Impacts of drinking-age laws on mortality in Canada, 1980-2009

BACKGROUND

Given the recent international debates about the effectiveness and appropriate age setpoints for legislated minimum legal drinking ages (MLDAs), the current study estimates the impact of Canadian MLDAs on mortality among young adults. Currently, the MLDA is 18 years in Alberta, Manitoba and Québec, and 19 years in the rest of Canada.

METHODS

Using a regression-discontinuity approach, we estimated the impacts of the MLDAs on mortality from 1980 to 2009 among 16- to 22-year-olds in Canada.

RESULTS

In provinces with an MLDA of 18 years, young men slightly older than the MLDA had significant and abrupt increases in all-cause mortality (14.2%, p=0.002), primarily due to deaths from a broad class of injuries [excluding motor vehicle accidents (MVAs)] (16.2%, p=0.008), as well as fatalities due to MVAs (12.7%, p=0.038). In provinces/territories with an MLDA of 19 years, significant jumps appeared immediately after the MLDA among males in all-cause mortality (7.2%, p=0.003), including injuries from external causes (10.4%, p<0.001) and MVAs (15.3%, p<0.001). Among females, there were some increases in mortality following the MLDA, but these jumps were statistically non-significant.

CONCLUSIONS

Canadian drinking-age legislation has a powerful impact on youth mortality. Given that removal of MLDA restrictions was associated with sharp upturns in fatalities among young men, the MLDA likely reduces population-level mortality among male youth under the constraints of drinking-age legislation. Alcohol-control policies should target the transition across the MLDA as a pronounced period of mortality risk, especially among males.

Effects of minimum legal drinking age on alcohol and marijuana use: evidence from toxicological testing data for fatally injured drivers aged 16 to 25 years

Background

Alcohol and marijuana are among the most commonly used drugs by adolescents and young adults. The question of whether these two drugs are substitutes or complements has important implications for public policy and prevention strategies, especially as laws regarding the use of marijuana are rapidly changing.

Methods

Data were drawn from fatally injured drivers aged 16 to 25 who died within 1 h of the crash in nine states with high rates of toxicology testing based from 1999 to 2011 on the Fatality Analysis Reporting System (N = 7,191). Drug tests were performed using chromatography and radioimmunoassay techniques based on blood and/or urine specimens. Relative risk regression and Joinpoint permutation analysis were used.

Results

Overall, 50.5% of the drivers studied tested positive for alcohol or marijuana. Univariable relative risk modeling revealed that reaching the minimum legal drinking age was associated with a 14% increased risk of alcohol use (RR = 1.14, 95% CI: 1.02 to 1.28), a 24% decreased risk of marijuana use (RR = 0.76, 95% CI: 0.53 to 1.10), and a 22% increased risk of alcohol plus marijuana use (RR=1.22, 95% CI: 0.90 to 1.66). Joinpoint permutation analysis indicated that the prevalence of alcohol use by age is best described by two slopes, with a change at age 21. There was limited evidence for a change at age 21 for marijuana use.

Conclusions

These results suggest that among adolescents and young adults, increases in alcohol availability after reaching the MLDA have marginal effect on marijuana use.

Can technology help to reduce underage drinking? Evidence from the false ID laws with scanner provision

Underage drinkers often use false identification to purchase alcohol or gain access into bars. In recent years, several states have introduced laws that provide incentives to retailers and bar owners who use electronic scanners to ensure that the customer is 21 years or older and uses a valid identification to purchase alcohol. This paper is the first to investigate the effects of these laws using confidential data from the National Longitudinal Survey of Youth, 1997 Cohort (NLSY97). Using a difference-in-differences methodology, I find that the false ID laws with scanner provision significantly reduce underage drinking, including up to a 0.22 drink decrease in the average number of drinks consumed by underage youth per day. This effect is observed particularly in the short-run and more pronounced for non-college students and those who are relatively younger. These results are also robust under alternative model specifications. The findings of this paper highlight the importance of false ID laws in reducing alcohol consumption among underage youth.

Long-term effects of minimum legal drinking age laws on marijuana and other illicit drug use in adulthood

BACKGROUND

Exposure to permissive minimum legal drinking age (MLDA) laws (ability to purchase alcohol <21 years) during adolescence can have long-term effects, including heavy alcohol use or alcohol use disorders as adults. We examined whether exposure to permissive MLDA laws during adolescence has long-term effects on illicit drug use and disorders in adulthood.

METHODS

Participants from the 2004-2012 National Survey of Drug Use and Health (NSDUH) were linked with historical state MLDA laws. Participants born in 1949-1972 (age 31-63 years at observation, n = 110,300) were analyzed because they came of legal age for alcohol purchase when changes occurred in state MLDA laws. Logistic regression was used to model drug use measures as a function of exposure to permissive MLDA during adolescence, adjusting for state and birth-year fixed effects, demographics, and salient state characteristics.

RESULTS

Rates of past month use, past year use, and abuse/dependence of marijuana were 4.7%, 7.8%, and 1.2%, respectively. Rates of past month use, past year use, and abuse/dependence of illicit drugs other than marijuana were 2.9%, 6.2%, and 0.7%, respectively. Among the full sample, exposure to permissive MLDA laws was not significantly associated with drug use or abuse/dependence in adulthood. Men exposed to permissive MLDA laws were at 20% increased odds of past year illicit drug use (aOR 1.20, 95% CI 1.09-1.32).

CONCLUSIONS

Restricting alcohol access during adolescence did not increase long-term drug use. Allowing the purchase of alcohol among those less than 21 years of age could increase the risk of drug use later in life.

Legal access to alcohol and criminality

Previous research has found strong evidence that legal access to alcohol is associated with sizable increases in criminality. We revisit this relationship using the census of judicial records on criminal charges filed in Oregon Courts, the ability to separately track crimes involving firearms, and to track individuals over time. We find that crime increases at age 21, with increases mostly due to assaults that lack premeditation, and alcohol-related nuisance crimes. We find no evident increases in rape or robbery. Among those with no prior criminal records, increases in crime are 50% larger-still larger for the most socially costly crimes of assault and drunk driving.

The impact of the false ID laws on alcohol consumption among young adults: New results from the NLSY97

In volume 36 of this journal, using data from the National Longitudinal Study of Youth, 1997 Cohort (NLSY97), Yörük (2014) finds that the false ID laws with scanner provision (FSP laws) significantly reduce underage drinking. In a recent paper, Zheng (2018) argues that analyses based on the NLSY97 data fail falsification exercises and uses data from the Youth Risk Behavior Surveillance System (YRBSS) to estimate the effectiveness of the FSP laws. This paper replies to Zheng (2018) and provides new results from the NLSY97, which show that the FSP laws were effective reducing several indicators of alcohol consumption among minors.

Sustained Alcohol Service Refusal Rates to Underage Patrons in Nightlife Setting: 25-Year Follow-Up of a Swedish Alcohol Prevention Program

PURPOSE

In 1996, a multicomponent alcohol prevention intervention was launched and later institutionalized in Stockholm. This study examines the long-term effects of the program on compliance with the legal minimum age limit for alcohol service at licensed premises.

METHODS

The intervention comprised community mobilization and collaboration, training, and enforcement aimed at preventing alcohol service to underage (<18 years) or obviously intoxicated patrons. Six cross-sectional studies were conducted between 1996 and 2022 in Stockholm using pseudo-underage mystery shoppers attempting to enter licensed premises and order alcoholic beverages. The primary outcome was refusal of entry to the premises or refusal of alcohol service.

RESULTS

Throughout the study period, regular collaboration meetings were held, the number of annual inspections and trained staff increased, and the number of sanctions varied. The refusal rate of alcohol service to pseudo-underage mystery shoppers rose from 54.8% in 1996 (baseline) to 59.1% in 1998, 67.6% in 2001, 88.3% in 2007, 91.3% in 2013, and 79.6% in 2022. Compared to the reference year 1996, all rates from 2001 to 2022 showed significant increases in the odds of refusal.

DISCUSSION

The multicomponent alcohol prevention program has been successfully sustained through collaboration and community mobilization, training, and enforcement. This success is evidenced by consistently high refusal rates for alcohol sales to underage customers over an extended period.

Underage access to alcohol and its impact on teenage drinking and crime

Does underage access to alcohol increase teenage drinking and crime? To address this question, I leverage a discontinuity in legal access to alcohol at age 16 in Germany, a country with high consumption levels and a particularly early access regulation. Using detailed survey data and administrative crime records from 2005 to 2015, I detect considerable increases in drinking participation, frequency, and intensity at the legal cutoff along the middle and lower end of the distribution. These increases coincide with discrete jumps in criminal engagement under the influence of alcohol, mostly due to violent and property crimes. My findings suggest that changes in drinking intensity induce these crimes, implying a drinking-crime elasticity of 0.4 at age 16.

Assessing the impacts of minimum legal drinking age laws on police-reported violent victimization in Canada from 2009 to 2013

BACKGROUND/AIM

Given that alcohol-related victimization is highly prevalent among young adults, the current study aimed to assess the potential impacts of Minimum Legal Drinking Age (MLDA) laws on police-reported violent victimization events among young people.

DESIGN

A regression-discontinuity (RD) approach was applied to victimization data from the Canadian Uniform Crime Reporting 2 (UCR2) Incident-based survey from 2009-2013. Participants/cases: All police-reported violent victimization events (females: n = 178,566; males: n = 156,803) among youth aged 14-22 years in Canada.

MEASUREMENTS

Violent victimization events, primarily consisting of homicide, physical assault, sexual assault, and robbery.

RESULTS

In comparison to youth slightly younger than the drinking age, both males and females slightly older than MLDA had significant and immediate increases in police-reported violent victimization events (females: 13.5%, 95% CI: 7.5%-19.5%, p < 0.001; males: 11.6%, 95% CI: 6.6%-16.7%, p < 0.001). Victimizations occurring in the evening rose sharply immediately after the MLDA by 22.8% (95% CI: 9.9%-35.7%, p =  0.001) for females and 19.3% (95% CI: 11.5%-27.2%, p < 0.001) for males. Increases in violent victimization immediately after MLDA were most prominent in bar/restaurant/open-air settings, with victimizations rising sharply by 44.9% (95% CI: 29.5%-60.2%, p < 0.001) among females and 18.3% (95% CI: 7.7%-29.0%, p =  0.001) among males.

CONCLUSIONS

Young people gaining minimum legal drinking age incur immediate increases in police-reported violent victimizations, especially those occurring in the evening and at bar/restaurant/open-air settings. Evidence suggests that increasing the MLDA may attenuate patterns of violent victimization in newly restricted age groups.