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EPIDEMIOLOGICAL BULLETIN

ALCOHOL CONSUMPTION AMONG YOUNG

ADULTS AGES 18-24 IN THE UNITED STATES:

RESULTS FROM THE 2001-2002 NESARC SURVEY

Chiung M. Chen, M.A., Mary C. Dufour, M.D.,

M.P.H., and Hsiao-ye Yi, Ph.D.

CHIUNG M. CHEN, M.A., is an analyst; MARY C. DUFOUR,

M.D., M.P.H., is a senior associate; and H

SIAO-YE YI, PH.D.,

is a senior analyst, all with the Alcohol Epidemiologic Data System of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), which is operated by CSR, Incorporated,

Arlington, Virginia.

The high prevale?ce of dri?ki?g i? you?g adults is a serious public health co?cer?. Alcohol use amo?g you?g adults ofte? is associated with a wide variety of risky behaviors a?d both immediate a?d lo?g-term ?egative co?seque?ces. The 2001Ð2002 Natio?al

Epidemiologic Survey o? Alcohol a?d Related

Co?ditio?s (NESARC) prese?ts a u?ique opportu?ity to exami?e you?g adult dri?ki?g because it has a? excelle?t respo?se rate, oversamples you?g adults ages

18Ð24, a?d i?cludes college-related group housi?g.

Accordi?g to the NESARC data, i? 2001Ð2002 over three-quarters of you?g adults ages 21Ð24 were curre?t dri?kers, as were ?early two-thirds of those ages 18Ð20, despite the fact that the legal dri?ki?g age is 21. More tha? half of you?g adult me? exceeded the recomme?ded daily dri?ki?g limit, as did two-fifths of you?g adult wome?. Although the prevale?ce of exceedi?g the daily limit is higher for those ages 21Ð24 tha? for those ages 18Ð20, it also is substa?tial for those ages 18Ð20. Because dri?ki?g more tha? the recomme?ded per-occasio? maximum is likely to impair me?tal a?d physical performa?ce, the i?crease over the past decade i? the prevale?ce amo?g you?g adults of dri?ki?g five or more dri?ks 12 or more times per year may help explai? the i?creased risk of i?jury a?d other acute ?egative co?seque?ces commo?ly observed amo?g college stude?ts ages 18Ð24. K EY

WORDS:

young adult; undergraduate student; underage drinking; National Epidemiologic Survey on Alcohol and Related Conditions (NESARC); heavy drinking; binge drinking; AOD (alcohol and other drug) use pattern; AOD use frequency; amount of AOD use; AOD intake per occasion; AOD use frequency; individual AOD consumption; aggregate AOD consumption; gender differences; ethnic differences; racial differences O ver the life course, drinkers in the United States tend to have the highest level of alcohol consumption in their late teens and early twenties (Naimi et al. 2003; Fillmore et al. 1991). According to the National Survey on Drug Use and Health (NSDUH), the prevalences of both binge drinking (i.e., consuming five or more [5+] drinks in a row at least once in the past month) and heavy drinking (i.e., consuming 5+ drinks in a row on at least five occasions in the past month) in 2003 were highest among young adults ages 18 to 25, peaking at age 21 (Substance Abuse and Mental Health Services Administration [SAMHSA] 2004). And according to the Monitoring the Future Survey, the prevalence of drinking and heavy drinking (i.e., consuming 5+ drinks in a row at least once in the prior 2-week period) among young adults changed relatively little between 1993 and 2003 after declining noticeably from 1980 to 1993 (Johnston et al. 2004). The high prevalence of drinking in young adults is a serious public health concern because alcohol use by this age group often is associated with a wide variety of risky behaviors and various negative consequences. Many of these consequences are immediate and tragic (Hingson et al. 2005) - most notably alcohol-related traffic fatalities (Yi et al.

2004).

College students continue to stand out from other young adults because of their relatively high rates of heavy drinking, even though their average daily alcohol consumption gener- ally is lower than that of their noncollege peers (Johnston et al. 2004). Until recently, however, college students have been a difficult population to study. In general, they are not well represented in normal household surveys, which typically exclude group housing, such as dormitories, fraternities, and sororities. In addition, group-housing-based samples of col- lege students must be quite large in order to attain accurate national representation because there is great heterogeneity in the types of student populations served in these institutions. Finally, the drinking behavior of young adults, particularly college students, often is characterized by episodic drinking, which may be more difficult to capture adequately on surveys that rely only on the measure of average alcohol consumption over a short period of time. This Epidemiological Bulletin draws on the rich data on young adult drinking behavior available from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). NESARC is uniquely suited to exam- ine young adult drinking for three reasons - the excellent response rate, the oversampling of young adults ages 18-24, and the inclusion of college-related group housing. Findings presented here include the prevalence of alcohol use in youth ages 18-24; drinking frequency and quantity; frequency of heavy drinking, intoxication, and driving after drinking; as well as age of drinking onset and choice of drinking locations for different types of alcoholic beverages. In particular, this Bulletin examines the number of young adults who exceed daily and weekly guidelines for low-risk drinking. The cur- rent public health recommendations for the nation -

Healthy

People 2010

(Department of Health and Human Services

2000) - include a number of goals related to alcohol use.

Recognizing the importance of both drinking volume and pattern of consumption as predictors of alcohol-related harm,

Vol. 28, No. 4, 2004/2005

269

EPIDEMIOLOGICAL BULLETIN

these recommendations include, for the first time, an explicit objective to "reduce the proportion of adults who exceed guidelines for low-risk drinking" (Objective 26-13). The accompanying text explains that men may be at risk for alcohol- related problems if they drink more than 14 drinks per week or more than 4 drinks per occasion and that women may be at risk if they drink more than 7 drinks per week or more than 3 drinks per occasion. Most people who exceed these guidelines do so by drinking more than the specified maximum number of drinks per occasion at least once a year. Drinking more than the per-occasion maximum impairs mental perfor- mance and physical coordination, increasing the risk of injury. In addition, this Bulletin provides insight into the drinking behavior of subgroups of young adults based on age, sex, race/ ethnicity, and college enrollment status. For example, the definition of young adults conventionally includes all people ages 18-24. Yet people who fall into the younger part of this group (i.e., those ages 18-20) are below the legal drinking age of 21. Underage drinking remains a major public health concern. To better understand the scope of this problem, the data presented here are given for the total young adult popu- lation as well as for the subgroups of people ages 18-20 and

21-24. Finally, recent trends in young adult risk drinking are

briefly examined by comparing the NESARC results with those from the 1991-1992 National Longitudinal Alcohol

Epidemiologic Survey (NLAES).

Methods

Data The analyses presented here are based on data from the 2001-

2002 NESARC, which was designed and sponsored by the

National Institute on Alcohol Abuse and Alcoholism (NIAAA) and fielded by the U.S. Bureau of the Census. Data were col- lected in face-to-face, computer-assisted personal interviews that were conducted in respondents" homes. The NESARC sample represents the civilian, noninstitutionalized adult pop- ulation of the United States, including residents of all 50
States and the District of Columbia (Grant et al. 2003). It includes people living in households, military personnel living off base, and people living in the following group quarters: boarding or rooming houses, nontransient hotels and motels, shelters, facilities for housing workers, college quarters, and group homes. The sampling frames for housing units and group quarter units are derived from the Census 2000/2001

Supplementary

Survey and the Census 2000 Group Quarters Inventory, respectively. One sample adult was selected for interview in each household. NESARC oversampled Black and Hispanic households and adults ages 18-24 to obtain more reliable estimates for these groups. The sampling frame response rate was 99 percent, the household response rate was 89 percent, and the person response rate was 93 percent, yielding an overall response rate of 81 percent. A total of 43,093 respondents age 18 and older completed the survey. The data reported here are based on responses from 5,199 young adults ages 18-24, including 3,551 current drinkers (i.e., young adults who reported drinking at least one alcoholic drink in the 12 months prior to the survey).

Drinking Measures

NESARC measures alcohol consumption separately for four specific types of alcoholic beverages (i.e., coolers, beer, wine, and liquor), detailing for each beverage the usual and heavi- est quantities and frequencies, as well as the usual time and place of drinking. Nevertheless, the variables selected to rep- resent the current drinking status of young adults pertain to any alcohol use regardless of beverage type. These items were taken directly from the survey and had a reference period of the last 12 months. The only exception is the daily volume of alcohol (i.e., ethanol) consumption. This measure was derived by NIAAA using a somewhat complex algorithm that summed beverage-specific volumes across the four bev- erage types. 1

In NESARC, one standard drink is assumed to

contain 0.6 ounces of ethanol. The various drinking mea- sures were defined as follows: Current drinking-Had at least one drink of alcohol in the past year.

Drinking frequency-Number of days on which any

alcoholic beverages were consumed in the past year. 2 Drinking quantity-Usual number of drinks (all types of alcohol combined) consumed on drinking days in the past year. Risk drinking-Drinking in excess of recommended drinking limits (for more detailed definitions, see the next paragraph). Intoxication-Drinking enough to feel intoxicated or drunk (e.g., exhibiting slurred speech or blurred vision or feeling unsteady on one"s feet).

Tolerance-Reported maximum number of drinks the

respondent can hold without feeling intoxicated or drunk. Driving after drinking-Driving a car or other motor vehicle (e.g., motorcycle, boat, jet ski, or skimobile) after consum-quotesdbs_dbs17.pdfusesText_23

[PDF] [PDF] ALCOHOL CONSUMPTION AMONG YOUNG ADULTS AGES 18–24

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