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Alcohol Consumption and Impact in the United States. David H. Jernigan Ph.D. Associate Professor Department of Health, Behavior and Society Johns Hopkins Bloomberg School of Public Health and Executive Director Center on Alcohol Marketing and Youth. Drinking in the U.S. Population.

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Alcohol consumption and impact in the united states

Alcohol Consumption and Impact in the United States

David H. Jernigan Ph.D.

Associate Professor

Department of Health, Behavior and Society

Johns Hopkins Bloomberg School of Public Health

and

Executive Director

Center on Alcohol Marketing and Youth


Drinking in the u s population
Drinking in the U.S. Population

  • Of Americans aged 12 or older (NSDUH):

    • Slightly more than half of Americans aged 12 or older reported being current drinkers of alcohol in the 2007 survey (51.1 percent, or 126.8 million people).

    • More than one fifth (23.3 percent or 57.8 million people) participated in binge drinking at least once in the 30 days prior to the survey in 2007.

    • In 2007, 6.9 percent (17.0 million people) reported heavy drinking (five or more drinks within two hours on five or days in the past 30 days).


Binge drinking among u s adults brfss 1993 2007
Binge Drinking* among U.S. Adults, BRFSS, 1993-2007

Measure

Prevalence

Total Episodes

Episodes per Person

1993

14.2%

1.2 billion

6.3

2001

14.3%

1.5 billion

7.4

2007

15.5%

1.6 billion

7.2

*Defined as ≥5 drinks/occasion for men, ≥5 drinks/occasion for women from 1993-2005, and ≥4 drinks/occasion for women from 2006-2007.

Source: Naimi T, et al. Binge Drinking Among U.S. Adults. JAMA 2003; 289:70–75, and CDC Behavioral Risk Factor Surveillance System, 2007


Binge drinking among u s adults who drink brfss 2007
Binge Drinking among U.S. Adults who Drink, BRFSS, 2007

Source: CDC Behavioral Risk Factor Surveillance System, 2007.


Average drinks per binge episode by age brfss 2004
Average Drinks per Binge Episode byAge, BRFSS, 2004

Source: Cremeens, et al. Socio-Demographic Disparities in Binge Alcohol Consumption among Adults, 14 States, United States, 2004. Morb Mortal Wkly Rep 2009 (in press).


Total binge drinks by beverage type brfss 2003 2004
Total Binge Drinks by Beverage Type, BRFSS, 2003-2004

Liquor

22%

Beer

67%

Wine

11%

Source: Naimi T, et al. What do binge drinkers drink? Implications for alcohol control policy. American Journal of Preventive Medicine 2007;33:188-93.


Public health impact of excessive alcohol use
Public Health Impact of Excessive Alcohol Use

  • 79,000 alcohol-attributable deaths and 2.3 million YPLL per year (29 years/death)

  • 3rd leading actual cause of death

  • $185 billion in economic costs per year

  • Most excessive drinkers are not alcohol dependent


Prevalence of past year alcohol dependence new mexico brfss 2002
Prevalence of Past-Year Alcohol Dependence, New Mexico, BRFSS, 2002

All Respondents

Binge Drinkers

Source: Woerle S, et al. Prevalence of Alcohol Dependence Among Excessive Drinkers in New Mexico. Alcoholism: Clinical & Experimental Research 2007; 31:293-298.


Adult and youth binge drinking
Adult and Youth Binge Drinking

  • Adult binge drinking is one of the strongest predictors of youth binge drinking (parents, states, etc.).

  • Binge drinking rates in states are a strong predictor of binge drinking rates on college campuses.

  • Binge drinking rates among college students were about one-third lower in the 10 states with lowest adult binge drinking rates compared to those with the highest rates.

  • States with lower binge rates tended to have more stringent alcohol control policies

Source: Nelson TF, et al. The State Sets the Rate: the Relationship of College Binge Drinking Rates to State Binge Drinking Rates and State Alcohol Control Policies.” Am J Pub Hlth 2005; 95:1-6.


Youth (age 12-20) Binge Drinking in the U.S.: Much better than it would have been without community efforts, but not making the progress we should be making

Source: NSDUH 2007 (SAMHSA 2008)


Binge drinking by youth ages 14 18 9 th to 12 th grade
Binge drinking by youth ages 14-18 (9th to 12th grade)

Source: YRBS 2007

(CDC 2008)


Beverage preference of 12 th grade female binge drinkers
Beverage preference of 12th grade female binge drinkers

Source: Monitoring the Future 2007 (NIDA, 2008)


Youth drinking
Youth drinking

  • In 2007, 10.7 million U.S. young people ages 12-20 (28%) reported drinking in the past month, and 7.2 million (19%) reported binge drinking. (NSDUH)

  • Every day, 5,000 kids under age 16 start drinking. (NSDUH)

  • The earlier young people begin drinking, the worse the consequences are likely to be.


Public health impact of underage drinking
Public Health Impact of Underage Drinking

  • Alcohol is the most widely used substance of abuse among America’s youth

  • 90% is consumed as binge drinks (i.e., while drinking to get drunk)

  • Closely tied to leading health and social problems among youth (e.g., impaired driving, violence, & risky sexual behavior)

  • Results in 1 of 4 deaths among males and 1 of 6 deaths among females age 15 to 20 years.


Consequences of youth drinking
Consequences of youth drinking

  • Young people who begin drinking at age 14 or younger are:

    • four times more likely to develop alcohol dependence than those who wait until they are 21(Grant and Dawson 1997).

    • seven times more likely to be in a motor vehicle crash because of drinking (Hingson et al. 2001)

    • eleven times more likely to be in a physical fight after drinking (Hingson et al. 2000)

    • twelve times more likely to suffer from other unintentional injuries after drinking (Hingson et al. 2001).

  • Annually, approximately 5,000 people under age 21 die from alcohol-related injuries resulting from underage drinking. (OSG, 2007)


Brain activity in 15 year olds during a memory task
Brain activity in 15 year-olds during a memory task

Heavy use of alcohol during adolescence can impair brain development, causing loss of memory and other skills.


RISK FACTOR

POTENTIAL CONDITION

Motor Vehicle Crashes

Interpersonal Violence

Underage & Binge Drinking

HIV, STDs

Unintended Pregnancy

FAS, SIDS

Alcohol Dependence


Interpersonal violence by drinking status yrbs 2003
Interpersonal Violence by Drinking Status, YRBS, 2003

Source: Miller JW, et al. Binge drinking and associated risk behaviors among high school students. Pediatrics 2007; 119:76-85.


Binge drinking by school performance yrbs 2003
Binge Drinking by School Performance, YRBS, 2003

Source: Miller JW, et al. Binge drinking and associated risk behaviors among high school students. Pediatrics 2007; 119:76-85.


State question on usual beverage consumption yrbs 2005

Beer

Malt beverages (e.g., Smirnoff Ice, Bacardi Silver, and Hard Lemonade)

Wine coolers

Wine

Liquor

Some other type

No usual type.

I did not drink alcohol in the past 30 days

State Question on Usual Beverage Consumption, YRBS, 2005

During the past 30 days, what type of

alcohol did you usually drink?


Usual beverage consumed by current drinkers yrbs 2005
Usual Beverage Consumed by Current Drinkers, YRBS, 2005

State Liquor Beer Malt Others No usual Beverages Type

Arkansas 44.7 13.5 25.7 7.9 8.3

Nebraska 34.1 32.7 16.4 7.5 9.4

New Mexico 35.6 19.9 20.4 12.3 11.9

Wyoming 40.2 20.5 20.4 7.7 11.2

Pooled 38.7 21.3 21.1 9.0 9.9

Source: Cremeens J, et al. Assessment of Source and Type of Alcohol Consumed by High School Students: Analyses from Four States. Journal of Addiction Medicine 2009; (in press).


Adult drinking and underage drinking
Adult Drinking and Underage Drinking

  • Strong tie between adult drinking and youth drinking.

  • Youth tend to model their behavior after adults.

  • Adults are often the source of the alcohol consumed by youth.

  • Many alcohol control policies affect youth and adults.


Other key factors in youth drinking
Other key factors in youth drinking

  • Low tax rates

    • State and federal levels – taxes at federal level not raised since 1991 – beer now cheaper than milk or juice

  • New product development – alcopops etc.

  • Alcohol advertising exposure

    • 38% increase in youth exposure to alcohol advertising on TV, 2001-2007 – more on this tomorrow…


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