Monday, August 31, 2009

The Tide is Turning

According to the latest Rasmussen poll, 30% of American adults believe that the drinking age should be lowered to 18, and 5% believe it should be lowered to 16. This combination, 35%, is a record high, and this is one of the few times in decades that we broke the 30% barrier. And only 51% believe it should remain at 21, a record low. Adults under 40 were fairly even on whether the drinking age should be 18 or 21 (last year it was about half of men and about a quarter of women under 40 who wanted the age to be 18), another sign of progress. (Now, if only we could get young people to vote more!)

Also, 50% of adults believe that drunk driving laws are too lenient, while only 8% think they're too tough. That's one thing we at 21 Debunked do agree with the majority on.

It appears we are fast approaching a critical mass, if we have not achieved one already. Remember that it does not always take a majority to prevail, as Samuel Adams so eloquently noted.

Forty years ago, it was 1969. Lots of great things happened in that fateful year (Woodstock, the moon landing, the first Earth Day, etc.), but most relevant to the debate is the fact that the first two states to lower the drinking age (the first time around) did so that year. From 1970-1976, 30 states would lower their drinking ages, chiefly in 1972-1973, after decades of it being 21 in most states (some were 18 since the 1930s or remained 21 throughout). This occurred because the voting age and age of majority were lowered, due to the hypocrisy that 18-20 year olds were dying in Vietnam but were not allowed to have full adult rights, leading to much protest from that age group. Sound familiar? There was a huge mass of young people at the time, whose numbers would decline to political impotence in the 1980s (when the drinking age was raised to 21) and rise again in the late 1990s and especially the 2000s. Forty years later, the children of the Baby Boomers have come of age. There are now at least as many young Millennials as there were young Boomers in 1969, and they are a force to be reckoned with as there is strength in numbers.

If the current groundswell continues, perhaps we can consider 2009 to be like the new 1969, and so on. Only now Vietnam is spelled "Iraq" (or perhaps "Afghanistan"). Thus, we may lay the events on a timeline and make a prediction that the first state or two to lower the drinking age will do so in 2009-2011. Those will be the "guinea pigs," and how the feds handle it in 2011 will be crucial to the movement's success--that will be the wild card. If a large number of states follow suit, that will likely occur in 2012-2013. If so, a few more may do so in 2014-2016, and hopefully the Millennials won't sell out like the Boomers did back in the day.

Of course, this is all just speculation, but it can happen. What better time than now?

Monday, August 24, 2009

Our Modest Proposal

While the first post outlines our purpose and views, and should be read, some folks may still be confused about details. Here is precisely what we at Twenty-One Debunked (a subsidiary of the True Spirit of America Party) propose, in concrete terms, to further the cause of justice and help reduce America's drinking problem:

  1. Lower the drinking age to 18, period. No compromises, except perhaps to have the age for kegs/cases/other very large quantities be 20 or 21.
  2. Raise the beer tax and liquor tax to its 1951 and 1991 inflation-adjusted values, respectively, and make the beer tax proportional to alcohol content. (No tax hike for microbrews.) Use the funds to pay for education, treatment, and DUI enforcement.
  3. Crack down hard on DUI, increase penalties, lower BAC limit to 0.05%. Have graduated (but stiff) penalties based on BAC, with serious jail time for high BAC offenders. Lose license forever on second offense above 0.08, regardless of age. No more excuses.
  4. Keep Zero Tolerance age at 21, and/or make it for anyone who has had a license for less than 5 years, regardless of age.
  5. Increase honest alcohol education, which should begin long before 18.
Lower-priority measures that we support include the following:
  • Restrict alcohol advertising to no more than what is allowed for tobacco.
  • Regulation of alcohol outlet density.
  • Price floors on off-premises sales.
  • Free or low-cost taxi service to and from bars and/or improved late night public transportation.
  • Increased alcohol treatment.
  • Make driver licenses tougher to get and easier to lose, and the road test much tougher.
  • Make it a federal crime to drive drunk across state lines, punishable by many years in federal prison.
What we do NOT support:
  1. Special restrictions on 18-20 year olds that do not apply to those over 21 (except perhaps on bulk quantities of alcohol) or any kind of strings attached, including "drinking licenses".
  2. Dram shop and social host laws of any kind.
  3. Loopholes that allow DUI offenders to get off easily (e.g. plea bargain for "reckless driving").
  4. Harsh criminal penalties for underage drinkers of any age.
  5. Blue laws.
  6. Public drunkenness laws based solely on BAC or the mere fact of drinking.*
  7. Laws that completely prohibit parents from giving their own children alcohol.
  8. Any laws that require that the Constitution be violated in order to adequately enforce them.**
*We do support laws against drunk violence and disorderly conduct, and tougher enforcement thereof.
**We do not consider implied consent laws to be against the constitution, and have no problem with stiff penalties for test refusals for drivers (but no one else).

Friday, August 14, 2009

Latest Brain Studies Demonstrate The Same Old Flaws

Potentially adding fuel to the fire of the drinking age debate is a new study of 18-20 year old first-year university students in Spain, that looked at the effects of so-called "binge" drinking on the brain. In this study, 95 students (42 "bingers", 53 controls) were given tests of attention and working memory, and their specific brain waves were monitored with electrodes. No statistically significant differences were observed between the two groups in terms of actual performance, but the electrophysiological test suggested that more attention was expended to complete a given task among the "binge" group, as well as other electrophysiological differences. This is a lot more nuanced and less certain than the media are implying, and hardly represents "dain bramage."

The biggest flaw in this study was the fact that there was no over-21 comparison group. So we simply cannot infer anything at all about age from this piece of research. Absolutely zilch. A better method would have been to have three groups: 15-17, 18-20, and 21-24 years of age. But no study that we know of meets this standard. This would help to settle the nagging question of whether or not it actually is worse to drink at 18 rather than 21. Or perhaps some people are afraid of the possibility that their rationale for keeping the drinking age at 21 would be debunked if such a comparison was done. As yet, there is essentially ZERO hard evidence that drinking at 18 is significantly worse than doing so at 21, ceteris paribus, but a plethora of evidence showing that excessive drinking is unhealthy at any age. To be fair, however, the purpose of the study was not to test the rationale for the drinking age, but rather the effects of alcohol on a particular segment of the population.

Other flaws included small sample size, and not enough information to determine whether the results are of any practical significance. The lack of behavioral performance differences between the two groups suggests that the answer is not very much, but still warrants more study before jumping to any conclusion either way. Subjects were only required to refrain from using alcohol or drugs for at least 12 hours, so acute and transient effects (such as hangover, which can last for up to 36 hours) cannot be ruled out. Also, this was a cross-sectional study, so we do not know whether or not the purported effects were acutally innate characteristics that predated (or even predisposed for) the "binge" drinking. Tobacco smoking was also not controlled for. In other words, this study is preliminary at best.

It is also interesting to note that the average age of onset of drinking in the "binge" group was 14, and 15 in the nonbinge group.

The reason this blog uses scare quotes on the word "binge" is by convention: we do not feel that the definiton used (6+ standard drinks on at least one occasion in the past month, at a pace of 3+ drinks per hour) was an adequate one. That was equivalent to about 4+ American drinks, and undercounting and underreporting can also confound the results as well. Given the small sample size, there could be a few students that drank much more than the others, and more than they led on, and skewed the results. Some could have been dishonest about alcohol use disorders, which were an exclusion criterion, and could also have skewed the results.

Another recent study, done on college students in Belgium, also found similar electrophysiological differences, but again no behavioral differences for some reason. In this study, there were no differences in alcohol consumption or electrophysiological results at baseline, but both changed significantly in the "binge" group when measured 9 months later, but not in the control group. However, we should keep in mind that the binge group averaged 12.5 units (about 9 American drinks) per binge session, and two such binge sessions per week, which is quite extreme. Number of (American) drinks per week averaged a whopping 35 units (25 American drinks) in the binge group, while the control group drank about one drink per week. And some participants drank as recently as three days before the tests as well, potentially conflating short and long term effects, though this was ostensibly controlled for. One good thing about this study, however, was that the sample size was significantly larger than the aforementioned one, and there was both a before test and and after test.

Still another study in 2007, this time of 21-25 year olds (you know, folks who are legally allowed to imbibe) who were self-identified heavy drinkers (more than 25 drinks per week), found that subtle brain changes are not exclusive to those under the magic age of 21.  The heavy drinkers did not exhibit significant neuropsychological test differences, but PET scans showed subtle differences.  Of course, this study did not gain nearly as much attention as the others previously mentioned.

Drinking ludicrous amounts of alcohol is dangerous, period.  Regardless of age.  That, if anything, should be the moral of the story. Keeping the drinking age at 21 only encourages such extremes, especially for college students.

We at 21 Debunked provide this for informational purposes only and do not in any way advocate drinking of any kind, underage or otherwise.

Tuesday, August 4, 2009

Looks promising for South Carolina (Updated)

Two recent lower (county level) court rulings have declared South Carolina's drinking age of 21 unconstitutional. The state's constitution says that “Every citizen who is eighteen years of age or older ... shall be ... endowed with full legal rights and responsibilities, provided that the General Assembly may restrict the sale of alcoholic beverages to persons until age twenty-one.” (emphasis added). Also cited was a SC Supreme Court decision in May 2008 that struck down a law banning handgun possession by 18-20 year olds. If these rulings are upheld on appeal, then the age for possession and consumption of alcohol would automatically revert to 18, like it was 25 years ago. But the age for sale would remain 21, unless the legislature decides to lower it. And the results of the court cases would only be binding in the affected counties unless the SC Supreme Court upholds the appeal as well.

However, the legislature could always change the state constitution, but only with voter approval.

While limited, this is clearly a step in the right direction. Domino effect you say? One can only hope.

UPDATE: We may have spoken too soon. On August 26, 2009, a circuit court upheld the drinking age of 21, unfortunately. The judge said it would create an "absurd result" to allow possession and consumption, but not sale, to 18-20 year olds. (But the SC constitution clearly says "sale" and nothing about possession or consumption). Honestly, the real absurdity is the fact that 18-20 year old legal adults are allowed to go to war, vote, get married, raise kids, and even (as of 2008) carry handguns in SC, but not drink--period. And we (the USA) stand alone among the developed world in maintaining this absurdity.

However, the latest ruling can still be appealed further if so desired, possibly all the way to the Supreme Court. It is too early to throw in the towel just yet.

The drinking age must be lowered, in the interest of justice. What better time than now?

Saturday, August 1, 2009

About-Face, About Time!

You know the 21 drinking age is on its last legs when one of its former supporters, substance abuse expert Dr. Morris Chafetz, has a sudden change of heart a quarter-century later. Remember that presidential commission in 1982? The one that gave 39 recommendations, #8 of which was to raise the drinking age to 21? Well, Dr. Chafetz was on that commission, and he now calls his decision to support Legal Age 21 "the single most regrettable decision" in his career.

Now THAT really says something! Especially given the length of his career. And he's no hippy-dippy or wild party animal either. Dr. Chafetz was the founding director of the NIAAA (pronounced "nee-ahh") beginning in 1970, a psychiatrist, and a renowned expert on alcohol.

He also notes, as 21 Debunked has, that the alcohol-related traffic fatality decline in the US was virtually identical to that in Canada, a country that did not raise the drinking age to 21. Even NHTSA admits this, and it is pretty tough to explain away. This fact alone puts a huge question mark over the specious claim the Legal Age 21 saves any lives at all. Additionally, he echoes the view that the 21 drinking age created unintended negative consequences, such as more deaths and injuries off the roads from clandestine, underground binge drinking (not unlike Prohibition).

As a result, we at 21 Debunked propose an honor for anyone who once fervently supported Legal Age 21 but has finally seen the light. Three cheers for the first ever recipient of the Chafetz award!

The tide, my friends, is turning as we speak. What better time than now?

Thursday, July 2, 2009

The Shell Game

A recent study found that "binge drinking"* has declined overall from 1979 to 2006 among young people, with one notable exception--college students. Oh yeah, and young females also.

During this period of nearly three decades, men and women experienced converging trends in reported "binge" drinking:

Males

Age 15-17: -50%
Age 18-20: -20%
Age 21-23: -10%

Females

Age 15-17: unchanged
Age 18-20: unchanged
Age 21-23: +40%

while college students and nonstudents the same age experienced diverging trends:

College:

Age 18-20, males: unchanged
Age 18-20, females: unchanged
Age 21-23, males: unchanged
Age 21-23, females: +40%

Non-college:

Age 18-20, males: -30%
Age 18-20, females: unchanged
Age 21-23, males: -10%
Age 21-23, females: +20%

The authors took this as evidence that raising the drinking age to 21 was successful. But there are two problems with that theory. One is that they are assuming that correlation was causal without controlling for other variables, while in reality the downward trend predated the raising of the drinking age to 21. It was a secular trend, albeit one with some groups bucking it. And a higher drinking age may also increase underreporting as well. The other flaw is that it even if it were partly due to the drinking age being raised, it appears to have been a rather hollow victory upon closer examination. Females seeing no change or even an increase? Ditto for 21-23 year olds? Zero progress among collegians? If that's success, I'd hate to see what failure looks like.

Using an overly broad definition of "binge" drinking, like the one used above (5 drinks in an evening at least once in the past month)* may mask trends in truly dangerous drinking. Another study found that between 1998 to 2005, there was an increase in alcohol-related deaths, self-reported "binge" drinking, and self-reported driving after drinking among college-age 18-24 year olds (but in most cases a peak was reached in 2001-2002). Deaths were driven by a near tripling in the number of alcohol poisoning fatalities. That's a good index of extreme drinking, well above the 5 drinks threshold. But because the increase in self-reported "binge" drinking and driving after drinking was primarily among 21-24 year olds, while 18-20 year olds stayed roughly the same, some people have taken that as a sign of success. Again, this is specious reasoning. It seems that the 21 drinking age (and increased enforcement thereof) simply shifted such behavior a few years into the future, not at all unlike the drunk driving studies mentioned on this blog.

And remember, from 1993-2001 when "binge" drinking was (modestly) increasing for all age groups, 18-20 year olds ironically saw the largest increase of all (+56% in the number of "binge" episodes per person per year) before ostensibly declining again. So part of the increase in 21-24 year old binge drinking could in fact be a cohort effect a few years later. But for 18-20 year olds, it remains elevated in spite of (or perhaps even because of) tougher 21 law enforcement over time. It is also worth noting that the number of episodes per person per year increased faster than the proportion of "binge" drinkers in the population.

Further evidence of failure is that, according to MADD, about half (48%) of the of the alcohol consumed by college students (at four-year schools) is consumed by students under 21. This is even more striking when you consider that only 37% of four-year collegians are under 21.

In other words, at best, a drinking age of 21 appears to merely delay binge drinking, drunk driving, and alcohol-related injuries and deaths. At worst, it may even prolong such behavior. In other words, a shell game.


*A convention on this blog is to always use scare quotes when referring to "binge drinking" defined as an arbitrary number of drinks in an evening. Definitions very as there is no international consensus on what qualifies as a "binge," but the most common definition is 5 or more drinks in the same occasion (evening), or 4 for a woman in some definitions, regardless of drinking speed, weight, etc. When no scare quotes are used, we are talking about truly heavy, rapid, high-intensity drinking--often involving serious chugging or slamming many shots in a short period of time--which involves an unacceptably high risk of harm for anyone of any age. Our definition implies very high intoxication, at least 0.15 BAC if not 0.20+. That is where the lion's share of real problems occur. Fortunately, the vast majority of Americans, even college students, do not do this, regardless of what the media says.

Sunday, June 14, 2009

Why should I support lowering the drinking age?

This is probably the first question you are asking. Here are the answers (adapted from the Drug War Rant FAQ by Pete Guither), each tailored to a different group:

Q1) I am a liberal Democrat. Why should I support lowering the drinking age?

A1) The drinking age of 21 is a form of age discrimination, and Democrats are not supposed to support discrimination. Young people are one of the party's greatest assets as well. It also creates just another excuse to arrest poor and/or minority youth, similar to what happens during the War on Drugs. Besides, the law does not work very well as written.

Alienating youth, the future of America, any further than necessary is foolish. It will come back to bite you in the end, since they are part of your base.

The right to privacy of Roe v. Wade fame, used often by the pro-choice crowd, would logically extend to personal choices about alcohol use among legal adults as well. And the age of adulthood is 18 in nearly every state.

If you're old enough to go to war, you're old enough to go to the bar.

One could also note that enforcement of such a futile law is expensive, wasting money that could be used on education, treatment, and other positive programs that would reduce alcohol abuse.

Q2) I am a conservative Republican. Why should I support lowering the drinking age?

A2) Interesingly, you have even stronger reasons to support a lower drinking age than the Democrats do. First, it is not fiscally conservative to spend ludicrous amounts of money enforcing a futile law. Over two decades after raising the drinking age, the majority of 18-20 year olds still drink. Secondly, basic conservative principles such as individual liberty and responsibility, free market economics, and respect fror the family are all grossly violated by having a drinking age higher than the age of majority. Thirdly, states' rights (another basic conservative principle) are violated by the federal coercion to have a drinking age of 21.

A law whose primary purpose is protecting legal adults from themselves is incompatible with free-market capitalism, and it would inherently retard natural selection if it were successful.  True conservatives and old-school Republicans do not support "nanny-state" policies.

In addition, "Law and Order" Republicans should note how diverting law enforcement resources away from real crimes cannot be good. A higher drinking age has never been proven to reduce crime. Plus, a high drinking age erodes respect for law and authority as well by making criminals out of otherwise law-abiding citizens.

Q3) I am a libertarian. Why should I support lowering the drinking age?

A3) Well DUH! If you need to ask, you are probably not a libertarian.

Q4) I am a member of the Green Party. Why should I support lowering the drinking age?

A4) The same reasons from Question 1 apply to you as well. But there are others as well.

The core principles of sustainability and social justice preclude any unenforceably high drinking age. Legal Age 21 is not very eco-friendly in that it leads to litter-laden "woods parties" and the use of disposable plastic cups at clandestine parties when they are forced underground.

Q5) I am a communitarian who does not believe in individual rights. Why should I support a lower drinking age?

A5) There are plenty of arguments for lowering the drinking age that do not appeal to a notion of individual rights. First of all, a drinking age of 21 inhibits social cohesion, creating an "us against them" mentality. Second of all, it fails to adequately protect young people from the dangers of alcohol--it merely forces drinking underground and in many ways makes things more dangerous. Third, it encourages truly dangerous drinking styles (extreme binge drinking), which can have knock-on effects on non-drinkers as well.

It would be better for all members of a community if 18 year olds were allowed to drink "above ground" like older adults can, where it can be better monitiored, and resources can be better prioritized.

Also, read Question 4 above and read on to Question 12.

Q6) I am a Christian who believes drinking, especially teen drinking, is immoral. Why should I support lowering the drinking age?

A6) Most of the negative alcohol references in the Bible concern the abuse of alcohol, rather than simply use. And none of these are age-specific. There also several positive references to alcohol in the Bible as well. In fact, the ratio to positive to negative references is almost 4 : 1. And let's not forget that Jesus turned water into wine. And there were plenty of people under 21 who partook of it. Im other words, there is zero Scriptural evidence that Jesus would have supported a legal drinking age of 21.

It can also be said that, like Prohibition, the 21 drinking age creates a "forbidden fruit" that tempts the youth to drink and behave in a more sinful manner, and potentially drags them further away from the church and into an underworld full of God knows what. It also erodes respect for the law by making criminals out of otherwise law-abiding citizens. So Matthew 18:6, the famous "millstone" verse often invoked by the Women's Christian Temperance Union, could actually be used to refute the 21 drinking age and other forms of neoprohibitonism.

However, there are some Christians who believe in abstinence and some who believe in moderation. Those are both perfectly acceptable personal spiritual beliefs and do not require civil laws to back them up.

Q7) I lost loved ones due to drunk driving. Why should I support lowering the drinking age?

A7) Because there are far better and more constructive ways to tackle that problem than age-discriminatory prohibition. You don't swat a fly with a sledgehammer unless you want to see unintended adverse consequences. Alternative approaches that have worked well in other countries include raising the alcohol taxes, lowering the blood alcohol limit further, tougher penalties and enforcement for DUI, and education would serve society much better. Increased public transporation would also likely reduce fatalities. Bottom line: we need to stop being so lenient with drunk drivers, the terrorists of the road, and mount a wholehearted campaign against the practice without the distractions of the 21 drinking age (which consumes precious resources that could be better spent elsewhere). And most drunk driving fatalities are caused by drivers over 21, with 21-24 year olds being the worst of all.

Q8) I have a relative/friend/acquaintance who died or had his/her life ruined from alcohol at an early age. Why should I support lowering the drinking age?

A8) A situation like this is a terrible tragedy. However, it does not mean that criminalization of teen drinking is the answer. I assume that this tragedy happened when the drinking age was 21, yet the extensive law enforcement resources and erosion of civil liberites did not prevent it.

In some cases, alcohol abuse tragedies will happen whether the drinking age is 18, 21, or any other number. On the other hand, criminal prohibition often adds to the dangers:

  • Criminalization adds a stigma to teen drinking that often prevents people from seeking help until it's too late.
  • Stigma can also interfere with seeking medical attention in the case of alcohol poisoning and alcohol-related injuries. Someone who would not hesitate to rush an over-21 friend with alcohol poisoning to the emergency room, may unfortunately wait a dangerous amount of time considering what to do with an under-21 friend who has overdosed or was injured under the influence. (Not that there is any real excuse, of course)
  • Forcing alcohol use underground increases the risk of alcohol poisoning, injuries, and violence associated with clandestine drinking.
  • Since they don't know when the next opportunity to drink will be, binge drinking often results. As they get older, the opportunities become more frequent, but the high drinking intensity remains. And when they finally do turn 21, they drink even more before the eventually begin drinking less.
  • Some teens drive drunk rather than ask their parents for a ride, out of fear that they will find out they had been drinking. Much teen drinking takes place in far-off locations as well, and this obviously spells trouble in rural areas.
  • By trying in vain to keep 18-20 year olds from drinking, law enforcement officers (and others) are often spread way too thinly to help keep alcohol away from those under 18, especially those under 15 (who appear to be at a heightened risk for later alcohol problems relative to older teen drinkers). Our priorities are clearly not straight. In fact, national surveys show that it is easier for 13 year olds to get alcohol than cigarettes (purchase age 18 in most states) despite such a high drinking age of 21!
The truth is that many, but not all, of the dangers associated with teen drinking can be eliminated or reduced through lowering the drinking age to 18. For the rest, Legal Age 21 won't help (it would merely mask or delay the problems, if it even does anything at all), but increased stigma-free treatment and education programs can. Remember, we don't have a teen drinking problem, we have an American drinking problem. Alcohol abuse is a problem at all ages, not just those under 21, and Legal Age 21 is not a solution. In fact, it is part of the problem, and distracts from the pinkest elephant of all in the room--the alcohol abuse among older adults.
Wiser societies, such as many European countries, have been able to tackle alcohol abuse much better than us without any sort of prohibitionist element present. Over there, parents teach their kids how to drink responsibly rather than approach alcohol from a position of moral panic. And most importantly, they draw a sharp distinction between use and abuse--to them, the first is natural and normal, while the second is greatly frowned upon at any age.

Q9) I am a feminist. Why should I support lowering the drinking age?

A9) The pro-21 crowd is constantly saying that Legal Age 21 protects young women from being victimized. But that is patently false. There is no hard evidence that this is true. In fact, forcing drinking underground needlessly puts young women in dangerous situations where they are more likely to be victimized. And enforcing the drinking age diverts precious resources away from fighting real crimes as well, including sexual violence. The dangers are real, but the drinking age does nothing to reduce them. And let's not forget Natallee Holloway, and the countless others like her as well.

What the pro-21 crowd is really saying is that 18-20 year old women, despite being legal adults, still need to be protected from themselves, as if they were children. Any self-proclaimed feminist that is not offended by this assertion is probably not a real feminist.

Q10) I am over 21. Why should I support lowering the drinking age?

A10) Believe it or not, there are plenty of non-altruistic reasons to support it. Do you have any friends under 21? Relatives? How about roommates? Or a significant other? Do they drink? Do you drink? If any of these is answered "yes," you have plenty of reasons to support a drinking age of 18.

Legal Age 21 arbitrarily divides the 18-24 demographic into two groups, creating a virtual Berlin Wall between them. One group can go to bars, the other can't. One lives in the Overworld, the other in the Underworld, so to speak. This limits the opportunities for socialization between them, especially in locations where the law is strictly enforced. Thus, the law inhibits social cohesion. And when the 18-24 demographic is divided in any way, they are more easily conquered as well.

Even worse, some states have "social host" laws in which you can be held criminally and/or civilly liable for what an underage person does after drinking in your apartment. And those cases, especially civil ones, can get real ugly in our over-litigious society.

Plus, you also have to deal with those annoying keg registration laws in some states, not to mention being constantly asked for ID no matter how old you look.

Yes, if you just turned 21 you may at first not like having your thunder stolen, or seeing 18 year olds hanging out in your favorite bars, but that's a small price to pay for liberty and social cohesion. Remember that you were 18 once as well.

Q11) I am a college president/professor/RA/RD/staff member. Why should I support lowering the drinking age?

A11) You have plenty of reasons:

  • Over 130 college presidents have signed the Amethyst Initiative, an initiative to debate the 21 drinking age. Most of those who have the courage to debate such a sacred cow are also ambivalent or against it rather than for it.
  • Your liability will most likely be reduced if the drinking age was 18, along with liability insurance costs. (One would hope that tuition would follow as well)
  • It would be a lot easier to monitor the drinking behavior of students when drinking is done "above ground" instead of "underground" like it is now.
  • It would be easier to teach students how to drink responsibly when they don't have to hide the fact that they drink.
  • Colleges are currently faced with a moral dilemma: either become arms of the law or havens from the law. Both have been tried; neither works very well.
  • You would now be able to focus on the real problems of alcohol abuse rather than drinking per se.
Q12) I am a parent of a high school student. Why should I support lowering the drinking age?

A12) Ah, the toughest nuts to crack. Where should I begin?
  • High school students in America, especially seniors, have always drank, and always will. The majority of upperclassmen will do so at least occasionally. That is about as certain as death and taxes. The 21 drinking age has not stopped it, though it often puts them in dangerous situations since drinking is forced underground.
  • They currently have little trouble getting their hands on booze, though the methods of procurement are highly unpredictable. Alcohol is easier to get than cigarettes according to surveys of both 8th and 10th graders. Even in grades 11 and 12, where the spillover should be strongest, the overall availability is not dramatically different. But since they don't know when their next opportunity to drink will be, binge drinking often results from this feast-or-famine mentality. The current situation is the worst of both worlds--it creates both "forbidden fruit" and "low-hanging fruit" at the same time.
  • Legal Age 21 turns alcohol into a "gateway" drug.
  • It would be better to focus enforcement on keeping alcohol out of the hands of kids much younger than 18 (especially those under 15) rather than divert precious resources toward utterly futile attempts at keeping 18-20 year olds from drinking.
  • Better methods of reducing teen alcohol abuse and related problems include raising the alcohol taxes (especially on cheap beer), advertising restrictions, honest alcohol education that begins well before 18, and tough enforcement against drunk driving, drunk violence, and disorderly conduct. These methods have been proven to work in numerous countries around the world.
  • A drinking age of 18 will likely be respected more than a drinking age of 21. Some 17 year olds may even choose to wait a year to remain within the bounds of the law.
  • Alcohol use is not the problem, alcohol abuse is. And that is true whether you're 18 or 88.
  • Eventually your kids will go to college, or at least move out (hopefully). It would be better in the long run to teach them to drink responsibly before high school ends than to bury your head in the sand or approach alcohol from a position of moral panic.
  • You can have a graduation party (like they did before 1984) without running afoul of the law if the drinking age was lowered to 18.
  • Social host liability would be greatly reduced if the drinking age was 18.
  • Two words: Natallee Holloway. If the drinking age was 18, she would likely still be alive today.
Q13) I am an illegal drug dealer/smuggler/kingpin. Why should I support lowering the drinking age?

A13) Actually, you shouldn't support a lower drinking age. The current drinking age of 21 turns alcohol into a gateway drug, increasing demand for your wares. In fact, in some parts of the country, a lot of the stuff you sell is easier for an 18-20 year old to get than beer, since you typically don't card your clients. But I'm sure you already knew that. Some studies (DiNardo and Lemieux, 2002) show that when legal drinking for 18-20 year olds retreats, cannabis advances (and probably vice-versa as well).

Q14) I am a member of a fraternity or sorority. Why should I support lowering the drinking age?

A14) Actually, you shouldn't support a lower drinking age. Take a look at the UK or Australia, where the drinking age is 18, and you see that Greek organizations are nonexistent. Even in Canada, which is 18-19 depending on the province, they are far less prevalent than in the United States. Notice a pattern here? Get ready to have a big "going out of business party" when the drinking age is lowered. You will no longer be needed.

However, if you are an academic or service-oriented fraternity/sorority, whose raison d'etre is something other than partying and getting wasted, rest assured that you will not suffer. In fact, your membership will likely rise instead, since the competition would be largely extinct.

Wednesday, June 3, 2009

What Would the Ideal Study Look Like?

This is the question that any researcher (or debunker) must ask and answer before doing anything else in order to avoid the common pitfalls that lead to specious inferences. We here at Twenty-One Debunked believe that any drinking age study that fulfills all of the following criteria is ideal:

  1. The study is longitudinal, also known as "panel data." In other words, it contains both a time element and a cross-sectional element. Most studies discussed on this blog are longitudinal. (10 points)
  2. The study contains a minimum of 10 consecutive years of data, ideally beginning before 1980 and lasting well after 1990. (Subtract 1 point from criterion #1, for every year less than 10. Add 0.5 points for every year greater than 10, maximum 15 points)
  3. The study includes all 50 states and DC. (5 points)
  4. The study includes Puerto Rico. (5 points)
  5. The study controls for state and year fixed effects. (10 points, 5 for each one)
  6. The study controls for state-specific time trends and/or other types of trends. (5 points)
  7. The study controls for all of the following variables: vehicle miles traveled, population of the age group(s) studied, number of licensed drivers, real per capita income, unemployment rate, seat belt laws (primary and secondary), speed limit, average vehicle size, tourism expenditures, BAC limits of 0.10 and 0.08, zero tolerance laws, administrative license suspension (ALS), sobriety checkpoints, other drunk driving laws, money spent of DUI enforcement, real beer tax (or price), gas price, dram shop laws, average outlet density, keg registration, and driving age. (0.5 points for each variable controlled for, 1 point for those in red)
  8. The study controls for demographic characteristics of each state's population (race, ethnicity, religion, etc.). (2 points)
  9. The study tests for border effects. (2 points)
  10. The study controls for adult per-capita alcohol consumption, but the models are tested without this covariate as well, and both results are reported. (1 points for with only, 1 points without only, 2 points for both)
  11. The study tests all four legal drinking ages: 18, 19, 20, 21. (3 points)
  12. Grandfather clauses are accounted for. (2 points)
  13. The study tests for robustness the effect of including or excluding certain states and time periods. (3 points)
  14. The study is done using total fatalities as the dependent variable, as well as using single-vehicle nighttime fatalities as a proxy for a crash being alcohol-related. The latter avoids reporting bias and testing bias associated with a crash being labeled as "alcohol-related." (3 points for using total fatalities, 2 points for alcohol-related fatalities, 5 points for single-vehicle nighttime fatalities, 2 points for a day/night counterfactual)
  15. The study separates data into four age groups: 15-17, 18-20, 21-24, and 25-29. The last one should be used as a control group for each of the other three, since it is too distant to be affected by the drinking age. DO NOT use 21-24 year olds as a control group! (2.5 points for each of the four age groups)
  16. Each model is tested for robustness by using driver fatalities in each age group studied, and/or using fatalities of any age that involved at least one driver of the age group studied. (3 points)
  17. If data before 1975 (the year FARS was created) are included, the models are further tested for robustness using 15-24 year old total fatalities. (-5 points if not)
  18. For studies that look at effects that are not traffic-related, additional variables need to be accounted for. (unrated, does not apply to every study)
  19. Regressions contain an error term. (3 points)
  20. R-squared values are reported, or some other measure of goodness-of-fit. (3 points)
  21. Tests for statistical significance are done at the 10%, 5%, and 1% levels, and/or 95% confidence intervals are reported (3 points for 5% level, 5 points for all three, 5 points for confidence interval).

As far as we know, not a single study meets all of these criteria. But a few do come very close indeed. As a result, we at Twenty-One Debunked generally consider any study that meets 90% of the above rubric's points as very high quality and one that meets 80% as high quality, provided that criteria #1 and #5 are met in full as well. We are not aware of any study that meets #4, which is unfortunate because Puerto Rico's drinking age is still 18 to this day, and there are otherwise no data points for a drinking age below 21 after 1988. And they are in the FARS database as well. However, one could potentially consider Louisiana to have had a de facto drinking age of 18 until 1995 due to a massive loophole that has since been closed.

The following scale is what we use to grade studies based on the above rubric:

90-100 points: A (very high quality)

80-89 points: B (high quality)

70-79 points: C (decent quality)

60-69 points: D (marginal quality; near-junk)

Below 60: F (inferior quality; junk)

For cross sectional, time-series, and pre/post studies, which are weaker than longitudinal studies and thus can never be considered high quality (points can never exceed 79), our criteria are more stringent. Fixed effects and time trends obviously cannot be controlled, so additional variables need to be accounted for in cross-sectional studies. Theoretically, if enough variables are controlled for, a cross-sectional study can closely approach the accuracy of a longitudinal one, and would be considered "decent quality" for our purposes. For time-series and pre/post studies, there needs to be a suitable comparison group (or state) as well. The comparison group may NOT simply be 21-24 year olds in the same state since there is some evidence that fatalities may be shifted to/from that age group when the drinking age changes. It would be better to use 25-29 year olds AND to control for as many observable variables as possible in that case.

For those that don't know:

Fixed effects and time trends are an easy way to control for some omitted variables (with caveats of course). State fixed effects control for relatively permanent yet unobservable characteristics of each state, as long as they do not change significantly over time. Year fixed effects control for national trends that are the same in every state (safer cars, etc.). State-specific trends are the interaction of the state and year fixed effects. Time trends can be linear or quadratic.

Wednesday, May 27, 2009

A New List of 39 Recommendations for the 21st Century

In 1982, President Reagan appointed a special commission to study the problem of drunk driving in America. They came up with 39 recommendations, #8 of which was to raise the drinking age to 21 in all 50 states. Of all the recommendations, that was the one that got the most attention, often at the expense of the others. Most of the other 38 were just simple common sense measures, and many of these were implemented to some extent in both the United States and Canada. Interestingly, the decline in alcohol-related traffic fatalities since 1982 occurred at about the same rate in both countries in every age group, with no evidence of divergence in the expected direction despite the fact that Canada did not raise the drinking age to 21. In fact, the decline was slightly faster in Canada (ditto for the UK and Australia as well, who remained at 18). While the problem of drunk driving has been greatly reduced in both the US and Canada, it remains persistent, and progress appears to have stalled somewhat in recent years. 
More than a quarter-century later, a new set of 39 recommendations is long overdue. We know a lot more about the problem now than we did in 1982, and have a better sense of what works in the long run and what does not. The nature of the problem has also changed, with most of the deaths caused by so-called "hardcore" DUI offenders who drive drunk repeatedly. By the time someone finally gets caught even once, they had already driven drunk an average of 88 times--often hundreds of times.  And it's an open secret that the vast majority of them are over 21, with 21-24 year olds being the worst of all.  Thus a multifaceted and wholehearted approach is essential. But what is currently being done is both over-inclusive and under-inclusive, and progress has stalled.  And as long as we keep following outdated methods, we will surely fail to see any further progress.  The updated list, devised by the TSAP, is as follows, with those in red being the highest priorities:
  1. Lower the drinking age to 18, ideally in all 50 states and DC. The more states, the better.
  2. Raise the federal beer tax to its 1951 real value and the liquor tax to its 1991 real value. That would be $2.38/gallon and $21.06/proof-gallon, respectively. Raise the alcopop tax to more than the tax on liquor as well, and make the beer tax proportional to alcohol content. Use the bulk of the revenue for education, treatment, and DUI enforcement.
  3. Lower the blood alcohol limit to 0.05 BAC generally, and maintain the Zero Tolerance law for drivers under 21. Or expand the latter to cover all drivers with less than 5 years of licensed driving.
  4. Increase the number of roving patrols for DUI enforcement, and their publicity. Sobriety checkpoints should be considered a supplement, not a substitute.
  5. Increase alcohol education programs, but make them more honest and comprehensive. An excellent model is AlcoholEdu, by Outside the Classroom. This can also be combined with social norms marketing campaigns.
  6. Toughen the penalties for driving under the influence, but have graduated penalties based on BAC. Drivers with BAC of 0.15 or higher should lose their licenses for at least 10 years, and repeat offenders of 0.08 or more should lose it forever on the second offense.
  7. Make fines for DUI proportional to the relative risk at a particular BAC. For example, 0.15 would be 50-100 times higher than 0.05.
  8. Restrict alcohol advertising to no more than what is currently allowed for tobacco. That means no TV, radio, or billboards.
  9. Increase alcohol treatment. Require all DUI offenders to undergo an alcohol assesment to determine if they have an alcohol use disorder. If so, force them into treatment via DUI court, in addition to other penalties.
  10. For those who fail a breathalyzer, a confirmatory blood test should be offered. If the latter is refused, the former alone should be considered sufficient evidence for a conviction. But no physically forced blood draws should ever be allowed, as they clearly violate the Constitution.
  11. For the eight states that currently lack it, institute administrative license suspension/revocation. The administrative penalty for refusing a breathalyzer or any other test should be greater than or equal to that for failing it.
  12. Have mandatory jail time for all DUI offenses of 0.08 or greater, including first offenses. Make driving with 0.15 BAC or higher a felony on the first offense, and 0.08 or higher a felony on the second offense, punishable by up to 5 years in prison.
  13. Those who kill or seriously injure someone else in an alcohol-related, at-fault crash should get a mandatory minimum of 10 years in prison, permanent license revocation, and forfeiture of any and all vehicles owned by that person upon conviction.
  14. Do not allow plea bargains for any DUI offense.
  15. Do not grant conditional or hardship licenses after conviction for second offenses at any BAC above 0.08.
  16. De-register any car owned (or registered) by a DUI offender, boot it, and confiscate the plates upon arrest. When (if) they get their license back, or get a conditional license, give them special "scarlet letter" DUI plates. 
  17. Require ignition interlocks for all conditional licenses, and for any DUI offender that gets their license back, forever.
  18. Make ignition interlocks standard on all newly manufactured vehicles sold in the USA, with use and maintenance of these devices voluntary for non-offenders (but see #19).
  19. Require auto insurance companies to give a deep discount (that more than covers maintenance costs) for non-offenders with an ignition interlock on their vehicles, especially for drivers under 25 (and their parents).
  20. Abolish the "assigned risk" pools for auto insurance, or at least forbid any DUI offenders from joining them. Let them pay the full market cost based on their own risk, without being subsidized by the innocent.
  21. Make it a federal crime to drive drunk across state lines. Punishable by up to 5 years hard labor in federal prison.
  22. Eliminate any rules of evidence that prohibit admission of chemical test refusals--it should be used against a DUI defendant in court.
  23. Make the road test tougher--an hour long like it is in the UK.
  24. Make licenses easier to lose for moving violations, especially during the first two years.
  25. Have driver's ed classes in every high school for free (or a nominal fee).
  26. Prohibit insurance companies from excluding alcohol-related accidents, but require all drivers involved in accidents to be tested for alcohol.
  27. Lift state-mandated smoking bans in bars, which have been shown to increase DUI fatalities.
  28. Extend bar hours to 3 am or later, but have a one-way door policy after 1 or 2 to reduce late night bar-hopping. Or let the locals decide rather than the state.
  29. Raise the gas tax by a penny each week until it is $1.00 higher than it currently is.  Call it "a penny for progress."
  30. Improve public transportation, especially very late at night. Use the alcohol and gas taxes to pay for it.
  31. Lift any "taxi tax" wherever it exists. Or better yet, subsidize taxi service or "Safe Rider" services.
  32. Limit or reduce alcohol outlet density in cities and other high-density areas, but increase it in rural areas. More rural bars within walking distance = less drunk driving deaths.
  33. Dry counties and towns should go wet, especially if their neighbors are wet.
  34. Abolish social host laws, both civil and criminal. Furnishing alcohol to minors should not include merely providing a safer location to drink.
  35. Allow parents to give their kids alcohol before 18 (within reason), and repeal all laws that prohibit it. But hold them accountable for what their under-18 kids do under the influence.
  36. Put a price floor on alcoholic beverages, especially for off-premises sales.
  37. For supermarkets, other non-alcohol-dedicated stores, and bottle shops/off-licenses, limit the quantities of alcohol sold per person per day (or transaction). Reasonable limits include 216 ounces of beer (i.e. an 18-pack), a gallon of wine, or a fifth (750 mL) of liquor.
  38. Kegs and cases should be sold only in beer distributors, which should close at 10 pm. A purchase age limit higher than 18 may be desirable for such bulk quantities, which are very unlikely to be for personal use. Ditto for very large quantities (i.e. multiple liters) of hard liquor.
  39. Forbid the sale of chilled beer or wine at gas stations, or at least to those who are purchasing gas at the same time or otherwise obviously drove there. A degree of separation is necessary. For the same reason, abolish drive-through liquor stores as well.
Recomendation #1 implies that, at the very least, we should repeal the federal highway funding penalty for doing so, and let the states use their Constitutional rights to decide for themselves. Or let them choose but additionally require that the drinking age be no higher than the age for being tried as an adult. Recommendations #3, #4, and especially #22 should take care of any potential adverse effects of unequal drinking ages across states or internationally, as well as dry counties that refuse to go wet.
To avoid collateral damage, recommendation #2 should not apply to microbrewers. Their beer is already relatively expensive anyway, and those who abuse alcohol tend to go for the mass-produced, cheap stuff.
If all 39 of these recommendations were followed, the alcohol-related fatality rates should be cut by more than half in the first few years alone. If only the ones in red were followed, or even just the first six, there would still be a dramatic drop in fatalities in both the short and long term. Some of them, such as #1, are a bit counterintuitive (the whole purpose of this blog explains in detail why #1 is actually a good thing rather than something to fear). But most are simply common-sense measures that are long overdue. And one who thinks holistically about the issues can see how it all fits together like pieces of a puzzle. It is hard to believe that even in 2009, any repeat DUI offender could still have a license at all, and that any state would refuse to do #11. By the same token, it is also baffling how Prohibition still exists in some counties in 2009.

When we say graduated penalties, the table below is a good guide to what they should be:

BAC ThresholdFirst offenseSubsequent offenses within 10 years
0.02-0.05
(under 21 or novice, administrative only)

1-2 drinks
$250 fine
30 day suspension
No jail
Alcohol education program
$500 fine
6 month suspension
No jail
Ignition interlock upon regaining license until 21
0.05-0.08
(administrative only)

2-3 drinks
$500 fine
Up to 90 day suspension
(6 month suspension)
No jail
Alcohol education program
$750 fine
Up to 6 month suspension
(1 year revocation or until 21, whatever is longer)
No jail
Ignition interlock 1+ year upon re-license
0.08-0.10

3-5 drinks
$1000 fine
Minimum 1 year revocation
(or until 21, whatever is longer)
Up to 6 months in jail
Ignition interlock 5+ years after re-license
$2500 fine
License revoked possibly forever
Mandatory 1+ year in jail (possible felony)
Possible vehicle forfeiture upon conviction
0.10-0.15

4-7 drinks
$5000 fine
Minimum 5 year revocation
Mandatory 6 months jail, up to 1 year
Ignition interlock forever
$7500 fine
License revoked forever
Mandatory 5 years prison (felony)
Vehicle forfeiture upon conviction
0.15+

7+ drinks
$10,000 fine
Minimum 10 year revocation
Mandatory 1 year in prison, up to 5 years (felony)
Ignition interlock forever
$20,000 fine
License revoked forever
Mandatory 5+ years prison (felony)
Vehicle forfeiture upon conviction

NOTES:  1) Any alternatives in parentheses refer to drivers under 21 or novice drivers who had their licenses less than 5 years. 2) Any vehicles owned by the driver should be de-registered and the plates confiscated in the event of a license suspension/revocation, 3) "No jail" does not preclude detaining a driver overnight or up to 24 hours in the drunk tank, 4) For all of the above cases, mandatory alcohol abuse assessment and treatement (if indicated) should be done, 5) For first offenders who qualify, diversion to DUI court may be the best choice, 6) Offenses that occur during a suspension or without a license should result in permanent license revocation and/or vehicle forfeiture, as well as mandatory jail time, 7) For BAC below 0.08, penalties listed are administrative only, and there is no criminal conviction.  Above 0.08, the penalties are criminal and are additional to any administrative license suspensions. 8) Number of drinks is a very rough guide, and it assumes consumption in 2 hours, reasonably full stomach, no other drugs, and a body weight of 150 lbs.  There is much variation by individual and circumstance.

Recommended administrative license suspensions/revocations above 0.08:

Test failure, first offense:  90 day suspension (6 months if under 21 or novice)
Test failure, second offense in 5 years: 1 year revocation (or until 21, whatever is longer)
Test refusal, first offense:  1 year suspension or revocation
Test refusal, second offense in 5 years: 2 year revocation (or until 21, whatever is longer)

Conditional licenses should only be given for grave reasons, be highly restricted, and require ignition interlocks.

Driving with a  BAC above 0.08 with kids under 16 in the car should be an automatic felony, and treated like 0.15+.

In other words, though we've clearly wrestled the problem to the ground by the mid-1990s, we have unfortunately allowed ourselves to become complacent and distracted.  It's time to finish the job.

A New Dimension to the Debate--And We Debunk It Too!

Just as more and more people are questioning the wisdom of the 21 drinking age, especially its purported lifesaving effects, a new dimension to the debate was added by a recently published study. Watson and Fertig (2009) did a study on the effects of the drinking age on three measures of infant health outcomes: premature birth, birth weight, and congenital anomalies (birth defects). All data was from 1978-1988. The results were hailed as proof that a lower drinking age leads to worse infant health outcomes, presumably through unwanted pregnancies that result from drunk sex. But after reading the study, there are several apparent flaws and caveats that the media glossed over or misrepresented:

  • Only the first two measures of health outcomes (prematurity and birth weight) were statistically significant, while congenital anomalies were insignificant and even had the "wrong" sign. The latter is difficult to explain away, since alcohol is a known teratogen.
  • Effect sizes were generally very small (10% or less). Such effects are very difficult to interpret in epidemiological studies, and causality virtually impossible to determine.
  • R-squared values were very low despite controlling for numerous variables, indicating that the regressions had a bad fit. This can lead to spurious effects.
  • Missing data can lead to noisy data.
  • Curiously, the three worst years for teen pregnancy since the 1950s (1989, 1990, 1991) were not included in the data for some reason.  All of which occurred after all 50 states raised the drinking age.
  • For survey data concerning drinking before or during pregnancy, underreporting (due to changes in alcohol laws or social acceptability) could be a confounding factor.
  • While much ado has been made of the fact that the apparent effects were stronger for black women, the authors do not seem to offer an adequate explanation for why. Although it could be that white women are more likely to abort unwanted pregnancies, or even simply have better access to birth control than black women. Another possibility is differential access to good prenatal care for those who carry to term.
  • There was no effect for immigrant women.
  • Controlling for beer taxes reduced the effects by half for the 14-17 year old black women, and made the effect on 18-20 year olds less significant as well. This implies that beer taxes may have an effect. But this variable was excluded from the authors' preferred specification.
  • When 14-24 year olds as a whole were looked at, the drinking age effects interestingly had the opposite sign than when women under 21 were examined separately. That means that for 21-24 year olds, a lower drinking age was associated with better health outcomes that outweighed the purported adverse effects in 14-20 year olds, especially for black women. We speculate that, like with some studies of traffic fatalities, the pregnancies (and their poorer outcomes) were simply shifted a few years into the future. Or it could simply be that the regressions had a bad fit, putting a giant question mark over the entire study. Either way, the net effect for 14-24 year olds is the opposite of what was predicted. These possiblities were completely ignored by both the authors and the media.
  • Effects were stronger for women under 18 (the spillover group) than for women aged 18-20 (the target group). While some spillover effect is plausible, alcohol was just as illegal for women under 18 either way, so the effect should still be the strongest for 18-20 year olds. Otherwise, it is very likely a proxy for something else.
  • While the apparent effects were robust to state-specific time trends, they were not robust to age-specific time trends. In fact, the "race effect" was reversed in the case of birth weight. Even the authors concede the possibility that secular trends may affect the youngest women first, and let the reader decide.
  • As far as race goes, one potential confounder is "liquorlining," or the practice of concentrating alcohol outlet density (chiefly liquor stores) in poor minority communities. Some states probably do this more than others. This was not addressed.
  • The authors found that controlling for paternal information weakens the relationship between drinking age and infant health outcomes. And missing paternal age (thought to be a proxy for unwanted pregnancy) was significantly correlated with a lower drinking age for black women under 21 (but not for white women), leading to the assumption that drunk sex was the causal factor behind it all. But the effect was statistically insignificant in states that did not have parental notification laws for abortion. That counterfactual is telling, especially since that was true for 18-20 year olds was well (notification laws only affect those under 18). Why the latter was the case is not explained.
  • And again, for 14-24 year olds as a whole the sign was "wrong," and both "wrong" and significant for black women in notification states. This supports the idea of merely shifting unwanted pregnancies, or just a bad fit of data, but again that possibility went unaddressed.
In other words, the study makes at most a very weak case for keeping the drinking age at 21. No scratch that, it is downright anemic. Effects could not be disentangled from age-specific secular trends, so the results are inconclusive at best. Even if the purported effects were real, which is still not very clear, the effect sizes are of little practical significance since so many other things affect both teen pregnancy and infant health outcomes much more strongly. And for 14-24 year olds as a whole, a drinking age of 18 actually appears to be beneficial in terms of net effects when the data are taken at face value.

The greatest irony of all is that America tends to have some of the worst infant health outcomes relative to other industrialized countries, especially infant mortality, yet our drinking age is the highest. This apparent paradox is mainly due to less prenatal care, among other things. In addition, our teen pregnancy rate is also the highest, and other countries had generally seen more progress in reducing its rate than we did in the years following the drinking age hike. In other words, those who put too much stock into this study clearly fail to see the forest for the trees.

Furthermore, it does not follow that the results are still relevant today since only 1978-1988 were examined. First of all, the effects may just be short-term. Secondly, a lot has changed since 1988. Although they rose in the late 1980s (after raising the drinking age, oddly enough), teen pregnancies (and abortions) have plummeted since 1991, reaching lows that had not been seen for decades. Birth control (including condoms) is more available now and used more frequently than before. And as hard as it is to believe, teenagers are also less likely to have sex now than in 1990. In other words, today's younger generation is significantly more responsible (at least in terms of sex and reproduction) than the Boomers and Gen-X were when they were teenagers. But you would never hear the media say that.

This is pure mission-creep. It's time to quit punishing today's young people for the sins of their parents.

UPDATE:  It appears that in 2005, for unknown reasons, birth weights from healthy, white mothers (of all ages) were 3 ounces lower than in 1990, and the length of gestation has shortened slightly.  This is rather surprising since for the past 50-70 years, birth weights have been rising.  And trend began reversing in 1990, which was a few years after raising the drinking age.  If you recall, the Watson and Feritg study only included 1978-1988, a relatively short timeframe during which both birth weights and drinking ages rose.  This latest finding casts further doubt on a study that is already on shaky ground.