Do Alcohol Harm Minimization Policies Reduce Alcohol Problems? a Comparison of Two Nations’ Approaches to Teen Drinking

Introduction: The U.S. has adopted a zero-tolerance policy toward youth drinking, with the goal of deterring all alcohol use before the legal drinking age of 21. By contrast, Australia had until recently maintained a harm minimization policy that, while discouraging problematic alcohol use among youth, expected that parents teach their children to drink responsibly prior to the legal age of 18 and that alcohol use is a normal part of adolescence. The purpose of the current study was to examine how these policy differences affect the relationship between early initiation of alcohol use and alcohol problems in young adulthood. That is, although youth drinking is not strictly prohibited in Australia, it is still linked to later alcohol problems? We also examine whether parent acceptance of youth drinking and gender moderate this relationship.

Methods: Data were drawn from a sample of 1958 participants in Victoria, Australia and Washington State, United States recruited into the study in 2002 when participants were in 7^th grade (age 13). The two states were matched on demographics and students were randomly sampled in each state. Participants were administered identical surveys when they were ages 13, 14, 15, and 25. Participants reported on the frequency of their alcohol use at ages 13-15 and drinking-related problems (e.g., getting in to a fight, problems with parents), and whether they thought their parents would think it was wrong if they drank alcohol regularly. At age 25, participants completed the Alcohol Use Disorders Identification Test (AUDIT) for alcohol abuse.

Results: Participants in Victoria reported more alcohol use in adolescence (ages 13-15), more alcohol problems in adolescence, as well as greater likelihood of scoring in the higher ranges of the AUDIT at age 25 (all ps < .001). Using multiple group Structural Equation Modeling (MGSEM), analyses showed that the association between alcohol use and problems during adolescence with the AUDIT scores at age 25 were not significantly different in Victoria than in Washington State. Testing for interactions with parent attitudes and gender did not reveal state differences in these associations.

Implications: Early initiation of alcohol use and experiencing early problems is equally related to young adult alcohol problems in both countries. Inasmuch as harm minimization policies promote greater youth drinking, this may lead to more cases of alcohol abuse in young adulthood. On the other hand, policies aimed at preventing alcohol use in adolescence are more effective at reducing later alcohol addiction.