Relationships between social host laws and underage drinking: findings from a study of 50 California cities

Characteristics of drinking episodes associated with simultaneous alcohol and cannabis use among underage drinkers in the United States

BACKGROUND

Simultaneous alcohol and cannabis (SAC) use is associated with more negative consequences than independent use of alcohol or cannabis. Contextual characteristics of drinking episodes are associated with the quantity of alcohol consumed and related risk. This study examined whether drinking contexts may also be associated with SAC use.

METHODS

National Survey on Drug Use and Health (NSDUH) 2010-2019 data from past 30-day drinkers aged 12-20 (n = 39,456) were used. A weighted multivariable logistic regression model examined associations between contextual characteristics (alcohol source, number of people, drinking location) and SAC use during their most recent drinking occasion. Models adjusted for survey year, heavy episodic drinking, age, sex, race/ethnicity, student status, and metropolitan area status.

RESULTS

More than one-in-five drinkers reported SAC use. Compared to getting alcohol from parents/family, those who took it from a home (OR = 1.51,95 %CI = 1.24,1.84), got it for free another way (OR = 2.30,95 %CI = 2.05,2.59), paid someone else for it (OR = 2.83,95 %CI = 2.46,3.25), or purchased it themselves (OR = 3.12,95 %CI = 2.66,3.67) had higher odds of SAC use. Compared to drinking alone, drinking with more than one person was associated with higher odds of SAC use (OR = 1.36,95 %CI = 1.12,1.66). Compared to drinking in their home, drinking in a bar (OR = 0.51,95 %CI = 0.41,0.64) had lower odds of SAC use, whereas drinking in someone else's home (OR = 1.12,95 %CI = 1.02,1.22), a car (OR = 1.36,95 %CI = 1.04,1.77), or multiple locations (OR = 1.29,95 %CI = 1.09,1.53) had higher odds of SAC use.

CONCLUSIONS

Findings suggest that alcohol-related contextual characteristics are associated with SAC use among underage drinkers. Laws addressing underage alcohol consumption, including social host liability and sales to minors laws, may also decrease simultaneous cannabis use.

Alcohol-related deaths among young passengers: An analysis of national alcohol-related fatal crashes

INTRODUCTION

There is consensus that riding with an impaired driver (RWI) constitutes a major threat to public health. The aim of this study was to characterize the factors contributing to the motor-vehicle deaths of 15-20 year-old (y/o) passengers that RWI with a peer.

METHOD

Secondary analyses of the 2010-2018 Fatality Analysis Reporting System. 5,673 passengers aged 15-20 y/o killed while riding in passenger cars with a driver aged 21 or older, 3,542 of these drivers also aged 15-20 y/o. Analyses were conducted between October 2019 and December 2020.

RESULTS

Sixty-three percent of the young passengers were killed while riding with a driver 15-20 y/o. Of these drivers, 26.8% had a blood alcohol concentration (BAC) >0.00 g/dL and 77.1% had a BAC ≥0.08 g/dL. Compared with those occurring during the day on weekdays, fatalities of young passengers who RWI with a peer driver with a BAC ≥ 0.08 g/dL often occurred on weekend nights (OR = 8.2) and weekday nights (OR = 5.2), and when the passenger and driver were both male (OR = 1.8). Race/ethnicity was not a significant contributor to RWI fatalities.

CONCLUSIONS

Most 15-20 y/o RWI fatalities occurred on weekends, at night, when the driver was a young peer with a high BAC, and the passenger and driver were male. The high prevalence of fatalities in these high-risk situations suggests that young driver-passenger dynamics may contribute to alcohol-related fatalities. Practical Applications: To curb RWI fatalities among underage passengers, countermeasures should focus not only on underage drinking drivers and riders, but also on drinking drivers of all ages. Prevention should increase focus on situations in which both the young passenger and young driver are males.

Relationships Between Social Host Policies, Youth Drinking Contexts, and Age

OBJECTIVE

We examined associations of city-level policies and enforcement operations (i.e., social host laws and party patrol operations) with youth drinking, heavy drinking, and drinking-related problems in private and public drinking contexts. We also examined whether these associations were modified by age.

METHOD

We surveyed 580 youth (ages 16-20 years; 53% male) living in 24 midsized California cities. We used mixed-effects negative binomial and logistic regression to calculate the frequency of youth drinking and heavy drinking and odds of drinking-related problems in each context (own home, friend's home, restaurant, bar, music venue, and outdoors).

RESULTS

There were positive associations between more comprehensive city-level social host policies and frequency of youth drinking and heavy drinking at music venues, and youth heavy drinking and drinking-related problems at restaurants. Younger youth who lived in cities with more comprehensive social host laws drank heavily less frequently in their own home than younger youth living in cities with less comprehensive social host laws. Youth ages 17 or under who lived in cities with more party patrol enforcement had higher odds of problems related to drinking outdoors in the past 12 months than those in cities with fewer party patrol operations.

CONCLUSIONS

City-level alcohol policies and enforcement targeting underage drinking may have differential effects depending on youth drinking contexts and age. Comprehensive social host policies, which aim to decrease drinking in private contexts, may displace or increase youth drinking in other contexts, such as restaurants and music venues. Comprehensive social host policies and party patrol operations may be more influential for younger youth drinking in their own home or outdoors.

Dual Use of Off-Premise Outlets for Alcohol and Grocery Purchases: Results From the East Bay Neighborhoods Study

OBJECTIVE

Alcohol privatization efforts have enabled consumers in many states in the United States to purchase alcohol in a variety of off-premise outlets, including grocery stores. This study examines the dual use of outlets to purchase both alcohol and groceries and the extent to which dual use is related to individual income, neighborhood income, and local physical availability of alcohol.

METHOD

The East Bay Neighborhoods Study surveyed residents from 72 microecological neighborhoods across six cities in Alameda County, California. Eligible respondents who purchased alcohol in the last year (n = 707) were asked about the off-premise outlet in which they most often purchase alcohol. Purchasing behaviors within this outlet, including purchasing groceries and frequency of visits to the outlet, were assessed. Multilevel logistic regression and negative binomial models assessed outcomes.

RESULTS

Seventy-three percent of participants reported dual use of their most used outlet for groceries and alcohol. In adjusted models, dual use of the outlet was not associated with individual income, alcohol use, or neighborhood outlet density but was positively associated with neighborhood income and the number of outlet visits. After adjustment, dual use of the most used outlet was associated with 0.77 more visits per 28 days.

CONCLUSIONS

Results suggest that convenience and reduced time costs for purchasing alcohol encourage the dual use of outlets, particularly in high-income neighborhoods. Differences in the dual use of outlets and frequency in outlet use by neighborhood environments highlight the importance of understanding the role of alcohol availability in distinct neighborhood income and outlet-level contexts.

More drugs, more problems? Simultaneous use of alcohol and marijuana at parties among youth and young adults

BACKGROUND

Simultaneous alcohol and marijuana (SAM) use by youth and young adults often occurs at parties and may result in an increased risk of experiencing adverse consequences compared to use of either substance alone. This study sought to examine the relationship between SAM use by youth and young adults and consequences experienced at, or immediately following, parties.

METHODS

We conducted a repeated cross-sectional survey of 15 to 20-year-olds residing in 24 communities across seven states within the United States in 2015 and 2016 (n = 2681). Logistic regression analyses were used to examine associations between SAM use and six consequences (e.g. hangover, sex without a condom, involved in a fight) among 834 youth and young adults (53.7% female, 78.3% White, mean age: 18.4 years) who reported using either alcohol or marijuana at the last party they attended.

RESULTS

72.3% consumed alcohol exclusively, 5.2% used marijuana exclusively, and 22.5% engaged in SAM use. In multivariable analyses, those who reported SAM use had significantly greater odds of experiencing any (AOR = 1.9; 95% CI: 1.3, 2.8) and 2 or more (AOR = 4.0; 95% CI: 2.0, 8.0) consequences compared to those who used only alcohol.

CONCLUSIONS

Our findings suggest that SAM use in a party context is associated with an increased risk of experiencing consequences among youth and young adults after controlling for the quantity of alcohol consumed. Policy and educational prevention strategies should target SAM at parties to reduce harms among youth and young adults.

Social and Situational Party Characteristics Associated With High-Intensity Alcohol Use Among Youth and Young Adults

BACKGROUND

Rates of high-intensity drinking, which is alcohol consumption that exceeds standard heavy drinking levels, have increased in recent years and peak in young adulthood. To identify modifiable environmental targets for prevention of high-intensity drinking, we identified characteristics of parties attended by youth and young adults that were associated with high-intensity drinking and the consequences of this excessive form of drinking.

METHODS

Data are from 15- to 20-year-old participants in an online survey (n = 2,442; 55.4% female, 74.8% White) who resided in 24 communities across 7 states that were a part of a community randomized intervention trial to reduce the incidence and consequences of underage drinking parties. We used multinomial logistic regression to predict level of drinking by 6 party characteristics (size, location, age and gender composition, supervision, others' drinking behavior), and to predict 6 consequences (hangover, not remember event, passed out, punished by parents, broke something/got in fight, and sex against will) from level of drinking. We tested study hypotheses in 2 models, one that used a single binge drinking threshold (below binge vs. at or above binge level) and one that additionally used a high-intensity drinking level (below binge, 1 to 2 times binge, 2+ times binge level).

RESULTS

We found that larger party size and a mostly male composition were unique predictors of high-intensity drinking when compared to those who consumed 1 to 2 times the binge drinking level. Odds of passing out, not remembering the drinking event, breaking/damaging property, or getting in a fight were more than double for high-intensity drinkers compared to standard binge level drinkers.

CONCLUSIONS

Results from this study indicate there are unique precursors and consequences of high-intensity alcohol consumption among youth and young adults. These environmental factors associated with high-risk drinking contexts can be used to develop prevention strategies to mitigate the harms associated with excessive alcohol consumption.

"It just depends on the environment": Patterns and decisions of substance use and co-use by adolescents

This study used rich qualitative data to examine the role that social and physical contexts play in decision-making related to simultaneous use of alcohol and marijuana among adolescents. In-depth, semi-structured interviews were conducted with 13 adolescents who used alcohol and marijuana within several hours of each other. Decisions about whether to use alcohol and marijuana simultaneously as well as use patterns (e.g. the sequence in which substances were used) were informed by the context and the desired effect of the substance(s). Also, simultaneous alcohol and marijuana use was described as occurring in multiple contexts, both destination and transitional. Interventions designed to reduce simultaneous alcohol and marijuana use could benefit from paying attention to substance use contexts.

Social and situational characteristics associated with adolescents' drinking at party and non-party events

We investigated social and situational characteristics associated with adolescents' drinking at party and non-party events and whether these associations vary by party location (homes versus other locations). Ecological momentary assessment data were obtained over two weekends from 149 adolescents in California (46% female, M age=16.4years), using smartphone surveys administered early and late in the evening and the following morning. We assessed whether, where, and with whom adolescents drank alcohol. Social contexts with more people (RRR=1.05, p≤0.005) and with mixed gender composition (RRR=3.15, p≤0.05) were positively associated with increased risks of alcohol use at parties, but not at non-party events. Conversely, social contexts with friends were positively associated with alcohol use at non-party events (RRR=4.32, p≤0.005), but not at parties. Perceived access to alcohol was associated with increased risks for alcohol use at both party and non-party events, but the association was stronger for alcohol use at parties than non-parties (RRR=1.85, p<0.005 versus 4.01, p≤0.005). Additional analyses showed that contexts with mixed gender composition were positively associated with alcohol use at parties not in homes (RRR=11.29, p≤0.05), and perceptions of getting caught by parents or police were negatively associated with non-party alcohol use in homes (RRR=0.57, p≤0.005). This study identified social-ecological contexts of underage drinking parties, which are high risk settings for heavier drinking and other alcohol-related problems. Findings can inform context-based interventions to target these high-risk settings, whether at homes or other locations.

Adolescents' alcohol use and strength of policy relating to youth access, trading hours and driving under the influence: findings from Australia

AIMS

To determine (i) whether the strength of Australian alcohol control policy in three domains (youth access, trading hours and drink driving) changed during the 2000s; and (ii) estimate associations between these policies and adolescent drinking after adjusting for television alcohol advertising exposures, alcohol outlet density, alcohol price changes, exposure to negative articles about alcohol in daily newspapers and adult drinking prevalence.

DESIGN

Repeated cross-sectional surveys conducted triennially from 2002 to 2011. Multi-level modelling examined the association between alcohol control policies and drinking prevalence after adjusting for covariates.

SETTING

Four Australian capital cities between 2002 and 2011.

PARTICIPANTS

Students aged 12-17 years participating in a triennial national representative school-based survey (sample size range/survey: 9805-13 119).

MEASUREMENTS

Outcome measures were: past month drinking and risky drinking (5+ drinks on a day) in the past 7 days. Policy strength in each of three domains (youth access, trading hours, drink-driving) were the key predictor variables. Covariates included: past 3-month television alcohol and alcohol-control advertising, alcohol outlet density, alcohol price change, negatively framed newspaper alcohol articles, adult drinking prevalence and student demographic characteristics.

FINDINGS

During the study period, the strength of youth access policies increased by 10%, trading hours policies by 14% and drink-driving policies by 58%. Past-month and risky drinking prevalence decreased (e.g. past-month: 2002: 47.4% to 2011: 26.3%). Multivariable analyses that included all policy variables and adjusted for year, student and other covariates showed past-month drinking to be associated inversely with stronger trading hours policies [odds ratio (OR) = 0.80, 95% confidence interval (CI) = 0.69, 0.94], but not youth access (OR = 0.92 95% CI = 0.81, 1.04) or drink-driving (OR = 1.00, 95% CI = 0.93, 1.09). Risky drinking was associated inversely with stronger youth access policies (OR = 0.82, 95% CI = 0.69, 0.98), but not trading hours (OR = 0.85, 95% CI = 0.66, 1.09) or drink-driving (OR = 1.02, 95% CI = 0.90, 1.14) policies.

CONCLUSIONS

Population-directed policies designed to reduce alcohol availability and promotion may reduce adolescents' alcohol use.

Places and social contexts associated with simultaneous use of alcohol, tobacco and marijuana among young adults

INTRODUCTION AND AIMS

Little is known about social-ecological correlates of simultaneous use of alcohol with other substances. This study examined places and social contexts associated with simultaneous use of alcohol, tobacco and marijuana among young adults.

DESIGN AND METHODS

We used survey data obtained from 1538 young adult recent alcohol drinkers (49% male; 18-30 years old) in 24 non-contiguous cities in California. Event-level measures included alcohol, tobacco and marijuana use, drinking places and social characteristics of the event. Individual-level measures included alcohol expectancies, depression and demographics.

RESULTS

Bars and restaurants had less alcohol and marijuana use (odds ratio = 0.34; 95% confidence interval 0.18, 0.62; P < 0.001) and alcohol, marijuana and tobacco use (odds ratio = 0.27; 95% confidence interval 0.14, 0.54; P < 0.001) compared with alcohol use only. Perceived percent of intoxicated people at an event was associated with greater likelihood of using alcohol with tobacco and marijuana at the event. At the individual level, greater age was generally associated with increased odds of simultaneous use. Participants who were male, less educated, more depressed and had positive alcohol expectancies were more likely to simultaneously co-use alcohol with tobacco and marijuana. Those with negative expectancies were less likely to simultaneously use these substances.

DISCUSSION AND CONCLUSIONS

Social events in private settings with a high percentage of people who are intoxicated had increased likelihood of simultaneous use of alcohol, tobacco and marijuana. Prevention efforts in these settings may reduce simultaneous use of these substances and related harms. [Lipperman-Kreda S, Paschall MJ, Saltz RF, Morrison CN. Places and social contexts associated with simultaneous use of alcohol, tobacco and marijuana among young adults. Drug Alcohol Rev 2017;00:000-000].

Increasing Parents' Awareness of Social Host Laws: A Pilot Study of Coalition Efforts

States and municipalities across the U.S. are adopting social host ordinances (SHOs) to reduce alcohol use by underage youth in private settings. SHOs are most likely to be effective if parents and other adults are aware of them and they are enforced. We examined the association between a multi-media SHO awareness campaign in northern California municipalities and parents' awareness of SHOs and SHO enforcement. We collected survey data from 1798 parents in a northern California county in fall 2014; all municipalities within the county had SHOs. We conducted descriptive and logistic regression analyses to determine whether parents living in municipalities with a SHO awareness campaign were more likely to be aware of SHOs and SHO enforcement than parents in municipalities without such a campaign. Findings showed that 55.6% of parents in municipalities with a SHO awareness campaign were aware of SHOs compared to 35.7% in municipalities without a campaign. Parents in municipalities with a SHO awareness campaign were also more likely to be aware of SHO enforcement activities (16.3 vs. 8.7%). Regression analyses indicated significant positive associations between the SHO awareness campaign and parental awareness of SHOs and SHO enforcement when controlling for parents' attitudes related to youth drinking, parenting characteristics, normative beliefs regarding other parents' awareness and youth drinking, and demographic characteristics. These findings suggest that a multi-media awareness campaign implemented by coalitions was positively associated with parental awareness of SHOs and perceived SHO enforcement, which may help to prevent or reduce underage drinking.

Characteristics of drinking events associated with heavy episodic drinking among adolescents in the United States

PURPOSE

To examine associations between characteristics of drinking events and the quantity of alcohol consumed by adolescents in the United States.

METHODS

Analyses relied on 2011-2015 data from the National Survey on Drug Use and Health (NSDUH). The study sample included 8110 adolescents, ages 12-17years old, who drank alcohol in the past 30days. A logistic regression model, weighted for national estimation, was constructed to examine factors associated with heavy episodic drinking (HED; 5+ drinks for males, 4+ drinks for females) during the underage drinker's most recent drinking event. These models were adjusted for study year and individual characteristics, including past year drinking frequency, age of drinking onset, and demographic variables.

RESULTS

Buying alcohol off-premise or from another person and being given alcohol from non-parent social sources were associated with greater odds of HED compared to being given alcohol by one of their parents. Drinking alcohol at someone else's house or multiple locations were associated with heavier alcohol consumption compared to drinking at one's own home. Being older and an earlier age of alcohol onset were associated with greater odds of HED.

CONCLUSIONS

This study identifies contextual factors associated with HED by adolescents. Compared to global association studies, the findings from these event-specific analyses provide strong evidence of the environmental conditions that contribute to HED in American adolescents. Although no level of alcohol consumption is safe for adolescents, knowledge of event-level risk factors can inform targeted interventions.

Coproduction of Research Questions and Research Evidence in Public Health: The Study to Prevent Teen Drinking Parties

Community-based participatory research (CBPR) provides a set of principles and practices intended to foster coproduction of knowledge. However, CBPR often has shortcomings when applied to population-level policy and practice interventions, including a focus on single communities and a lack of focus on policy change. At the same time, community trials focused on policy have shortcomings, including lack of stakeholder involvement in framing research questions and modest engagement in study implementation and interpretation and dissemination of results. We describe an attempt to hybridize CBPR and community trials by creating a partnership that included a national membership organization, a coalition advisory board, intervention and delayed intervention communities, and an academic study team, which collaborated on a study of community strategies to prevent underage drinking parties. We use qualitative and quantitative data to critically assess the partnership. Areas where the partnership was effective included (1) identifying a research question with high public health significance, (2) enhancing the intervention, and (3) improving research methods. Challenges included community coalition representatives' greater focus on their own communities rather than the production of broader scientific knowledge. This model can be applied in future attempts to narrow the gap between research, policy, and practice.

Adolescent drinking in different contexts: What behaviors do parents control?

Previous research suggests that the context in which drinking occurs contribute to specific alcohol-related problems. In the current study we assessed how often adolescents attended different contexts in which they could drink, how often they drank in those contexts, and whether drinking patterns and parental monitoring were related to alcohol use in those contexts. We collected survey data from 1,217 adolescents 15-18 years of age in 24 midsized California cities. Measures included past-year frequencies of attending and drinking in restaurants, bars/nightclubs, and outdoor places, typical hours spent at home (i.e., own home or someone else's home), perceptions of parental control and disclosure to parents about free time activities, and demographics. Multilevel zero-inflated negative binomial models were used to assess associations between drinking patterns, parental control, and disclosure and frequency of attending and drinking in specific contexts. There were large variations in attending contexts in which drinking could take place. More frequent drinking was related to less time spent at home, while heavier drinking was associated with more time spent at home. Parental control was related to less frequent attendance at bars/nightclubs, and disclosure to less frequent involvement in outdoor activities and spending more time at home. Among drinkers, frequencies of attendance were strongly related to frequencies of drinking in all contexts except the home. Parental control and disclosure were related to more frequent drinking at restaurants and exposure to bars/nightclubs and drinking at outdoor activities. Parental monitoring may reduce exposure to risks by shifting adolescent contexts for alcohol use.

Identifying Strategies to Limit Youth Drinking in the Home

OBJECTIVE

The present study aims to better understand the situational, contextual, and social event-level characteristics that contribute to youth drinking behavior in the home.

METHOD

We used survey data from 1,217 adolescents (15-18 years, 47.7% female) living in 24 midsized, noncontiguous California cities. The study focused on those who reported at least one drink during their last drinking occasion at home or a friend's home (n = 336). We obtained data about total drinks at last event as well as contextual and situational characteristics at last event, including adult presence, number of people present, participant's home or friend's home, ease of alcohol access, and gender ratio. We also gathered information on individual-level characteristics such as past-year drinking behavior, perceived drinking norms, age, ethnicity, and gender. Multilevel Poisson regression models were used to analyze the data.

RESULTS

Among the full sample, the number of people at the event and the perceived ease of access were positively associated with an increase in number of drinks consumed. Among females, having a responsible adult present was associated with consuming fewer drinks. Among males, having more boys at the event was related to consuming fewer drinks, whereas increased perceived access to alcohol was positively associated with consuming more drinks.

CONCLUSIONS

Parents may be able to manage or manipulate the home drinking environment to reduce heavy drinking and alcohol-related problems. Future research is needed to explore additional contextual factors that may enable or inhibit heavy drinking.

Do Juvenile Curfew Laws Reduce Underage Drinking?

OBJECTIVE

Although not originally enacted to deter the problem of underage drinking in the United States, one set of laws that may influence this behavior is juvenile curfew laws. This research asked the following: (a) What is the effect of enacting a juvenile curfew law on youth drinking, and (b) do demographic variables moderate the relation between juvenile curfew law enactment and drinking? This study examined the effect of juvenile curfew laws on underage drinking, using data from 46 U.S. cities from 1991 to 2005.

METHOD

In 2014, we compiled a data set containing alcohol and curfew law data by zip code. It included 63,081 minors (ages 12-17 years) from 1,081 zip codes. We used difference-in-difference regressions to analyze the data.

RESULTS

The effect of the enactment of a curfew law on the likelihood of consuming alcohol in the past year or past 30 days or of heavy episodic drinking in the past 2 weeks was not significant when compared with cities without curfew laws during the same periods. Although the likelihood of consuming alcohol over the past year differed depending on an individual's characteristics (e.g., race/ethnicity, age, and gender), none of the interaction terms between these characteristics and curfew laws were significant.

CONCLUSIONS

Curfew laws appear to have a nonsignificant effect on youth drinking, but these results are unclear without more knowledge as to where and when youth are drinking both before and after the enactment of curfew laws and how these laws are being enforced.

Impacts of New Zealand's lowered minimum purchase age on context-specific drinking and related risks

AIMS

The minimum purchase age (MPA) for alcohol in New Zealand (NZ) was reduced from 20 to 18 years in 1999. We assessed the degree to which this change was associated with alterations in uses of drinking contexts, drinking and related problems.

METHODS

NZ National Alcohol Surveys among people 14+ years of age provided demographics, frequencies and amounts consumed in drinking places, and problem measures for 1995, 2000 and 2004. Censored regression estimates of parameters of a context-specific dose-response model identified MPA-associated changes in drinking and problems.

RESULTS

The lowered MPA was associated with more frequent drinking at pubs/nightclubs among the newly of-age 18-19-year-olds (b = 15.26, P = 0.009), moderated drinking quantities at these places (b = -0.94, P = 0.034) and greater quantities consumed at home (b = 1.01, P = 0.010) and others' homes (b = 0.87; P = 0.029). Drinking frequency and quantity in the 16-17-year age group increased at home (b = 22.11, P = 0.040 and b = 1.22, P = 0.002) and others' homes (b = 11.65, P = 0.002 and b = 0.91, P = 0.021). Problems associated with drinking contexts changed post-MPA (G(2)  ≥ 27.45, P ≤ 0.002), specifically increased association with drinking in pubs/nightclubs (b = 0.09, P < 0.001) across both age groups.

CONCLUSIONS

The 1999 change in New Zealand's minimum purchase age for alcohol from 20 to 18 years appears to have been associated with substantive changes in uses of drinking contexts, drinking and associated drinking problems among 16-19-year-olds.