Relationships between Adult Binge Drinking and Alcohol-Related Behaviors among Youth: Implications for Public Health

Background: Underage drinking is an important public health problem; most efforts to combat it have a youth-oriented focus. However, little is known about the relationship between state-level adult binge drinking prevalence and youth's individual alcohol use.

Methods: Individual-level alcohol-related behaviors among students in grades 9-12 were obtained from biennial state-based Youth Risk Behavior Surveys from1999–2009. State-level adult binge drinking prevalence was obtained from the Behavioral Risk Factor Surveillance System survey for the same states and years. Adjusted odds ratios were used to assess the effect of a 1% increase in adult binge drinking on alcohol-related behaviors among youth.

Results: After adjusting for individual-level youth demographics and state-level covariates including age, sex, racial/ethnic composition, per capita income, educational attainment, religious affiliation, consumer price index, level of urbanization and alcohol treatment characteristics, a 1% increase in state-level adult binge drinking prevalence was associated with a 2% (95% CI: 1.01, 1.02) increase of odds of youth binge drinking, and a 3% (95% CI: 1.02, 1.03) increase of odds of youth drinking and driving.

Conclusions: Adult binge drinking is a strong predictor of alcohol-related behaviors among youth. Further studies are needed to determine the extent to which population-based alcohol control policies contribute to these relationships, and the degree to which population-based alcohol policies should be prioritized in efforts to reduce youth drinking and its consequences.