Binge Drinking Above and Below Twice the Adolescent Thresholds and Health-Risk Behaviors

Abstract

Background: Underage drinking has been associated with health-risk behaviors: unintentional and unprotected sex; physical and sexual assault; suicide; homicide; traffic and other unintentional injuries; and overdoses. Five drinks consumed over 2 hours by adult males and 4 drinks by adult females typically produce blood alcohol levels (BALs) of ≥0.08%, which the National Institute on Alcohol Abuse and Alcoholism considers binge drinking. Being smaller, young adolescents can reach adult binge-drinking BALs of ≥0.08% with fewer drinks. Previous research indicates boys ages 9 to 13 would reach ≥0.08% with 3 drinks, 4 drinks at ages 14 to 15, and 5 drinks at ages ≥16. For girls, ≥0.08% is reached with ≥3 drinks at ages 9 to 17 and ≥4 drinks at ages ≥18. This study explores whether, among a national sample of high school students, adolescent binge drinking at ≥twice versus <twice the age-/gender-specific thresholds versus nonbinge drinking heightens associations of drinking with health-risk behaviors.

Methods: In 2015, the Youth Risk Behavior Survey asked a national probability sample of 15,624 high school students grades 9 to 12 (response rate 60%) about their past-month drinking and past-month or past-year health-risk behaviors. Logistic regressions with pairwise comparisons examined the association between different drinking levels and selected risk behaviors, adjusting for age, sex, race/ethnicity, and drinking frequency.

Results: Seven percent binged ≥twice and 9% <twice the age-/gender-specific thresholds, and 14% drank less than the binge thresholds. Significantly higher percentages of binge drinkers at ≥twice versus <twice the thresholds versus other drinkers reported illegal drug and tobacco use, risky sexual and traffic behaviors, physical fights, suicide, less school-night sleep, and poorer school grades.

Conclusions: Adolescent alcohol misuse screening should query the maximum number of drinks consumed per occasion and frequency of such consumption. State and national surveillance surveys should include those questions to investigate which individual, family, school, community, and policy interventions reduce consumption beyond binge thresholds and related health-risk behaviors.

Keywords: Adolescent Health; Age-/Gender-Specific Thresholds; Binge Drinking; Health-Risk Behaviors.