Age of drinking onset, driving after drinking, and involvement in alcohol related motor-vehicle crashes

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Abstract

This study assessed whether persons who begin drinking at younger ages are more likely to report drunk driving and alcohol-related crash involvement over the life course, even after controlling analytically for diagnosis of alcohol dependence, years of drinking alcohol, and other personal characteristics associated with the age respondents started drinking. A national survey asked 42 862 respondents the age that they started drinking, whether they drove after drinking too much, and whether they were in motor-vehicle crashes because of their drinking. This analysis focused on 27 081 (65%), who reported ever drinking in their lifetime. The earlier the age respondents started drinking, the more likely they were to report driving after drinking too much and being in a motor-vehicle crash because of their drinking even after adjusting for current/ever diagnosis of alcohol dependence, number of years respondents had been drinking, and other characteristics and behaviors associated with the age respondents started drinking. Particularly, among persons who were never alcohol-dependent, those who began drinking in each age group under 21, relative to those starting at age 21 or older, were more likely to report “ever” and “in the past year” being in a crash after drinking too much. The traffic safety benefits of delaying drinking may extend well beyond the legal drinking age of 21.

Introduction

To reduce alcohol-related fatal crashes among youths, all states have adopted a minimum legal drinking age (MLDA) of 21. States adopting MLDAs of 21 in the early 1980s experienced a 10–15% decline in alcohol-related traffic deaths among drivers in the targeted ages compared with states that did not adopt such laws (General Accounting Office, 1987). The National Highway Traffic Safety Administration (NHTSA) has estimated that the MLDA of 21 prevents 700–1000 traffic deaths annually among persons under 21, and that over 18 000 traffic deaths among persons under 21 have been prevented since 1975 (National Highway Traffic Safety Administration, 1999).

MLDA laws not only decreased drinking among persons under age 21, but they also lowered drinking among people age 21–25 who grew up in states with MLDAs of 21 relative to those who grew up in other states (O'Malley and Wagenaar, 1991). However, it is not known whether these laws, and other efforts to reduce underage drinking, lower both driving after drinking and alcohol-related motor vehicle crash involvement later in life.

A recent analysis of the National Longitudinal Alcohol Epidemiologic Survey (NLAES) found that the age of drinking onset was strongly related to having experienced alcohol dependence during one's life, as defined by the diagnostic criteria of the Diagnostic and Statistical Manual, Fourth Edition (DSM-IV) (American Psychiatric Association, 1994). Among both males and females and persons with and without a family history of alcoholism, persons who began drinking regularly before age 14 were at least three times more likely than those who did not drink alcohol until they were over age 21 to experience diagnosable alcohol dependence during their life (Grant, 1998). Questions in that survey permit us to explore whether age of drinking onset is similarly related to whether respondents, ever in their life, and specifically during the year prior to the survey, reported having:

  • •

    driven a motor vehicle after having too much to drink; and

  • •

    been in a motor-vehicle crash because of their drinking

Independent of factors such as alcohol dependence and years of drinking that are related to early age of drinking onset.

Section snippets

Method

The National Longitudinal Alcohol Epidemiologic Survey (NLAES) was a national probability survey sponsored by the National Institute on Alcohol Abuse and Alcoholism. In 1992, the US Bureau of the Census administered face-to-face interviews with 42 862 respondents age 18 and older, mean age 44, residing in the non-institutionalized population of the contiguous states including the District of Columbia.

Results

Sixty-five per cent of respondents ever drank alcohol, 49% before age 21 and 3% before age 14. The mean drinking onset age was 19.0 years. Four per cent were classified as alcohol-dependent in the past year and 13% ever in their life.

Twenty-three per cent of respondents reported driving a motor vehicle after having too much to drink ever in their life and 5% in the past year. Four per cent of respondents reported ever having been in a motor-vehicle crash because of their drinking, 0.2% in the

Discussion

The relative risk of involvement in fatal crashes increases with increasing driver blood alcohol content and the risks increase more steeply for drivers under age 21 than for older drivers (Zador et al., 2000). Previous studies have shown that raising the legal drinking age to 21 reduced drinking and alcohol-related motor-vehicle crash involvement among persons under age 21 (General Accounting Office, 1987, National Highway Traffic Safety Administration, 1999). Prior research also indicated

Acknowledgements

The National Longitudinal Alcohol Epidemiology Study (NLAES) was sponsored by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). We would like to thank Dr Bridgett Grant at NIAAA for her help on this project. The National Highway Traffic Safety Administration (NHTSA) sponsored the data analysis for this paper.

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