The list of policy recommendations that emerged from MADD's early October Youth Summit in Washington, DC suggested that MADD will address underage drinking as aggressively as it has attacked drunken driving. Among the Youth Summit's recommended policies: increase excise taxes on alcohol beverages with funds earmarked for alcohol prevention/awareness programs; prohibit alcohol beverage ads on television before 10 PM, and "equal time" for anti-alcohol ads paid for by the industry; adopt a federally funded campaign to prevent underage drinking; require all states to use magnetic strips or bar codes on drivers' licenses and all sales outlets to use scanner equipment to verify age.

"There is a strong base of support for alcohol control policies in the US," according to long-time control policy advocate Alexander Wagenaar. He based the claim on his just-published 1997 survey of 7,041 adults in the US that found a majority strongly favored or favored somewhat 19 of 23 separate alcohol policies. On average fully 2/3 of those surveyed supported any given measure. Support was fairly consistent across different age groups, genders, races and political orientation. But note that control advocates have learned from political pollsters. A close reading of the questions shows that at least some were clearly worded in a way to increase support by suggesting controls would reduce underage drinking.

Over 80% of those surveyed favored: at least some restrictions on sale in various public places; requiring alcohol beverage servers to be trained in responsible practices; fines for those who serve underage patrons; higher excise taxes if they

No doubt about it: "social norms" is a hot topic. This was displayed most prominently by the Wall Street Journal

Here’s yet another example of how American drinking habits and attitudes about drinking appear to be at odds. The consensus among beer industry executives and analysts is that the growing number of consumers age 21-27 (which represent 14% of the population, but 27% of beer sales) bodes well for volume growth through the end of the decade. In fact, AB, Miller and others project 1.5%+ annual beer volume growth through 2010 as this "contemporary adult" segment continues to expand. Yet this key "demographic" seems to be no less ambivalent about alcohol beverages than previous generations. National survey data from the University of Michigan shows that 73.4% of 23-26 year-olds and 67.9% of 27-30 year-olds say they disapprove of "people 18 and over" having 1 or 2 drinks nearly every day. In addition, about 2/3 of the same adults say their friends disapprove of moderate drinking. A third point: over 1/4 of these adults believe that moderate drinking poses a "great risk." About the only good news in these numbers is that the percentage of contemporary adults who disapprove of moderate drinking has declined, albeit slightly, over the last decade. In 1989, about 74% of 23-30 year-olds said they disapproved of moderate drinking. Attitudes about moderate drinking among 19-22 yr-olds are no more positive. Meanwhile in 1999, 68% of adults age 19-28 said they had at least one drink in the last month, a tiny increase from 94, and a 4-point decrease compared to 89. Only 4.8% of 19-28 year-olds say they drink every day. You have to wonder what the prospects for the beer industry would be if the majority of young adults actually "approved" of moderate drinking. Ref 3

"The need for a strong Beer Institute is greater today than at virtually any time in recent history," Chairman John Bowlin (who is also president of Miller) told the brewers

Taken together with other recent findings that moderate drinking prevents bone loss and improves cognitive functioning among older drinkers, this study adds to the body of evidence that indicates a broad range of benefits for older adults who drink moderately. "In general the prevalence of hearing loss decreased significantly with increasing alcohol consumption," the authors of this new study wrote. That was their conclusion after reviewing the drinking habits and hearing of 3600 adults (average age 65.6) in Beaver Dam, WI. This is an important finding because hearing loss is "one of the most common chronic conditions affecting the health of older adults," according to the authors. In the study, those who consumed over 11 drinks per week had the least risk of any hearing loss, about 30% lower than those who did not drink. When the authors looked at "moderate hearing loss," those who consumed 6-11 drinks per week had the least risk of such a loss, about 50% lower than non-drinkers. Even the heaviest drinkers (over 11 drinks per week) had a 30% lower risk for moderate hearing loss. When they looked at "low frequency hearing loss" and "high frequency hearing loss," those who consumed 11 drinks or more per week had the lowest risk of either type of loss. Interestingly, even those with a history of heavy drinking (4 or more drinks per day) were not at higher risk for moderate hearing loss or low-frequency hearing loss.

A protective effect for alcohol against hearing loss makes sense since risk factors for hearing loss include cardiovascular disease, hypertension and blood lipid levels. But when the researchers made adjustments for history of cardiovascular disease, cholesterol problems, hypertension and blood pressure

The recently published 10^th Special Report on Alcohol & Health from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) includes a little more attention to the benefits of moderation and a little less support for restrictive policy measures than some previous editions. No one knows how many practitioners, politicians or prevention people actually read these periodic 500+ page reports, but they're as close to an "official" position on alcohol as the federal government provides. As such, it's good to see that NIAAA director Dr. Enoch Gordis makes the following point early in his introduction to the current report: "Most individuals who use alcohol drink in ways that do not increase risk for alcohol use problems." (This point had been dropped from the last report and is a far cry from a previous NIAAA position that "all drinking is risky.") "Defining precisely who is at risk for alcohol use problems and assessing the risks versus benefits of alcohol use are the first steps toward providing accurate public health information and designing effective interventions to reduce alcohol use problems," Dr. Gordis continues. Like past editions, the current report focuses on alcohol problems, but it also includes recent research that links moderate consumption to reduced psychological stress, lower risk for cardiovascular disease, and lower mortality rates. Indeed, the very first chapter leads off with an analysis titled: "Measuring the Health Risks and Benefits of Alcohol." Previous reports have acknowledged benefits; none has given them such emphasis.

Equally important, the 10^th report contains little pro-control advocacy. In fact, a chapter on "Community Based Prevention Approaches," (which could easily be code for control measures) points out: "Reducing traffic accidents and other problems associated with drinking, for example, but not necessarily the incidence of drinking, is a legitimate goal." (Our emphasis.) Nor do NIAAA's specific analyses of the latest price/tax and advertising research, for example, lend support for either measure. While the last report suggested prices and/or tax policy could be "useful tools" to reduce harm, the current report concludes that price has "modest effects," if any. NIAAA concludes also that research on the effect of advertising on consumption is "mixed and far from conclusive. In general, studies based on economic analyses suggest that advertising does not increase overall consumption but instead may encourage people to switch beverage brands or types."

Since both alcohol beverage consumption and real alcohol beverage prices have fallen since 1978, NIAAA points out, alcohol "demand may not respond as much to price changes as previously thought." The current report cites several studies that ostensibly show that higher prices reduce consumption/problems, but it also acknowledges that other studies differ, and that very heavy drinkers and male college students are "unresponsive" to price. "Recent studies disagree about the level of alcohol taxation that would best balance benefits and costs," NIAAA concludes, and calls for more research. NIAAA further shows that neither experimental research, surveys, econometrics, nor studies of media literacy programs definitively link advertising to consumption or alcohol problems. And even

though some studies suggest advertising "may predispose young people to drink, the reverse may be true instead," NIAAA concludes, since young people who already "look favorably on drinking" for other reasons "may seek information about alcohol and thus be more attentive to alcohol advertisements." In sum, advocates may be able to pick out an isolated citation or two from the 10^th Report to support policy initiatives, but the approach at this key federal agency seems to be increasingly balanced. Ref 1