Young Adult Drinking Prevention

by National Institute of Health

This article briefly summarizes three evidence-based community intervention trials sponsored by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Designed to reduce alcohol use among youth and young adults, these trials demonstrate the potency of community interventions that can influence the price, availability, drinking context, and perceived risks of heavy drinking among young people. The effectiveness of comprehensive, research-based local prevention efforts is confirmed by research examining other programs to reduce alcohol sales to youth as well as the harm caused by alcohol use among youth and young adults, including alcohol-related traffic accidents and assaults. By restructuring the total alcohol environment in a way that can be self-sustaining, these interventions are more likely to be effective than one-time interventions.

Community action is essential to preventing problems associated with drinking alcohol, and especially those related to heavy alcohol use among youth and young adults. The rationale behind targeting communities instead of a subgroup of young people, such as those enrolled at a particular school, is compelling. Whether they are working, attending college, or in the military, young adults typically are part of a community. The means through which young people usually obtain alcohol - retail outlets, restaurants, bars, and social settings such as parties - operate within the environment of the community.

Community strategies that focus on changing the local environment to decrease heavy drinking and reduce alcohol problems, among all age groups or specifically among young people, have the potential to effect structural changes in the community drinking environment that could have an especially broad and long-lasting impact on drinking behavior.

Research indicates that the prevention strategies most effective with minors and young adults are policy strategies that influence the price, availability, drinking context, or perceived risks of heavy drinking. Substantial changes in the conditions of sale (such as changing which outlets can legally sell alcohol and when they can do so) may alter young people's access to alcohol as well as stimulate or reduce heavy drinking in this age group. Similarly, introducing or legalizing specific beverage types (wine coolers, high-alcohol beer) appears to change beverage preferences and may increase alcohol consumption.

Federal as well as State laws - including those governing legal drinking age, licensing of alcohol outlets, the legal blood alcohol level for drinking and driving, service to obviously intoxicated people, and alcohol advertising - often form the basis for local policies. Local governments, in turn, are responsible for implementing and enforcing these laws. Examples of local government action can include giving priority to drinking-and-driving enforcement; mandating server training for bars, pubs, and restaurants; defining responsible alcoholic beverage service by licensed retail establishments; and allocating enforcement resources to prevent alcohol sales to people who are underage or obviously intoxicated. The relative emphasis that local police departments give to different alcohol-related policies is an example of the kind of administrative decision that is made locally.

To be effective, community prevention interventions require a mix of evidence-based program components and policy strategies. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has been at the forefront of encouraging evidence-based community prevention. Although many such efforts have been sponsored by other Federal and State agencies, this article discusses three research-based community prevention trials sponsored by NIAAA. These trial programs are comprehensive local efforts that use a combination of environmental strategies in concert to affect heavy drinking and related problems among all age groups, but especially among youth and young adults.

The Saving Lives Project

The Saving Lives project was designed to reduce alcohol-impaired driving and related problems such as speeding in six communities in Massachusetts over a 5-year period. In each community a full-time city employee organized a task force of representatives of city departments to work on the project, which was funded at the rate of $1 per inhabitant annually to pay for the local coordinator, police enforcement, program activities, and educational materials. The task force designed the specific activities its community would implement. These included media campaigns, speeding and drunk-driving awareness days, telephone hotlines for reporting speeders, police training, high school peer-led education, establishment of Students Against Drunk Driving chapters, programs for college students, and information for retail alcohol outlets about drinking and risks.

Over the 5 years of the program, the participating communities saw a 25-percent reduction in fatal car crashes and more than a 40-percent reduction in alcohol-related fatal crashes relative to the rest of the State. The program effect was most pronounced among drivers between ages 15 and 25; among young adults in this age range there was a 39-percent reduction in fatal crashes compared with the rest of the State. In addition, program communities experienced a 5-percent reduction in crashes involving injuries that required medical attention and an 8-percent reduction in crash injuries among 16- to 25-year-olds.

The program did not significantly affect adults' perceptions that police would stop drunk drivers and speeders. However, there were statistically significant increases in the number of 16- to 19-year-olds who believed that their licenses would be suspended if they were caught drinking and driving and that speeders would be stopped by police and fined substantially. In addition, 16- to 19-year-olds were half as likely to report driving after drinking in program communities, and there were 50 percent fewer citizen reports of speeding.

About the Author

NIH is the nation's medical research agency - making important medical discoveries that improve health and save lives. The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services, is the primary Federal agency for conducting and supporting medical research.