Underage Drinking: A South Carolina Priority

1. Underage Drinking: A South Carolina Priority November 16, 2010 CAST Training

2. State Epidemiological Outcomes Workgroup (SEOW) • SEOW is a subcommittee of Gov. Council • Began meeting in 2006 • Determined four state priorities, approved by GC in 2008 • Underage Drinking • Alcohol-Related Traffic Crashes • Youth Tobacco Use (including smokeless tobacco) • Substance Use During Pregnancy

3. Strategic Prevention Framework Consequences Consumption Causal Factors

4. South Carolina Community Action for a Safer Tomorrow (CAST) Environmental Logic Model: Underage Drinking Consumption Pattern Risk Factors & Underlying Conditions Environmental Strategies Social norms accepting and/or encouraging use Community media advocacy Social event monitoring & enforcement Underage Drinking Insufficient enforcement of laws Adjudication systems enhancement Easy social access High-visibility best practice enforcement operations Easy retail access • 35% of SC high school students drink • 18% of SC high school students drank 5 or more drinks on one occasion in the past two week • 1 in 10 SC high school students drove after drinking in the past month Merchant education Inappropriate promotion of use Alcohol advertising restrictions Low or discount pricing Increase product price Insufficient laws and policies Community mobilization for policy change Insufficient enforcement of school policies Model school policies w/ enforcement Lack of identification of early problem behaviors Improved screening & referral systems Last updated 8/6/10

5. Death Traffic Crashes Homicide Suicide Violent Crime Injuries/Assaults Dependence Teen Pregnancy Academic Failure Cost Consequences

6. Death 5,000 people under age 21 in the U.S. die each year from alcohol-related injuries Using 2001-2005 data, CDC estimates 84 alcohol-related SC deaths for those under 21 annually.

7. SC Crash Statistics 2005

8. Youth Alcohol Use & Crashes # of Fatalities & Injuries in Alcohol-Related Crashes with an “At Fault” Underage Driver DAODAS/PIRE Analysis of Office of Highway Safety Crash Data

9. High School StudentsDriving after Drinking (past month)

10. High School StudentsRiding with Drinking Driver (past month)

11. Homicide • Estimated 47% of homicides are alcohol-related (all ages) • SC: 7.7 deaths per 100,000 • 31% higher than US

12. SC Homicide Deaths per 1,000

13. Homicides by Age, SC 2004 15- to 24-year olds: 2nd highest homicide death rates

14. Suicide • SC: 11.3 deaths per 100,000 • SC rates similar to US • Estimated 23% of suicides are alcohol-related • Means 103 alcohol-related suicide deaths per year in SC • SC high school drinker twice as likely as non-drinker to have attempted (13% in past year) (2007 YRBS)

15. Suicide Deaths per 100,000

16. Suicides by Age, SC 2004 Comparatively low rates among 15- to 24-year olds.

17. Violent Crime • 7.7 reported offenses per 1,000 residents • 64% higher than US

18. Violent Crime Reports per 1,000

19. Injuries/Assaults among Young Adults, US • 599,000 18-24 year old students are unintentionally injured under the influence of alcohol • 696,000 18-24 year old students are assaulted by another student who has been drinking • 97,000 18-24 year old students are victims of alcohol-related sexual assault or date rape • SC: High school drinker twice as likely to have been forced to have sex (14%) than non-drinker Sources: The Surgeon General’s Call to Action to Prevent and Reduce Underage Drinking 2007 and SC YRBS 2007

20. Teen Pregnancy • In 2004, there were 52.1 live births per 1,000 women ages 15 to 19 in SC • 41.1 per 1,000 women in the US • SC 27% higher than US

21. Teen Sex and Alcohol/Drug Use • 19% of SC high school students report alcohol or drug use before the last time they had sex (2009 YRBS) • 22% nationally

22. Alcohol Dependence

23. Dependence/Abuse (DSM-IV Criteria) Percent of Persons Age 12 to 17 and 18 to 25 Meeting DSM-IV Criteria For Alcohol Dependence or Abuse in the Past Year, South Carolina and US, 2002-2006

24. Academic Failure Grades Mostly Received by Students Reporting Alcohol Use (Using 2007 YRBS)

25. Other Drug Use • High school drinkers, compared to non-drinkers, are . . . • Seven times more likely to use smokeless tobacco or ecstasy • Eight times more likely to use steroids • Nine times more likely to use marijuana • Eleven times more likely to smoke • Twelve times more likely to use cocaine DAODAS/PIRE Analysis Using 2007 YRBS Data

26. Other Correlations • High school drinkers, compared to non-drinkers, are . . . • Twice as likely to have been in a fight • Twice as likely to have had sex • Three times as likely to be in a gang • Three times as likely to carry a weapon • Four times as likely to ride in a car with a drinking driver

27. Underage Drinking is a $1.1 Billion a Year Problem in South Carolina. Total Costof Underage Alcohol Usein SC for 2007: $1.1 billion US Total Cost: $68 billion Medical Care:$121 million Work Loss & Other Costs:$263 million Pain & Lost Quality of Life: $684 million $2,428 per year per youth PIRE 2008

28. Costs of Underage Drinking by Problem, South Carolina 2005

29. SC Middle School Use SC Adult Use SC College Use Age of First Use SC High School Use How much they drink What they drink Where they drink Consumption Patterns

30. SC Alcohol Use Across Lifespan Note: This timeline uses a variety of data sources with different methodologies and samples and should not suggest a “clean” timeline. For general information only. Middle School = 2009 MS YRBS; High School = 2009 HS YRBS; College = 2009 weighted Core Data from 10 SC colleges; Adult = 2009 BRFSS (18 & older)

31. 2009 South Carolina Middle School YRBS Percentage of students who ever had a drink of alcohol, other than a few sips 100 80 53.0 60 45.4 42.5 41.6 42.1 41.7 41.9 40 25.0 20 0 Total Male Female 6th 7th 8th Black* Hispanic/ White* Latino QN25 - Weighted Data *Non-Hispanic. Missing bars indicate less than 100 students in the subgroup.

32. Alcohol & Other Drug Use Among HS Students, 2009 YRBS

33. Alcohol & Other Drug Use Among HS Students, 2009 YRBS

34. HS Alcohol Use Over Time Current (Past 30-Day) Alcohol Use among Youths in Grades 9 through 12, South Carolina and US, 1995 to 2009

35. High School Use (2009 YRBS) • 69% had at least one drink of alcohol on one or more days during their life. • 35% of SC high school students drink; down 19% from 2005! • 18% engaged in binge drinking in past month; down 22% from 2005! • 31% of drinkers had their first drink of alcohol, other than a few sips, before age 13.

36. SC High School Drinkers

37. Past-Month Drinking: 12 to 25 NSDUH

38. Initiation Before Age 13, SC

39. Past-Month HS Binge Drinking

40. High School Binge Drinking

41. Consumption Amounts (US) • Adults average 2.6 drinks per occasion • Youth average 4.6 drinks per occasion • 96% of alcohol consumed by ages 15-20 is done while binge drinking

42. Frequency and Volume of Use Adults drink more often, but youth drink more when they drink.

43. Binge Drinking

44. WHO USES ALCOHOL MORE IN HIGH SCHOOL—THOSE GOING TO COLLEGE OR NOT?WHO USES ALCOHOL MORE IN “COLLEGE-AGE” YEARS, THOSE IN COLLEGE OR NOT?

45. “The College Effect” In HS, those not going to college drink more A year later, those at college drink more than non-college peers

46. US College Drinking • Recent CASA Study • No decline in proportion of college students who drink or binge drink from 1993-2005 • Proportion of students who “frequently” binge drink is up16% • Who drink on 10 or more occasions in a month up 25% • Those who get drunk at least 3 times/month is up26% • Who drink to get drunkup 21%

47. But . . . “Outside The Classroom” says data they’ve reviewed from past 3 years show % of Freshman abstainers is rising for first time in many years

48. Core Survey • National survey taken by 10 SC colleges/universities in 2009 • Random sample at each • N ranged from 223 to 1,062 • Total: 6,119

49. Prevalence • 85% drank in past year • Range: 61% to 90% • National (Core Institute ’06): 84% • 74% drank in past month • Range: 39% to 80% • National: 72% • 51% engaged in binge drinking in past 2 weeks • Range: 23% to 61% • National: 55%

50. Comparison by Institution SC Core Survey Data, 2009