Nation-scale primary prevention to reduce newly incident adolescent drug use: the issue of lag time

Abstract

BackgroundThere is limited evidence about the effects of United States (US) nation-level policy changes on the incidence of alcohol drinking and tobacco smoking. To investigate the potential primary prevention effects on precocious drug use and to clarify lag-time issues, we estimated incidence rates for specified intervals anticipating and lagging after drug policy enactment. Our hypotheses are (a) reductions in underage drinking or smoking onset and (b) increases of incidence at the legal age (i.e., 21 for drinking and 18 for smoking).MethodsThe study population is 12–23-year-old non-institutionalized US civilian residents. Estimates are from 30 community samples drawn to be nationally representative for the US National Surveys on Drug Use and Health 1979–2015. Estimates were year-by-year annual incidence rates for alcohol drinking and tobacco smoking by 12–23-year-olds, age by age. Meta-regressions estimate age-specific incidence over time.ResultsIncidence of underage alcohol drinking declined and followed a trend line that started before 1984 enactment of the National Minimum Drinking Age Act, but increased drinking incidence for 21 year olds was observed approximately 10 years after policy enactment. Eight years after the Synar amendment enactment, evidence of reduced smoking incidence started to emerge. Among 18 year olds, a slight increase in tobacco smoking incidence occurred about 10 years after the Synar amendment.ConclusionOnce nation-level policies affecting drug sales to minors are enacted, one might have to wait almost a decade before seeing tangible policy effects on drug use incidence rates.

Examining the Intended and Unintended Impacts of Raising a Minimum Legal Drinking Age on Primary and Secondary Societal Harm and Violence from a Contextual Policy Perspective: A Scoping Review

“…Thirty-five studies were found which reported information (37 units of information) on the impacts of an increase in an MLDA on primary societal impacts (i.e., drinking, possession and purchasing patterns of alcohol) [ 44 , 45 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 ]. Thirty-seven units of information were found, since 2 of the 35 studies reported information on multiple types of primary societal impacts, finding significant/relevant impacts in some cases and finding no impact in others.…”

“…Of these 35 studies, 29 (82.9%) found a significant and relevant impact from an increase in the MLDA on primary societal impacts [ 44 , 45 , 49 , 51 , 52 , 53 , 54 , 55 , 56 , 58 , 59 , 61 , 62 , 63 , 64 , 65 , 67 , 68 , 70 , 71 , 72 , 73 , 74 , 76 , 77 , 78 , 79 , 80 , 81 ]. More specifically, of these 29 studies, 14 found a negative (protective) impact on various short-term output measures of drinking patterns (i.e., alcohol consumption for underage youth) after the increase in the MLDA [ 45 , 53 , 54 , 55 , 56 , 58 , 61 , 62 , 64 , 65 , 71 , 74 , 76 , 79 ]. Short-term impact was reported on: past month alcohol use [ 45 , 57 , 66 , 78 , 80 , 81 ]; ...…”

“…Furthermore, in 4 of the 14 studies mentioned above, a joint impact on drinking patterns was found with increase in the MLDA and the real prices of beer [ 71 , 76 ], Zero Tolerance laws [ 53 ] and excise taxes, mass media campaigns, grassroots movements and variations in the implementation of policies over time [ 54 ]. Furthermore, out of the 29 studies, 2 studies reported a negative (protective) impact on long-term decreases in drinking patterns after the MLDA was raised [ 49 , 77 ].…”

“…Increases were reported in the frequency of teenagers’ obtaining alcohol at parties and having others purchase alcohol for them [ 44 , 51 , 62 ]. Additionally, 8 of the 29 studies found that raising an MLDA had a significant decrease on aggregate or per capita alcohol sales [ 54 , 58 , 63 , 65 , 67 , 73 , 76 , 77 ].…”

Trends and Determinants of Catastrophic Health Expenditure in China 2010-2018: A National Panel Data Analysis

“…These CHE determinants vary across time and geographical location. The time lag between the implementation of health policy and its outcomes requires panel, or longitudinal data [23]. Most CHE China studies utilized cross-sectional survey data [19][20][21][22] or limited 2 or 3 year longitudinal comparison studies [16].…”