Minimum Legal Drinking Age Research Articles

Driving Under the Influence of Alcohol, Marijuana, and Alcohol and Marijuana Combined Among Persons Aged 16-25 Years - United States, 2002-2014.

Motor vehicle accidents are the leading cause of death among youths and young adults aged 16-25 years in the United States (1). The prevalence of drinking and driving among high school students aged 16-19 years has declined by 54%, from 22.3% in 1991 to 10.3% in 2011 (2). However, the prevalence of weekend nighttime driving under the influence of marijuana (based on biochemical assays) among drivers aged ≥16 years has increased by 48%, from 8.6% in 2007 to 12.6% in 2013-2014 (3). Use of marijuana alone and in combination with alcohol has been shown to impair driving abilities (4-9). This report provides the most recent self-reported national estimates of driving under the influence of alcohol, marijuana, and alcohol and marijuana combined among persons aged 16-25 years, using data from the Substance Abuse and Mental Health Services Administration (SAMHSA) National Survey on Drug Use and Health (NSDUH) from 2002-2014. Prevalence data on driving under the influence of both substances were examined for two age groups (16-20 years and 21-25 years) and by sex and race/ethnicity. During 2002-2014, the prevalence of driving under the influence of alcohol alone significantly declined by 59% among persons aged 16-20 years (from 16.2% in 2002 to 6.6% in 2014; p<0.001) and 38% among persons 21-25 years (from 29.1% in 2002 to 18.1% in 2014; p<0.001). In addition, the prevalence of driving under the influence of alcohol and marijuana combined significantly declined by 39%, from 2.3% in 2002 to 1.4% in 2014 (p<0.001) among persons aged 16-20 years and from 3.1% in 2002 to 1.9% in 2014 (p<0.001) among persons aged 21-25 years. The prevalence of driving under the influence of marijuana alone declined 18%, from 3.8% in 2002 to 3.1% in 2014 (p = 0.05) only among persons aged 16-20 years. Effective public safety interventions,* such as minimum legal drinking age laws, prohibition of driving with any alcohol level >0 for persons aged <21 years, targeted mass media campaigns, roadside testing (e.g., sobriety checkpoints), and graduated driver licensing programs (10) have contributed to the decline in driving under the influence of alcohol in this population. These or similar interventions might be useful to prevent driving under the influence of other substances, such as marijuana alone or combined with other substances.

Time Trends and Policy Gaps: The Case of Alcohol Misuse Among Adolescents in Lebanon

Background: Monitoring studies are crucial for informing and reforming local policies. Objectives: Using the Lebanon 2005 and 2011 Global School-based Student Health Surveys (GSHS), alcohol time trends were described, policy gaps were identified, and harm reduction policy recommendations were made. Methods: In 2005 and 2011, 100 (n = 5109 students) and 44 (n = 2784 students) middle schools were surveyed, respectively. Self-reported cross-sectional data on alcohol use among 7–9th graders in private and public schools was collected including 30-day prevalence, lifetime drunkenness, alcohol-related problems, and sources of alcohol. Results: In 2011, the majority (87%) had alcohol before turning 14. Between 2005 and 2011, past 30-day alcohol use had increased by 40% and lifetime drunkenness by 50% in the total sample (122% among females with a narrowing in the gender gap). Drinking was regular for more than a third of the past 30-day drinkers (drank two or more drinks on the days they drank). Male adolescents were more likely to obtain alcohol from “stores” or “through their friends” whereas females’ main source was their “family.” One in twenty reported experiencing alcohol-related problems (e.g., getting into fights with family/friends and skipping school). Conclusion/Importance: Evidence-informed policy implications include enforcing a minimum legal drinking age, regulating alcohol advertising, and marketing particularly those targeting youth and women, and ensuring the availability of youth-friendly services. Public messages to increase awareness among all stakeholders including youth, their parents, and larger community are also needed.

The Mechanisms of Alcohol Control.

A substantial economics literature documents that tighter alcohol controls reduce alcohol-related harms, but far less is known about mechanisms. We use the universe of Canadian mortality records to document that Canada's Minimum Legal Drinking Age (MLDA) significantly reduces mortality rates of young men but has much smaller effects on women. Using drinking data that are far more detailed than in prior work, we document that the MLDA substantially reduces 'extreme' drinking among men but not women. Our results suggest that alcohol control efforts targeting young adults should focus on reducing extreme drinking behavior.

Effects of Dram Shop, Responsible Beverage Service Training, and State Alcohol Control Laws on Underage Drinking Driver Fatal Crash Ratios

Objectives: In this study, we aimed to determine whether three minimum legal drinking age 21 (MLDA-21) laws—dram shop liability, responsible beverage service (RBS) training, and state control of alcohol sales—have had an impact on underage drinking and driving fatal crashes using annual state-level data, and compared states with strong laws to those with weak laws to examine their effect on beer consumption and fatal crash ratios.Methods: Using the Fatality Analysis Reporting System, we calculated the ratio of drinking to nondrinking drivers under age 21 involved in fatal crashes as our key outcome measure. We used structural equation modeling to evaluate the three MLDA-21 laws. We controlled for covariates known to impact fatal crashes including: 17 additional MLDA-21 laws; administrative license revocation; blood alcohol concentration limits of.08 and.10 for driving; seat belt laws; sobriety checkpoint frequency; unemployment rates; and vehicle miles traveled. Outcome variables, in addition to the fatal crash ratios of drinking to nondrinking drivers under age 21 included state per capita beer consumption.Results: Dram shop liability laws were associated with a 2.4% total effect decrease (direct effects: β =.019, p =.018). Similarly, RBS training laws were associated with a 3.6% total effect decrease (direct effect: β =.048, p =.001) in the ratio of drinking to nondrinking drivers under age 21 involved in fatal crashes. There was a significant relationship between dram shop liability law strength and per capita beer consumption, F (4, 1528) = 24.32, p <.001, partial η2 =.016, showing states with strong dram shop liability laws (Mean (M) = 1.276) averaging significantly lower per capita beer consumption than states with weak laws (M = 1.340).Conclusions: Dram shop liability laws and RBS laws were both associated with significantly reduced per capita beer consumption and fatal crash ratios. In practical terms, this means that dram shop liability laws are currently associated with saving an estimated 64 lives in the 45 jurisdictions that currently have the law. If the remaining 6 states adopted the dram shop law, an additional 9 lives could potentially be saved annually. Similarly, RBS training laws are associated with saving an estimated 83 lives in the 37 jurisdictions that currently have the laws. If the remaining 14 states adopted these RBS training laws, we estimate that an additional 28 lives could potentially be saved.

Did the 18 Drinking Age Promote High School Dropout? Implications for Current Policy.

Disagreement exists over whether permissive minimum legal drinking age (MLDA) laws affected underage adolescents (e.g., those age 17 years with the MLDA of 18). We used MLDA changes during the 1970s and 1980s as a natural experiment to investigate how underage exposure to permissive MLDA affected high school dropout. MLDA exposure was added to two data sets: (a) the 5% public use microdata samples of the 1990 and 2000 censuses (n = 3,671,075), and (b) a combined data set based on the 1991-1992 National Longitudinal Alcohol Epidemiological Survey (NLAES) and the 2001-2002 National Epidemiological Survey on Alcohol and Related Conditions (NESARC; n = 16,331). We used logistic regression to model different thresholds of MLDA on high school dropout. We also estimated models conditioned on demographic variables and familial risk of developing alcohol problems. Only the MLDA of 18 predicted high school dropout. Exposure was associated with 4% and 13% higher odds of high school dropout for the census and NLAES/NESARC samples, respectively. We noted greater impact on women (5%-18%), Blacks (5%-19%), and Hispanics (6%). Self-report of parental alcohol problems was associated with 40% higher odds, which equals a 4.14-point increase in dropout rate for that population. The MLDA of 18 likely had a large impact on high school dropout rates, suggesting that the presence of legal-aged peers in a high school setting increased access to alcohol for younger students. Our results also suggest that policy can promote less dangerous drinking behavior even when familial risk of alcohol use disorders is high.

The Utility of Including the Strengths of Underage Drinking Laws in Determining Their Effect on Outcomes.

To control underage drinking in the United States, which has been associated with an estimated 5,000 deaths and 2.6 million injuries or other harm annually, each state has developed a unique set of laws. Previous research examining these laws' effectiveness has frequently focused on the laws' existence without considering variance in sanctions, enforcement, or exemptions. We scored 20 minimum legal drinking age 21 (MLDA-21) laws for their strengths and weaknesses based on (i) sanctions for violating the law, (ii) exceptions or exemptions affecting application, and (iii) provisions affecting the law or enforcement. We then replicated a 2009 study of the effects of 6 MLDA-21 laws in 3 different ways (using identical structural equation modeling): Study 1-8 additional years of data, no law strengths; Study 2-years from the original study, added law strengths; Study 3-additional years, law strengths, serving as an update of the 6 laws' effects. In all 3 studies-and the original study-keg registration laws were associated with both an unexpected significant increase (+11%, p < 0.001) in underage drinking-driver ratios and a notable 25% reduction in per capita beer consumption-opposing results that are difficult to explain. In Study 3, possession and purchase laws were associated with a significant decrease in underage drinking-driver fatal crash ratios (-4.9%, p < 0.001; -3.6%, p < 0.001, respectively). Similarly, zero tolerance and use and lose laws were associated with reductions in underage drinking-driver ratios (-2.8%, p < 0.001; -5.3%, p < 0.001, respectively). Including strengths and weaknesses of underage drinking laws is important when examining their effects on various outcomes as the model fit statistics indicated. We suggest that this will result in more accurate and more reliable estimates of the impact of the laws on various outcome measures.

Historical variation in young adult binge drinking trajectories and its link to historical variation in social roles and minimum legal drinking age.

This study examines historical variation in age 18 to 26 binge drinking trajectories, focusing on differences in both levels of use and rates of change (growth) across cohorts of young adults over 3 decades. As part of the national Monitoring the Future Study, over 64,000 youths from the high school classes of 1976 to 2004 were surveyed at biennial intervals between ages 18 and 26. We found that, relative to past cohorts, recent cohorts both enter the 18 to 26 age band engaging in lower levels and exit the 18 to 26 age band engaging in higher levels of binge drinking. The reason for this reversal is that, relative to past cohorts, binge drinking among recent cohorts accelerates more quickly across ages 18 to 22 and decelerates more slowly across ages 22 to 26. Moreover, we found that historical increases in minimum legal drinking age account for a portion of the historical decline in age 18 level, whereas historical variation in social role acquisition (e.g., marriage, parenthood, and employment) accounts for a portion of the historical acceleration in age 18 to 22 growth. We also found that historical variation in the age 18 to 22 and age 22 to 26 growth rates was strongly and positively connected, suggesting common mechanism(s) underlie historical variation of both growth rates. Findings were generally consistent across gender and indicate that historical time is an important source of individual differences in young adult binge drinking trajectories. Beyond binge drinking, historical time may also inform the developmental course of other young adult risk behaviors, highlighting the interplay of epidemiology and etiology.

Breaking The Link Between Legal Access To Alcohol And Motor Vehicle Accidents: Evidence From New South Wales.

A large literature has documented significant public health benefits associated with the minimum legal drinking age in the USA, particularly because of the resulting effects on motor vehicle accidents. These benefits form the primary basis for continued efforts to restrict youth access to alcohol. It is important to keep in mind that policymakers have a wide variety of alcohol-control options available to them, and understanding how these policies may complement or substitute for one another can improve policy making moving forward. Towards this end, we propose that investigating the causal effects of the minimum legal drinking age in New South Wales, Australia, provides a particularly informative case study, because Australian states are among the world leaders in their efforts against drunk driving. Using an age-based regression discontinuity design applied to restricted-use data from several sources, we find no evidence that legal access to alcohol has effects on motor vehicle accidents of any type in New South Wales, despite having large effects on drinking and on hospitalizations due to alcohol abuse. Copyright © 2015 John Wiley & Sons, Ltd.

The Effect of Alcohol Regulation on Violence Against Women: Evidence from India

We provide quasi-experimental evidence on the role of alcohol regulation on alcohol consumption and violence against women using detailed individual level and aggregate data from India, where state level laws generate substantial variation in the availability of alcohol across people of different ages. We find that men are more likely to drink when they are of legal drinking age, and that the wives of these men are substantially more likely to report being physically abused. We then extend our analysis to a longer panel data set of state level crime rates, and find that some evidence that higher state minimum legal drinking ages are associated with lower rates of reported crimes against women.

The Minimum Legal Drinking Age and Crime.

We use variation from the minimum legal drinking age to estimate the causal effect of access to alcohol on crime. Using a census of arrests in California and a regression discontinuity design, we find that individuals just over age 21 are 5.9% more likely to be arrested than individuals just under 21. This increase is mostly due to assaults, alcohol-related offenses, and nuisance crimes. These results suggest that policies that restrict access to alcohol have the potential to substantially reduce crime.

Scoring the Strengths and Weaknesses of Underage Drinking Laws in the United States.

Several studies have examined the impact of a number of minimum legal drinking age 21 (MLDA-21) laws on underage alcohol consumption and alcohol-related crashes in the United States. These studies have contributed to our understanding of how alcohol control laws affect drinking and driving among those who are under age 21. However, much of the extant literature examining underage drinking laws use a "Law/No law" coding which may obscure the variability inherent in each law. Previous literature has demonstrated that inclusion of law strengths may affect outcomes and overall data fit when compared to "Law/No law" coding. In an effort to assess the relative strength of states' underage drinking legislation, a coding system was developed in 2006 and applied to 16 MLDA-21 laws. The current article updates the previous endeavor and outlines a detailed strength coding mechanism for the current 20 MLDA-21 laws.

Long-term effects of minimum legal drinking age laws on marijuana and other illicit drug use in adulthood

BackgroundExposure to permissive minimum legal drinking age (MLDA) laws (ability to purchase alcohol <21 years) during adolescence can have long-term effects, including heavy alcohol use or alcohol use disorders as adults. We examined whether exposure to permissive MLDA laws during adolescence has long-term effects on illicit drug use and disorders in adulthood. MethodsParticipants from the 2004–2012 National Survey of Drug Use and Health (NSDUH) were linked with historical state MLDA laws. Participants born in 1949–1972 (age 31–63 years at observation, n=110,300) were analyzed because they came of legal age for alcohol purchase when changes occurred in state MLDA laws. Logistic regression was used to model drug use measures as a function of exposure to permissive MLDA during adolescence, adjusting for state and birth-year fixed effects, demographics, and salient state characteristics. ResultsRates of past month use, past year use, and abuse/dependence of marijuana were 4.7%, 7.8%, and 1.2%, respectively. Rates of past month use, past year use, and abuse/dependence of illicit drugs other than marijuana were 2.9%, 6.2%, and 0.7%, respectively. Among the full sample, exposure to permissive MLDA laws was not significantly associated with drug use or abuse/dependence in adulthood. Men exposed to permissive MLDA laws were at 20% increased odds of past year illicit drug use (aOR 1.20, 95% CI 1.09–1.32). ConclusionsRestricting alcohol access during adolescence did not increase long-term drug use. Allowing the purchase of alcohol among those less than 21 years of age could increase the risk of drug use later in life.

The Effect of Alcohol Consumption on Labor Market Outcomes of Young Adults: Evidence from Minimum Legal Drinking Age Laws

Abstract This paper uses a regression discontinuity design to estimate the impact of the minimum legal drinking age (MLDA) laws on alcohol consumption and labor market outcomes of young adults. Using confidential data from the National Longitudinal Survey of Youth 1997 Cohort (NLSY97), I find that granting legal access to alcohol at age 21 leads to an increase in several measures of alcohol consumption. The discrete jump in the alcohol consumption at the MLDA has also negative spillover effects on the labor market outcomes of young adults. In particular, I document that the MLDA is associated with a 1 hour decrease in weekly working hours. However, the effect of the MLDA laws on wages is negative only under certain specifications. These results suggest that the policies designed to curb drinking may not only have desirable effects in reducing alcohol consumption among young adults but also have positive spillover effects on their labor market outcomes.

Effects of minimum legal drinking age on alcohol and marijuana use: evidence from toxicological testing data for fatally injured drivers aged 16 to 25 years.

BackgroundAlcohol and marijuana are among the most commonly used drugs by adolescents and young adults. The question of whether these two drugs are substitutes or complements has important implications for public policy and prevention strategies, especially as laws regarding the use of marijuana are rapidly changing.MethodsData were drawn from fatally injured drivers aged 16 to 25 who died within 1 h of the crash in nine states with high rates of toxicology testing based from 1999 to 2011 on the Fatality Analysis Reporting System (N = 7,191). Drug tests were performed using chromatography and radioimmunoassay techniques based on blood and/or urine specimens. Relative risk regression and Joinpoint permutation analysis were used.ResultsOverall, 50.5% of the drivers studied tested positive for alcohol or marijuana. Univariable relative risk modeling revealed that reaching the minimum legal drinking age was associated with a 14% increased risk of alcohol use (RR = 1.14, 95% CI: 1.02 to 1.28), a 24% decreased risk of marijuana use (RR = 0.76, 95% CI: 0.53 to 1.10), and a 22% increased risk of alcohol plus marijuana use (RR=1.22, 95% CI: 0.90 to 1.66). Joinpoint permutation analysis indicated that the prevalence of alcohol use by age is best described by two slopes, with a change at age 21. There was limited evidence for a change at age 21 for marijuana use.ConclusionsThese results suggest that among adolescents and young adults, increases in alcohol availability after reaching the MLDA have marginal effect on marijuana use.

Impacts of the minimum legal drinking age on motor vehicle collisions in Québec, 2000-2012.

International debates are occurring about the effectiveness of minimum legal drinking age laws. Most minimum legal drinking age evaluation studies have focused on motor vehicle collision outcomes, but this literature is primarily based on naturalistic experiments involving legislation changes in the U.S. in the mid-1980s. Few studies have provided up-to-date estimates of the impacts of Canadian drinking age laws on motor vehicle collisions to inform current policy discussions. To estimate the impacts of minimum legal drinking age legislation on motor vehicle collisions occurring in 2000-2012 in Québec, a province with a minimum legal drinking age of 18 years. Using Québec Ministry of Transportation records of police-reported motor vehicle collisions in 2000-2012, regression-discontinuity analyses were employed to assess the impacts of the minimum legal drinking age on motor vehicle collisions. All data were analyzed in 2013. Relative to individuals slightly younger than the minimum legal drinking age, male and female drivers just older than the minimum legal drinking age had a significant and abrupt increase of approximately 6% (men, 6.3%, p=0.003; women, 5.9%, p=0.047) in population-level motor vehicle collisions, as well as a significant 11.1% (p=0.001) rise in nighttime motor vehicle collisions (a proxy for alcohol-related collisions). Drinking-age laws continue to be an integral component of contemporary alcohol-control and driving-related policies designed to limit motor vehicle collisions among youth. In addition, the regression-discontinuity approach can guide future work to estimate potential minimum legal drinking age impacts on other health outcomes.

Underage access to online alcohol marketing content: a YouTube case study.

With the proliferation of the Internet and online social media use, alcohol advertisers are now marketing their products through social media sites such as YouTube, Facebook and Twitter. As a result, new recommendations have been made by the Federal Trade Commission concerning the self-regulation of digital marketing strategies, including content management on social and digital media sites. The current study sought to determine whether alcohol companies were implementing the self-imposed mandates that they have developed for online marketing. Specifically, we examined whether alcohol companies were implementing effective strategies that would prevent persons under the minimum legal drinking age in the USA from accessing their content on YouTube. We assessed 16 alcohol brands (beer and liquor) associated with the highest prevalence of past 30 day underage alcohol consumption in the USA. Fictitious YouTube user profiles were created and assigned the ages of 14, 17 and 19. These profiles then attempted to access and view the brewer-sponsored YouTube channels for each of the 16 selected brands. Every underage profile, regardless of age, was able to successfully subscribe to each of the 16 (100%) official YouTube channels. On average, two-thirds of the brands' channels were successfully viewed (66.67%). Alcohol industry provided online marketing content is predominantly accessible to underage adolescents. Thus, brewers are not following some of the self-developed and self-imposed mandates for online advertising by failing to implement effective age-restriction measures (i.e. age gates).

Effectiveness of Social Host and Fake Identification Laws on Reducing Underage Drinking Driver Fatal Crashes

Objective: The public generally assumes that the minimum legal drinking age of 21 (MLDA-21) legislation in the United States is embodied in a single law and therefore all states have the same law. Actually, the MLDA-21 state laws consist of multiple provisions that support the core MLDA-21 laws and include a family of policies directed at controlling underage drinking and underage drinking and driving. Because social host and fake identification laws have recently garnered interest by policy makers in the states, this study was designed to determine their effectiveness.Methods: The effective dates for 2 types of social host laws and 3 fake identification laws were documented using the Alcohol Policy Information System (APIS), the Substance Abuse and Mental Health Services Administration's (SAMHSA) 2011 Report to Congress on the Prevention and Reduction of Underage Drinking, and legal research tools. These laws include social host prohibitions (SHPs) and social host civil liability (SHCL), the use of fake identification (FID), retailer support for FID, and transfer/production of FID. We used a pre–post design to evaluate the influence on underage drinking-and-driving fatal crashes of these 5 laws using the Fatality Analysis Reporting System (FARS) data set for the years 1982 through 2010. The data were analyzed using structural equation modeling (SEM) controlling for as many variables as possible.Results: For those drivers younger than aged 21 years, FID supplier laws were associated with significant decreases in FARS ratios after states adopted these laws (−1.0%, P =.030).Conclusions: The 24 states that have adopted FID supplier laws are saving an estimated 14 lives per year in the United States. An additional 16 lives could be saved if the remaining states adopted this law. FID supplier laws prohibit the production of a FID or transfer of an ID or FID to another person. The more stringent the law (i.e., whether a state prohibits only one element [weaker law] compared to both transferring and manufacturing a FID [stronger]) the more effective a deterrent it becomes to supplying a minor with a FID. States without FID supplier laws should consider adopting them.

The effect of minimum drinking age laws on pregnancy, fertility, and alcohol consumption

Analysis of micro-level data reveals that changes in the minimum legal drinking age (MLDA) could induce changes in the intensity and location of alcohol consumption, sexual behavior, and teen fertility. Effects on teen fertility vary across different populations. Among 15–20 year-old non-poor whites, less restrictive legal access to alcohol decreases the probability of first pregnancy and abortion. For this group, easier legal access to alcohol likely increases the alcohol consumption in bars. For black and poor white young women, the results are sensitive to the alcohol consumption restrictions measure. A decrease in the MLDA increases the probability of first pregnancy and abortion. Yet, using a more precise measure that accounts for the MLDA and the woman’s age, these results generally no longer hold.

The effects of random breath testing and lowering the minimum legal drinking age on traffic fatalities in Australian states

ObjectiveThis study aims to apply time series analysis techniques to examine the effects of random breath testing (RBT) on three age-specific traffic fatalities in four Australian states while considering the...

Determinants of drink-driving and association between drink-driving and road traffic fatalities in Ghana

Damsere-Derry, J., Afukaar, F., Palk, G., &amp; King, M. (2014). Determinants of drink-driving and association between drink-driving and road traffic fatalities in Ghana. The International Journal Of Alcohol And Drug Research, 3(2), 135-141. doi:http://dx.doi.org/10.7895/ijadr.v3i2.135Aims: The objective is to establish determinants of drink-driving and its association with traffic crashes in Ghana.Methods: A multivariable logistic regression was used to establish significant determinants of drink-driving, and a bivariate logistic regression to establish the association between drink-driving and road traffic crashes in Ghana.Results: In total, 2,736 motorists were randomly stopped for breath testing, of whom 8.7% tested positive for alcohol. Among the total participants, 5.5% exceeded the legal BAC limit of 0.08%. Formal education is associated with a reduced likelihood of drink-driving compared with drivers without formal education. The propensity to drink-drive is 1.8 times higher among illiterate drivers than it is among drivers with basic education. Young adult drivers also recorded elevated likelihoods for driving under alcohol impairment, compared with adult drivers. The odds of drink-driving among truck drivers is OR = 1.81 (95% CI = 1.16 to 2.82) and two-wheeler riders is OR = 1.41 (95% CI = 0.47 to 4.28) compared with car drivers. Contrary to general perception, commercial car drivers have a significant reduced likelihood of 41%, OR = 0.59 (95% CI = 0.38 to 0.92) compared with private car drivers. Bivariate analysis conducted showed a significant association between the proportion of drivers exceeding the legal BAC limit and road traffic fatalities (p &lt; 0.001). The model predicts that a 1% increase in the proportion of drivers exceeding the legal BAC will be associated with a 4% increase in road traffic fatalities (95% CI = 3% to 5%) and vice versa.Conclusions: A positive and significant association between roadside alcohol prevalence and road traffic fatality has been established. Scaling up roadside breath tests, determining standard drink (e.g., any drink which contains about 10 grams of absolute alcohol) and disseminating this information to the populace, and formulating policies targeting youth (such as increasing minimum legal drinking age and reducing the legal BAC limit for youth and novice drivers) might reduce drink-driving related crashes in Ghana.