Nation nal Institutte on Alcoh hol Abuse and Alcoh holism Key Unanswered L Legal lD Drinking i ki A Age Q Questions ti Exceptions: Depending on the state, it CAN be legal: • For persons under 21 to possess alcohol with parental/guardian consent and/or presence (24 States) • For a parent or guardian to furnish alcohol to a person under 21 (31 states) • In fact fact, only 31 States and DC explicitly prohibit consumption of alcohol by a person under age 21 • In 47 states, people under 21 can serve alcohol Source: NIAAA Alcohol Policy Information System at http://www.alcoholpolicy.niaaa.nih.gov/stateprofiles//index.asp Nation nal Institutte on Alcoh hol Abuse and Alcoh holism Key Unanswered Questions Explore Effects of: 1) Removing loopholes and exceptions in age g 21 MLDA laws 2) Keg registration laws 3) Social host liability laws 4) Minimum legal age children can be provided id d alcohol l h lb by parents t 5) Raising age youth can serve alcohol Nation nal Institutte on Alcoh hol Abuse and Alcoh holism Is Passing Laws Enough? Nation nal Institutte on Alcoh hol Abuse and Alcoh holism Potential Process of Change After a Drinking Age Increase P li andd Enforcement Police E f Legall Drinking L D i ki Age Increase Court Enforcement Public Education Who - Minors - Alcohol Outlets What - Reasons for Law - Enforcement G General lL Legall Deterrence D Reduction In Drinking & Driving After Drinking Changes g in Public Perception about Alcohol AlcoholRelated Fatal Crash Reductions Nation nal Institutte on Alcoh hol Abuse and Alcoh holism Successful Comprehensive Community Interventions Saving Lives Program, Hingson (1996) Project Northland, Perry (1996) Comm nities Mobili Communities Mobilizing ing for Change Change, Wagenaar (2002) Community Trials, Holder (2000) A Matter of Degree, Weitzman (2004) Fighting Back, Hingson (2005) Sacramento Neighborhood Prevention Project, Treno Treno,, (2007) State Coalitions to Reduce Underage Drinking, Wagenaar ((2007)) Neighborhoods Engaging with Students (NEST), Saltz (2009) Communities That Care Care, Hawkins et al al. (2009) College community program, McCartt et al. (2009) 80 Safer California Universities, Saltz (in press, 2010) Nation nal Institutte on Alcoh hol Abuse and Alcoh holism Comprehensive community interventions address college age and underage drinking at multiple levels - Coordinate multiple city departments Clear measurable Objectives and Strategic Plans Combine Education and Law Enforcement Include screening g and early y interventions Use Data to Plan and Evaluate Involve Private Citizens – Be Inclusive Involve Youth Nation nal Institutte on Alcoh hol Abuse and Alcoh holism Hawkins et al., Communities That Care, Arch. Pediatric Adol. Adol. Med., Med., 2009 Methods: • 13 communities matched with 13 comparison p communities for state, population size, racial/ethnic diversity, and economic indicators • Surveyed student in 5th through 8th grade in 2004 2004--2007 (N=4,407) (half in intervention and half compared) Intervention: • Coalition members were trained to use data from surveys in 1998, 2000, and 2002 – To prioritize risk factors for preventive action – To use evidenceevidence-based programs targeting youth grades 5 5--9 (age 1010-14). Nation nal Institutte on Alcoh hol Abuse and Alcoh holism Hawkins et al. (cont.) Evidence--Based Programs: Evidence School-Based S h lB d Programs -All Stars -Life Skills Training -Lion’s Quest Skill Skills -Project Alert -Olweus Bullying Prevention Program Community C it Youth Y th Programs -Participate and Learn Skills -Stay Smart -Big Brothers/Sisters -Academic A d i T Tutoring t i F il Programs Family P -Strengthening Families -Parents Who Care -Family Matters -Parenting P ti Wi Wisely l Nation nal Institutte on Alcoh hol Abuse and Alcoh holism Hawkins et al. (cont.) Results: • Intervention I t ti students t d t 60% lless lik likely l tto iinitiate iti t alcohol use by grade 8 • Intervention Inter ention less likel likely to start smoking • Intervention students 41% less likely to initiate delinquent behavior • By grade 8 in intervention, communities lower: – Alcohol use – Binge drinking − Smokeless tobacco use − Delinquent behavior Nation nal Institutte on Alcoh hol Abuse and Alcoh holism Fighting Back Program Selected Interventions Limit Alcohol Availability Youth access compliance check surveys Responsible beverage service training M i i and Monitoring d closing l i problem bl liliquor outlets l Bill board restrictions E Expand d Treatment T t t Sales tax increase for expanded treatment New Ne treatment programs programs-- courts, co rts jails jails, health care agencies, public housing Emergency department screening/brief interventions New inpatient, outpatient and recovery programs Source: Hingson et al., Injury Prevention, 2005 Nation nal Institutte on Alcoh hol Abuse and Alcoh holism Greater Relative Reduction in AlcoholAlcoholRelated Fatal Crashes VS Fatal Crashes with Zero BAC Pooled Effects Drivers 5 FB sites VS S controls co t o s BAC .01%+ 01%+ VS Zero BAC All Ages 16 16--20 22% P= 01 P=.01 26% P= 08 P=.08 Communities: Kansas City City, MO MO, *Milwaukee, WI, San Antonio, TX, *Santa Barbara, CA, and *Vallejo, CA Source: Hingson et al., Injury Prevention, 2005 C Courtney Birch i h A Matter of Degree g ((AMOD)) Nation nal Institutte on Alcoh hol Abuse and Alcoh holism Weitzman et al. American Journal of Preventive Medicine Medicine.. 2004 College/ Community Partnerships Environmental strategies to reduce drinking problems: • • • • • Keg registration M d t Mandatory responsible ibl b beverage service i Police wild party enforcement Substance free residence halls Advertising bans A Matter of Degree g ((AMOD)) Nation nal Institutte on Alcoh hol Abuse and Alcoh holism Weitzman et al. American Journal of Preventive Medicine Medicine.. 2004 AMOD achieved reductions among college students in • • • • Binge drinking Driving after drinking Alcohol related injuries Being assaulted by other drinking college students Nation nal Institutte on Alcoh hol Abuse and Alcoh holism McCartt et al.,, Injury j y Prevention, Prevention, 2009 Intervention • Marshall M h ll U University, i it H Huntington ti t (WV) West Virginia University, Morgantown (comparison) • Increased enforcement – DUI laws – Zero tolerance laws – Minimum legal drinking age of 21 – Fake ID • Sobriety checkpoints • Saturation patrols • DUI patrols • Multi Multi--media campaign Nation nal Institutte on Alcoh hol Abuse and Alcoh holism Saltz, Safer California Universities, Am J Prev Med Med,, In press. Random Assignment: Intervention Sites Comparison Sites CSU Chico Sacramento State CSU Long Beach UC Berkeley UC Davis UC Riverside UC Santa Cruz Cal Poly SLO San Sa Jose State CSU Fullerton UC Irvine UC Los Angeles UC San Diego UC Santa Barbara Nation nal Institutte on Alcoh hol Abuse and Alcoh holism Integrated Intervention Strategies for OffOffCampus Parties (focused on beginning of academic year) A Social Host Safe Party Campaign Compliance Checks DUI Check Points Party Patrols Pass Social Host “Response Cost” Ordinance O Nation nal Institutte on Alcoh hol Abuse and Alcoh holism Results: Practical Significance At each campus, camp s 900 fe fewer er students st dents drinking to intoxication at offoff-campus parties and 600 fewer getting drunk at bars/restaurants during the fall semester at intervention schools relative to controls. Equivalent to 6,000 fewer incidents of intoxication at offoff-campus parties and 4,000 4 000 fewer incidents at bars & restaurants during the fall semester at Safer intervention schools relative to controls Nation nal Institutte on Alcoh hol Abuse and Alcoh holism Conclusions Research indicates reductions in underage and college g age g drinking g and related problems can be achieved with interventions that focus on - Individuals - Families - Schools - Environmental Changes/Legislation Interventions I t ti targeting t ti multiple lti l levels l l are more effective Nation nal Institutte on Alcoh hol Abuse and Alcoh holism Key Unanswered Questions: Comprehensive Community Interventions to Reduce Youth Alcohol Problems 1) Will a combination of – – environmental interventions to reduce alcohol availability and enforce alcohol policy policy, e e.g. g DWI and drinking age laws increased alcohol screening and early intervention achieve greater problem reduction than either alone? 2) Are programs that target both underage youth and young adults more effective in reducing youth alcohol problems than underage oriented programs only? Nation nal Institutte on Alcoh hol Abuse and Alcoh holism Key Unanswered Questions: Comprehensive Community Interventions to Reduce Youth Alcohol Problems 3) Will programs th thatt reduce d youth th consumption ti produce carry over alcohol problem reduction in adult life? 4) How can effective comprehensive community interventions be sustained over time? 5) What types of community interventions are most effective in reducing youth alcohol problems with ith the least cost? Drivers in Fatal Crashes with Positive Blood Alcohol Concentrations, Rate per 100,000, Ages 18-20 vs. 21-24, United States, 1982-2007 Nation nal Institutte on Alcoh hol Abuse and Alcoh holism U.S. MLDA Age 21 law MLDA 21 in all 50 states 27.8 30.00 (n=4,811) 25.00 26.96 (n=3,454) (n 3,454) Ages g 21-24: ↓ 46% % 20.00 15.06 (n=2,538) 15.00 10.00 5.00 9.91 ( 1 259) (n=1,259) Ages 18-20: ↓63% 0.00 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 Sources: U.S. Fatality Analysis Reporting System, 2009; U.S. Census Bureau, 2009 Nation nal Institutte on Alcoh hol Abuse and Alcoh holism 97
© Copyright 2026 Paperzz