title: Impacts of drinking-age laws on mortality in Canada, 1980-2009.
abstract: BACKGROUND
  Given the recent international debates about the effectiveness and appropriate age setpoints for legislated minimum legal drinking ages (MLDAs), the current study estimates the impact of Canadian MLDAs on mortality among young adults. Currently, the MLDA is 18 years in Alberta, Manitoba and Québec, and 19 years in the rest of Canada.
  
  
  METHODS
  Using a regression-discontinuity approach, we estimated the impacts of the MLDAs on mortality from 1980 to 2009 among 16- to 22-year-olds in Canada.
  
  
  RESULTS
  In provinces with an MLDA of 18 years, young men slightly older than the MLDA had significant and abrupt increases in all-cause mortality (14.2%, p=0.002), primarily due to deaths from a broad class of injuries [excluding motor vehicle accidents (MVAs)] (16.2%, p=0.008), as well as fatalities due to MVAs (12.7%, p=0.038). In provinces/territories with an MLDA of 19 years, significant jumps appeared immediately after the MLDA among males in all-cause mortality (7.2%, p=0.003), including injuries from external causes (10.4%, p<0.001) and MVAs (15.3%, p<0.001). Among females, there were some increases in mortality following the MLDA, but these jumps were statistically non-significant.
  
  
  CONCLUSIONS
  Canadian drinking-age legislation has a powerful impact on youth mortality. Given that removal of MLDA restrictions was associated with sharp upturns in fatalities among young men, the MLDA likely reduces population-level mortality among male youth under the constraints of drinking-age legislation. Alcohol-control policies should target the transition across the MLDA as a pronounced period of mortality risk, especially among males.
authors.affiliation: Northern Medical Program, University of Northern British Columbia (UNBC), 3333 University Way, Prince George, British Columbia V2N 4Z9, Canada; Human Brain Laboratory, Centre for Addiction and Mental Health (CAMH), 33 Russell Street, Toronto, Ontario M5S 2S1, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street, Health Science Building, Toronto, Ontario M5T 3M7, Canada. Electronic address: russ.callaghan@unbc.ca.
authors.forename: Russell C
authors.initials: RC
authors.lastname: Callaghan
authors.affiliation: Biostatistical Consulting Unit, Centre for Addiction and Mental Health (CAMH), 33 Russell Street, Toronto, Ontario M5S 2S1, Canada.
authors.forename: Marcos
authors.initials: M
authors.lastname: Sanches
authors.affiliation: Northern Medical Program, University of Northern British Columbia (UNBC), 3333 University Way, Prince George, British Columbia V2N 4Z9, Canada; Human Brain Laboratory, Centre for Addiction and Mental Health (CAMH), 33 Russell Street, Toronto, Ontario M5S 2S1, Canada.
authors.forename: Jodi M
authors.initials: JM
authors.lastname: Gatley
authors.affiliation: Centre for Addictions Research of British Columbia, University of Victoria, PO Box 1700 STN CSC, Victoria, British Columbia V8W 2Y2, Canada.
authors.forename: Tim
authors.initials: T
authors.lastname: Stockwell
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000428:Alcohol Drinking / Q000331:legislation & jurisprudence* / Q000401:mortality*; D000434:Alcoholic Beverages / Q000009:adverse effects*; D002170:Canada / Q000453:epidemiology; D006801:Humans; D008297:Male; D012737:Sex Factors; D055815:Young Adult
keywords: Canada; Gender differences; Minimum legal drinking age; Mortality; Regression-discontinuity