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U.S. Department of Justice Office of Justice Programs Office of Juvenile Justice and Delinquency Prevention UPDATED FOR 2002 NATIONAL SURVEY ON DRUG USE AND HEALTH Drinking in America: Myths, Realities, and Prevention Policy Myths About American Drinking Adults: Who drinks and “Alcohol is an integral part of American life. It is a normal how much? accompaniment to most social events. Most Americans A large majority of Americans either do not drink or drink enjoy drinking on a regular basis.” These are widely held perceptions about alcohol—created in part by alcohol infrequently. For this majority alcohol is an unimportant advertising and popular culture. But these perceptions consumer product. According to the National Survey are not entirely true. These perceptions—and on Drug Use and Health (an interview survey carried out in misperceptions—affect our attitudes toward alcohol and homes), about 46 percent of adults 21 years of age and our policies regarding the sale to and consumption of older report that they did not consume any alcohol in the alcohol by youth as well as adults. past month and an additional 26 percent report drinking once a week or less.3 (See Figure 1.) This paper provides a more realistic picture of who drinks, how much, and how often. It compares the drinking pat- In addition to information about how frequently people terns of adults to those of people under age 21. It then ana- drink, it is also important to examine the quantity people lyzes the implications of these drinking patterns for typically drink on each occasion. Figure 2 provides infor- alcohol policy. mation about whether adults 21 and over had five or more drinks per occasion (termed here a “binge”). Among adults, 46 percent did not drink at all, and 31 percent drank but Alcohol: Counting the cost did not have five or more drinks on any occasion. That is, While there are many positive impressions associated with 77 percent of adults do not drink at a hazardous level. alcohol, Americans are becoming conscious of the prob- lems created by alcohol. For example, we no longer accept impaired-driving crashes as unavoidable “accidents.” But alcohol-related problems go well beyond impaired driving. FIGURE 1 Frequency of Drinking Among U.S. In fact, more than 75,000 deaths are attributable to alcohol Adults 21 and Older consumption each year and the economic costs associated (past 30 days) with alcohol problems total more than $184 billion annu- 60 1 ally. As large as they are, these figures do not begin to cap- 50 ture all of alcohol’s social and health toll; more than 46 40 one-third of Americans report that alcohol has caused prob- lems in their immediate family.2 30 26 Percent 20 When society views drinking as a normal and accepted part 10 13 9 6 of life, these problems may seem inevitable. Some of this 0 view is based on misperception of drinking patterns. A 0 1 to 4 5 to 10 11 to 21 21+ Number of Drinking Days more accurate picture has implications for strategies to Source: NSDUH, 2002. reduce alcohol-related problems. FIGURE 2 Drinking Patterns Among U.S. Ⅵ Frequent bingers are only 7 percent of the popula- Adults 21 and Older tion, but drink 45 percent of the alcohol. (past 30 days) These statistics show the importance of heavy drinkers for the alcohol market. Alcohol sales depend on the heaviest 7% drinking consumers. The claim that the “overwhelming majority of Americans” use alcohol responsibly is true only 16% Nondrinkers because most Americans either abstain or consume alcohol very infrequently. 46% Nonbingers Infrequent Bingers The following picture of adult drinking emerges from Frequent Bingers 31% these data: Ⅵ Most American adults either abstain or drink very little. Source: NSDUH, 2002. Ⅵ A relatively small percentage of drinkers drink most of the alcohol. Ⅵ This small percentage often consumes several Even among drinkers, only a minority consume this much drinks at a time, increasing the risk of serious alcohol on any occasion. About 43 percent of adult drinkers health and safety problems. had five or more drinks on any occasion in the last 30 days. The average number of drinks consumed by drinkers who Underage: Who drinks and do not binge was fewer than three per week. By contrast, frequent bingers who have had five or more drinks at a time how much? five or more times in the past month consume on average The picture for underage drinking is somewhat different. more than 24 drinks per week. Even though frequent Most young people reported to the National Household bingers are only seven percent of the population, they drink Survey that they had not had anything to drink in the last month. About 94 percent of 12- to 14-year-olds reported 45 percent of the alcohol consumed by adults in the United that they had not drunk alcohol while 72 percent of 15- to States. Figure 3 shows the proportion of alcohol consumed 17-year-olds and 49 percent of 18- to 20-year-olds reported by different types of adult drinkers. that they had not drunk in the preceding month. Figure 4 shows the proportions of young people reporting drinking Ⅵ Binge drinkers are 23 percent of the population, but at different frequencies. drink 76 percent of the alcohol. In terms of the quantity of drinking (Figure 5), the propor- tion of young drinkers who report drinking heavily (five or FIGURE 3 Alcohol Consumed by Drinking Pattern Among Adult Drinkers more drinks at a sitting) is higher than for adults. (past 30 days) 60 FIGURE 4 Drinking Among Youth (past 30 days) 50 12- to 14- 15- to 17- 18- to 20- 45 Year-Olds Year-Olds Year-Olds 40 10% 30 31 31 94% 24% 18% Percent 20 24 49% 72% 27% 16 10 5% 7 0 1% Frequent Bingers Infrequent Bingers Non-bingers Drinking Occasions: Population Alcohol 0 1 to 4 5 or more Source: NSDUH, 2002. Source: NSDUH, 2002. FIGURE 5 Binge Drinking Among Youth Ⅵ Young people who do consume alcohol are more and Adult Drinkers likely than adults to drink heavily. (past 30 days) Ⅵ The small proportion of youth who drink heavily 100 consume the vast majority of the alcohol consumed 28 by underage drinkers. 80 35 50 57 60 Social norms and social policy: Percent 40 72 65 50 Correcting perceptions 43 20 How do social beliefs about drinking affect our efforts to prevent problems associated with drinking? Social norms 0 12- to 14- 15- to 17- 18- to 20- Adults and expectations play a powerful role in shaping the alco- year-olds year-olds year-olds hol environment at both the community and societal level. Binge Drinking Occasions: The belief that most adults drink in moderate amounts 0 at least one without problems translates into public policies that make Source: NSDUH, 2002. alcohol readily available at low prices and permit wide- spread marketing that communicates only positive mes- sages about alcohol’s effects. These policies in turn create While about 43 percent of adult drinkers report heavy drink- an environment that encourages alcohol use and downplays ing on one or more occasions in the past month, 50 percent its potential for harm to public health and safety. of 12- to 14-year-old drinkers, 65 percent of 15- to 17-year- old drinkers and 72 percent of 18- to 20-year-old drinkers Although we may think that our alcohol policies are simply report heavy drinking in the past month. helping to meet the demand from moderate-drinking adults, Young people who drink heavily consume the vast majority they are actually accommodating heavy and hazardous of the alcohol consumed by their age group (Figure 6). Per- drinking by a small minority of consumers, many of whom centages range from 91 percent for 12- to 14-year-olds to are underage. Such policies undercut our efforts to reduce 96 percent for 18- to 20-year-olds. Underage drinkers con- alcohol-related problems and underage drinking. sume about 11 percent of all the alcohol purchased in the United States in 2002, and the vast majority of this alcohol Consider the impact of the following environmental influ- is consumed in a risky fashion. ences on potential consumers—especially young people. Ⅵ Alcohol is cheap and becoming cheaper. The real The following picture of underage drinking emerges: price of alcohol has been steadily dropping for the Ⅵ The majority of young people abstain from regular last five decades, in part due to the decline in the use of alcohol—a greater percentage than adults. real value of alcohol excise taxes (which have been eroded by inflation). Cheap beers are now roughly 5 FIGURE 6 Percentage of Drinks Consumed by the same price as popular brands of soft drinks. Drinking Pattern Among Underage Drinkers Price promotions, such as happy hours and drink- ing games, often target young drinkers and promote 12- to 14- 15- to 17- 18- to 20- binge drinking.6 Year-Olds Year-Olds Year-Olds 6% 4% Ⅵ Americans are bombarded with $4 billion of alco- 9% hol marketing each year. Alcohol advertising and product placements are very common and often 29% 47% 38% occur on television and in radio shows for which 44% 56% 67% the majority of the audience is underage, on Inter- net sites attractive to young people, and on bill- boards and in retail outlets where young people are Non-bingers Infrequent bingers Frequent bingers frequently present.7 Advertising often uses youth- Source: NSDUH, 2002. oriented themes.8 Ⅵ Alcohol is one of the most readily available con- Increasing alcohol prices sumer products.

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