and 20 would most likely be subjected to initiation by drinking to be considered part of their age group would increase those who would be addicted to alcohol. There might also be cases that there are already teenagers who enter college who already started binge drinking. Should the age be lowered to 18, it would not impact these teenagers and would make the provision useless in its intention to prevent and regulate teenage drinking . According to Hyde and Setaro (1999) when the legal drinking age in the United States was still 18 in the early 1970s, cases of increased fatalities have been reported especially in 48 states in the United States caused by the low drinking age as victims were aged 18 and younger. States have also recorded an increase of 11 percent worth of fatalities in the age group as seen in the 1978 National Study of Adolescent Drinking Behavior. The study has pointed out that 10th to 12th graders in states that have lower drinking ages were prone in drinking more than their average capacity Teenagers were also drunk more often, causing erratic behaviour and recklessness. The study has also pointed that teenagers are less likely to abstain from drinking considering that they are legally allowed to purchase and drink them. The study, along with many others, have consolidated that the reason why the drinking age must be raised to 21 is due to the concern that the number of teenage-drinking problems may continue to increase if the age is not changed to 21 .

Von Wormer (2010) and Biglan, Brennan, Foster, and Holder (2005) support Hyde and Setaro’s arguments as to why the legal drinking age should remain in 21. One of the most common reasons of teenage deaths is usually related to alcoholism and binge drinking. Deaths can range from alcohol poisoning, mixing drugs with alcohol and to accidents both vehicular and accidental. Most of these cases are normally due to teenagers being younger than 21, which is considered still immature than those aged 21 and over . Kivisto (2010) added the position of groups such as the Mothers Against Drunk Driving (MADD), the American Medical Association, the Governor’s Highway Safety Association, the National Transportation Safety Board, and others that rendering the 21 age requirement to a much lower and younger requirement would constitute to more teenage casualties. These groups have noted that studies have proven that the 21 drinking law saved many teenagers’ lives and shows that these teenagers are less likely to continue drinking as they grow older. If teenagers younger than 21 are allowed to drink, the more likely they would become dependent to the substance and drive drunk often, which may cause to more accidents . In addition to this, Bonnie and O’Connell (2004) stated that a reason as to why the drinking age is set to 21 is to delay underage alcohol consumption as long as possible, or if it has already started, restrain the teenager from consuming more alcohol. This policy would then support parents in watching and protecting their children especially in the risks that can be caused by drinking. The only problem with the implementation of this law is how to apply the law without suppressing the teenager and supervising. Nevertheless, the authors argue that having the drinking age set to 21 has saved 18,220 lives and reports have concluded that the 21 year age requirement for drinking was the main proponent for reducing 19% casualties involving teenagers ages 20 below .

Regardless which age requirement is allowable for drinking, it is still important that alcohol presents enough risks for both young and adult drinkers. The federal government, alongside all state departments and organizations, must create a stricter and specific policy to restrict alcohol drinking in all aspects. On the one hand, reducing the age requirement to 18 would be able to entice parents to become stricter and hands on in dealing with their children on their drinking habits. Legalization of a younger age drinking requirement would also force the government to enforce the law to ensure that teenagers would be regulated in their drinking habits. On the other hand, there is a reason as to why the age for drinking is set to 21 years old. Teenagers in this age are more informed to the risk involved with alcohol, and it becomes a deterrent for many teenagers to resist alcohol consumption. However, both positions would be in vain if proper education with the risks and effects of alcohol would not be done. Without proper education and policy implementation, it is plausible that any form of action on teenage drinking would become irrelevant as education would enable people to understand the importance of knowing the risks of alcohol and drinking.

Biglan, A., Brennan, P., Foster, S., & Holder, H. (2005). Helping Adolescents and Risk: Prevention of Multiple Problem Behaviors. New York: Guilford Press. Bonnie, R., & O'Connell, M. E. (2004). Reducing Underage Drinking: A Collective Responsibility. Washington, D.C: National Academies Press. Hyde, M., & Setaro, J. (1999). Alcohol 101: An Overview for Teens. Minneapolis: Twenty-First Century Books. Kivisto, P. (2010). Illuminating Social Life: Classical and Contemporary Theory Revisited. Thousand Oaks: Pine Forge Press. Maisto, S., Galizio, M., & Connors, G. (2010). Drug Use and Abuse. Belmont: Cengage Learning. Peck, G. (2009). The Prohibition Hangover: Alcohol in America from Demon Rum to Cult Cabarnet. Piscataway: Rutgers University Press. Smith, T. P., & Brogan, R. (2008). Alcohol. New York: Infobase Publishing. von Wormer, K. (2010). Alcohol Problems: Practice Intervention. London: Oxford University Press. White, H. R., & Rabiner, D. (2011). College Drinking and Drug Use. New York: Guilford Press. Youngerman, B., & Kittleson, M. (2005). The Truth About Alcohol. New York: Infobase Publishing.

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Sober minded

Why young americans are abstaining from alcohol.

By Anneka Williams

I lived in the French Alps for nearly six months while in graduate school, ending workdays with long hikes in rugged mountains, eating more than my fair share of freshly baked baguettes, and wandering down cafe-lined streets watching locals sip glasses of wine as meals stretched on for hours and warm wishes of camaraderie and abundance were toasted.

There, I learned that in French, santé is synonymous with the English “cheers.” It also translates to “health.” I’m not sure if that’s the etymological intention, but it certainly gave me pause for reflection, mostly because it conveyed a very different relationship to alcohol than the one I see unfolding in my own culture. It also is underpinned by the irony of a toast for health being associated with alcohol — something that we’re finding has objectively unhealthful qualities.

Today, young people in the United States — and other countries around the world — are drinking less than ever before. According to Pew Research Center, adults ages 18 to 34 who reported that they ever drink dropped from 72% in 2001-03 to 62% in 2021-23.

A 2023 Gallup survey found that the rate of drinking has declined by 10% in that same age group bracket over the last two decades. It seems that temperance is tapping into the roots of modern-day life.

Our relationship with alcohol in the United States has been fraught for about as long as we’ve been a country. To drink or not to drink has long been the subject of social judgment, public scrutiny and moral division. While what we consume is a deeply personal decision, alcohol tends to carry more weight than most other food or drink choices.

Historical angst around alcohol dates back to the late 19th century with the beginnings of an aggressive temperance movement and, later, more than a decade of nationwide prohibition in the 1920s. The temperance movement had numerous religious affiliations and opposed alcohol’s impact on moral character.

In this era, alcohol was framed as the cause of many social problems such as domestic violence, poverty and crime, so constitutional prohibition was enacted to try to remedy these social ills by banning the assumed cause. Today, opposition to alcohol seems to stem more from education and personal choice around general physical and mental well-being.

In response to emerging research about the impacts of alcohol consumption on our health, young adults are forging a new relationship with alcohol than generations before them.

I am Gen Z, while my partner is millennial. We like to keep a healthy amount of generational rivalry present in our relationship, so we have a crudely made Venn diagram taped lopsidedly to our fridge that features “millennials” on one side, and “Gen Z” on the other. Most of the diagram’s contents are lighthearted nods to generational icons and trends. Gen Z gets “Noah Kahan” and “TikTok,” while my partner has claimed “Blink-182″ and “avocado toast” for the millennials.

I don’t often feel like the line between millennials and Gen Z is all that apparent, even when it comes to drinking alcohol or not drinking it. Both generations drink less than those before us. But a closer look shows that abstaining from drinking is more of an identifier for Gen Z than it currently is for millennials.

Research on Gen Z alcohol use

Javier Lastra, one of the lead authors of a 2017 Berenberg Report on generational drinking habits, found that Gen Z (individuals born between 1997 and 2012) was drinking 20% less per capita than millennials who, in turn, were drinking less than Gen Xers and baby boomers did at the same age. One of the main reasons they found to drive this shift? Health, both mental and physical.

“There’s generally a greater awareness by Gen Z (compared to previous generations) about health,” Lastra explains. “They seem to be a much more health-conscious generation than previous ones.”

There is also evidence of increasing health consciousness across all age groups. A 2023 Gallup survey found that 39% of all adults and 52% of young adults (age 18-34) view consuming even one or two drinks a day as bad for health, representing a marked increase in this point of view just since 2018.

Public interest in mindfulness meditation has exploded over the last several decades, the fitness industry is booming to meet rising consumer demand for workout classes and gym services, and there is an increase in the use of health-tracking technologies such as apps and smartwatches that measure sleep, calories and other physiological metrics of health.

Amid all this information about how to be healthier, live longer and look better, decisions around alcohol are just one piece in the broader puzzle.

In recent decades, there has been a proliferation of research suggesting that alcohol is bad for human health.

In 2023, the World Health Organization announced that there is no safe amount of alcohol to drink; any amount of alcohol has adverse health impacts such as increased risk of heart disease, high blood pressure and mental health problems. Research from the International Journal of Environmental Research and Public Health shows that alcohol consumption, no matter the amount, alters how our body functions at a cellular level, “triggering a number of adverse effects.” This includes disrupting neural stem cell growth, interfering with the communication between nerve cells and causing inflammation that inhibits our mitochondria’s energy production. That can manifest in poor sleep, inflammation in the body, high blood pressure and other negative effects.

Alcohol is classified as a group 1 carcinogen by the International Agency for Research on Cancer, placing it among other high-risk carcinogens such as asbestos and harmful radiation. With information like this at hand, it would make sense for anyone of any age to be at least a little scared of alcohol.

History is important, too.

“Young people have seen the behavior of their parents and grandparents and have dealt with family, friends ... people that they know (deal) with addiction issues, probably more than any other generation,” says Gary Frankel, a licensed social worker in Vermont who conducts individual and group therapy sessions for young adults.

According to the National Council on Alcoholism and Drug Dependence, more than half of all adults have a family history of alcohol abuse or problem drinking. It’s not uncommon for families in America today to be dealing with the repercussions of generations of familial strife driven by these issues. In that context, it’s simply hard to view alcohol as “cool.” It’s hard to view anything that’s wrapped up in negative feelings as “cool.”

“There’s generally a greater awareness by Gen Z about health. They seem to be a much more health-conscious generation.”

Red Brick Road, a U.K.-based ad agency, conducted a report focused on Gen Z drinking habits in the United Kingdom and found that 51% of Gen Z respondents reported that their “online image” was a factor when going out “socializing and drinking.”

Lastra found the same thing in a separate report: Gen Z is drinking less, in part due to fear that drunk escapades and reckless decisions will be etched into permanence on the internet.

“(Respondents) were afraid of being humiliated,” Lastra explains. But more and more, instead of making choices to avoid negative consequences, Americans are incentivized by the positive effects of their health-based choices.

Health concerns and alcohol use

Just a few weeks ago, I drove by a billboard on Utah’s I-215 that read “Self-care is cool.” In a 2022 McKinsey report, around 50% of U.S. consumers reported wellness was a top priority in their daily lives, which represented an 8% increase from 2020.

This newfound dedication to health seems to be pushing Americans, particularly young adults, away from alcohol. By some estimates, more than a third of people under the age of 27 in the United States abstain from alcohol for the sake of their mental health. And many more take a more moderate and flexible approach.

“Gen Z is drinking less alcohol and I think that where that might stem from is social things like what mental health and physical health is and what it means to be a well person,” explains Frankel.

But prioritizing health isn’t as simple as just abstaining from alcohol. In a culture that’s drinking less, there’s a need to navigate new ways to socialize that don’t involve drinks at the bar with friends.

For centuries, the social hubs where alcohol has traditionally been served have been proven to bring people together and facilitate social connections that benefit health. Robin Dunbar, an anthropologist at Oxford University, found that living near a pub significantly increased an individual’s happiness thanks to the in-person connections and local community fostered through frequent pub visits.

As I flash back to the hum of voices and the rich sound of laughter echoing down the cobblestone streets of that French village, glasses clinking santé, I can’t help but wonder what changes await as the sober-curious movement gains traction. But one issue to be aware of as alcohol becomes less prevalent in the U.S. is creating solutions to mitigate ongoing social division and isolation.

Historically, churches, offices and clubs have been important hubs of social interaction that facilitate community and benefit mental health, but these institutions are declining. In 2020, a Gallup survey found that only 47% of Americans said they belonged to a church, a 23% decrease since 1999.

The share of individuals who work remotely has skyrocketed over the past two decades. And, thanks to the iPhone and other technological advancements, more socializing is happening digitally. While there is merit to being connected digitally, in-person interactions have been shown to have a greater benefit to overall well-being, and American adults are now spending 30 percent less time face-to-face socializing than 20 years ago. Simply put, we are spending less time with other people and that is taking a toll on our health.

Social disconnection, an increasing phenomenon in our culture, can have devastating impacts on long-term health. Researchers from Brigham Young University suggest that poor social relationships or the lack of social community can have health impacts of a similar magnitude to smoking and alcohol consumption.

Drinking alcohol is objectively harmful to health, but, when it comes to curtailing the negative impacts of social isolation, there could be something to be said for the health benefits of finding new ways to go out with friends.

The future of alcohol consumption in the United States is uncertain, but it’s clear that we are all drinking — or not — and hanging out — or not — in markedly different ways than in generations past. Where this will lead in terms of net health and happiness remains to be seen.

As Americans grapple with the idea of what it means to be a healthy person, our culture is at an inflection point, and it’s hard to know whether and how alcohol fits into the equation. It is increasingly apparent that being a healthy person is more complicated than simply being sober. By approaching alcohol more mindfully, young adults are providing space for consumption to be an ongoing and deeply personal choice, rather than a categorical decision. Cheers, or santé, to that.

This story appears in the May 2024 issue of Deseret Magazine . Learn more about how to subscribe .

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Less alcohol, or none at all, is one path to better health

Moderate drinking was once thought to have benefits for the heart. But better research methods have thrown cold water on that idea. A growing number of public health experts say if you choose to drink alcohol, you should drink as little as possible. (AP Video: Laura Bargfeld)

FILE - Bottles of alcohol sit on shelves at a bar in Houston on June 23, 2020. Moderate drinking was once thought to have benefits for the heart, but better research methods starting in the 2010s have thrown cold water on that. (AP Photo/David J. Phillip, File)

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It’s wine time. Beer Thirty. Happy hour. Five o’clock somewhere.

Maybe it’s also time to rethink drinking ?

Moderate drinking was once thought to have benefits for the heart, but better research methods have thrown cold water on that.

“Drinking less is a great way to be healthier,” said Dr. Timothy Naimi, who directs the Canadian Institute for Substance Use Research at the University of Victoria in British Columbia.

AP AUDIO: Less alcohol, or none at all, is one path to better health.

AP correspondent Haya Panjwani reports.

ARE DRINKING GUIDELINES CHANGING?

Guidelines vary a lot from country to country but the overall trend is toward drinking less.

The United Kingdom, France, Denmark, Holland and Australia recently reviewed new evidence and lowered their alcohol consumption recommendations. Ireland will require cancer warning labels on alcohol starting in 2026.

“The scientific consensus has shifted due to the overwhelming evidence linking alcohol to over 200 health conditions, including cancers, cardiovascular diseases and injuries,” said Carina Ferreira-Borges, regional adviser for alcohol at the World Health Organization regional office for Europe.

From Dry January to Sober October to bartenders getting creative with non-alcoholic cocktails , there’s a cultural vibe that supports cutting back.

“People my age are way more accepting of it,” said Tessa Weber, 28, of Austin, Texas. She stopped drinking for Dry January this year because she’d noticed alcohol was increasing her anxiety. She liked the results — better sleep, more energy — and has stuck with it.

“It’s good to reevaluate your relationship with alcohol,” Weber said.

WAIT, MODERATE DRINKING DOESN’T HAVE HEALTH BENEFITS?

That idea came from imperfect studies comparing groups of people by how much they drink. Usually, consumption was measured at one point in time. And none of the studies randomly assigned people to drink or not drink, so they couldn’t prove cause and effect.

People who report drinking moderately tend to have higher levels of education, higher incomes and better access to health care, Naimi said.

“It turns out that when you adjust for those things, the benefits tend to disappear,” he said.

Another problem: Most studies didn’t include younger people. Almost half of the people who die from alcohol-related causes die before the age of 50.

“If you’re studying people who survived into middle age, didn’t quit drinking because of a problem and didn’t become a heavy drinker, that’s a very select group,” Naimi said. “It creates an appearance of a benefit for moderate drinkers that is actually a statistical illusion.”

Other studies challenge the idea that alcohol has benefits. These studies compare people with a gene variant that makes it unpleasant to drink to people without the gene variant. People with the variant tend to drink very little or not at all. One of these studies found people with the gene variant have a lower risk of heart disease — another blow to the idea that alcohol protects people from heart problems.

HOW MANY DRINKS CAN I HAVE PER DAY?

That depends.

Drinking raises the risk of several types of cancer , including colon, liver, breast and mouth and throat. Alcohol breaks down in the body into a substance called acetaldehyde, which can damage your cells and stop them from repairing themselves. That creates the conditions for cancer to grow.

Thousands of U.S. deaths per year could be prevented if people followed the government’s dietary guidelines, which advise men to limit themselves to two drinks or fewer per day and women to one drink or fewer per day, Naimi said.

One drink is the equivalent of about one 12-ounce can of beer, a 5-ounce glass of wine or a shot of liquor.

Naimi served on an advisory committee that wanted to lower the recommendation for men to one drink per day . That advice was considered and rejected when the federal recommendations came out in 2020.

“The simple message that’s best supported by the evidence is that, if you drink, less is better when it comes to health,” Naimi said.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.