Studies conducted by the Addiction Treatment Magazine in the United States reveals the latest data on the federal states with the highest rates of teen alcohol use in the country. The study looked at the number of young people between the ages of 12 and 20 who consumed alcohol within the last month. It also considered those who engaged in binge alcohol use. The publication defined heavy episodic (binge) alcohol use as the consumption of four or more alcoholic drinks in one sitting. The data are from the 2021 National Survey on Drug Use and Health. This survey was conducted by the Substance Abuse and Mental Health Services Administration in the US (SAMHSA).
The study reveals that the state of Vermont has the highest prevalence of under-age alcohol users between the ages of 12 and 20 in the U.S.
Nearly 25% of minors in the state consumed alcohol within the month preceding the survey. And 14% engaged in binge-drinking at least once.
Other states with high under-age alcohol consumption rates are:
- Rhode Island,
- underage alcohol use prevalence: 22%
- binge alcohol use prevalence: 12%,
- New Hampshire,
- underage alcohol use prevalence: 20.6%,
- Massachusetts,
- underage alcohol use prevalence: 20.4%).
- Oregon, Iowa, Wisconsin, Colorado, Maine, and North Dakota.
The state with lowest recorded figures on the other hand is Mississippi, with an underage alcohol consumption rate of 9.7%. Only 5.4% of teens in Mississippi have engaged in binge alcohol use as well.
Other federal states with lower prevalence of under-age alcohol use are:
- Utah,
- underage alcohol use prevalence: 11%
- binge alcohol use prevalence: 6.8%,
- North Carolina,
- underage alcohol use prevalence: 11.3%,
- Alabama,
- underage alcohol consumption: 12%,
- Arkansas
- underage alcohol consumption: 12.3%,
- Indiana, Georgia, Idaho, Tennessee, and Texas – together are the ten states with lowest under-age alcohol use prevalence.
Under-age alcohol use a major concern in United States
The results of this study provide insights into where under-age alcohol use is the most pervasive throughout the U.S. While some progress has been made in reducing under-age alcohol consumption rates, it is still clearly a matter of concern.
The legal age limit for alcohol purchase and consumption is 21 years in the U.S. and numerous studies show that this is a highly protective measure. For example a 1996 study demonstrated the effectiveness of a higher minimum legal age limit in preventing alcohol-related injuries and deaths among youth. Simply put: when the legal minimum age limit was lowered, rates of injuries and deaths increased; when the legal minimum age limit was raised, injuries and deaths significantly decreased.
The benefit of using environmental approaches, such as higher legal age limits, is further supported by the fact that alcohol use rates were reduced even after youth turned age 21.
The problem in the U.S. is that the age limit law is poorly implemented and enforced.
For example, one study in 2007 showed that under-age youth could easily purchase alcohol through off-premise outlets 30% of the time. These include grocery and convenience stores.
A 2021 evaluation found that the local ordinance in Baltimore City which prevents underage youth from making any purchase in liquor stores were largely not implemented. The noncompliance rate was 68.1%. Without proper enforcement, ordinances are neither likely to be honored nor to achieve the intended public health benefits.
Additionally, most under-age youth obtain alcohol from older adults in their household. This is specifically harmful since it perpetuates pervasive alcohol norms which lead to heavier alcohol use later in life.
Alcohol marketing drives under-age alcohol use
Marketing by the alcohol industry is a major driver of under-age alcohol use. A growing body of scientific findings illustrates that alcohol marketing is causes youth alcohol consumption, earlier initiation to alcohol use and high-risk alcohol use.
With social media and the internet becoming increasingly popular, digital alcohol marketing has been linked to increased alcohol use among minors, too. But it is harder to protect children and youth from alcohol marketing on social media and in the digital world in general.
Most existing alcohol marketing standards are too outdated to prevent under-age alcohol marketing exposure on digital media.
Under-age alcohol use is major source of revenue for Big Alcohol
And alcohol companies have a significant profit interest in making minors take up alcohol consumption as early as possible.
In 2016, the alcohol industry earned $17.5 billion or 8.6% of their sales revenue from alcohol sold to under-age adolescents in the U.S.
Three major alcohol companies – AB Inbev, Molson Coors, and Diageo – made almost half (45%) of these profits.
- AB InBev alone was responsible for 21% – amounting to $2.2 billion of these sales;
- Molson Coors – which was called MillerCoors until 2019 – was responsible for 12.3% of the under-age market share amounting to $1.1 billion in sales revenue; and
- Diageo accounted for 11.1% of the alcohol market share for minors, taking in an estimated $2 billion in sales revenue.
A fundamental conflict of interest
The data exposing how much the alcohol industry relies on under-age alcohol consumption for substantial profits illustrate the fundamental conflict of interest in the alcohol industry.
Increased alcohol consumption leads to increased negative health and development impacts – especially among children, adolescents, and youth. It also leads to increased sales for the alcohol industry. Therefore public health and development interests are placed in an inherent and direct conflict with corporate interests of profit maximization.
Speaking to UNC Gillings School News in 2021, Dr. Pamela Trangenstein, lead study author and assistant professor of health behavior at the UNC Gillings School of Global Public Health shed light on this fundamental conflict of interest.
The alcohol industry has said they don’t want minors to [consume alcohol], but when we counted up the [alcoholic beverages], it was clear that they were making billions of dollars from these sales. There is a clear disconnect when an industry advocates prevention, but then makes billions from prevention’s failure.”
Dr. Pamela Trangenstein, lead study author, assistant professor of health behavior, UNC Gillings School of Global Public Health
Under-age alcohol use heightens risk of lifelong alcohol use problems
According to Dr. Chris Tuell, this evidence of alcohol use before the age of 14 is particularly problematic, as per Fox News reporting. This is because it raises the risk of lifelong alcohol use problems or even alcohol addiction.
“Early alcohol use – at age 14 or earlier – [means a] 7 times greater risk for developing an alcohol problem than someone who begins alcohol consumption at age 21.”
Dr. Chris Tuell, Clinical Director, Addiction Services, Lindner Center of HOPE, Ohio
Dr. Tuell also noted that there are clear reasons for the higher rates of under-age alcohol consumption in certain states. He points to alcohol marketing geared at the youth as one plausible reason. The use of flavoured drinks and the link of alcohol marketing with characteristics particularly appealing to the youth have been well documented by Movendi International.
