Forecasting the Future Alcohol Burden: Binge Drinking Rates to Converge in Young Men and Women, and Increase Among 29- to 30-year-olds, by 2040

A study has revealed important gender and age differences in forecasted future levels of binge drinking, and highlighted key factors underlying these trends. Binge drinking is implicated in over half of alcohol-attributable deaths in the US, and reducing its prevalence among young adults is a major public health goal. To target resources and intervention strategies effectively, future levels of binge drinking can be estimated using forecasting models, and modifiable influences on binge drinking trends assessed. In the new study, reported in Alcoholism: Clinical and Experimental Research, researchers forecasted binge drinking prevalence and gender differences among cohorts of young adults from 2016 through 2040, and evaluated the influence of social and demographic determinants of binge drinking.

The research team used data from the US Monitoring the Future study, in which a sample of high school seniors (12^th grade) is surveyed annually, and a subset followed into adulthood. For the current analysis, respondents were grouped by cohort (the year they were high school seniors) and age in order to estimate recent rates of binge drinking (defined as having had 5+ drinks in a row within the past two weeks). The researchers developed statistical models to estimate forecasted prevalence through to 2040 among cohort groups aged 18, 23-24, and 29-30 years. To understand the drivers of binge drinking, models estimated prevalences with vs. without adjustment for changes in three sets of factors: sociodemographics; social roles (e.g. residential independence); and drinking norms and substance use (reflecting the level of respondents’ disapproval of binge drinking and perception of its risk, perceived drinking among friends, and past-year marijuana and tobacco use). Data from over 70,000 respondents from each age group were included.

There were three key findings. First, compared with the most recent observed prevalence for each age group, binge drinking prevalence by 2040 was forecast to decline from 26% to 11% among 18-year-olds, continuing the downward trend in this age group observed in recent decades. Among 23/24-year-olds, a slight decline was forecast (38% to 34%), and among 29/30-year-olds binge drinking prevalence was forecast to slightly increase, from 32% to 35% − concordant with recent evidence of an upward shift in the peak ages of binge drinking. Second, gender-stratified forecasts showed continued narrowing of binge drinking prevalence between young men and women, although with the magnitude of narrowing differing by age − consistent with research showing growing acceptability of heavy alcohol use among young adult women, in concert with targeted alcohol marketing toward women in this age group. Third, by comparing the total (unadjusted) trends with trends adjusted for changes in social, demographic, and drinking norms and substance use factors, it was apparent that the strongest drivers of past and future binge drinking patterns are changes in drinking norms, peer use, and other substance use − particularly at younger ages. In the older age group, other factors, such as income, may become more important determinants of binge drinking, although this was not directly investigated.

The findings suggest that strategies to reduce binge drinking should be prioritized throughout early adulthood, and particularly among women as they approach middle adulthood. Prevention should continue to focus on changing alcohol norms among young adults, with particular attention to emerging high-risk groups. Drinking norms can be addressed through targeted interventions that raise awareness of the dangers of heavy drinking and reduce its social acceptability – countering the efforts of alcohol producers to influence norms in the other direction. The forecasting in this study did not account for the Covid pandemic, and further research will be needed to understand the long-term effect of the pandemic on binge drinking.

Forecasting future prevalence and gender differences in binge drinking among young adults through 2040. J. M. Platt, J. Jager, M. E. Patrick, D. Kloska, J. Schulenberg, C. Rutherford, K. M. Keyes (pages xxx).

ACER-21-4793.R1