Alcohol Sales to Youth: Data from Rural Communities within the Cherokee Nation

Introduction: Access to alcohol among individuals under age 21 continues to be a public health concern with approximately 5,000 youth deaths attributable to alcohol each year (U.S. Department of Health and Human Services, 2007). American Indian families and youth suffer from significant alcohol-related health disparities.  Therefore, understanding the extent of access to alcohol for underage youth is of particular concern within the 14-county jurisdictional service boundaries of the Cherokee Nation in northeastern Oklahoma, which is home to a high proportion of American Indian families.

Methods: We evaluated commercial access to alcohol by underage-appearing female confederates in 4 rural towns within the jurisdictional service boundaries of the Cherokee Nation. Alcohol purchase attempts were conducted monthly for 10 months at every off-premise alcohol retail outlet within a 20 minute drive-time from the town center for a total of 915 alcohol purchase attempts. Confederates were required to be at least 21 years of age but judged to look under 20 years of age by between 10 and 20 community members. In addition to purchase attempt outcome, we collected data on characteristics of the outlets (e.g., exterior maintenance, presence of signage related to underage drinking, loitering) and of the sellers (e.g., age, gender).

Results: Alcohol was sold to the confederates without use of age identification on 23% of all purchase attempts. Across repeated attempts, 74% of outlets sold alcohol to a confederate at least once. Males and younger clerks were more likely to sell alcohol to the confederates. Grocery stores and gas stations were more likely to sell alcohol to the confederate than liquor stores in the bivariate analysis but this effect was no longer significant in the multivariable model due to systematic associations between seller age and business type (e.g., younger clerks worked at grocery stores and gas stations).

Conclusion: This study found that 3 out of every 4 outlets sold alcohol to young-appearing buyers at least once across repeated attempts, with a number of outlets selling alcohol at almost every buy attempt. Results reinforce the continuing need for regular enforcement of the laws against selling or serving alcohol to minors.