title: Tax policy, adult binge drinking, and youth alcohol consumption in the United States.
abstract: BACKGROUND
  Prior research attributed youth alcohol consumption to the attitudes and drinking patterns among adults. Yet at a population level, few have examined the relationship between state-level adult binge drinking prevalence and youth drinking behaviors, or whether tax policy plays a role in this relationship.
  
  
  METHODS
  We analyzed 6 biennial surveys (1999 to 2009) of individual-level youth alcohol use and related behaviors from state-based Youth Risk Behavior Surveys and corresponding years of state-level adult binge drinking prevalence from the Behavioral Risk Factor Surveillance System. We employed logistic regression with generalized estimating equations method to assess the extent to which state adult binge drinking predicted individual-level youth drinking outcomes and examined the role of alcohol taxes in that relationship.
  
  
  RESULTS
  Population-aggregate analyses based on 194 state-year strata showed a positive correlation between state adult binge drinking and youth binge drinking (Pearson r = 0.40, p < 0.01). For individual-level youth drinking outcomes, a 5 percentage point increase in binge drinking prevalence among adults was associated with a 12% relative increase in the odds of alcohol use (adjusted OR = 1.12, 95% CI: 1.08, 1.16). Taxes were strongly inversely related with adult and youth drinking measures, and the effect of tax on youth drinking was attenuated after controlling for adult binge drinking.
  
  
  CONCLUSIONS
  Both tax and adult binge drinking are strong predictors of youth drinking. Tax may affect youth drinking through its effect on adult alcohol consumption. Implementing effective alcohol policies to reduce excessive drinking in the general population is an important strategy to reduce youth drinking.
authors.affiliation: Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts.
authors.forename: Ziming
authors.initials: Z
authors.lastname: Xuan
authors.forename: Toben F
authors.initials: TF
authors.lastname: Nelson
authors.forename: Timothy
authors.initials: T
authors.lastname: Heeren
authors.forename: Jason
authors.initials: J
authors.lastname: Blanchette
authors.forename: David E
authors.initials: DE
authors.lastname: Nelson
authors.forename: Paul
authors.initials: P
authors.lastname: Gruenewald
authors.forename: Timothy S
authors.initials: TS
authors.lastname: Naimi
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D000428:Alcohol Drinking / Q000191:economics / Q000453:epidemiology; D063425:Binge Drinking / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D013660:Taxes / Q000191:economics*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Adult Drinking; Alcohol Policy; Binge Drinking; Tax; Youth Drinking