Young People and Alcohol: Impact, Policy, Prevention, Treatment

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Teenagers -- Alcohol use. Youth -- Alcohol use. Summary "Young People and Alcohol is a practical and comprehensive reference for professionals and researchers in the field of alcohol misuse who work with people aged 12 to 25 years. The book provides readers from a range of professional backgrounds with authoritative and up to date information about the effects of alcohol use in the young and, particularly, its management, with an emphasis on interventions whose effectiveness is supported by evidence. Written by an internationally renowned team of contributors, chapters span five key sections: Focus is on treatment, relating the science to everyday clinical practice; Evidence-based; List of further resources; Tables and flowcharts; Glossary of key terms and abbreviations.

Juhasz, and Robert A. Boden and David M.

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Saunders, Peter Anderson, and Joseph M. Rey Community-based approaches to prevention: Kaner and Bridgette M. Bewick Preventing and responding to alcohol misuse in specific contexts: Rey and Robert F. Kelly and Julie D. Keyes and Deborah S. Includes bibliographical references and index. View online Borrow Buy Freely available Show 0 more links Set up My libraries How do I set up "My libraries"?

These 21 locations in All: National Drugs Sector Information Services. Open to the public Alcohol and Drug Foundation Druginfo Library. Barwon Health Library Service. Not open to the public Held. May not be open to the public Open to the public ; Open to the public ; HV May not be open to the public Held. Health Sciences Library, Rockhampton Hospital. Not open to the public ; Not open to the public University of Queensland Library. University of Wollongong Library. Open to the public. These 2 locations in Australian Capital Territory: The messages to young people and adults in these two contexts are identical: The task of developing a strategy for preventing and reducing alcohol use among young people, in contrast, faces an uncertain policy goal.

A strong cultural, political, economic, and institutional base supports certain forms of drinking in the society. Unlike the goals for illegal drugs and tobacco, the nation does not aim to discourage or eliminate alcohol consumption by adults.

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For example, as long as others are not endangered or offended, attitudes toward intoxication per se vary according to religious beliefs and personal moral standards. In short, current alcohol policy rests on a collective judgment, rooted in the Prohibition experience, that the wisdom and propriety of alcohol use among adults should be left to the diverse moral judgments of the American people.

This is not to say that everyone supports this stance of government neutrality. Many public health experts would like to take steps short of prohibition to suppress alcohol consumption as a way of reducing alcohol problems, and some conservative religious groups would take a more aggressive public stance against intoxication itself. However, the current stance of tempered neutrality seems to be widely accepted and therefore fairly stable. In this policy context, the message to young people as well as adults about alcohol use is both subtle and confusing.

Unlike the policies for those other products, the ban on underage alcohol use explicitly represents a youth-only rule, and its violation is often viewed as a rite of passage to adulthood. Explaining convincingly—to young people as well as adults—why alcohol use is permissible for year-olds but not for anyone younger is a difficult but essential task for reducing or preventing underage drinking. There is also confusion about whether messages to young people should emphasize abstention, perhaps drawing together alcohol, tobacco, and illegal drugs, or whether messages should focus on the dangers of intoxication and heavy drinking.

Many people believe that abstention messages are more appropriate and more likely to be effective for younger teens than for older teens and college students. This overall debate raises the same question posed by all wait rules: What is the age of demarcation between childhood and adulthood see, generally, Zimring, ; Kett, The argument has been given a raw edge by the trend, in recent years, to curtail the jurisdiction of juvenile courts and to prescribe severe punishments, including the death penalty, for teenagers who commit crimes Fagan and Zimring, A strategy to suppress underage alcohol use must somehow be implemented in the very midst of a society replete with practices and messages promoting its use, and with a strong sector of deeply vested economic interests and the accompanying political and economic power.

A significant level of underage use is inevitable under these circumstances—as an inevitable spillover effect, even if unintended by the industry—no matter what strategy is implemented. Although a similar challenge confronts tobacco control policy makers in the effort to prevent youthful use of tobacco products, the potency and impact of tobacco industry activity are gradually being lessened by the growing consensus that tobacco is a deadly and disapproved product, that.

In contrast, the alcohol industry is diverse and uniformly acknowledges the dangers of underage drinking. Alcohol experts generally assume that the level of adult demand for alcohol products will not be substantially affected, over the long term, by reducing underage consumption—although getting young people to wait will obviously reduce the overall level of consumption. Thus, while the commercial interests of the alcohol industry are not perfectly aligned with the public health, they are not as antagonistic to the public health as the interests of the tobacco industry.

In any case, a strategy for preventing and reducing underage drinking will have a much better chance for success if it attracts the active cooperation, and at least the acquiescence, of various segments of the alcohol industry. The effectiveness of any policy focused explicitly on reducing underage drinking will be limited by the existence of a large legitimate practice of drinking and by the power of a large industry responding to legitimate consumer demand.

When alcohol is available in many home liquor cabinets, the success of strategies to discourage young people from buying at package stores will be much different than in a world where relatively few parents have stocks of alcohol. One can establish a clear-cut boundary between acceptable drinking and unacceptable drinking at conceptual, policy, and legal levels, but it must be understood not only that different communities will construct that boundary differently as a matter of policy but also that the scope created for legal drinking has a profound, practical effect on the effectiveness of other policy instruments in discouraging unwanted, underage drinking.

In sum, the committee set about its task of developing a strategy for preventing and reducing underage drinking while being fully aware of the complexity of defining the public interest in this area and mindful of the severe constraints within which the strategy must be framed and implemented.

In conducting its work, the committee did not begin with a blank slate. That policy aims to delay drinking by young people as long as possible and forbids lawful access to alcohol for people under Some people argue that the delay strategy is misguided and that the legal drinking age should be lower than 21 typically Whatever the merits of this view, the committee believes that Congress intended us to work within the framework of current law, anchored in the National Minimum Drinking Age Act of , and that reconsideration of the year-old drinking age, and of the premises on which it is predicated, is beyond our mandate.

Moreover, as a practical matter, the current policy framework, though disputed by some, rests on a strong scientific foundation, is widely accepted, and is certain to be preserved for the foreseeable future.

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Young People and Alcohol: Impact, Policy, Prevention, Treatment. John Saunders (Editor), Joseph Rey (Editor). ISBN: Jun , Wiley-. Young People and Alcohol: Impact, Policy, Prevention, Treatment up to date information about the effects of alcohol use in the young and.

Until the last decades of the 19th century, society relied largely on nonlegal mechanisms of social control to constrain youthful drinking. However, in the wake of urbanization, immigration, and industrialization, alcohol came under tighter control, including bans against selling it to people under the legal age Mosher et al. After the repeal of Prohibition in , it became settled that decisions about alcohol control rested with the states, and the structure of modern alcohol regulation took shape.

Until , the minimum drinking age in most states was Between and , 21 states reduced the minimum drinking age to 18, and another 8 states reduced it to 19 or 20 usually as part of a more general statutory reform reducing the age of majority to 18 Wagenaar, Proposals to restore a higher age were soon introduced, however, largely because alcohol-related automobile crashes had significantly increased among teenagers and young adults. Of the 29 states that lowered their drinking age, 24 raised the age again between and By that time, only three states allowed year-olds to drink all types of alcoholic bever-.

Thirteen states set a uniform age of 19, and four others allowed year-olds to drink beer and set the limit at 21 for other alcoholic beverages. Four states set the age at 20 for all alcohol, and the remaining 22 states set a uniform age of 21 Bonnie, In Congress enacted the National Minimum Drinking Age Act, as recommended by the Presidential Commission on Drunk Driving, using the threat of withholding 10 percent of federal highway funds to induce states to set the minimum drinking age at 21 for all alcoholic beverages.

All states eventually complied and have a variety of mechanisms in place to enforce this restriction. The explicit aim of existing policy is to delay underage alcohol use as long as possible and, even if use begins, to reduce its frequency and quantity as much as possible. Most people recognize that drinking itself is not the issue. Rather, the underlying challenge is protecting young people while they are growing up. Children and adolescents need to be protected in the first instance from the immediate harms that can occur when they are drinking.

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But they also need to be protected from the possibility that they will mortgage their own future prospects by initiating practices that could cause them permanent harm during a critical developmental period and that could lead to patterns of drinking that will worsen as they grow older. The question is how best to go about that protective task.

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Alcohol policy and the prevention of harm. However, in the wake of urbanization, immigration, and industrialization, alcohol came under tighter control, including bans against selling it to people under the legal age Mosher et al. Page 14 Share Cite. Not open to the public Held. Written by an internationally renowned team of contributors, chapters span five key sections:

As indicated, some people argue that the most sensible approach is to permit drinking by young people at least older teens rather than trying to suppress it. They would allow youthful drinking and focus on supervision rather than drinking per se at least for older adolescents. Admittedly, the current approach may create incentives for heavy unsupervised drinking on the occasions where alcohol is available.

In addition, a substantial body of scientific evidence shows that raising the minimum drinking age reduced alcohol-related crashes and fatalities among young people Cook and Tauchen, ; U. General Accounting Office, ; Wagenaar and Toomey, as well as deaths from suicide, homicide, and nonvehicle unintentional injuries Jones et al.

Voas, Tippetts, and Fell , using data from all 50 states and the District of Columbia for through , concluded that the enactment of the uniform year-old minimum drinking age law was responsible for a 19 percent net decrease in fatal crashes involving young drivers who had been drinking, after controlling for driving exposure, beer consumption, enactment of zero tolerance laws, and other relevant changes in the laws during that time. These findings reinforce the decision by Congress to act in In short, current national policy rests on the view, supported by substantial evidence, that delaying drinking reduces problem drinking and its consequences.

Our earlier comparison among alcohol, tobacco, and illegal drugs raises another important preliminary question—about the role of the law in the prevention of underage drinking. It is possible to imagine an official policy aiming to delay and discourage underage drinking that does not rely in any way on the coercive authority of the state to implement this policy: Various forms of social disapproval, including social and economic sanctions e.

In contrast, the United States has decided that there must be laws against supplying alcohol to young people and that it should also be illegal for young people to possess or use alcohol, at least in public. At the outset, it should be emphasized that a secular society seeks to delay underage drinking because it is dangerous to youths and others, not because it is inherently evil or wrong.

The ban on underage drinking is an age-specific prohibition, implying that the aim is to delay alcohol use, not to condemn it or inoculate against it. For this reason, the prohibition is distinctly instrumental in nature and is not grounded in the moral disapproval that characterizes many legal prohibitions. To use a traditional legal classification, underage drinking is an example of a prohibition that is malum prohibitum wrong because it is prohibited rather than malum in se wrong in itself.

Punishment for an underage drinker, or even for an adult facilitator, is not an expression of public moral condemnation as is, for example, punishment for child sexual abuse or robbery. Enforcement of prohibitions against immoral behavior serves the twin goals of reducing the harmful behavior and condemning and punishing the perpetrator for the transgression.

The prohibition of underage drinking does not aim to serve this second retributive objective in any strong sense. Its aim is exclusively instrumental. Law is a blunt instrument. It is not self-executing, and it requires the affirmative support of a substantial proportion of the population and of those who are expected to enforce it. These characteristics of a law are particularly important for instrumental prohibitions, such as the ban against underage drinking, because the level of compliance will depend heavily on the willingness of a large number of individuals to adhere to the law simply because they accept its moral authority to command their obedience.

That is, a legal norm of this kind, which affects so many people in so many everyday social and economic contexts, cannot be successfully implemented based on deterrence the threat of punishment alone. Since the ultimate goal is to protect youths and others within the zone of danger from harmful consequences, one might wonder whether it is possible to implement an underage alcohol policy by focusing exclusively on the dangerous behavior rather than the drinking itself. In theory, it might be possible to define the prohibited conduct exclusively in relation to the magnitude of the risk: It is also relevant to note that at least one of the risks associated with underage drinking is intrinsic to the drinking itself—the permanent damage of alcohol consumption on the adolescent brain see Chapter 3.

Given an age-based categorical prohibition aiming to serve exclusively instrumental aims, other policy judgments are needed regarding the scope of the restrictions, the severity of the prescribed sanctions, and the resources and tools that should be used to enforce the law. Banning commercial distribution of alcohol to underage persons is an essential element of the prohibition, but what about noncommercial distribution? Even if noncommercial distribution is banned, what about parental distribution to their own children in their own home?

Many states do not prohibit this distribution. Is it also necessary to penalize young people who purchase or consume alcohol? Even in their own homes? What enforcement strategies should be used? And how severe should the sanctions be? These issues are addressed in Chapter 9. The answers require careful assessment of the possible benefits in reducing harms associated with underage drinking and the costs of any particular strategy. The degree of public support and the difficulty of enforcement bear on both the potential effectiveness and on the possible costs.

In requesting the National Academies to develop a strategy for reducing and preventing underage drinking, Congress clearly anticipated that we would do so from a public health perspective, reviewing the etiology and consequences of alcohol use by the underage population and assessing the effectiveness of interventions that might be deployed to reduce the prevalence of drinking in this population, particularly the patterns of consumption most clearly associated with alcohol problems.

The outcomes of interest in assessing the effectiveness of interventions are discussed in Chapter 5. Accordingly, we emphasize the population-oriented tools of primary prevention, rather than the individually oriented methods of secondary or tertiary prevention. Thus, identification and treatment of youths with drinking problems, or at high risk for developing such problems, and the challenge of instilling habits of responsible drinking as young people mature are addressed only incidentally in this report.

These issues are important for improved policy and practice, but they are peripheral to our basic charge—delaying underage drinking and reducing its prevalence. In developing a strategy to delay and reduce underage drinking, the committee has tried to understand the problem from two angles. First, we looked at the problem from the viewpoint of a young person deciding whether and under what circumstances to use alcohol. Our framework draws on the developing literature regarding adolescent decision making, especially in relation to health and risk behaviors.

We pay particular attention to youthful decision-making abilities at various ages in the context of the changing social realities of teenage alcohol use. Some components of a comprehensive strategy must aim to help young people make the right decisions, depending on their age and developmental stage, taking account of the dangers of alcohol use at varying points in development. It is not enough, however, to try to persuade young people to make the right choices.

If the strategy relied exclusively on tools directed at changing the attitudes and behavior of underage youths, it would not have much chance of succeeding. To complement a youth-centered decision-making perspective, the committee also drew on the multidisciplinary perspective used by public policy analysts. This framework combines the disciplines of epidemiology, economics, health communications, law, and other social sciences to envision the array of policy instruments that can be brought to bear on the problem and to assess their probable effectiveness and costs, used alone or in combination.

Our work is presented in two parts. Part I , Chapters 2 through 4 , provides important contextual information about underage drinking and its consequences and determinants. Chapter 2 discusses key definitions and presents pertinent demographic and epidemiological data regarding the scope of underage drinking and the. It includes data on the prevalence of alcohol use and drinking behavior by gender, race, and ethnicity as well as comparisons of youth and adult drinking patterns.

Chapter 3 provides an account of the social consequences and costs of underage drinking. The chapter also discusses the social environment in which young people are immersed and the ways that community and social factors affect underage drinking. In each of these chapters, the committee summarizes what is known about the effectiveness of existing programs or interventions in the pertinent domain and presents its conclusions and recommendations.

The committee has tried to be realistic in assessing the potential effectiveness of efforts to prevent and reduce underage drinking. The committee assumes that most adults in the United States will continue to use alcohol and that most drinkers will begin their alcohol use sometime before they are 21, despite laws and policies to the contrary.

Within that constraint, however, there is substantial room for preventing and reducing underage drinking in the United States, and this part of the report explores various tools that can be used in this effort. Adults often facilitate or enable underage drinking directly by supplying alcohol to young people, by failing to take effective precautions to prevent it, or by sending the message that alcohol use is to be expected.

Few programs currently seek to influence parents to alter their behaviors and attitudes toward youth drinking as a way of reducing youth access to alcohol, changing permissive social norms about underage drinking, and galvanizing community action. This chapter is the foundation for the rest of the report. In Chapter 6 we discuss development of a national media effort as a major component of a campaign aimed at educating parents and other adults about underage drinking and ways adults can help.

In Chapter 7 we discuss how the alcoholic beverage industry can become a partner in the overall effort by helping to establish and fund an independent nonprofit organization charged with reducing underage drinking and by exercising greater self-restraint in advertising and promotional activity.

Our messages to the alcohol industry and other industries that benefit from a large alcohol market are clear: Your efforts to satisfy and expand the legitimate adult market for alcohol inevitably spill over to a large underage market. Even if you do not intend to stimulate or satisfy underage demand, you derive financial benefits from it.

As a society, we cannot have a substantial impact on underage drinking without your active engagement in this effort. Chapter 8 issues a similar challenge to the entertainment media, urging more attentive self-regulation to reduce exposure of children and adolescents to lyrics and images that portray drinking in an attractive way.

The committee believes that market incentives can be used to reward companies, including entertainment media, who take meaningful steps to help reduce underage drinking, and to punish companies that do not. Chapter 9 explores ways to reduce youth access to alcohol through both commercial and noncommercial channels. Chapter 10 explains why the committee does not recommend a youth-oriented national media campaign at this time, preferring instead a cautious program of research and development.

It also addresses educational efforts in schools, colleges, and other settings designed to persuade young people to choose not to drink and to reduce alcohol problems. The chapter also briefly discusses programs for assisting youths with alcohol problems.

Chapter 11 reviews the potential advantages of mobilizing communities to implement locally specific efforts to reduce underage drinking. Chapter 12 identifies several ways in which the federal and state governments can help implement the proposed strategy, including through increases in excise taxes. Thus, the committee focuses its attention on community action, business responsibility, public-private partnerships, and all the other institutional expressions of a genuine social movement.

In this context, government has a supportive, but nonetheless indispensable, role—to provide funding possibly through increased excise taxes on alcohol and technical support to strengthen and enforce access restrictions, to keep regulatory pressure on the alcohol industry to act responsibly, and to monitor the effectiveness of the overall strategy. Alcohol use by young people is extremely dangerous - both to themselves and society at large. Underage alcohol use is associated with traffic fatalities, violence, unsafe sex, suicide, educational failure, and other problem behaviors that diminish the prospects of future success, as well as health risks — and the earlier teens start drinking, the greater the danger.

Despite these serious concerns, the media continues to make drinking look attractive to youth, and it remains possible and even easy for teenagers to get access to alcohol. Why is this dangerous behavior so pervasive?

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What can be done to prevent it? What will work and who is responsible for making sure it happens? Reducing Underage Drinking addresses these questions and proposes a new way to combat underage alcohol use. It explores the ways in which may different individuals and groups contribute to the problem and how they can be enlisted to prevent it.

Young People and Alcohol: Impact, Policy, Prevention, Treatment

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