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Vol. LXIII, No. 19
September 16, 2011

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Culture, Events Influence Demarcation
Professor Traces Nation’s ‘Drinking Age Debates’

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Dr. Joy Getnick
Dr. Joy Getnick
Anyone hoping to make sense of the nation’s wrangling over the establishment of a sensible legal age for drinking alcoholic beverages had better be prepared to follow a stumbling, lurching course, not unlike the route traced by—a tippler.

As part of NLM’s “Summer of Seminars,” Dr. Joy Getnick of the State University of New York at Geneseo presented “The Drinking Age Debates” on Aug. 11. While no one was carded upon entry to the NLM Visitor Center, where the talk took place, dizziness upon exit might not have been inappropriate as Getnick reviewed the weaving, careering 80-year (80 proof?) history of the topic, which grew out of Prohibition.

As early as 1912, Massachusetts established a law prohibiting teenagers from using fake ID cards to get alcohol, Getnick reported. Her own interest in the field emerged during college, when she worked for her school’s health promotion office, teaching a course on “how to host a party without killing your friends.”


As a newly minted Ph.D. who will teach this fall at SUNY-Geneseo, Getnick finds herself in front of young students who claim that the current drinking age of 21 forces them—since it is not yet legal for most of them to drink—to imbibe like desperadoes: not all that frequently, but massively when they can.

She observes of today’s youth, “There is no cultural shame associated with drunkenness…These kids are convinced it’s the law’s fault.”

As factions such as the Choose Responsibly movement, which argues for lowering the drinking age to 18, compete with more conservative interests, including Mothers Against Drunk Driving (MADD), which insists that 21 is the more appropriate age, Getnick is inclined to call a time-out: “We shouldn’t change a policy we don’t understand,” she said.

The drinking age debates, she said, grew out of Prohibition, which was repealed in 1933. Prior to Prohibition, laws restricting access to booze were largely an attempt “to control youth behavior,” she said. “The debate was not ‘how much?’ but when and where?”

Temperance groups sought to keep bars well removed from schools. Yet by the 1920s, college drinking had become a national concern, and by a dozen years later, almost every state adopted a drinking age of 21, Getnick said. By 21, the so-called “age of majority,” young people could vote—and also drink.

Over time, however, states adopted their own policies; New York chose 18. Delaware settled on 20. While the 1930s saw an increase in the amount of research on the impact of alcohol on youth, World War II pushed the issue aside, said Getnick.

In 1953, a landmark, book-length study titled Drinking in College was published, examining all aspects of youth drinking. Its principal finding was that youth drinking mimics adult mores; hard-drinking towns tended to produce hard-drinking kids.

The study drew stories in Time and Newsweek, igniting a national debate. The fear in the America of the mid-1950s was that kids who drank took “a ride on a skid-row toboggan,” Getnick noted.

Others argued that, by giving drink the glamour of sin and restricting access to it, authorities were creating the allure of the forbidden.

The issue that made age a principal factor in regulating access to alcohol (which historically had been considered an adult concern) was so-called “border deaths.” The highways linking Connecticut, where the drinking age was 21, and New York, where it was 18, were marred by a dramatic upswing in traffic fatalities.

Getnick suggested that 19 would be her personal recommendation for a legal drinking age, enabling college communities

Getnick suggested that 19 would be her personal recommendation for a legal drinking age, enabling college communities— on which a majority of the nation’s 19- to 21-year-olds live—to focus on problematic behavior, not a number.

Photos: Bill Branson

The legislatures in New York, New Jersey and Connecticut became embroiled in controversy and blame, Getnick reported, out of which emerged, for the first time, the solution of a uniform drinking age, as well as regulation of bar hours.

In some states, gender became an issue; Illinois allowed women to drink at 19, since they were thought to be more mature than men, who were restricted before age 21.

With the advent of youth culture and the Vietnam War in the 1960s, the pendulum swung back toward 18 as people argued that anyone fit to die in battle was also fit to drink, and to vote. Twenty- four states lowered their drinking age between 1970 and 1973, Getnick said.

“One of the arguments for lowering the age was ‘At least alcohol is not a drug [like marijuana or LSD],’” she added. Alcohol use was often thought to be less harmful than smoking cigarettes, as well.

But teen deaths associated with driving while drunk began escalating; a Wisconsin study showed that teenagers were more likely to die in single-vehicle crashes, alone at night, with alcohol consumption a factor.

Science, too, entered the debate as the association between blood alcohol content and impaired driving was recognized. A BAC of 0.15 had been set as a standard of drunkenness, but was then lowered to 0.1, then 0.08, Getnick noted.

By the later 1970s, as mounting fatalities cast doubt on the wisdom of 18 as the legal drinking age, many states reverted back to 21, or at least raised it from 18.

Getnick said the establishment of the National Institute on Alcohol Abuse and Alcoholism in 1970 “became the public face of alcohol problems” in the U.S. Its first director, Dr. Morris Chafetz, determined that there were some 450,000 teenage alcoholics in the U.S., a figure that spurred much debate: was there really a teen epidemic or was this a phantom problem?

NIAAA also pushed “the medicalization of alcoholism,” Getnick said. “It became a diagnosis.”

When MADD was established in 1980 with the goal of making drunk driving “socially unacceptable,” Getnick said, there was no particular focus on youth. But a 1982 Presidential commission on drunk driving created by Ronald Reagan came up with a list of 39 recommendations. While only one of them dealt with youth, it became a cause célèbre: age 21 was pitched as the national legal drinking age.

Within 2 years, spurred on by the emotional message of “saving our children,” a bill passed establishing 21 as the national drinking age. Further, states that did not comply with the statute were denied federal highway funds, which no state could afford to forego. By 1988, all 50 states fell in line with the new norm.

That same era saw a “wealth of research on the impact of the drinking age,” Getnick reported. Studies showed that youth drank, regardless of the law, and that parental norms were the most powerful factor in regulating it. Setting the bar at 21, another study showed, meant kids drank fewer days per week, but more per sitting.

The mid- to late-1990s were characterized by a focus on the negative consequences of binge drinking, Getnick said. “There was a shift away from the law, toward the behavior.” Social norms campaigns sprang up with the message that “not everyone was binge drinking every night.”

But quandaries remained: how do you promote safe drinking when, for many, it’s illegal? One group, a committee of college presidents, suggested issuing “drinkers’ licenses” that, like drivers’ licenses, would show that the holder was trained in the art of safe drinking. Two states, Wisconsin and South Carolina, moved to lower their drinking age to 18, for active military only. And last year, Congress lowered the drinking age for military bases near Canada, to lower the incidence of border deaths.

Getnick said that, at the moment, the national age of 21 has firm legal footing, but acknowledged that, historically, the tides change. During a brief Q&A session, she suggested that 19 would be her personal recommendation, enabling college communities—on which a majority of the nation’s 19- to 21-year-olds live—to focus on problematic behavior, not a number. Her audience included not only NIAAA acting director Dr. Kenneth Warren, but also NIAAA epidemiologist Dr. Ralph Hingson, whom Warren labeled a world authority on the issue at hand. Hingson reported that raising the drinking age to 21 has resulted in a lower rate of traffic deaths for all ages.

Hingson noted that raising the drinking age to 21 partly contributed to alcohol-related traffic deaths among persons of all ages being cut in half per 100,000 persons in the last 25 years, with the steepest decline in the 18-20 age range. He highlighted a recent study showing each alcoholic drink consumed increases a driver’s risk of being in a fatal crash; the risk increases more for drivers under 21 than 21 and older.

Hingson also underscored the “second-hand effect” of youth drinking and driving and indicated approximately half of the people who die in traffic crashes involving drinking drivers under 21 are people other than the young drinking drivers. He finally called for a wider consideration of alcohol’s deleterious effect beyond the drinking driver, noting that injuries are the leading cause of death among people ages 1-44 in the United States, with alcohol misuse being the leading contributor. Of 44,000 injury deaths attributable to alcohol misuse annually, 13,800 are traffic deaths.

“Just as most fatally injured drivers have been tested for alcohol, thereby facilitating research on what laws reduced alcohol-related traffic deaths, we need to more consistently test other injury deaths for alcohol so that we can learn which of myriad interventions can also reduce those deaths,” he said. NIHRecord Icon

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