Harmful drinking is one of the leading causes of death in the U.S., with an estimated 63,718 deaths attributable to alcohol in the year 2000. Research indicates that harmful drinking generally begins during adolescence, and the risk of adult alcohol dependence is two- to three-fold greater for those who begin drinking by age 12 than it is for those who begin at age 19. Given this pattern, primary prevention among children and adolescents may represent a key element in any effort to reduce the death toll attributable harmful drinking.
A ban on alcohol advertising and an increase in the alcohol tax were both found to be effective in reducing youthful drinking, according to research by investigators at the Harborview Injury Prevention & Research Center and the University of Washington. “Prevention of Deaths From Harmful Drinking in the United States: The Potential Effects of Tax Increases and Advertising Bans on Young Drinkers” is published in the March 2006 issue of the Journal of Studies on Alcohol.
A standard drink, equivalent to a 12-ounce can of beer or a five-ounce glass of wine, contains about 10 grams of alcohol. Heavy episodic (binge) drinking, defined as more than five drinks on one occasion, may cause death through injury, homicide or alcohol poisoning. Higher levels of habitual drinking, equivalent to more than two drinks per day for women and more than four drinks per day for men, may lead to chronic health problems, such as liver cirrhosis, alcohol dependence syndrome and hemorrhagic stroke.
The researchers conducted reviews of the literature and contacted experts in the field of alcohol misuse to determine effective interventions to decrease the prevalence of harmful drinking by 20-year-olds. They examined evidence for the effectiveness of increased alcohol-excise taxes; restriction of alcohol advertising; counter advertising; school-, community-, and college-based programs; family-based interventions; and interventions to prevent driving while intoxicated.
The researchers found that harmful drinking among adolescents and teenagers is sensitive to increases in the price of alcohol, yet federal alcohol taxes have not kept pace with inflation since 1991. The researchers projected that an excise-tax increase of $1 per six pack of beer would reduce harmful drinking and prevent an estimated 1,490 alcohol-related deaths each year.
A complete ban on alcohol advertising would be more effective in reducing these deaths, with the researchers estimating 7,610 lives saved each year, equating to a 13.8 percent decrease in alcohol-related deaths.
“While a complete ban on alcohol advertising would likely reduce the number of deaths caused by harmful drinking, the relatively low risk of mortality due to low levels of consumption make such a ban hard to justify,” explains Will Hollingworth, a UW research assistant professor of radiology based at the HIPRC, and lead author on the study. “Limiting advertising exposure in high-risk age groups, as well as tax increases on alcohol at the state and federal levels may be more feasible interventions.”
Media campaigns focusing on drinking and driving, random alcohol screening, and hospital counseling following alcohol-related injuries can also discourage harmful drinking and reduce the resources required for treating alcohol-related injury and illness, Hollingworth says. Harmful drinking is a complex problem, and wide-scale interventions will need to extend beyond tax increases and limits on advertising.
In addition to Hollingworth, the study was conducted by Dr. Beth Ebel, a UW assistant professor of pediatrics; Carolyn McCarty, a UW research assistant professor of pediatrics; Michelle Garrison, a UW research consultant in pediatrics; Dr. Dimitri Christakis, a UW associate professor of pediatrics; and Dr. Frederick Rivara, a UW professor of pediatrics and adjunct professor of epidemiology.
The research was supported in by a grant from the Robert Wood Johnson Foundation.