Underage Drinking Starts Before Adolescence

"A review of national and statewide surveys conducted over the last 15 years shows that among typical 4th graders, 10% have already had more than a sip of alcohol and 7% have had a drink in the past year. While the numbers are small in the fourth grade, the surveys show that the percent of children who have used alcohol increases with age, and doubles between grades four and six. The largest jump in rates occurs between grades five and six," according to John E. Donovan, Ph.D., an associate professor of psychiatry and epidemiology at the University of Pittsburgh Medical Center.

He is author of the study, "Really Underage Drinkers: The Epidemiology of Children's Alcohol Use in the United States," published in the September issue of Prevention Science.

Dr. Donovan said that although there are many published national surveys of alcohol use among adolescents, national surveys and those conducted by state governments that have looked at alcohol use among young children are often unpublished.

He found that 39 of the 50 states have conducted statewide surveys that included children in the 6th grade or younger. His study summarized the results of the available national surveys as well as the statewide surveys conducted by Arizona, Delaware, New York, Ohio and Texas, which included fourth and fifth graders.

Several of the surveys conducted on a regular basis since 1990 show that the numbers of elementary school children who have ever used alcohol, who have used alcohol in the past year, and who have used alcohol in the past month have all decreased significantly over time. "But the numbers are still alarming because of the connection between early alcohol consumption and negative outcomes later during both adolescence and young adulthood. It is this linkage that argues most strongly for preventing alcohol use prior to adolescence," Donovan said.

The surveys also show that African-American children are at as much at risk for early drinking as are other children, despite their lower risk for drinking as adolescents. "Children are drinking, and our concern with underage drinking needs to start in elementary school, not in high school or college. Research shows that prevention programs should begin before the targeted behavior begins. But alcohol use prevention programs among 5th graders or younger students have shown inconsistent results. Successful programs aimed at these children have involved parents and other family members, not just the children in the school setting," according to Donovan. "Prior to this review, these data on children's drinking were buried in foundation or state government reports, or stored on hard-to-find internet web sites, so we didn't know the true extent of the problem of children's involvement with alcohol," he said.

Donovan located four national surveys that included questions about children's alcohol and drug use. The four surveys were the Partnership Attitude Tracking Study (PATS), the National Survey of Parents and Youth (NSPY), the Health Behavior in School-aged Children (HSBC) survey and the PRIDE Survey. These surveys included limited questions about children's use of alcohol. Surveys of young children conducted by states included versions of the Youth Risk Behavior Survey (YRBS), the Communities that Care (CTC) questionnaire, and the PRIDE survey

The study by the University of Pittsburgh researcher was funded by the National Institute on Alcohol Abuse and Alcoholism. It points out the need for an ongoing national survey of children aged 12 and under to monitor children's alcohol use and the need for alcohol prevention efforts in this population.

"Knowing how many children have had experience with alcohol would serve as an indicator of the number potentially at risk for later use of marijuana and other illicit drugs. Childhood use of alcohol also predicts involvement in alcohol problems, alcohol abuse and dependence in both adolescence and adulthood. And early drinking relates to a variety of other problems, including absences from school, delinquent behavior, drinking and driving, sexual intercourse and pregnancy," Donovan said.