President Reagan signing the NMDAA

Thirty years ago President Reagan signed the National Minimum Drinking Age Act (NMDAA) that required states to make 21 as the minimum age for purchasing or public possessing alcohol. As a result all 50 states now have 21 as the minimum drinking age. Occasionally, there are efforts made to reduce the drinking age to 18, arguing that teens and college students are still drinking, thus the law is a failure.

The NMDAA Saving Lives on our Highways

This episode and the previous one are examining the National Minimum Drinking Age Act. Part one (Episode 25) examined the law’s purpose and asked if has it been successful in achieving that goal.   Part two considers if the law has had any additional benefits and what can be done about underage drinking. To answer that question I speak with Dr. Ralph Hingson, Director of the Epidemiology and Prevention Research at the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

Dr. Ralph Hingson

The NMDAA was initially passed to save lives on our roads and highways, and it has been extremely successful in that effort. It is estimated that almost 30,000 lives have been saved because of the requirement to be 21 years old to drink alcohol. Dr. Hingson notes that the estimate of lives saved is most likely very conservative.

Since the early 1980s, there has been a 77% decline in drunk driving deaths for drivers ages 16 to 20. No other age group has had a greater improvement. Dr. Hingson declared that the NMDAA is a “success story of major consequence.”

It has also had a positive impact in matters other than traffic safety. Underage drinking is associated with a variety of significant problems, including: homicides, suicides, risky sexual behavior and poor academic performance. By reducing the number of teens drinking alcohol, these problems have also been reduced.

Lowering the Drinking Age is not the Answer

During our discussion, Dr. Hingson examines the reasons given for reducing the underage drinking law and refutes each claim. The first argument made is that the current age requirement drives teens to drink “underground” and leads teens to drink explosive amounts of alcohol. Supposedly, if the drinking age were lower, then teens wouldn’t be looking for hidden places to drink and they would drink responsibly. However, the research demonstrates that those individuals who are ages 21-24 and are legal to drink, are actually consuming greater quantities of alcohol, 10-20 drinks on an occassion. Thus it is the legal drinkers who are drinking the extreme quantities of alcohol, not the teens for who it is illegal.

A second argument raised is that we should follow Europe’s example on drinking age laws and tolerance since European countries supposedly have fewer issues with drinking. But the research says otherwise. European youth drink more alcohol than here in the Untied States, and there is a higher proportion of those who drink to intoxication. Also of concern, when European countries are compared to other regions of the world, Europe has the highest per capita of alcohol consumption, the highest proportion of alcohol dependence and the highest rate of deaths due to alcohol misuse. When looking at all of the measures used to consider this issue, Dr. Hingson stated that Europe is not a model to emulate. In actuality, it is the U.S. that should be considered a role model for other countries when considering an alcohol policy and teens.

Teens Drinking in Europe

The NMDAA Saving Lives in Our Communities

The research on underage drinking demonstrates that the earlier a person starts to drink, the greater the likelihood the person will become alcohol dependent at some point in his or her life. Over 40% of the youth who start drinking at age 14 or younger will become alcohol dependent; versus 10% of those who become dependent when they start drinking at age 21 or later.

It is also noteworthy that after New Zealand reduced its minimum drinking age from 20 to 18, there was a significant increase in alcohol-related crashes among 15-19 year olds.  The increase in drinking by those 18-19 years old was followed by an increase by 16-17 years old even though it was still illegal for the younger ages.

Other scientific research discovered after the NMDAA was passed also supports the law’s continuation.  Thanks to technological advances involving brain scans, we now know that even at 21 the brain is still developing. There are important changes occurring in brain development during the teenage years.  Alcohol retards these changes, and has both short- and long-term effects, including damage to:

• Memories


• Learning capabilities


• Decision–making process, and


• Reasoning ability

Battling Underage Drinking

Underage drinking is definitely a problem

While there is no question that underage drinking is an issue, the answer is not to lower the age, the answer is a multi-level approach that targets: individuals, families, and schools. It is important to note that web-based interventions have also shown some promise.

Looking at the individual efforts, having health care professionals to provide screening and brief counseling has been found highly effective, including when it is done at college. Dr. Hingson recommends that all college students who use the health care services should be screened and receive brief counseling, and that the health care professionals take a more proactive role when dealing with young people. Many times a doctor or nurse learns that a teen is drinking or smoking – even though it is illegal – and they don’ provide health care advice on these issues. The research indicates that when these professionals take action, there is a recognized benefit.

In considering the family influence, Dr. Hingson pointed out that parents probably have the strongest influence on preventing underage drinking. If parents binge drink, their children are very likely to do so. Parental permission of alcohol use generally leads to greater incidents of alcohol use by their teens, increased binge drinking and higher rates of alcohol problems.

On the flip side, parents who talk with their children, and provide good role models can have a significant impact on whether or not their children drink alcohol before the age of 21. This is true even after leaving home for college.

Tips for Parents