Magnitude of alcohol-related mortality and morbidity among U.S. college students ages 18-24.

OBJECTIVE This report estimates the numbers of 18-24 year old United States college students who annually experience alcohol-related deaths, injuries and other health problems. METHOD We examined traffic and unintentional injury deaths in 1998 reported by the National Highway Traffic Safety Administration and the Centers for Disease Control (CDC). We also examined results of national coroner studies, Department of Education college enrollment data, the National Household Survey on Drug Abuse (NHSDA), the CDC National College Health Risk Behavior Survey and the Harvard School of Public Health College Alcohol Survey (CAS). All survey participants were ages 18-24: 6,930 college and 12,394 noncollege respondents in the NHSDA survey; 3,077 college students in the CDC survey; and 12,217 full-time 4-year college students in the CAS. Based on the number and proportion of 18-24 year olds enrolled in college, data on alcohol involvement in injury deaths among 18-24 year olds and survey responses, we calculated the numbers of 18-24 year old alcohol-related injury deaths and other health problems. RESULTS We estimate that over 1,400 students aged 18-24 and enrolled in 2- and 4-year colleges died in 1998 from alcohol-related unintentional injuries, including motor vehicle crashes. According to surveys conducted in 1999, in the preceding year, over 2 million of the 8 million college students in the United States drove under the influence of alcohol and over 3 million rode with a drinking driver. Over 500,000 full-time 4-year college students were unintentionally injured under the influence of alcohol and over 600,000 were hit or assaulted by another student who had been drinking. CONCLUSIONS There is an urgent need for expanding prevention and treatment programs, to reduce alcohol-related harm among U.S. college students and other young adults.

[1]  G A Marlatt,et al.  Screening and brief intervention for high-risk college student drinkers: results from a 2-year follow-up assessment. , 1998, Journal of consulting and clinical psychology.

[2]  Patrick M. O'Malley,et al.  Monitoring the Future National Results on Adolescent Drug Use: Overview of Key Findings, 2004. , 2003 .

[3]  C. Cronin,et al.  Harm reduction for alcohol-use-related problems among college students. , 1996, Substance use & misuse.

[4]  M. Goldman,et al.  Expectancy challenge and drinking reduction: process and structure in the alcohol expectancy network. , 1998, Experimental and clinical psychopharmacology.

[5]  Susan A Ferguson,et al.  Awareness of zero tolerance laws in three states. , 2002, Journal of safety research.

[6]  D. Rohsenow,et al.  Stress management training as a prevention program for heavy social drinkers: cognitions, affect, drinking, and individual differences. , 1985, Addictive behaviors.

[7]  M. Grossman,et al.  ALCOHOL REGULATION AND DOMESTIC VIOLENCE TOWARDS CHILDREN , 1998 .

[8]  K. Barry,et al.  Brief physician advice for problem alcohol drinkers. A randomized controlled trial in community-based primary care practices. , 1997, JAMA.

[9]  M. Goldman,et al.  Expectancy challenge and drinking reduction: experimental evidence for a mediational process. , 1993, Journal of consulting and clinical psychology.

[10]  F. Chaloupka,et al.  Alcohol-Control Policies and Motor-Vehicle Fatalities , 1991, The Journal of Legal Studies.

[11]  H. Wechsler,et al.  The marketing of alcohol to college students: the role of low prices and special promotions. , 2003, American journal of preventive medicine.

[12]  D. Murray,et al.  Communities mobilizing for change on alcohol (CMCA): effects of a randomized trial on arrests and traffic crashes. , 2000, Addiction.

[13]  Joseph H. Miller,et al.  Reducing Alcohol Use in College Students: A Controlled Trial of Two Brief Interventions , 2000, Journal of drug education.

[14]  P. Gruenewald,et al.  The relationship of outlet densities to alcohol consumption: a time series cross-sectional analysis. , 1993, Alcoholism, clinical and experimental research.

[15]  F. Chaloupka,et al.  Youth Alcohol Use and Public Policy , 1993 .

[16]  W. Manning,et al.  The demand for alcohol: the differential response to price. , 1995, Journal of health economics.

[17]  K. Carey,et al.  Effects of a brief motivational intervention with college student drinkers. , 2000, Journal of consulting and clinical psychology.

[18]  T. Heeren,et al.  Reducing alcohol-impaired driving in Massachusetts: the Saving Lives Program. , 1996, American journal of public health.

[19]  H. Wechsler,et al.  Early age of first drunkenness as a factor in college students' unplanned and unprotected sex attributable to drinking. , 2003, Pediatrics.

[20]  H. Wechsler,et al.  College Binge Drinking in the 1990s: A Continuing Problem Results of the Harvard School of Public Health 1999 College Alcohol Study , 2000, Journal of American college health : J of ACH.

[21]  M. Grossman,et al.  The effects of beer taxes on physical child abuse. , 2000, Journal of health economics.

[22]  R. Woolard,et al.  Brief intervention for harm reduction with alcohol-positive older adolescents in a hospital emergency department. , 1999, Journal of consulting and clinical psychology.

[23]  P. O'Malley,et al.  Lowered legal blood alcohol limits for young drivers: effects on drinking, driving, and driving-after-drinking behaviors in 30 states. , 2001, American journal of public health.

[24]  K. Barry,et al.  Brief Physician Advice for Problem Alcohol Drinkers A Randomized Controlled Trial in Community-Based Primary Care Practices , 1997 .

[25]  M. Copass,et al.  Alcohol interventions in a trauma center as a means of reducing the risk of injury recurrence. , 1999, Annals of surgery.

[26]  Robert B. Voas,et al.  Alcohol and Highway Safety 2006: A Review of the State of Knowledge , 2001 .

[27]  Jae Eun Lee,et al.  Drinking and driving among college students: the influence of alcohol-control policies. , 2003, American journal of preventive medicine.

[28]  Kim Fromme,et al.  Implementation of the Risk Skills Training Program: A brief intervention targeting adolescent participation in risk behaviors. , 2000 .

[29]  Traci L Toomey,et al.  The Minimum Legal Drinking Age: History, Effectiveness, and Ongoing Debate. , 1996 .

[30]  R. Hingson,et al.  Comprehensive community interventions to promote health: implications for college-age drinking problems. , 2002, Journal of studies on alcohol. Supplement.

[31]  I. Sirtalan.  An Empirical Analysis of Alcohol Addiction , 1996 .

[32]  H. White.  Alcohol and Interpersonal Violence: Fostering Multidisciplinary Perspectives , 1995 .

[33]  S A Ferguson,et al.  Drinking drivers missed at sobriety checkpoints. , 1997, Journal of studies on alcohol.

[34]  F. Chaloupka,et al.  The Effects of Price on Alcohol Consumption and Alcohol-Related Problems , 2002, Alcohol research & health : the journal of the National Institute on Alcohol Abuse and Alcoholism.

[35]  L. Johnston,et al.  Monitoring the Future national survey results on drug use, 1975-2019: Volume II, college students and adults ages 19-60 , 2000 .

[36]  A. Mokdad,et al.  Binge drinking among US adults. , 2003, JAMA.

[37]  M. French,et al.  Benefit-cost analysis of brief physician advice with problem drinkers in primary care settings. , 2000, Medical care.

[38]  H. Wechsler,et al.  Changes in binge drinking and related problems among American college students between 1993 and 1997. Results of the Harvard School of Public Health College Alcohol Study. , 1998, Journal of American college health : J of ACH.

[39]  L. Aubrey.  Motivational interviewing with adolescents presenting for outpatient substance abuse treatment. , 1998 .

[40]  W. Manning,et al.  Perspectives on Alcohol Taxation , 1996, Alcohol health and research world.

[41]  G A Marlatt,et al.  Lifestyle modification with heavy alcohol drinkers: effects of aerobic exercise and meditation. , 1986, Addictive behaviors.

[42]  H. Chesson,et al.  Sex Under the Influence: The Effect of Alcohol Policy on Sexually Transmitted Disease Rates in the United States* , 2000, The Journal of Law and Economics.

[43]  R W Hingson,et al.  Preventing Impaired Driving , 1999, Alcohol research & health : the journal of the National Institute on Alcohol Abuse and Alcoholism.

[44]  W. Miller,et al.  Effects of Normative Feedback on Consumption among Heavy Drinking College Students , 1995, Journal of drug education.

[45]  J L Collins,et al.  Youth Risk Behavior Surveillance--United States, 1997. State and Local YRBSS Coordinators. , 1998, The Journal of school health.

[46]  B Barnwell,et al.  SUDAAN User's Manual, Release 7.5, , 1997 .

[47]  M. Larimer,et al.  An experimental test of three methods of alcohol risk reduction with young adults. , 1992, Journal of consulting and clinical psychology.

[48]  R B Voas,et al.  Age differences of arrested and crash-involved drinking drivers. , 1986, Journal of studies on alcohol.

[49]  W. Evans,et al.  Teens and Traffic Safety , 2001 .

[50]  H. Wechsler,et al.  Health and behavioral consequences of binge drinking in college. A national survey of students at 140 campuses. , 1994, JAMA.

[51]  Randy W. Elder,et al.  Reviews of evidence regarding interventions to reduce alcohol-impaired driving. , 2001, American journal of preventive medicine.

[52]  R B Voas,et al.  The relationship of alcohol safety laws to drinking drivers in fatal crashes. , 2000, Accident; analysis and prevention.

[53]  P. Cook,et al.  The Effect of Liquor Taxes on Heavy Drinking , 1982 .

[54]  John D. Alcorn,et al.  Behavioral Strategies for Alcohol-Abuse Prevention with High-Risk College Males , 1990 .

[55]  G. Globetti.  Journal of Studies on Alcohol , 1979 .

[56]  T. Toomey,et al.  Effects of minimum drinking age laws: review and analyses of the literature from 1960 to 2000. , 2002, Journal of studies on alcohol. Supplement.

[57]  Toben F Nelson,et al.  Reducing drinking and related harms in college: evaluation of the "A Matter of Degree" program. , 2004, American journal of preventive medicine.

[58]  H. Wechsler,et al.  BINGE DRINKING IN COLLEGE: THE IMPACT OF PRICE, AVAILABILITY, AND ALCOHOL CONTROL POLICIES , 1996 .

[59]  A C Wagenaar,et al.  Communities mobilizing for change on alcohol: outcomes from a randomized community trial. , 2000, Journal of studies on alcohol.

[60]  D. Kenkel.  Drinking, Driving, and Deterrence: The Effectiveness and Social Costs of Alternative Policies , 1993, The Journal of Law and Economics.

[61]  Richard J BonnieMary Ellen O'Connell,et al.  Reducing underage drinking: a collective responsibility. , 2004 .

[62]  F. Chaloupka,et al.  An Empirical Analysis of Alcohol Addiction: Results from the Monitoring the Future Panels , 1995 .

[63]  P. Gruenewald,et al.  Effect of community-based interventions on high-risk drinking and alcohol-related injuries. , 2000, JAMA.

[64]  T. Heeren,et al.  Lower legal blood alcohol limits for young drivers. , 1994, Public health reports.

[65]  C W Preusser,et al.  OBSTACLES TO ENFORCEMENT OF YOUTHFUL (UNDER 21) IMPAIRED DRIVING. , 1992 .

[66]  C. Ruhm.  Alcohol Policies and Highway Vehicle Fatalities , 1995, Journal of health economics.

[67]  M. Grossman,et al.  Effects of Alcoholic Beverage Prices and Legal Drinking Ages on Youth Alcohol Use , 1988, The Journal of Law and Economics.

[68]  R. Bonnie,et al.  Social, Health, and Economic Consequences of Underage Drinking , 2004 .

[69]  M. Sutton,et al.  A grouped data regression approach to estimating economic and social influences on individual drinking behaviour. , 1995, Health economics.

[70]  H. Wechsler,et al.  Age of first intoxication, heavy drinking, driving after drinking and risk of unintentional injury among U.S. college students. , 2003, Journal of studies on alcohol.

[71]  Susan A. Ferguson,et al.  ENFORCEMENT OF ZERO TOLERANCE LAWS IN THE UNITED STATES , 2000 .

[72]  P. O'Malley,et al.  Effects of minimum drinking age laws on alcohol use, related behaviors and traffic crash involvement among American youth: 1976-1987. , 1991, Journal of studies on alcohol.

[73]  Youth Risk Behavior Surveillance: National College Health Risk Behavior Survey--United States, 1995. , 1997, MMWR. CDC surveillance summaries : Morbidity and mortality weekly report. CDC surveillance summaries.

[74]  P. Gruenewald,et al.  Access to Alcohol: Geography and Prevention for Local Communities. , 1996 .

[75]  M. Larimer,et al.  Identification, prevention and treatment: a review of individual-focused strategies to reduce problematic alcohol consumption by college students. , 2002, Journal of studies on alcohol. Supplement.