National surveys of adolescents, college students, and other young adults in the United States reveal high rates of alcohol use among these age groups as well as high rates of dangerous drinking practices such as binge drinking and daily drinking. Additional health-compromising behaviors such as tobacco use and drinking and driving often co-occur with alcohol use in these populations. The physical locations or drinking contexts where alcohol use occurs can predict drinking practices and consequences. This information can be used to identify appropriate targets for effective interventions and social policies. KEY WORDS: adolescent; young adult; high school student; undergraduate student; high-risk youth; AOD (alcohol and other drug) use; prevalence; epidemiological indicators; AOD associated consequences; risk-taking behavior; gender differences; United States
Alcohol use during adolescence and young adulthood remains a prominent public health problem in the United States. National survey results indicate that 28.6 percent of 12th graders and 40.1 percent of college students reported binge drinking (i.e., consuming five or more drinks in a row) during the 2-week period preceding the survey (Johnston et al. 2003a, b). Alcohol use among adolescents and college students is also associated with a broad array of risk behaviors, including tobacco use and drinking and driving. In addition, studies on college campuses have shown that students who do not drink nevertheless experience adverse secondhand effects of drinking, including victimization (e.g., verbal or physical threats and actions) and personal intrusion (e.g., disruption of sleep or study habits) by those who have been drinking (Wechsler et al. 1998). Another disturbing trend in youth drinking is the initiation of alcohol use at younger ages. Between 1987 and 1996, surveys have shown that the average age of initiation to alcohol use decreased by more than 1.5 years, from 17.8 years in 1987 to 15.9 years in 1996 (Office of National Drug Control Policy 1997). In 1999, more than 32 percent of young people reported beginning to drink before age 13 (Centers for Disease Control and Prevention [CDC] 2000). Earlier initiation of alcohol use (prior to age 15) has been associated with increased risk for alcohol-related problems later in life (Grant and Dawson 1997).
This article reviews epidemiological data on alcohol use among adolescents, college students, and young adults not in college, and presents data on the physical locations or drinking contexts where alcohol use occurs. In addition, this article discusses the prevalence of health-compromising behaviors that often co-occur with youth drinking, such as smoking, illicit drug use, and risky sexual behaviors.
PREVALENCE OF ADOLESCENT ALCOHOL USE
Findings from the Monitoring the Future Survey (MFS) (Johnston et al. 2003a)--for which a nationally representative sample of 8th, 10th, and 12th graders are surveyed each year on alcohol and other drug use--indicate a very high rate of alcohol use in this population. Table 1 presents data on two common indicators of adolescent alcohol use, the percentage of respondents who report having consumed alcohol in the 30 days before the survey (30-day prevalence) and the percentage of those who report having been drunk within the previous 30 days. There are clear trends toward higher prevalence of both 30-day use and having been drunk in the last 30 days among those in higher grades; it is significant that 19.6 percent of 8th graders reported using alcohol in the previous 30 days, and 6.7 percent reported having been drunk during that time. All of these students are legally underage drinkers. Furthermore, the high prevalence of drinking at an early age bodes ill for psychosocial development among youth because of the increased risk for both alcohol-related problems (e.g., poorer school performance, more substance-using peers) and other co-occurring problems (e. …