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On the Web – Concept 19

Web19-01: Alcohol and Drunk Driving

Web 19-02: Alcohol Consumption in the U.S.

Web19-03 Drinking on College Campuses

Web19-04 Changing Social Norms in Drinking

Web19-05 Web Resources

Web19-06 Supplemental Readings

Web19-01: Alcohol and Drunk Driving

Alcohol consumption contributes to an alarming number of traffic fatalities and crashes in the United Statistics. The National Highway Transportation Safety Association (NHTSA) provides updated statistics on the risks of impaired driving. In 2002, they estimated that alcohol was a contributing factor in a 26% of the United States' crashes. Alcohol-related crashes in the United States cost the public an estimated $114.3 billion in 2000, including $51.1 billion in monetary costs and an estimated $63.2 billion in quality of life losses. Because of the large risk and major public health impact there have been considerable efforts to reduce drunk driving in the United States. The following statistics from the NHTSA reveal how recent policies and laws have helps to reduce these statistics.

Administrative License Revocation: State laws that allow police or driver licensing authorities to revoke a driver's license swiftly and automatically for refusing or failing a BAC test have reduced alcohol-related fatalities by 6.5% on average and saved an estimated $54,000 per driver sanctioned.

Zero Tolerance Law: Nationwide laws making it illegal for persons under 21 to drive with a positive BAC have reduced impaired driving fatalities by 4% on average.

.08 BAC Law: Well-publicized laws lowering driver BAC limits to .08 have reduced alcohol-related fatalities by an average of 7% in 32 States, the District of Colombia and Puerto Rico. On average, .08 laws save an estimated $40 per licensed driver nationwide.

Minimum Legal Drinking Age (MLDA): All 50 States and the District of Columbia have now adopted a MLDA of 21 and this is thought to prevent an estimated 700-1,000 traffic deaths annually among youth targeted. The loss of liquor sales (estimated at $160 cost per youthful driver) is offset by the estimated savings of $540 per youthful driver in reduced accident costs.

While the rates of drunk driving accidents is still very high, tremendous progress has been made in recent years to combat the problem. Additional efforts including road checkpoints, enforcement of alcohol selling practices in bars, and better training of servers would help to further reduce the incidence of alcohol related crashes. There are a number of advocacy groups that continue to lobby for additional efforts to reduce alcohol related fatalities. The Mothers Against Drunk Driving - MADD (www.madd.org) have increased public awareness about the problem and contributed to lobbying efforts needed to change laws. A student organization called Students Against Drunk Driving (http://www.sadd.org/) has contributed to similar efforts within college campuses. Visit their web pages to learn more about these efforts.

A company that manufactures alcohol testing equipment has developed an interactive tool called the "drinkwheel" that estimates BAC based on personal information and estimated rates of alcohol consumption. Visit the drinkwheel website at http://www.intox.com/wheel/drinkwheel.asp

Web 19-02: Alcohol Consumption in the U.S.

Alcohol consumption is an embedded part of life in American society and most other countries. A recent Gallup poll (released Aug 9, 2002) indicates that the majority of Americans report using alcohol. A full one-third of the population say they never drink alcoholic beverages but the remaining amount (66%) report drinking at least somewhat. Overall, 72% of men are drinkers compared to 60% of women. Approximately 75% of younger respondents (age < 30) reported drinking compared to about 50% for the oldest group (age > 65). For additional information on the Gallup poll read the press release.

Surveillance research conducted by the Centers for Disease Control and Prevention (CDC) has sought to understand the progression of risk behaviors among youth in the United States. The surveillance system (known as the Youth Risk Behavior Surveillance System) provides updated statistics on alcohol consumption that reveal how patterns for drinking become established. Nationwide, 78.2% of students reported consuming alcohol during their lifetime. Hispanic and white students (80.8% and 80.1%, respectively) were significantly more likely than black students (69.1%) to report lifetime alcohol use and this racial/ethnic difference was identified for both female and male students. Students in grades 11 and 12 (80.4% and 85.1%, respectively) were significantly more likely than students in grade 9 (73.1%) to report lifetime alcohol use.

A more useful marker of regular use is the percentage of students reporting alcohol consumption in the past 30 days. Nearly one half (47.1%) of students nationwide had had >1 drinks of alcohol on at least 1 of the 30 days preceding the survey. Male students in grade 11 (53.6%) were significantly more likely than female students in grade 11 (45.1%) to report current alcohol use and similar ethnic patterns were evident with white and Hispanic students more likely to report drinking than black students. The percentage of students that had had more than 5 drinks of alcohol on at least one occasions during the 30 days preceding the survey (i.e., episodic heavy drinking) was estimated at 29.9%. Male students (33.5%) were significantly more likely than female students (26.4%) to report episodic heavy drinking.

Another nationwide survey called "Monitoring the Future" provides additional information about risky behaviors among youth. Each year, a total of some 50,000 8th, 10th and 12th grade students are surveyed about alcohol, drug and tobacco use patterns. Visit the Monitoring the Future website at www.monitoringthefuture.org.

Web19-03 Drinking on College Campuses

A number of studies have been conducted on college campuses to better understand the prevalence and consequences of alcohol consumption. One study (Weschler, 1994) surveyed 17,542 students from 140 Colleges about their drinking habits. Binge drinking in this study was defined as having 5 drinks in a row at least once every 2 weeks. The results from the study are included below:

	Males	Females
Non-drinkers	15%	16%
Occasional Drinker	35%	45%
Binge Drinker*	50%	39%

The consequences of alcohol use are quite significant for both the users and the society as a whole. Alcohol contributes greatly to an increased risk of accidental death, violence and other harmful behaviors. Because binge drinking is higher on college campuses, the consequences of alcohol on college campuses are especially significant. The results from a survey of college campuses revealed that alcohol is directly associated with a number of negative consequences.

• 50% of all motor vehicle fatalities involve alcohol
• 80% of campus vandalism involve alcohol
• 70% of violent behavior on campus involve alcohol
• 75% of men and 55% of women involved in acquaintance rape were under the influence of alcohol
• 40% of poor academic performance at college has been linked to drinking

Source: Weschler, H. et al., 1994 Health and Behavioral consequences of binge drinking in college. JAMA 272(21):1672-1677.

Visit the National Clearinghouse for Alcohol and Drug Information (NCADI) website at www.health.org .

Data from the Monitoring the Future Study reveal that patterns developed in college may change after students get into the "working world" and have additional responsibilities. See the press release for more information.

Web19-04 Changing Social Norms in Drinking

Because of the problems associated with binge drinking on college campuses there have been major efforts to address this problem. The U.S. Department of Education sponsors a group known as the Higher Education's Center for Alcohol and Other Drug Prevention (www.edc.org/hec). The Higher Education Center's purpose is to "help college and community leaders develop, implement, and evaluate programs and policies to reduce student problems related to alcohol and other drug use and interpersonal violence".

A major part of this group's efforts have been aimed at changing the social norm regarding drinking on college campuses. An example of promotional materials used to change the social norm is this flyer from the University of Arizona.

Click here to see a web page devoted to social norms and alcohol consumption

Click here to see examples of what various college campuses and communities are doing to address alcohol problems.

Web19-05 Web Resources

Alcohol.edu – www.alcoholedu.com

Alcoholics Anonymous - http://www.alcoholics-anonymous.org

Drinker's Check-up – http://www.drinkerscheckup.com

E-Chug – www.e-chug.com

My Student Body – www.mystudentbody.com

National Clearinghouse for Alcohol and Drug Information (NCADI) - www.health.org

National Institute on Alcohol Abuse and Alcoholism - http://www.niaaa.nih.gov

National Institute on Alcohol Abuse and Alcoholism College Drinking – www.collegedrinkingprevention.gov

Rational Recovery – www.rational.org

Smart Recover – http://www.smartrecovery.com

Web19-06 Supplemental Readings

References new to 7e/14e:

Ahrens. R.W. and Snider, J. (2005). Alcohol manufacturers send their ads to college. USA Today, November 17.

American College Health Association. (2006). American College Health Association – National College Health Assessment: Reference Group Data Report Fall 2005. Baltimore, MD: American College Health Association.

American Medical Association. (2006). Sex and intoxication among women more common on spring break according to AMA poll. Available at http://www.ama-assn.org/ama/pub/category/16083.html Accessed June, 6, 2006.

Anton, R.F. et al. (2006). Combined pharmacotherapies and behavioral interventions for alcohol dependence. The COMBINE study: A randomized controlled trial. Journal of the American Medical Association 295: 2003-2017.

Hahn, D. B. et al. 2007. Focus on Health (8^th ed.). New York: McGraw-Hill Higher Education, Chapter 8.

Helliker, K. (2006). Online counsel, discreet advice for drink woes. The Arizona Republic, March 12.

Hingson, R. and Winter, M. (2003). Epidemiology and consequences of drinking and driving. Alcohol Research and Health 27: 63-78.

Hingson, R. et al. (2005). Magnitude of alcohol-related mortality and morbidity among U.S. college students ages 18-24: Changes from 1998-2001. Annual Review of Public Health 26: 259-279.

Kinney, J. 2006. Loosening the Grip: A Handbook of Alcohol Information (8^th ed.). New York: McGraw-Hill Higher Education.

Knight, J.R. et al. (2002). Alcohol abuse and dependence among U.S. college students. Journal of Studies on Alcohol 63: 263-270.

Meister, K.A., Whelan, E.M., and Kava, R. (2000). The health effects of moderate alcohol intake in humans: An epidemiologic review. Critical Reviews in Clinical Laboratory Sciences 37: 261-296.

Midey, C. (2005). Liver overload: heavy drinking can irreversibly damage this vital organ. The Arizona Republic, May 3.

Mitchell, T. (2004). RU-21: License to drink? USA Today, August, 27-29.

Mumenthaler, M.S. et al. (1999). Gender differences in moderate drinking effects. Alcohol Research and Health 23: 55-64.

Naimi, T. et al. (2003). Binge drinking among U.S. adults. Journal of the American Medical Association 289: 70-75.

Naimi, T.S. et al. (2005). Cardiovascular risk factors and confounders among nondrinking and moderate-drinking U.S. adults. American Journal of Preventive Medicine 28: 369-373.

National Institute on Alcohol Abuse and Alcoholism. (2004). Alcohol: What you don't know can harm you. NIH Publication No. 99–4323. Rockville MD: NIAAA.

Presley C. A., J. S. Leichliter, and P. W. Meilman. 1999. Alcohol and Drugs on American College Campuses: Finding from 1995, 1996, and 1997. A Report to College Presidents. Carbondale, IL: Southern Illinois University, 1999.

Rehm, J. et al. (2002). Alcohol-related morbidity and mortality. Alcohol Research and Health 27: 39-51.

Rehm, J. et al. (2003). The relationship of average volume of alcohol consumption and patterns of drinking to burden of disease: An overview. Addiction 98: 1209-1228.

Stampfer, M.J. et al. (2005). Effects of moderate alcohol consumption on cognitive function in women. The New England Journal of Medicine 352: 245-253.

Substance Abuse and Mental Health Services Administration. (2004). Alcohol Use: Overview of Findings from the 2004 National Household Survey on Drug Abuse. Available at: http://oas.samhsa.gov/NSDUH/2k4NSDUH/2k4Overview/2k4Overview.pdf Accessed June 6, 2006.

Swift, R. and Davidson, D. (1998). Alcohol hangover. Alcohol Health & Research World 22: 54-60.

Teague, M. L. et al. 2007. Your Health Today: Choices in a Changing Society. New York: McGraw-Hill Higher Education, Chapter 11.

The Center on Alcohol Marketing and Youth (2005). Alcohol industry "responsibility" advertising on television, 2001 to 2003: Executive Summary. Washington DC: Center on Alcohol Marketing and Youth.

The Higher Education Center for Alcohol and other Drug Prevention. (January, 2003). College academic performance and alcohol and other drug use. Infofacts Resources. Washington D.C.: U.S. Department of Education.

Wechsler, H. et al. (2000). College binge drinking in the 1990s: A continuing problem. Results from the Harvard School of Public Health 1999 College Alcohol Study. Journal of American College Health 48: 199-210.

Wechsler, H. et al. (2002). Trends in college binge drinking during a period of increased prevention efforts. Findings from 4 Harvard School of Public Health College Alcohol Study Surveys: 1993-2001. Journal of American College Health 50: 203-217.

References from Past Editions:

• "Alcohol and Cognition." Alcohol Alert. Washington, DC: National Institute on Alcohol Abuse and Alcoholism, 1989. Produced for the U.S. Department of Health and Human Services; Public Health Service; Alcohol, Drug Abuse, and Mental Health Administration.
• Alcohol and Health. Seventh Special Report to the U.S. Congress from the Secretary of Health and Human Services, NIAAA. Rockville, MD: U.S. Department of Health and Human Services, 1990.
• "Alcohol and Prescription Drugs." Reprint. SRX—Medication Education for Seniors of San Francisco Health Department. San Francisco, CA: Office of Senior Health Services, n.d.
• "Alcohol and Tolerance." Alcohol Alert. Nov. 28 PH356 April, 1995, National Institute on Alcohol Abuse and Alcoholism.
• "Alcohol Related Impairment." Alcohol Alert. No. 25 PH351 July, 1994, National Institute on Alcohol Abuse and Alcoholism.
• "Booze for Health: Let the Drinker Beware." San Rafael, CA: The Marin Institute for the Prevention of Alcohol and Other Drug Problems (Summer 1991):4.
• "Drinking and Driving." Alcohol Alert. No. 31 PH362 January 1996. National Institute on Alcohol Abuse and Alcoholism.
• Eigen, L.D. "Alcohol Practices, Policies and Potentials of American Colleges and Universities: An OSAP White Paper." Washington, DC: Office for Substance Abuse and Prevention; Alcohol, Drug Abuse and Mental Health Administration; U.S. Department of Health and Human Services, 1991.
• Fields, R. Drugs and Alcohol in Perspective. Dubuque, IA: Brown &Benchmark Publishers, 1996.
• Fuchs, C.S., et al. "Alcohol Consumption and Mortality Among Women." New England Journal of Medicine 332(1995):1245.
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• Johnston, L. D. O'Malley, P. M. & Bachman, J. G. The Monitoring of Future National Survey Results on Adolescent Drug Use. Rockville, MD: National Institute on Drug Abuse. 2000.
• National Institute on Alcohol Abuse and Alcoholism. Tenth Special Report to the U.S. Congress on Alcohol and Health from the Secretary of Health and Human Services. Bethesda, MD: National Institute on Alcohol Abuse and Alcoholism, 2000.
• National Institute on Alcohol Abuse and Alcoholism. Seventh Special Report to the U.S. Congress on Alcohol and Health. Washington, DC: U.S. Department of Health and Human Services, 1990.
• National Center for Health Statistics. Health, United States, 1998: With Socioeconomic Statistics and Health Chartbook. Hyattsville, MD: National Center for Health Statistics, 1998.
• Payne, W. A. & D. B. Hahn. Understanding Your Health (5^th Ed.). St. Louis: WCB/McGraw-Hill, 1998.
• Reiken, G.B. "Negative Effects of Alcohol on Physical Fitness and Athletic Performance." Journal of Physical Education, Recreation and Dance 62(October 1991):64.
• Sobell, M. B. & Sobell, L. C. Problem Drinkers. New York: Guilford Press, 1993.
• U.S. Department of Health and Human Services. Healthy People 2010. (Conference Edition in Two Volumes). Washington, DC: USDHHS, 2000. Chapter 26, Substance Abuse.
• U.S. Department of Health and Human Services. (1998). Healthy People 2010 Objectives: Draft for Comment. Washington, DC: U.S. Department of Health and Human Services, Objectives Chapter 26: Substance Abuse.
• U.S. Department of Health and Human Services. Alcohol and Health. Seventh Special Report to the U.S. Congress from the Secretary of Health and Human Services. NIAAA, Rockville, MD: 1990.
• Wechsler, H., Lee, J.E., Kuo, M., & Lee, H. College Binge Drinking in the 1990s: A Continuing Problem. Results of the Harvard School of Public Health 1999 College Alcohol Study. Journal of American College Health, 48 (2000): 199.
• Wechsler, H. What Colleges Are Doing About Student Binge Drinking: A Survey of College Administrators." Journal of American College Health, 48 (2000): 219.