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ASK YOURSELF
As Parents
Do you know how to discuss alcohol use with your child and where to get information to help you?
Do you know your child's friends, and do you feel that they provide positive influences on your child's activities?
Do you know the extent of drinking by children in your neighborhood and how to find local organizations that are working on the issue?
Do you know the legal consequences if your child is caught drinking alcohol?
As Teachers, Administrators, and School Counselors
Has your school or community assessed student drinking to determine the extent of the problem?
Do you know what factors may be contributing to student drinking in your school or community, (e.g., easy access to alcohol, peer pressure, adults'inability to address the issue)?
Do you know what steps, if any, are being taken within your school system to help kids resist the pressure to drink?
Is your school currently working to educate parents about alcohol use among children?
Does your school have an active partnership with the families of your students?
As Concerned Citizens
Do you know how easily children in your community can obtain alcohol and what communities can do to prevent access to alcohol by young people?
Does your community have educational programs and policies to prevent children from drinking?
Does your community have "alcohol-free" activities for families? If not, do you know how to initiate them?
Is there collaboration among public and private schools, community businesses, local government, and the police force to develop and enforce policies about youth alcohol use?
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Do you know how you can become involved in addressing the problem of alcohol use by children?
For information about how you can become involved with activities to stop children from drinking in your community, e-mail: Leadership@cdmgroup.com.
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THE CHILD
"Parents must understand that they are the first line of defense in raising healthy children." Peggy Sapp, President, National Family Partnership
Almost 42% of ninth grade students reported having consumed alcohol before they were 13.1
About 44% of ninth grade students reported drinking in the past month. In contrast, only 33% of ninth graders reported smoking in the past month.1
One fourth (25%) of ninth grade students reported binge drinking (having had five or more drinks on one occasion) in the past month.1
Rates of drinking differ among racial and ethnic minority groups. Among ninth graders, binge drinking was reported by 27% of non-Hispanic white students and 30% of Hispanic students, but only 15% of African American students and 5% of Asian-Pacific Islander students.2
The gap between alcohol use by boys and girls has closed. Girls consume alcohol and binge drink at rates equal to boys.1
Forty percent of children who start drinking before the age of 15 will become alcoholics at some point in their lives. If the onset of drinking is delayed by 5 years, a child's risk of serious alcohol problems is decreased by 50%.3
1 Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance - United States, 1997. Morbidity and Mortality Weekly Report: CDC Surveillance Summaries 47(No. SS-3):1-89.
2 Alcohol Epidemiologic Data System, National Institute on Alcohol Abuse and Alcoholism. [Racial/ethnic breakdown of youth alcohol rates.] Unpublished data, 1999. Based on Centers for Disease Control and Prevention Youth Risk Behavior Surveillance, 1997.
3 Grant, B.F., & Dawson, D.A. Age at onset of alcohol use and association with DSM-IV alcohol abuse and dependence: Results from the National Longitudinal Alcohol Epidemiologic Survey. Journal of Substance Abuse 9:103-110, 1997.
FAMILY
"I've seen alcohol at work in my family and that's enough for a lifetime. I'm not drinking." - Matthew, Michigan
Current research suggests children are less likely to drink when their parents are involved with them and when they and their parents report feeling close to each other.1, 2
Adolescents drink less and have fewer alcohol-related problems when their parents discipline them consistently and set clear expectations.1
Nearly 17% of children under 14 and 20% of children under 18 live with a parent (or responsible adult) who drinks heavily or has an alcohol problem.3
Parents'drinking behaviors and favorable attitudes about drinking have been associated with adolescents'initiating and continuing drinking.1, 4, 5
The immediate family members of alcoholics are 2 to 7 times more likely than the general population to develop problems with alcohol during their lifetime.6, 7
Drinking during pregnancy has been associated not only with fetal alcohol syndrome but with offspring learning and behavioral problems into adolescence.8
Elevated rates of alcoholism are consistently found in parents of youth with Attention Deficit/Hyperactivity Disorder (ADHD).9
1 Hawkins, J.D., et al. Exploring the effects of age of alcohol use initiation and psychosocial risk factors on subsequent alcohol misuse. Journal of Studies on Alcohol 58(3):280-290, 1997.
2 Resnick, M.D., et al. Protecting adolescents from harm: Findings from the National Longitudinal Study on Adolescent Health. Journal of the American Medical Association 278(10):823-832, 1997.
3 Alcohol Epidemiologic Data System, National Institute on Alcohol Abuse and Alcoholism. [Number of children living with parent who has alcohol problem.] Unpublished data, 1999. Based on National Institute on Alcohol Abuse and Alcoholism 1992 National Longitudinal Alcohol Epidemiologic Survey.
4 Andrews, J.A., et al. Parental influence on early adolescent substance use: Specific and nonspecific effects. Journal of Early Adolescence 13(3):285-310, 1993.
5 Ary, D.V., et al. The influence of parent, sibling, and peer modeling and attitudes on adolescent use of alcohol. International Journal of the Addictions 28(9):853-880, 1993.
6 Cotton, N.S. Familial incidence of alcoholism: A review. Journal of Studies on Alcohol 40:89-116, 1979.
7 Merikangas, K.R. Genetic epidemiology of alcoholism. Psychological Medicine 20(1):11-22, 1990.
8 Olson, H.C., et al. Association of prenatal alcohol exposure with behavioral and learning problems in early adolescence. Journal of the American Academy of Child and Adolescent Psychiatry 36(9):1187-1194, 1997.
9 Wilens T.E., et al. Attention-deficit hyperactivity disorder and the psychoactive substance use disorders. Child and Adolescent Psychiatric Clinics of North America 5(1):73-91, 1996.
SCHOOL
"Alcohol almost destroyed my life. I started out drinking with my friends, trying to be cool. I drank to get drunk . . . and I did some stupid things while I was drunk. Now I'm trying to get my life back, and it's not easy with a baby." - Amy, ado
Evidence suggests that alcohol use by peers is a strong predictor of adolescent use and misuse of alcohol.1
According to a 1995 national survey of fourth through sixth graders who read the Weekly Reader, 30% of students reported that they received "a lot" of pressure from their classmates to drink beer.2
Three-quarters of eighth graders reported having friends who use alcohol. In fact, one-fourth of eighth graders said that most or all of their friends drink.3
Among eighth graders, students with higher grade point averages reported less alcohol use in the past month.4
Among eighth graders, higher truancy rates were associated with greater rates of alcohol use in the past month.4
One national study found that students are less likely to use alcohol if they are close to people at school, are a part of their school, and if they feel that teachers treat students fairly.5
According to the 1995 Weekly Reader survey, over half (54%) of fourth through sixth graders reported learning about the dangers of illicit drugs at school, but less than a third (30%) learned about the dangers of drinking and smoking at school.2
In 1995, 76% of seventh through twelfth grade teachers polled felt that underage student drinking was a serious or somewhat serious problem.6
1 Hawkins, J.D., et al. Exploring the effects of age of alcohol use initiation and psychosocial risk factors on subsequent alcohol misuse. Journal of Studies on Alcohol 58(3):280-290, 1997.
2 The Weekly Reader National Survey on Drugs and Alcohol, Middletown, CT: Field Publications, Spring 1995.
3 Johnston, L.D., et al. National Survey Results on Drug Use from the Monitoring the Future Study, 1975-1997: Volume 1. Secondary School Students. Rockville, MD: National Institute on Drug Abuse, 1998.
4 O'Malley, P.M., et al. Alcohol use among adolescents. Alcohol Health & Research World 22(2):85-93, 1998.
5 Resnick, M.D., et al. Protecting adolescents from harm: Findings from the National Longitudinal Study on Adolescent Health. Journal of the American Medical Association 278(10):823-832, 1997.
6 Metropolitan Life/Louis Harris Associates, Inc. The Metropolitan Life Survey of the American Teacher, 1984-1995. Cited in Department of Education. Digest of Education Statistics, 1996. Washington, DC: National Center for Education Statistics, 1996.
COMMUNITY
"Alcohol is the number one drug of choice among our Nation's youth. Yet the seriousness of this issue does not register with the general public or policymakers."- Enoch Gordis, M.D., Director, National Institute on Alcohol Abuse and Alcoholism
An overwhelming majority of Americans (96%) are concerned about underage drinking. In fact, a majority support measures that would help reduce teen drinking, such as stricter controls on alcohol sales, advertising, and promotion.1
Recent advertising expenditures in the United States for beer, wine, and liquor combined ($1.2 billion) totaled more than 10 times the amount spent on milk ads ($70.5 million). A total of $764.2 million was spent on beer ads, $131.5 million on wine ads, and $291.2 million on liquor ads.2, 3
A study of fifth- and sixth-grade students found that those who demonstrated an awareness of beer ads also held more favorable beliefs about drinking and intended to drink more frequently when they grew up.4
One study of Midwestern States found that 46% of ninth graders who reported drinking alcohol in the previous month said they obtained the alcohol from a person aged 21 or older.5
In 38 States and the District of Columbia, areas with greater numbers of drinking establishments had higher rates of alcoholism.6
Among drivers aged 15-20, fatal crashes involving a single vehicle at night are three times more likely than other fatal crashes to be alcohol-related. The proportion of fatal crashes that involved single vehicles at night declined 22 percent among drivers in States with zero tolerance polices (0.00 blood alcohol concentration limits) for drivers younger than 21.7
Since 1975, the National Highway Traffic Safety Administration estimates that the 21-year-old minimum drinking age laws have saved 18,220 lives.8
1 Wagenaar, A.C., et al. The Robert Wood Johnson Foundation Youth Access To Alcohol Survey: Summary. Minneapolis: University of Minnesota, Alcohol Epidemiology Program, 1998.
2 Adams Business Media. Liquor handbook 1999. New York: Author, 1999; Adams Business Media. Wine handbook 1999. New York: Author, 1999; & Adams Business Media. Beer handbook 1999. New York: Author, 1999.
3 Blisard, N., et al. Analyses of Generic Dairy Advertising, 1984-97. Technical Bulletin No. 1873. Washington, DC: U.S. Department of Agriculture, Food and Rural Economics Division, Economic Research Service. March 1999. (p.10)
4 Grube, J.W., & Wallack, L. Television beer advertising and drinking knowledge, beliefs, and intentions among schoolchildren. American Journal of Public Health 84(2):254-259, 1994.
5 Wagenaar, A.C., et al. Sources of alcohol for underage drinkers. Journal of Studies on Alcohol 57(3):325-333, 1996.
6 Harford, T.C., et al. Relationship between the number of on-premise outlets and alcoholism. Journal of Studies on Alcohol 40(11):1053-1057, 1979.
7 Hingson, R., et al. Lower legal blood alcohol limits for young drivers. Public Health Reports 109(6):738-744, 1994.
8 National Highway Traffic Safety Administration. Traffic Safety Facts 1998 - Alcohol. Washington, DC: U.S. Department of Transportation.
IMPACT ON CHILDREN'S HEALTH AND SAFETY
"Underage alcohol use is a significant threat to the health and safety of our children. It is time for us to come to grips with this widespread, devastating, public health problem." - Steven A. Schroeder, M.D. President/CEO, The Robert Wood Johnson Foundation
In 1997, nearly 10% of ninth graders reported driving one or more times while drinking. Thirty-three percent of ninth graders reported having ridden in a car driven by someone who had been drinking alcohol.1
Of all children under age 15 killed in vehicle crashes in 1998, 20% were killed in alcohol-related crashes.2
Among 12-to 17-year-old current drinkers, 31% had extreme levels of psychological distress, and 39% exhibited serious behavioral problems.3
In 1994, suicides or homicides accounted for 18% of the estimated number of alcohol-related deaths of children aged 9-15.4
Current drinkers among a nationally representative sample of youth aged 12-16 had higher levels of diastolic blood pressure than did their non-drinking counterparts.5
Adolescent females who drink exhibit higher levels of estradiol (an estrogen) and testosterone than non-drinking girls. High levels of estrogen may contribute to increased risk for specific diseases, including breast cancer, and high levels of testosterone are associated with an increased risk of substance use.6
Girls, aged 12-16, who were current drinkers were four times more likely than their non-drinking counterparts to suffer depression.7
1 Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance - United States, 1997. Morbidity and Mortality Weekly Report: CDC Surveillance Summaries 47(No. SS-3):1-89.
2 National Highway Traffic Safety Administration. Traffic Safety Facts 1998- Children. Washington, DC: U.S. Department of Transportation, 1999.
3 Substance Abuse and Mental Health Services Administration. The Relationship Between Mental Health and Substance Abuse Among Adolescents. Rockville, MD: Author, 1999.
4 Alcohol Epidemiologic Data System, National Institute on Alcohol Abuse and Alcoholism. [Estimates for alcohol-related deaths by age and cause.] Unpublished data, 1999. Based on National Center for Health Statistics 1994 Mortality Data.
5 Hanna, E.Z. et al. Drinking, smoking, and blood pressure: Do their relationships among youth foreshadow what we know among adults? Paper presented at the American Public Health Association Annual Meeting, Chicago, IL, November, 1999.
6 Martin C.A., et al. Alcohol use in adolescent females: Correlates of estradiol and testosterone. American Journal on Addiction 8(1):9-14, 1999.
7 Hanna E.Z., et al. The relationship of early onset regular smoking and alcohol use to one another, depression, illicit drug use and other risky behaviors during early adolescence: Results from the youth supplement to the Third National Health and Nutrition Examination Survey (NHANES III). Alcoholism: Clinical and Experimental Research, in press.
IMPACT ON SOCIETY
Approximately 14 million Americans'about 7.4% of the adult population'meet the diagnostic criteria for alcohol abuse or alcoholism.1
More than one-half of American adults have a close family member who has or has had alcoholism.2
The total cost attributable to underage drinking, including costs of traffic crashes, violent crime, injuries, and treatment, is over $52 billion per year.3
In 1995, the estimated annual cost of alcohol abuse in the U.S. was $166.5 billion. Alcohol use disorders cost $56.7 billion more than the estimated annual economic cost of illegal drug use and $36.5 billion more than the estimated annual economic cost of smoking.4, 5
In 1992, the estimated productivity loss for employees with past or current alcoholism was $66.7 billion. Productivity losses were greatest for male employees who initiated drinking before age 15.4
Nearly 60% of 18-to 24-year-old current drinkers who failed to complete high school had begun to drink before age 16.6
In 1996, the average American drank 32 gallons of beer compared to 52 gallons of soft drinks, 24 gallons of milk, and 23 gallons of coffee.7
Adults who consume more than one to two alcoholic drinks per day are at risk for many health problems, including several types of cancer, digestive diseases, cardiovascular diseases, addiction-related mental disorders, accidents, and injuries.8
Alcohol is implicated in more than 100,000 deaths annually.9
In 1996, about 2 million (38%) of the estimated 5.3 million convicted offenders under the jurisdiction of corrections agencies were drinking at the time of the offense.10
1 Grant B.F., et al. Prevalence of DSM-IV alcohol abuse and dependence: United States, 1992. Alcohol Health & Research World 18(3):243-248, 1994.
2 Dawson, D.A., & Grant, B.F. Family history of alcoholism and gender: Their combined effects on DSM-IV alcohol dependence and major depression. Journal of Studies on Alcohol 59(1):97-106, 1998.
3 Pacific Institute for Research and Evaluation. Costs of Underage Drinking. Updated edition. Prepared for the Office for Juvenile Justice and Delinquency Prevention Enforcing the Underage Drinking Laws Program under contract no. 98-AH-F8-0114. Rockville, MD: Author, 1999.
4 Harwood, H., et al. The Economic Costs of Alcohol and Drug Abuse in the United States, 1992. Rockville, MD: National Institute on Drug Abuse, 1998. 5 U.S. Department of the Treasury. The Economic Costs of Smoking in the United States and the Benefits of Comprehensive Tobacco Legislation. Washington, DC: Author, 1998.
6 National Institute on Alcohol Abuse and Alcoholism. Drinking in the United States: Main Findings from the 1992 National Longitudinal Alcohol Epidemiologic Survey (NLAES). U.S. Alcohol Epidemiologic Data Reference Manual, Volume 6. Bethesda, MD: Author, 1998.
7 U.S. Census Bureau. Statistical Abstract of the United States, 1998 (118th ed.). Washington, DC: Author, 1998.
8 U.S. Department of Agriculture, & U.S. Department of Health and Human Services. Nutrition and Your Health: Dietary Guidelines for Americans (4th ed.). Washington, DC: USDA, 1995.
9 McGinnis, J.M., & Foege, W.H. Actual causes of death in the United States. Journal of the American Medical Association 270(18):2207-2212, 1993.
10 U.S. Department of Justice, Bureau of Justice Statistics. Alcohol and Crime: An Analysis of National Data on the Prevalence of Alcohol Involvement in Crime. (NCJ-168632). Washington, DC: Author, 1998.
For information about how you can become involved with activities to stop children from drinking in your community, e-mail: Leadership@cdmgroup.com.
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