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Long-Term Impact on Alcohol-Involved Crashes of Lowering the Minimum Purchase Age in New Zealand
Abstract
Objectives:
We assessed the long-term effect of lowering the minimum purchase age for alcohol from age 20 to age 18 years on alcohol-involved crashes in New Zealand.
Methods:
We modeled ratios of drivers in alcohol-involved crashes to drivers in non-alcohol-involved crashes by age group in 3 time periods using logistic regression, controlling for gender and adjusting for multiple comparisons.
Results:
Before the law change, drivers aged 18 to 19 and 20 to 24 years had similar odds of an alcohol-involved crash (P = .1). Directly following the law change, drivers aged 18 to 19 years had a 15% higher odds of being in an alcohol-involved crash than did drivers aged 20 to 24 years (P = .038). In the long term, drivers aged 18 to 19 years had 21% higher odds of an alcohol-involved crash than did the age control group (P ≤ .001). We found no effects for fatal alcohol-involved crashes alone and no trickle-down effects for the youngest group.
Conclusions:
Lowering the purchase age for alcohol was associated with a long-term impact on alcohol-involved crashes among drivers aged 18 to 19 years. Raising the minimum purchase age for alcohol would be appropriate.
... In the literature, limiting access to alcohol is often considered as a potential measure to limiting alcohol harm. Many studies conclude by suggesting further limits to alcohol availability, such as raising prices (HPA, 2018), limiting the number of outlets permitted to sell alcohol (Connor et al., 2011) or increasing the purchase age (Huckle & Parker, 2014;Kypri et al., 2006). However, just because people cannot access alcohol, does not mean they will not drink it. ...
... The Sale of Liquor Amendment Act 1999 17 resulted in New Zealand's legal purchasing age being lowered from 20 to 18 years of age. Many studies were published by New Zealand health researchers looking at the periods before and after this change, showing that because of the change more alcohol-related crashes have occurred among under-20-year-olds (Huckle & Parker, 2014;Kypri et al., 2006) and a greater incidence of injury is attributable to them (Kypri et al., 2017). However, the same relationship does not seem to extend to fatal alcohol-related crashes (Huckle & Parker, 2014). ...
... Many studies were published by New Zealand health researchers looking at the periods before and after this change, showing that because of the change more alcohol-related crashes have occurred among under-20-year-olds (Huckle & Parker, 2014;Kypri et al., 2006) and a greater incidence of injury is attributable to them (Kypri et al., 2017). However, the same relationship does not seem to extend to fatal alcohol-related crashes (Huckle & Parker, 2014). Furthermore, research has been released by economists debating whether the change in purchase age had any effect at all, arguing that crash rates amongst 18-to 19-year-olds were already rising before the change (Boes & Stillman, 2013). ...
The consumption of any amount of alcohol impairs people’s driving ability, increasing the risk and severity of crashes. This research addresses a knowledge gap around recent trends in alcohol-related crashes and what insights the underlying data can reveal. It focuses in particular on exploring alcohol-related crash trends following the 2014 change in legislation reducing alcohol limits for drivers aged 20 years and over. The research aimed to examine how ‘fit for purpose’ alcohol-related crash data is and to study trends in such crashes over the past 10 years and their connection with other factors.
... There is also evidence, as in Australia and New Zealand, that when legal purchase age restrictions are lowered, road accidents, accident-related hospital admissions, rates of juvenile crime and intoxication cases at emergency departments increased for the age groups affected (131)(132)(133)(134)(135). A 21% increase in alcohol-involved crashes was found among drivers aged 18-19 years up to 10 years following the lowering of the purchase age in New Zealand (the purchase age was lowered from 20 to 18 years in 1999) (136). This may suggest that a purchase age of 20 years is more effective in preventing harm than setting the law at 18 years. ...
... The number and density of alcohol outlets is a key aspect of a neighbourhood's alcohol environment, and alcohol outlets play an important role in regulating the risks to which young people are exposed (137). Higher outlet density is related to heavier drinking among young people internationally (138)(139)(140)(141), and in some Western Pacific countries and areas, such as Australia, New Zealand and the Republic of Korea (120,(132)(133)(134)(135)(136)(137)(138)(139)(140)(141)(142)(143)(144). ...
... Kidney Stone Statistical and data mining aspects on kidney stones: a systematic review and meta analysis Mai Shouman [12] 2012 Heart Disease Applying K-nearest neighbor in diagnosing heart disease patients Abhishek Taneja [13] 2013 Heart Disease To design a predictive model for heart disease detection to enhance their liability of heart disease diagnosis. Kawsar Ahmed et al [7], [23] 2013 ...
... Databases used with Respect to Treacherous DiseasesAuthor Disease Considered Data Set/Database UsedDursun Delen et al [3], Bellaachia et al [4] Breast cancer SEER cancer incidence databaseJyoti Soni[22], Mai Shouman[12] ...
... In Australia, several studies (Smith and Burvill 1987;Jiang et al. 2015) found that lowering the drinking age to 18 in three Australian states was associated with increases in traffic-related deaths, hospital admissions, and rates of juvenile crime. Similarly, lowering the purchase age in New Zealand from 20 to 18 was associated with increased alcohol problems for 16-to 19year olds , traffic injuries among 15-to 19-year olds (Huckle and Parker 2014), and prosecutions for disorder offences among 14-to 15-year olds (Huckle et al. 2006). ...
This book is about alcohol policy: why it is needed, how it is made, and the impact it has on health and well-being. It is written for both policymakers and alcohol scientists, as well as the many other people interested in bridging the gap between research and policy. It begins with a global review of epidemiological evidence showing why alcohol is not an ordinary commodity, and it ends with the conclusion that alcohol policies implemented within a public health agenda are needed to reduce the enormous burden of harm it causes. The core of the book is a critical review of the cumulative scientific evidence in seven general areas of alcohol policy: pricing and taxation; regulating the physical availability of alcohol; modifying the environment in which drinking occurs; drink-driving countermeasures; marketing restrictions; primary prevention programmes in schools and other settings; and treatment and early intervention services. The final chapters discuss the current state of alcohol policy in different parts of the world, the detrimental role of the alcohol industry, and the need for both national and global alcohol policies that are evidence-based, effective, and coordinated. This book shows that opportunities for evidence-based alcohol policies that better serve the public good are clearer than ever before, as a result of accumulating knowledge on which strategies work best.
... In Australia, several studies (Smith and Burvill 1987;Jiang et al. 2015) found that lowering the drinking age to 18 in three Australian states was associated with increases in traffic-related deaths, hospital admissions, and rates of juvenile crime. Similarly, lowering the purchase age in New Zealand from 20 to 18 was associated with increased alcohol problems for 16-to 19year olds , traffic injuries among 15-to 19-year olds (Huckle and Parker 2014), and prosecutions for disorder offences among 14-to 15-year olds (Huckle et al. 2006). ...
This book is about alcohol policy: why it is needed, how it is made, and the impact it has on health and well-being. It is written for both policymakers and alcohol scientists, as well as the many other people interested in bridging the gap between research and policy. It begins with a global review of epidemiological evidence showing why alcohol is not an ordinary commodity, and it ends with the conclusion that alcohol policies implemented within a public health agenda are needed to reduce the enormous burden of harm it causes. The core of the book is a critical review of the cumulative scientific evidence in seven general areas of alcohol policy: pricing and taxation; regulating the physical availability of alcohol; modifying the environment in which drinking occurs; drink-driving countermeasures; marketing restrictions; primary prevention programmes in schools and other settings; and treatment and early intervention services. The final chapters discuss the current state of alcohol policy in different parts of the world, the detrimental role of the alcohol industry, and the need for both national and global alcohol policies that are evidence-based, effective, and coordinated. This book shows that opportunities for evidence-based alcohol policies that better serve the public good are clearer than ever before, as a result of accumulating knowledge on which strategies work best.
... Research utilising pre-post data assessed whether rates of motor vehicle crashes changed after the New Zealand MLDA decreased from 20 years to 18 years in 1999 and after the Australian MLDA decreased from 21 years to 18 years in the 1970s. In New Zealand it was found that compared with those above the MLDA (approximately 22-years-old), decreasing the MLDA to 18 years increased motor vehicle crash rates for 15 to 17-year-old by 15% to 24% (Huckle & Parker, 2014;Kypri et al., 2016). These findings are contrary to Australian research, wherein no change in motor vehicle fatalities were recorded after the MLDA was reduced to 18 years (Laslett et al., 2018). ...
Background
Children are often exposed to increased rates of secondary harm such as physical harm, motor vehicle incidents, maltreatment, and neglect because of others’ or their own alcohol consumption. Alcohol supply reduction, or alcohol control policies, are often enacted to mitigate alcohol harms within the community. The current systematic narrative review aims to synthesise recent literature that examines how alcohol supply reduction policies impact the physical health, mental health, and offending behaviour of children and adolescents.
Methods
Eight databases and grey literature sources were systematically searched, and results were synthesised by policy under evaluation. Twenty-one peer reviewed articles and ten grey literature articles were included after screening of 7,135 original articles. Included articles examined the alcohol control policies of the minimum legal drinking age, price control, and trading restrictions, with the most common outcomes under evaluation being related to the physical health or offending behaviour of adolescents.
Results
Overall, the current review identified that the impact of alcohol policy on children and adolescents varied depending on the policy type, policy environment and assessed outcome. Common limitations within the literature include inability to control for covariates, use of alcohol related outcomes unsuitable to children and adolescents, and use of cross-sectional data and regression-discontinuity analysis in lieu of actual policy changes.
Conclusions
The current review highlights the need to further evaluate the impact of actual alcohol-related policy changes on children and adolescents.
... These effects were likely mediated by reduced alcohol use, including but not limited to heavy episodic drinking. Studies from outside North America have corroborated the impact of MLDA in both directions; i.e. introductions and increases of MLDA were associated with reduced consumption and attributable harm, whereas lowering the MLDA (or minimum purchasing age) was associated with increased consumption, self-reported problems, traffic injuries and deaths, hospital admissions and rates of juvenile crime (Gruenewald et al., 2015, Huckle et al., 2014, Jiang et al., 2015. ...
Aims:
To determine the effect of an alcohol policy change, which increased the minimum legal drinking age (MLDA) from 18 years of age to 20 years of age on all-cause mortality rates in young adults (18-19 years old) in Lithuania.
Methods:
An interrupted time series analysis was conducted on a dataset from 2001 to 2019 (n = 228 months). The model tested the effects of the MLDA on all-cause mortality rates (deaths per 100,000 individuals) in three age categories (15-17 years old, 18-19 years old, 20-22 years old) in order to control for general mortality trends in young adults, and to isolate the effects of the MLDA from other alcohol control policies. Additional models that included GDP as a covariate and a taxation policy were tested as well.
Results:
There was a significant effect of the MLDA on all-cause mortality rates in those 18-19 years old, when modelled alone. Additional analyses controlling for the mortality rate of other age groups showed similar findings. Inclusion of confounding factors (policies on alcohol taxation, GDP) eliminated the effects of MLDA.
Conclusions:
Although there was a notable decline in all-cause mortality rates among young adults in Lithuania, a direct causal impact of MLDA on all-cause mortality rates in young adults was not definitively found.
... These effects were likely mediated by reduced alcohol use, including but not limited to heavy episodic drinking. Studies from outside North America have corroborated the impact of MLDA in both directions; i.e., introductions and increases of MLDA were associated with reduced consumption and attributable harm, whereas lowering the MLDA (or minimum purchasing age) was associated with increased consumption, self-reported problems, traffic injuries and deaths, hospital admissions and rates of juvenile crime (Gruenewald et al., 2015, Huckle et al., 2014, Jiang et al., 2015. ...
Aims: To determine the effect of an alcohol policy change, which increased the minimum legal drinking age (MLDA) from 18 years of age to 20 years of age on all-cause mortality rates in young adults in Lithuania.
Methods: An interrupted time series analysis was conducted on a dataset from 2001 to 2019 (n = 228 months). The model tested the effects of the MLDA on all-cause mortality rates (deaths per 100,000 individuals) in 3 age categories (15-17 years old, 18-19 years old, 20-22 years old). Additional models that included GDP as a covariate and taxation policy were tested as well.
Results: There was a significant effect of the MLDA on all-cause mortality rates in those 18-19 years old, when modelled alone. Additional analyses controlling for the mortality rate of other age groups showed similar findings. Inclusion of confounding factors (policies on alcohol taxation, GDP) eliminated the effects of MLDA.
Conclusions: Although there was a notable decline in all-cause mortality rates among young adults in Lithuania, a direct causal impact of MLDA on all-cause mortality rates in young adults was not definitively found.
... Melanoma is one of the fastest growing cancers worldwide: Age-adjusted incidence rates have been increasing in most of the fair-skinned populations in recent decades; and 160,000 new cases are diagnosed annually worldwide (1)(2)(3)(4)(5). Melanoma is a malignancy of pigment-producing cells (melanocytes) located predominantly in the skin, but also found in the eyes, ears, GI tract, leptomeninges, and oral and genital mucous membranes. ...
... A systematic review including studies conducted between 1960 and 1999 and investigating the effects of the legal minimum drinking age on related health and harm showed that a higher minimum legal drinking age in the U.S. of 21 years (by 1988, all states had established an age -21 minimum legal drinking age) has led to a reduction in alcohol consumption among adolescents, as well as a reduction in alcohol-related harm, including road fatalities, crime, violence and drunkenness convictions (Wagenaar & Toomey, 2002). In New Zealand, the lowering of the legal drinking age for alcohol from 20 to 18 years has led directly to a higher number of weekend assaults, emergency admissions and traffic accidents caused by alcohol consumption among 15-to 19-year olds (Everitt & Jones, 2002;Kypri et al., 2006;Kypri, Davie, McElduff, Connor, & Langley, 2014), as well as to a higher prevalence of alcohol-related road accidents among 18-and 19-year-olds in the long term (Huckle & Parker, 2014). An increase in the alcohol minimum legal age could well decrease the availability of alcohol for underage adolescents, which in turn could reduce alcohol-related health and societal harm for adolescents. ...
Background
As of January 2014, the Dutch minimum legal age for the sale and purchase of all alcoholic beverages has increased from 16 to 18 years of age. The effectiveness of a minimum legal age policy in controlling the availability of alcohol for adolescents depends on the extent to which this minimum legal age is complied with in the field. The main aim of the current study is to investigate, for a country with a West-European drinking culture, whether raising the minimum legal age for the sale of alcohol has influenced compliance rates among Dutch alcohol vendors.
Methods
A total of 1770 alcohol purchase attempts by 15-year-old mystery shoppers were conducted in three independent Dutch representative samples of on- and off-premise alcohol outlets in 2013 (T0), 2014 (T1), and 2016 (T2). The effect of the policy change was estimated controlling for gender and age of the vendor.
Results
Mean alcohol sellers’ compliance rates significantly increased for 15-year-olds from 46.5% before to 55.7% one year and to 73.9% two years after the policy change. Two years after the policy change, alcohol vendors were up to 3 times more likely to comply with the alcohol age limit policy.
Conclusion
After the policy change, mean alcohol compliance rates significantly increased when 15-year-olds attempted to purchase alcohol, an effect which seems to increase over time. Nevertheless, a rise in the compliance rate was already present in the years preceding the introduction of the new minimum legal age. This perhaps signifies a process in which a lowering in the general acceptability of juvenile drinking already started before the increased minimum legal age was introduced and alcohol vendors might have been anticipating this formal legal change.
... Kidney Stone Statistical and data mining aspects on kidney stones: a systematic review and meta-analysis Mai Shouman [12] 2012 Heart Disease Applying K-nearest neighbor in diagnosing heart disease patients Abhishek Taneja [13] 2013 Heart Disease To design a predictive model for heart disease detection to enhance their liability of heart disease diagnosis. ...
Background: Automated disease classification using machine learning often relies on features derived from segmenting individual objects, which can be difficult to automate. Proposed model is a classification based an efficient approach in which machine learning concepts are used for the detection of Lung cancer diseases. The algorithm obtained encouraging results but requires considerable computational expertise to execute. Furthermore, some benchmark sets have been shown to compare the proposed work model working. Results: We developed user friendly disease prediction model based on PCA and LDA. To validate the method, the proposed method is applied in MATLAB 2014a to achieve high accuracy performance metric and then comparison has been made with ICA and SURF method. Conclusions: The proposed approach offers improved user-friendliness, as feature extraction is performed in an easily editable. As a direct implication, intermediate results are more easily accessible.
... BAC = blood alcohol content; ISS = injury severity score. in BAC to 0.05% directly correlated to a decrease in alcohol-related fatalities and a decrease in the incidence of drivers under the influence of alcohol involved in motor vehicle crashes. Conversely, decreasing the stringency of deterrence by lowering the legal drinking age to 18 years in New Zealand was associated with a significant increase in alcohol-related MVCs among 18-and 19-yearolds (Huckle & Parker, 2014). taken the law a step further by enacting distinctions between "administrative sanctions" and "criminal sanctions" (p. ...
In 2013, the National Transportation Safety Board advised lawmakers in the United States to reduce the legal limit of blood alcohol content (BAC) from 0.08% to 0.05%. The purpose of this research was to evaluate the rationale for reducing the legal limit of BAC to 0.05% through analysis of the relationship between BAC and injury severity. A correlational study was conducted on patients with positive BAC involved in a motor vehicular collision. Retrospective review of 446 trauma patients (aged 18–80 years) injured in a vehicular collision routinely screened for BAC was conducted. Two groups were compared: Group 1, patients with nonzero blood alcohol concentration (n = 101); and Group 2, patients with zero blood alcohol (n = 345). Standard statistical analyses were utilized. A total of 101 patients (23%) had a detectable BAC on admission. Patients with a detectable BAC were younger (33 and 44 years) and more likely to be male (27% and 16%). There was no statistically significant association between both injury severity score (ISS) and BAC or between ISS and age. There was no significant correlation between higher BAC and a higher ISS. Positive BAC alone may not affect ISS, but the potential for risk-taking behaviors by drivers under the influence may increase injury severity.
The minimum alcohol purchasing age in New Zealand was lowered from 20 to 18 in December 1999. Focusing on two distinct legislative regimes, we utilize a national‐level census of all criminal convictions to examine the impact of unrestricted alcohol purchasing rights on alcohol‐induced criminal behaviour. Our study reveals that overall trends in alcohol‐related convictions are obscured by offenses that can only be prosecuted up to a certain age. After removing confounding influences from additional regulations that hold relevance under one legislative regime but not the other, we do not find a statistically meaningful increase in overall measures of alcohol‐related crimes at the minimum legal alcohol purchasing age. The novel empirical findings from our study extend the geographic focus of the existing international literature on the social costs of gaining unrestricted access to alcohol.
Purpose:
Age limits are effective in reducing alcohol- and tobacco-related harm, however, their effectiveness depends on the extent to which they are complied with. This study aimed to investigate the effectiveness of different age verification systems (AVSs) implemented by 400 Dutch supermarkets on requesting a valid age verification (ID) and on sellers' compliance.
Methods:
A mixed method design was used. Compliance was measured by 800 alcohol and tobacco purchase attempts by 17-year-old mystery shoppers. To analyze the effectiveness of AVSs, logistic regression analyses were performed. Insight into facilitating and hindering factors in the purchase process was obtained by 13 interviews with supermarket managers.
Results:
Only a tendency toward a positive effect of the presence of the keying-on-date-of-birth AVS or ID swiper/checker was found on ID request for both alcohol and tobacco purchase attempts. The use of the keying-on-date-of-birth AVS or ID swiper/checker significantly increased the odds for compliance after an ID was requested, for both alcohol and tobacco purchase attempts. Managers indicated that ID requests and compliance could be facilitated by providing cashiers with sufficient managerial support, technical support, and regular training about the purchase process and use of the AVS.
Conclusions:
The usage of AVSs calculating and confirming whether the customer reached the legal purchase age for cashiers significantly increases the odds for cashiers to comply with age limits of alcohol and tobacco. Future research should gain insight into how usage of effective AVSs can be improved and explore the feasibility of implementation and effectiveness in other outlets.
Introduction and aims:
In December 1999, New Zealand lowered the alcohol minimum purchasing age from 20 to 18 years. We tested hypotheses that this change was associated with long-term increases in traffic injury attributable to alcohol-impaired driving among 18- to 19-year-olds (target age group) and 15- to 17-year-olds (affected by 'trickle-down').
Design and methods:
We undertook a controlled before-and-after comparison of rates of fatal and non-fatal traffic injury to persons of any age attributable to impaired drivers aged 18-19 years and 15-17 years, versus 20- to 21-year-olds. Crash data including assessment of driver alcohol impairment were recorded by New Zealand Police. The pre-change period was 1996-1999. Post-change periods were 2000-2003, 2004-2007 and 2008-2010. Outcomes were population-based and vehicle travel-based rates.
Results:
Compared with the change in injury rates attributable to alcohol-impaired 20- to 21-year-old male drivers, injuries attributable to 18- to 19-year-old male drivers increased in all post-change periods and significantly so in the second post-change period (incidence rate ratio [IRR] 1.3, 95% confidence interval [CI] 1.1 to 1.5). For 15- to 17-year-old male drivers, rates increased in all post-change periods compared with 20- to 21-year-olds, and more so in the second (IRR 1.2, 95% CI 1.1 to 1.4) and third (IRR 1.2, 95% CI 1.1 to 1.4) periods. There was a short-term relative increase in harm attributable to 18- to 19-year-old female drivers (IRR 1.5; 1.1 to 2.0). Results were similar for vehicle travel-based rates.
Discussion and conclusions:
Reducing the alcohol minimum purchasing age was followed by long-term increases in the incidence of traffic injury attributable to male 15- to 19-year-old alcohol-impaired drivers. [Kypri K, Davie G, McElduff P, Langley J, Connor J. Long-term effects of lowering the alcohol minimum purchasing age on traffic crash injury rates in New Zealand. Drug Alcohol Rev 2016].
We examine the association between reducing the alcohol minimum purchasing age from 20 to 18 years in December 1999 and rates of weekend assault hospitalisation among young Māori in the following 12 years. Our previous work showed deleterious effects for young people overall. In keeping with Treaty of Waitangi principles, we sought to determine whether the policy was similarly detrimental for Māori.
We used Poisson regression to examine data from 1995 to 2011 on Māori hospitalised on Friday-Sunday following assault, separately by gender among 15- to 17-year-olds and 18- to 19-year-olds, versus 20- to 21-year-olds as a control for changes in economic and environmental factors.
There was no evidence to suggest weekend assault hospitalisations increased significantly more among 15- to 17-year-old or 18- to 19-year-old Māori males in the post-change periods (incidence rate ratios varied between 0.83 and 1.13; P values >0.25) compared with increases observed in 20- to 21-year-old Māori males. For Māori females, estimates were more variable, but overall, there was no evidence of the hypothesised effect (incidence rate ratios between 0.60 and 1.09; P values >0.07).
Overall, we find no evidence that lowering the minimum alcohol purchasing age increased weekend hospitalised assaults among young Māori. Inferences are compromised by lack of statistical power which underlines the importance of planning for evaluation of important policies well before they are implemented, particularly with a view to meeting obligations to Māori arising from the Treaty of Waitangi. [Kypri K, Davie G, McElduff P, Langley J, Connor J. Effects of lowering the alcohol minimum purchasing age on weekend hospitalised assaults of young Māori in New Zealand. Drug Alcohol Rev 2015].
© 2015 Australasian Professional Society on Alcohol and other Drugs.
Background
In 2005 a Bill was introduced to the New Zealand parliament to increase the alcohol minimum purchasing age (MPA) from 18 to 20 years and submissions were invited from interested parties. We sought to characterise and critique the arguments tendered for and against the proposal.
Methods
We used template analysis to study written submissions on the Bill from 178 people and organisations in New Zealand. Independent raters coded submissions according to the source, whether for or opposed, and the arguments employed.
Results
The most common sources of submissions were members of the public (28%), the alcohol industry (20%), and NGOs (20%). Overall, 40% opposed increasing the MPA, 40% were in favour, 4% supported a split MPA (18 years for on-premise, 20 years for off-premise), 7% were equivocal, and 8% offered no comment. The most common proponents of increasing the MPA were NGOs (36%) and members of the public (30%) and their arguments concerned the expected positive effects on public health (36%) and public disorder/property damage (16%), while 24% argued that other strategies should be used as well. The most common sources of opposition to increasing the MPA were the alcohol industry (50%) and the public (20%). It was commonly claimed that the proposed law change would be ineffective in reducing harm (22%), that other strategies should be used instead (16%), that it would infringe adult rights (15%), and that licensed premises are safe environments for young people (14%). There were noteworthy examples of NGOs and government agencies opposing the law change. The alcohol industry maximised its impact via multiple submissions appealing to individual rights while neglecting to report or accurately characterise the scientific evidence. Several health and welfare agencies presented confused logic and/or were selective in their use of scientific evidence.
Conclusion
In contrast to the fragmented and inconsistent response from government and NGOs, the alcohol industry was organised and united, with multiple submissions from the sector with most at stake, namely the hospitality industry, and supporting submissions from the manufacturing, import, and wholesale sectors. Systematic reviews of research evidence should be routinely undertaken to guide the legislature and submissions should be categorised on the basis of pecuniary interest.
Alcohol: No Ordinary Commodity - Research and Public Policy Second Edition is a collaborative effort by an international group of addiction scientists to improve the linkages between addiction science and alcohol policy. It presents the accumulated scientific knowledge on alcohol research that has a direct relevance to the development of alcohol policy on local, national, and international levels. It provides an objective analytical basis on which to build relevant policies globally, and informs policy makers who have direct responsibility for public health and social welfare. By locating alcohol policy primarily within the realm of public health, this book draws attention to the growing tendency for governments, both national and local, to consider alcohol misuse as a major determinant of ill health, and to organize societal responses accordingly. The scope of the book is comprehensive and international. The authors describe the conceptual basis for a rational alcohol policy and present new epidemiological data on the global dimensions of alcohol misuse. The core of the book is a critical review of the cumulative scientific evidence in seven general areas of alcohol policy: pricing and taxation; regulating the physical availability of alcohol; modifying the environment in which drinking occurs; drink-driving countermeasures; marketing restrictions; primary prevention programs in schools and other settings; and treatment and early intervention services. The final chapters discuss the current state of alcohol policy in different parts of the world and describe the need for a new approach to alcohol policy that is evidence-based, realistic, and coordinated.
Although both youth and inexperience contribute to the elevated crash rates of teenage drivers, the relative contribution of these factors has not been firmly established.
A review was undertaken of eleven recent (1990 or newer) studies that tried to separate the crash effects of age and experience, represented by length of licensure.
The weight of evidence is that age and experience have important, independent effects on crash risk, even after differences in driving mileage are accounted for. The studies consistently found that teenage drivers had dramatically higher crash rates than older drivers, particularly drivers older than 25, after controlling for length of licensure. Studies that distinguished 16-year-olds found that crash rates for novice 16-year-olds were higher than rates for novice 17-year-olds, but crash rates for novice 17-year-olds were not consistently higher than rates for novice 18- to 19-year-olds. With regard to experience, the weight of evidence suggests a steep learning curve among drivers of all ages, particularly teenagers, and strong benefits from longer licensure. Of the studies that attempted to quantify the relative importance of age and experience factors, most found a more powerful effect from length of licensure.
The findings lend support to delaying licensure among teenagers in the United States, where licensure commonly is allowed at age 16, and to graduated licensing systems that phase in unsupervised driving during high-risk situations as teenagers gain independent driving experience.
This study used a pre- to post-design to evaluate the influence on drinking-and-driving fatal crashes of 6 laws directed at youth aged 20 and younger and 4 laws targeting all drivers.
Data on the laws were drawn from the Alcohol Policy Information System data set (1998 to 2005), the Digests of State Alcohol Highway Safety Related Legislation (1983 to 2006), and the Westlaw database. The Fatality Analysis Reporting System data set (1982 to 2004) was used to assess the ratio of drinking to nondrinking drivers involved in fatal crashes [fatal crash incidence ratio (CIR)]. The data were analyzed using structural equation modeling techniques.
Significant decreases in the underage fatal CIR were associated with presence of 4 of the laws targeting youth (possession, purchase, use and lose, and zero tolerance) and 3 of the laws targeting all drivers (0.08 blood alcohol concentration illegal per se law, secondary or upgrade to a primary seat belt law, and an administrative license revocation law). Beer consumption was associated with a significant increase in the underage fatal CIR. The direct effects of laws targeting drivers of all ages on adult drinking drivers aged 26 and older were similar but of a smaller magnitude compared to the findings for those aged 20 and younger. It is estimated that the 2 core underage drinking laws (purchase and possession) and the zero tolerance law are currently saving an estimated 732 lives per year controlling for other exposure factors. If all states adopted use and lose laws, an additional 165 lives could be saved annually.
These results provide substantial support for the effectiveness of under age 21 drinking laws with 4 of the 6 laws examined having significant associations with reductions in underage drinking-and-driving fatal crashes. These findings point to the importance of key underage drinking and traffic safety laws in efforts to reduce underage drinking-driver crashes.
This study has two separate but related purposes: (1) to delineate cross-sectional differences among U.S. high school seniors and young adults that may be due to variations in recent years in state-level minimum drinking age laws and (2) to examine the effects of recent changes in minimum drinking age laws on alcohol consumption and other relevant attitudes and behaviors. Analyses used existing data collected by the Monitoring the Future project, an ongoing study involving annual, nationally representative surveys of high school seniors and annual follow-up surveys by mail of recent graduates. A separate, coordinated study used time-series analyses of official reports to examine effects of increases in the minimum drinking age in several states on rates of fatal crashes. Time-series results were compared with findings from self-report data. The major findings include: higher minimum drinking ages were associated with lower levels of alcohol use among high school seniors and recent high school graduates, even after multivariate controls; lower levels of alcohol use were observed across a number of demographic variables; the lower levels of use persisted into the early 20s, even after all respondents were of legal age; and lowered involvement in alcohol-related fatal crashes among drivers under 21 appeared due to lower alcohol consumption rates--in particular, less drinking in bars or taverns.
In 1999, New Zealand lowered the minimum purchasing age for alcohol from 20 to 18 years. We tested the hypothesis that this increased traffic crash injuries among 15- to 19-year-olds.
Poisson regression was used to compute incidence rate ratios for the after to before incidence of alcohol-involved crashes and hospitalized injuries among 18- to 19-year-olds and 15- to 17-year-olds (20- to 24-year-olds were the reference).
Among young men, the ratio of the alcohol-involved crash rate after the law change to the period before was 12% larger (95% confidence interval [CI]=1.00, 1.25) for 18- to 19-year-olds and 14% larger (95% CI=1.01, 1.30) for 15- to 17-year-olds, relative to 20- to 24-year-olds. Among young women, the equivalent ratios were 51% larger (95% CI=1.17, 1.94) for 18- to 19-year-olds and 24% larger (95% CI=0.96, 1.59) for 15- to 17-year-olds. A similar pattern was observed for hospitalized injuries.
Significantly more alcohol-involved crashes occurred among 15-to 19-year-olds than would have occurred had the purchase age not been reduced to 18 years. The effect size for 18- to 19-year-olds is remarkable given the legal exceptions to the pre-1999 law and its poor enforcement.
To assess alcohol-related harms and offences in New Zealand from 1990 to 2003, a period of alcohol policy liberalization, that included the lowering of the purchase age from 20 to 18 years in 1999.
Time trend analyses were carried out on routinely collected data for prosecutions for driving with excess alcohol; alcohol-involved vehicle crashes (all and fatal) and prosecutions for disorder offences. These were carried out separately for those aged 14-15, 16-17, 18-19, 20-24 and 25 years and over.
Rates of: prosecutions for driving with excess alcohol (1990-2003); rates of alcohol- involved vehicle crashes (all and fatal) (1990-2003); and rates of prosecutions for disorder offences (1994-2003).
Effects of alcohol policy liberalization: positive trends were found in the rates of prosecutions for disorder in the 16-17, 18-19, 20-24 and 25 + age groups; with 18-19-year-olds and 16-17-year-olds having the largest rates and largest positive trend in rates. For 16-17-year-olds, there was a positive trend in the rates of prosecutions for excess breath alcohol. Negative trends in rates were found for alcohol-related crashes (all and fatal) among all age groups. Negative trends for those over 16-17 years were found for prosecutions for driving with excess breath alcohol (this was prior to the lowering of the purchase age). Effects of lowering the minimum purchase age: the lowering of minimum purchase age coincided with an increase in the trend of alcohol-related crashes for 18-19-year-olds; the next largest increase was among the 20-24-year-olds (all other age groups also increased but at a much lower rate). A similar result was found for driving with excess alcohol for those aged 18-19 (and those aged 20-24 years). An increase in the rates of prosecutions for disorder offences occurred for the 14-15-year-old group following the lowering of the purchase age.
The liberalization of alcohol throughout the 1990s may have influenced younger people more, as reflected in increases in their disorder offences and drink driving. The lowering of the minimum purchase age may have led to an increase in drink-driving among the 18-19-year-olds (those directly affected by the change in purchase age).
Lowering of the drinking age in 3 Australian States was found to adversely affect traffic safety. In South Australia, the reduction from 20 to 18 yrs resulted in a significant increase in the number of male drivers and motorcyclists injured, which still existed 4–6 yrs later. For Western Australia and Queensland, different results were obtained for the metropolitan and rest-of-state areas. A highly significant increase in drink-driving enforcement activity in Queensland was not able to contain the adverse effect on traffic safety of increasing the availability of alcoholic beverages. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
We examine whether adults’ alcohol consumption and traffic fatalities are associated with the legal drinking environment those adults experienced between the ages of 18 and 20. We find that the difference between an environment in which a person was never allowed to drink legally at those ages and one in which a person could always drink legally is associated with a 20–33 percent increase in alcohol consumption and a 10 percent increase in fatal accidents for adult males. There are no statistically significant or practically important associations between the youths’ legal drinking environment and adult females’ alcohol consumption and driving fatalities.
Young drivers have a disproportionately high risk of experiencing a road traffic crash. On 1 August 1987 a Graduated Driver's Licensing System (GDLS) was introduced in New Zealand. This system was designed to give young drivers (i.e. 15–24 years inclusive) experience in driving while being excluded from high risk driving situations. We sought to determine the impact of the GDLS on serious injury crashes. The source of the injury crash data was New Zealand's Health Information Services' national public hospital inpatient morbidity data files for the years 1979–1992 inclusive. We disaggregated the occupant data into three age groups 15–19 years, 20–24 years, and persons 25 years of age or older and compared their trends in injury. In order to determine whether the incidence of motor vehicle crashes was simply following trends in other injury events we also included two 15–19 year old non-traffic injury comparison groups. Using time series analyses we showed that the introduction of the GDLS was closely followed by substantial reductions in car crash injuries for all age groups, especially 15–19 year olds (23% reduction). After considering effects for older occupants we speculate that the effect is likely to be substantially less than 23%. An analysis of licensure data suggests that the reduction in crashes may, in large part, be attributable to an overall reduction in exposure.
Results of a 6-year follow-up of previous research evaluating the effects of Michigan's December 1978 increase in the legal drinking age from 18 to 21 are reported. Earlier research demonstrated the immediate effect of Michigan's raised legal age in reducing motor vehicle crash involvement among young drivers. The current study examined 6 years of post-law traffic crash data, using Box-Jenkins intervention analysis methods to assess the long-term effects of the raised drinking age. Results revealed long-term ef- fects of the law similar to the initial effects identified earlier. Over the 6-year follow-up period, the rate of involvement in injury-producing single-vehicle nighttime crashes among drivers age 18–20 was 16 % lower than the level ex- pected, had the drinking age law not changed. Police-reported drinking driver crash involvement was down 19%. In contrast to many alcohol-im- paired driving countermeasures, the raised legal drinking age appears to have a long-term effect in reducing motor vehicle crash involvement among young drivers.
The aim of this study was to assess trends in drinking patterns and alcohol-related problems among age and gender groups in the context of a liberalized alcohol policy environment.
Eleven comparable general population alcohol surveys were conducted between 1990 and 2000 in Auckland, New Zealand, during which a substantial number of liberalizing alcohol policy changes occurred. Measurements included typical-occasion quantity and frequency of drinking in the last 12 months. Self-reported alcohol-related problems in the last 12 months were divided into two groups based on risk curve analysis: threshold problems (experienced only once a high level of consumption is reached) and nonthreshold problems (those exhibiting a dose-response relationship). Age groups were 14-19, 20-24, 25-39, and 40-65 years.
Significant increases in typical-occasion quantity were found for young men and young women ages 14-19 years and for women 20-24 and 40-65 years. The increase was most marked among those 14-19 years old. Only women ages 25-39 years increased how often they drank. The prevalence of threshold problems significantly increased among male drinkers ages 14-19 and 40-65 years. The proportion of 14- to 19-year-olds experiencing threshold problems was observed to be higher in each year compared with those 40-65 years old, and the 14- to 19-year-olds experienced a greater year-on-year increase. Increases in nonthreshold alcohol-related problems occurred for the youngest and oldest males and for most female age groups (14-19, 25-39, and 40-65 years). The increase was most marked among those 14-19 years old.
Increases in quantities consumed and alcohol-related problems were found predominantly among young people and women. The youngest age group, those 14-19 years old, experienced the most marked increases in quantity consumed and problems including, for males, the experience of more serious problems such as "had hands shake in the morning" (experienced only once a high level of consumption is reached).
Prior to the establishment of the uniform drinking age of 21 in the United States, many states permitted legal purchase of alcohol at younger ages. Lower drinking ages were associated with several adverse outcomes, including elevated rates of suicide and homicide among youth. The objective of this study is to examine whether individuals who were legally permitted to drink prior to age 21 remained at elevated risk in adulthood.
Analysis of data from the U.S. Multiple Cause of Death files, 1990 to 2004, combined with data on the living population from the U.S. Census and American Community Survey. The assembled data contained records on over 200,000 suicides and 130,000 homicides for individuals born between 1949 and 1972, the years during which the drinking age was in flux. Logistic regression models were used to evaluate whether adults who were legally permitted to drink prior to age 21 were at elevated risk for death by these causes. A quasi-experimental analytical approach was employed, which incorporated state and birth-year fixed effects to account for unobserved covariates associated with policy exposure.
In the population as a whole, we found no association between minimum drinking age and homicide or suicide. However, significant policy-by-sex interactions were observed for both outcomes, such that women exposed to permissive drinking age laws were at higher risk for both suicide (OR = 1.12, 95% CI: 1.05, 1.18, p = 0.0003) and homicide (OR = 1.15, 95% CI: 1.04, 1.25, p = 0.0028). Effect sizes were stronger for the portion of the cohort born after 1960, whereas no significant effects were observed for women born prior to 1960.
Lower drinking ages may result in persistent elevated risk for suicide and homicide among women born after 1960. The national drinking age of 21 may be preventing about 600 suicides and 600 homicides annually.
Significant changes have occurred in the alcohol environment in New Zealand recently and there has been debate about how trends in alcohol consumption may currently look. This paper reports trends in drinking over three general population samples in New Zealand.
Three nationally representative comparable surveys were analysed for trends in: prevalence of drinking, typical occasion quantity, annual frequency and heavier drinking (5+ drinks). Analyses assessed the mean difference of the measures at each year point. Adjustments for multiple comparisons were made. Analysis was undertaken for age and separately for gender.
Increases in quantities consumed on a typical occasion occurred for the majority of age groups between 1995 and 2000. Women were as likely as men to increase the quantities they consumed. Observing differences between age groups found that young people tended to show the greatest increases in quantity (including heavier drinking) and frequency of consumption between 1995 and 2000. Drinking levels remained relatively stable between 2000 and 2004 with the exception of increases in abstention for some of the younger groups and increases in quantities consumed and heavier drinking among some of the older men.
Increases in quantities consumed per occasion have occurred almost across the board between 1995 and 2000 in New Zealand. Women were as likely as men to increase the quantities they consumed. Young people tended to show the greatest increases in quantity (including heavier drinking) and frequency of consumption between 1995 and 2000. Drinking remained relatively stable between 2000 and 2004.
Effects on motor vehicle crash involvement of raising the legal drinking age in Texas from 18 to 19 were examined, using an interrupted time-series design. Rates of single-vehicle-nighttime (SVN) and non-SVN crashes per 100,000 licensed drivers from 1978 through 1984 were examined for three levels of crash severity (serious injury, minor injury, property damage only) and four age groups (16-17, 18, 19-20, 21 and over). Results revealed significant reductions in SVN crashes for the 18-year-old target population across all levels of crash severity: serious injury, down 10.8% ; minor injury, down 14.3% ; and property damage only, down 12.8%. In comparison, no significant changes in SVN crashes among drivers age 21 and over were found. When the effects of macroeconomic conditions on crash rates were controlled statistically, no change in the estimated effect of the legal age law was seen. It is clear that the 1-year increase in legal age in Texas had a significant effect on youth crash involvement. Peer Reviewed http://deepblue.lib.umich.edu/bitstream/2027.42/26362/1/0000449.pdf
Lowering of the legal minimum drinking age to 18 years in two Australian States significantly increased male juvenile crime by 20–25%. In the case of a third State the limited data available yielded similar results. Particularly as the above increases were over and above those for between-State control groups of the same age, and older control groups within the same State, the findings appeared to be valid. For the females the results varied from State to State. From the view point of preventing alcohol-related juvenile crime, a 20 or 21 year legal minimum drinking age is preferable to an 18-year-old limit.
The aim of the research was to: determine the incidence of serious assault in and around licensed premises in New Zealand, and to compare the circumstances of assault with those that occurred in other locations. For the period 1978-87, inclusive, 49 assault fatalities occurred in or around licensed premises representing 9.4% of all homicides and 12.9% where a place was specified. The comparable figures for assaults resulting in hospitalization in 1988 were: 251, 10.2% and 18.4%, respectively. Further analyses suggests that our estimate of the incidence rate is likely to be an underestimate due to changes over time in the large number of assault cases which have no specific place of occurrence identified. In comparison with homes homicides in licensed premises were more likely to involve: males; Maori, unarmed fights and brawls; unknown assailants; alcohol; occur during the evening and toward the end of the week; and result in head injury. For non-fatal events similar differences were found. In comparison with homes non-fatal assaults were more likely to involve: males; young adults, Maori, the unemployed, unarmed fights and brawls, and head injury. There have been a number of significant policy changes in New Zealand since 1988 which may have resulted in a change to the situation reported here.
To quantify the effect of a recent national law change on the presentation of ethanol intoxicated patients to a central city Emergency Department (ED).
All records of ethanol intoxicated patients presenting to the ED for twelve months before and after the change to the minimum legal drinking age were studied. Each patient was classified as having laboratory confirmed intoxication, clinical suspicion only, or no record of intoxication. Three age groups were identified, 15-17 year olds, eighteen and nineteen year olds and over 20 year olds. Within each age group the proportion of presentations with ethanol intoxication was compared across the two time periods.
The number of intoxicated 18 and 19 year olds increased in the twelve months after the national law change from 66 to 107 (52 to 80 for laboratory confirmed intoxication and fourteen to 27 for clinical suspicion only). This represented an increase in the proportion of presentations in this age group with intoxication (p=0.009) from 2.9% to 4.4%, a 50% increase (RR=1.51, 95%CI 1.11-2.03). There was no evidence of an increase in the proportion intoxicated for those over nineteen years (3.4% vs 3.3%, p=0.48, RR=0.97, 95%CI=0.89-1.06) although the numbers increased slightly (963 to 992). However there was a worrying trend for an increase in the 15-17 year olds, with numbers increasing from 72 to 95 and the proportion increasing from 5.0% to 6.7% (p=0.07, RR=1.35, 95%CI=0.98-1.88).
The recent lowering of the minimum legal drinking age from 20 to eighteen years has resulted in increased presentations to the ED of intoxicated eighteen and nineteen year olds. A similar trend was seen in the 15-17 year olds.
The objective of this research was to determine the extent to which the decline in alcohol-related highway deaths among drivers younger than age 21 years can be attributed to raising the minimum legal drinking age (MLDA) and establishing zero tolerance (0.02% blood alcohol concentration (BAC) limit for drivers younger than age 21 years) laws. Data on all drivers younger than age 21 years involved in fatalities in the United States from 1982 to 1997 were used in the study. Quarterly ratios of BAC-positive to BAC-negative drivers in each of the 50 states where analyzed in a pooled cross-sectional time-series analysis. After accounting for differences among the 50 states in various background factors, changes in economic and demographic factors within states over time, and the effects of other related laws, results indicated substantial reductions in alcohol-positive involvement in fatal crashes were associated with the two youth-specific laws. The policy of limiting youth access to alcohol through MLDA laws and reinforcing this action by making it illegal for underage drivers to have any alcohol in their system appears to have been effective in reducing the proportion of fatal crashes involving drinking drivers.
Alcohol-impaired driving is one of the major contributing factors to fatal and serious crashes in New Zealand. To curb the high level of road trauma resulting from drink-driving, a compulsory breath test (CBT) programme was introduced in 1993 and a supplementary road safety package (SRSP) in 1995/1996. The SRSP aimed to enhance road safety enforcement and advertising activities, and focused primarily on drink-driving and speeding. These interventions have resulted in a substantial reduction in alcohol-related road trauma. Subsequently, in 1999, the drinking age was lowered from 20 to 18 years. This paper examines the impacts of these drink-driving interventions. The analysis shows that the CBT programme and the SRSP have contributed to the reduction in alcohol-related crashes in recent years. There is also some evidence that, following the lowering of the drinking age, there has been an increase in drink-driving and subsequent alcohol-related crash involvement for drivers under 18 years.
A common method of normalizing crash fatality data for comparing subgroups of drivers has been the estimated vehicle miles traveled (VMT). Unfortunately, the VMT method fails to provide for exposure to risks such as those related to alcohol consumption (among others). Recently, the "crash incidence ratio" (CIR) has been introduced to address some of these limitations. The goals of this study are first, to show that the CIR method is intrinsically similar to an increasingly popular quasi-induced method: the relative accident involvement ratio (RAIR); second, to compare the VMT-based, the CIR, and the RAIR methods when applied to the evaluation of alcohol-related crash fatalities across racial/ethnic groups.
We use the 1990-1996 Fatal Accident Reporting System (FARS) with information on the drivers' race/ethnicity and alcohol involvement (BAC). Descriptive and statistical ratio tests were applied.
The RAIR and CIR are indeed closely related measures that, when used for comparisons against a reference group, yield exactly the same numerical estimates. Strikingly different outcomes were obtained depending on using the VMT or the CIR/RAIR.
Choosing one measure over another should depend on the questions to be answered. The implication of this finding for researchers and policy makers is discussed.
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