General and youth-specific state alcohol control policies and drinking among high school-aged youth

Background: Alcohol use is related to the three leading causes of death for high school-aged youth and is a significant contributor to academic and social problems. Policies targeting youth drinking can reduce youth drinking, but little is known about the relationship between general population-based alcohol policies and youth drinking.

Methods: An Alcohol Policy Scale (APS) score was constructed based on the presence or absence of 29 state-level alcohol policies (after weighting each policy based on its relative efficacy and degree of implementation in states) for each U.S. state-year from 2000-2011. Using similar methods, 2 additional scales were created: one restricted to the 14 policies targeting the general population (P-APS), and another restricted to the 15 youth-specific policies (Y-APS). Data on state-level youth drinking prevalence were obtained from the Youth Risk Behavior Survey from biennial years from 1999-2011. The relationship of state-level youth drinking prevalence and P-APS was examined using linear regression models.

Results: In separate bivariate analyses, the APS, Y-APS and P-APS scores were all significantly inversely associated with youth drinking prevalence (APS beta=-2.20, Rē=0.24, p<0.01; Y-APS beta=-3.67, Rē=0.19, p<0.01; P-APS beta=-3.09, Rē=0.18, p<0.01). After controlling for Y-APS scores, there was a significant independent inverse relationship between P-APS and youth drinking (beta=-1.94, p=0.0008) that was comparable to the magnitude of the association between Y-APS and youth drinking.

Summary: A strong state-level alcohol control environment is associated with less drinking among high school students. In addition, policies targeting the general population may have a strong impact on youth drinking.