Q&A: Teenagers — underage drinking

May 2013

1 Is alcohol a significant factor in teenagers' crashes?

Yes. Young drivers are less likely than adults to drive after drinking alcohol, but their crash risk is substantially higher when they do. Peck, R.C.; Gebers, M.A.; Voas, R.B.; and Romano, E. 2008. The relationship between blood alcohol concentration (BAC), age, and crash risk. Journal of Safety Research 39:311-19. Voas, R.B.; Torres, P.; Romano, E.; and Lacey, J.H. 2012. Alcohol-related risk of driver fatalities: an update using 2007 data. Journal of Studies on Alcohol and Drugs 73(3):341-350. This is especially true at low and moderate blood alcohol concentrations (BACs) and is thought to result from teenagers' relative inexperience with drinking, with driving and with combining the two.  

In 2011, 28 percent of 16-20-year-old passenger vehicle drivers fatally injured in crashes had BACs of 0.08 percent or higher. The percentage of fatally injured 16-20-year-old drivers with high BACs was much lower among females (18 percent) than among males (33 percent), and also was lower among 16-17-year-old drivers (19 percent) than among 18-19-year-old (29 percent) or 20-year-old (36 percent) drivers.

Drivers ages 16-20 with BACs of 0.05-0.079 percent are 12 times more likely to be killed in single-vehicle crashes than sober teenage drivers. At BACs of 0.08-0.099, fatality risks are even higher, 32 times that of sober drivers. At the same BAC, the risk of involvement in a fatal crash and the risk of dying in a single-vehicle crash are the same for 16-20 year-old male and female drivers. Voas, R.B.; Torres, P.; Romano, E.; and Lacey, J.H. 2012. Alcohol-related risk of driver fatalities: an update using 2007 data. Journal of Studies on Alcohol and Drugs 73(3):341-350.

2 Are there special laws aimed at reducing drinking and driving among teenagers?

Yes. Minimum alcohol purchasing age laws limit access to alcohol among teenagers. For a long time, the legal age for purchasing alcohol was 21 in most of the United States. In the 1960s and early 1970s, many states lowered their minimum purchasing ages to 18 or 19. However, states gradually restored higher minimum purchasing ages so that, by the end of 1984, 22 states had minimum purchasing ages of 21 in effect. Federal legislation was enacted to withhold highway funds from the remaining 28 states if they did not follow suit. Since July 1988, the minimum alcohol purchase age has been 21 in all 50 states and the District of Columbia. McCartt, A.T.; Hellinga, L.A.; and Kirley, B.B. 2009. The effects of minimum legal drinking age 21 laws on alcohol-related driving in the United States. Journal of Safety Research 41:173-81.

In all 50 states and the District of Columbia people younger than 21 are prohibited from driving after drinking. Typically these laws prohibit driving with a BAC of 0.02 percent or greater. Federal legislation enacted in 1995 that allowed for the withholding of highway funds played a role in motivating states to pass such zero-tolerance laws.

3 Are minimum purchasing age laws and zero-tolerance laws effective in reducing teenage crashes?

Yes. When many states lowered the minimum alcohol purchasing age in the 1960s and early 1970s, Institute research indicated an increase in the number of drivers younger than 21 involved in nighttime fatal crashes. Williams, A.F.; Rich, R.F.; Zador, P.L.; and Robertson, L.S. 1975. The legal minimum drinking age and fatal motor vehicle crashes. Journal of Legal Studies 4:219-39.  As states restored the minimum legal drinking age to 21, numerous studies found that doing so reduced teenage crashes. Williams, A.F.; Zador, P.L.; Harris, S.S.; and Karpf, R.S. 1983. The effect of raising the legal minimum drinking age on involvement in fatal crashes. Journal of Legal Studies 12:169-79. Du Mouchel, W.; Williams, A.F.; and Zador, P.L. 1987. Raising the alcohol purchase age: its effects on fatal motor vehicle crashes in twenty-six states. Journal of Legal Studies 16:249-66. General Accounting Office. 1987. Drinking-age laws: An evaluation synthesis of their impact on highway safety: General Accounting Office Report to the Chairman. Subcommittee on Investigations and Oversight, Committee on Public Works and Transportation, House of Representatives. Washington, DC. O'Malley, P.M.; and Wagenaar, A.C. 1991. Effects of minimum drinking age laws on alcohol use, related behaviors, and traffic crash involvement among American youth: 1976-1987. Journal of Studies of Alcohol 52:478-91. Shults, R.A.; Elder, R.W.; Sleet, D.A.; Nichols, J.L.; Alao, M.O.; Carande-Kulis, V.G.; Zaza, S.; Sosin, D.M.; Thompson, R.S.; and Task Force on Community Preventative Services. 2001. Reviews of evidence regarding interventions to reduce alcohol-impaired driving. American Journal of Preventative Medicine 21(4 Suppl.):66-88. Wagenaar, A.C.; and Toomey, T.L. 2002. Effects of minimum drinking age laws: review and analysis of the literature from 1960 to 2000. Journal of Studies on Alcohol Suppl. 14:206-25.  The National Highway Traffic Safety Administration estimates that laws establishing 21 as the minimum purchase age in every state saved 3,258 lives during 2007-11. National Highway Traffic Safety Administration. 2012. Lives saved in 2011 by restraint use and minimum drinking age laws. Report no. DOT HS-811-702. Washington, DC: U.S. Department of Transportation.

Studies of zero-tolerance laws indicate they reduce crashes among drivers younger than 21. A study of 12 states that passed zero-tolerance laws reported a 20 percent reduction in the proportion of fatal crashes that were single-vehicle nighttime events (crashes likely to involve alcohol impairment) among drivers ages 15-20. Hingson, R.; Heeren, T.; and Winter, M. 1994. Lower legal blood alcohol limits for young drivers. Public Health Reports 109:739-44.

Presentation by IIHS President Adrian Lund in support of 21 as minimum drinking age

4 How has the teenage drinking and driving problem changed over time?

In 1982, only 15 states had a minimum purchasing age of 21, and 53 percent of all fatally injured drivers younger than 21 had BACs of 0.08 percent or higher. This percentage declined dramatically as states adopted older purchasing age laws. By 1995, it had declined to 24 percent, the biggest improvement for any age group, and was 28 percent in 2011.

5 What can be done to further reduce teenage drinking and driving?

States and communities can make it more difficult for teenagers to purchase alcohol. During 1990-91, Institute researchers found that 19-20 year-olds could easily buy alcohol in Washington, D.C., and a New York City suburb. Preusser, D.F. and Williams, A.F. 1992. Sales of alcohol to underage purchasers in three New York counties and Washington, D.C. Journal of Public Health Policy 13:306-17. But in two New York counties where police recently had cracked down on underage alcohol purchases, youths were less successful. A study of 45 communities in Oregon conducted in 2005 found that alcohol was sold to youthful-looking decoys on 34 percent of purchase attempts. Paschall, M.J; Grube, J.W.; Black, C.; Flewelling, R.L.; Ringwalt, C.L.; and Biglan, A. 2007. Alcohol outlet characteristics and alcohol sales to youth: results of alcohol purchase surveys in 45 Oregon communities. Prevention Science 8(2):153-159. Ownership of fake identification increases dramatically over the first two years of college (from 13 percent precollege to 32 percent by the end of the second year), and is predictive of heavy drinking. Martinez, J.A.; Rutledge, P.C.; and Sher, K.J. 2007. Fake ID ownership and heaving drinking in underage college students: prospective findings. Psychology of Addictive Behaviors 21(2):226-232. According to an annual survey of young people in the United States, the perceived availability of alcohol has declined significantly among eighth and 10th graders since 1996 but has been fairly steady among high school seniors. Johnston, L.D.; O'Malley, P.M.; Bachman, J.G.; and Schulenberg, J.E. 2013. Monitoring the future national survey results on drug use: 2012 overview, key findings on drug use. Ann Arbor, MI: Institute for Social Research, UNiversity of Michigan.  In 2012, 91 percent of high school seniors believe it is fairly easy or very easy to get alcohol. 

Stepped-up enforcement of minimum alcohol purchasing age laws is needed to make them more effective. One barrier to rigorous enforcement is low funding for state alcohol beverage control agencies. This may inhibit not only the identification of servers, sellers, and purchasers who are violating the law but also the timely application of administrative penalties. Establishments do not always check teenagers' identification cards to establish age, and some teenagers use borrowed/altered or false identifications that are difficult to distinguish from official licenses. Schwartz, R.H.; Farrow, J.A.; Banks, B.; and Giesel, A.E. 1998. Use of false ID cards and other deceptive methods to purchase alcoholic beverages during high school. Journal of Addictive Diseases 17:25-33. Research shows that increased enforcement can reduce the sale of alcohol to minors. Grube, J.W. 1997. Preventing sales of alcohol to minors: results from a community trial. Addiction 92:S251-S260.

Institute researchers found zero-tolerance laws difficult to enforce in some states because police must suspect that a young driver has a high BAC before administering an alcohol test for any measurable BAC.  Ferguson, S.A.; Fields, M.; and Voas, R.B. 2000. Enforcement of zero tolerance laws in the United States. Proceedings of the 15th International Conference on Alcohol, Drugs, and Traffic Safety (CD ROM). Borlänge, Sweden: Swedish National Road Administration. Offenders with low BACs may not display the erratic driving that leads to a traffic stop. Institute surveys of young people in three states found limited knowledge about zero-tolerance laws, and many of those who knew about the laws did not believe they often were enforced. Ferguson, S.A. and Williams, A.F. 2002. Awareness of zero tolerance laws in three states. Journal of Safety Research 33:293-99. When zero-tolerance laws are enforced they can be effective. An Institute study of Washington state's zero-tolerance law found that it increased the likelihood that an underage person would be sanctioned for drinking and driving, especially among drivers with BACs less than 0.08 percent. McCartt, A.T.; Blackman, K.; and Voas, R.B. 2007. Implementation of Washington state's zero tolerance law: patterns of arrests, dispositions, and recidivism. Traffic Injury Prevention 8:339-45. An Institute study in West Virginia found that a college community program of publicized, strong enforcement of minimum alcohol purchasing age laws and drinking and driving laws, including the zero-tolerance law, was associated with significant reductions in young drivers’ BACs relative to young drivers in a comparison community without an enforcement program. McCartt, A.T.; Hellinga, L.A.; and Wells, J.K. 2009. Effects of a college community campaign on drinking and driving with a strong enforcement component. Traffic Injury Prevention 10:141-147.