Published online May 1, 2007
PEDIATRICS Vol. 119 No. 5 May 2007, pp. 1035 (doi:10.1542/peds.2007-0042)

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LETTER TO THE EDITOR

Is the Binge-Drinking Glass Half Full or Half Empty?

James C. Turner, MD
Department of Student Health, the National Social Norms Institute, and Department of Clinical Medicine
University of Virginia
Charlottesville, VA 22908

To the Editor.—

The recent article by Miller et al¹ reaffirms the risks associated with heavy episodic drinking among adolescents. However disturbing these findings, it is important to recognize some positive trends regarding alcohol use among teens. First, it should be emphasized that 55% of respondents indicated no alcohol consumption in the previous 30 days, and 16.1% had consumed alcohol but not at the binge-drinking level. Thus, the vast majority of teens had actually not engaged in high-risk alcohol consumption in the preceding month. That is very good news.

Most importantly, the authors did not address recent substantial downward trends in heavy episodic drinking among teens. The Youth Risk Behavior Survey results from 1991–2005 demonstrated declines in heavy episodic drinking, and since 1997 the rates have decreased from 33.4% to 25.5%.² These changes represent rather dramatic shifts among the population and mean that millions fewer teens have engaged in alcohol misuse since 1997.

The authors state that short of enforcement of the minimum drinking age, little has been done over the years to reduce underage drinking. They also suggest a number of interventions that should be implemented to reduce underage drinking. I respectfully disagree with their assertions and admonitions. I think it is critical that researchers carefully study these positive trends and try to determine what factors have actually contributed to substantial reductions in youth binge drinking. A better understanding of the reasons behind these positive findings will eventually lead to evidence-based interventions and public policy.

In the meantime, physicians caring for teens should be aware that a substantial minority of them (25%–28%) have likely engaged in alcohol misuse in the preceding month. Screening, counseling, and appropriate referral are vital interventions that can be conducted in the office setting and will likely reduce future high-risk alcohol use among these patients. Perhaps as important, for alcohol users and nonusers alike, clinicians should strongly reinforce that the majority of American teens (71%–75%) chose not to use alcohol (or to use it minimally). Adolescents generally respond to pressure to engage in normative social behaviors; they just need to know what the normative behavior is.

REFERENCES

1. Miller JW, Naimi TS, Brewer RD, Jones SE. Binge drinking and associated health risk behaviors among high school students. Pediatrics. 2007;119 :76 –85[Abstract/Free Full Text]
2. Centers for Disease Control and Prevention, Department of Health and Human Services. National Youth Risk Behavior Survey: 1991–2005—trends in the prevalence of alcohol use. Available at: www.cdc.gov/HealthyYouth/yrbs/pdf/trends/2005_YRBS_Alcohol_Use.pdf. Accessed January 4, 2007

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PEDIATRICS (ISSN 1098-4275). ©2007 by the American Academy of Pediatrics

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This Article Extract Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services E-mail this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Request Permissions Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Turner, J. C. Search for Related Content PubMed PubMed Citation Articles by Turner, J. C. Related Collections Adolescent Medicine Social Bookmarking                         What's this?