Reducing Underage Drinking on America’s Campuses

Remarks as prepared; not a transcript.

RADM Steven K. Galson, M.D., MPH
Acting Surgeon General
U.S. Department of Health and Human Services<</p>

Remarks at Montana State University

August 20, 2008
Bozeman, MT

Thank you, Geoff (Dr. Geoff Gamble, President, Montana State University) for that gracious introduction.

It is my special pleasure to be with you.

I know we have administrators and prevention specialists from Montana State University and other campuses are with us today.

All of you should know that I consider America’s Colleges and Universities to be one of this nation’s crown jewels.

In my career as a physician in the US Public Health Service I have traveled overseas on many occasions; and the respect for our institutions of higher education is universal.

You are the guardians of that - so thank you.

Two of my three children are university students, so I feel as though I am have two roles as they pertain to the interests of America’s colleges.

First I am your Surgeon General, but a good part of my family’s earnings is being invested in higher education…so I am really working FOR YOU in more ways than one.

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I know you take seriously your responsibilities to ensure that the college experience:

• enables young people to make sound decisions and realize their full potential, and
• provides lifelong skills that give them the greatest chance for professional success.

I am here today to emphasize that underage drinking imperils that process and imperils your chance of institutional success.

University environments should be settings where students can thrive academically, grow personally, and mature socially without peer pressure to use alcohol.

All too often that is hardly the case.

College campuses are frequently places where underage alcohol use is facilitated, inadvertently or otherwise - and even with actively encouraged with “a wink and a nod” by some students and organizations.

In fact, some parents and administrators appear to benignly accept a culture of drinking as an integral part of the college experience.

This worries me greatly.

The consequences of underage drinking are serious.

That’s why activities like those you have underway here at Montana State and in Bozeman are so important.

It underscore your willingness to bring people and resources together in order to influence the culture that ultimately influences the decisions that students make about alcohol use. 

I want to take a moment to share with you the data that confirms the negative consequences of underage drinking.

You know that underage drinking begins well before a student enters college.

Alcohol is the most widely used and abused substance among our Nation's youth: a higher percentage of young people between the ages of 12 and 20 use alcohol than use tobacco or illicit drugs.

The 2006 National Survey on Drug Use and Health (NSDUH) estimated that the rate of current alcohol use among youths aged 12 to 17 was approximately 17 percent.

In 2006, about 11 million persons aged 12 to 20 reported drinking alcohol in the 30 days prior to the survey.  Approximately 7 million were binge drinkers, and 2 million were heavy drinkers.

Findings like these are one reason we released the "Surgeon General’s Call to Action to Prevent and Reduce Underage Drinking" last year. 

The Science

Alcohol use during adolescence is pervasive and it ramps up dramatically between the ages of 12 and 21.

Science confirms that the brain continues to develop well beyond childhood - and through adolescence.

This raises concerns that underage drinking may affect short-term and long-term cognitive functioning, and may even affect the brain in ways that could contribute lead to future alcohol dependence.

Research also shows that young people who start drinking before age 15 are five times more likely to have alcohol problems later in life.

Two critical questions are: 

• Why does alcohol have such a strong appeal to so many youth?
• Are young people more vulnerable to alcohol’s effects?

To answer these questions we need to take a step back and consider what is happening during the period of adolescence and why.

Scientists once believed that the brain finished developing at a very early age.

Not so.

We now know that the brain continues to mature throughout adolescence and into a person’s twenties.

This protracted development of the brain has significant implications both for decision-making -- including decisions about alcohol -- and for vulnerability to consequences from alcohol use.

Other changes during adolescence include hormonal changes that influence everything from the timing of maturation of various brain functions to outward physical appearance, and from mood to an increase in sexuality.

In adolescents we also see an increase in risk taking, sensation seeking and impulsivity.

Neuroscientists tell us that what we know to be typical teenage behavior actually has its roots in development of the brain – and that certain parts continue to mature into a person’s twenties.

These changes may be responsible for the shift in thrill-seeking behavior we see in teenagers.

Neuroscientists believe that the part of the brain, the   prefrontal cortex, develops ops gradually during adolescence - as a function of age and experience.

Since this area of the brain influences self-regulation, planning and so-called executive functions, there is a temporal gap between the system driving emotions and the not fully mature self-regulatory system.

We don’t have to know neuroanatomy though, to know that young adults may be at increased risk from alcohol abuse.

We don’t have all the answers but we know enough to raise concern.

The college environment itself) may contribute to college students’ risk of alcohol-related harm.

And you, as leaders of universities are all too familiar with the consequences of underage drinking.

Researchers have found that although college-bound high school students generally drink less than their peers, their alcohol consumption surpasses that of their non-college peers during the college years - only to decrease again after they finish college.

What all these observations tell us is that underage is drinking is hardly an inevitable rite of passage.

Drinking among college students is a consequential activity that merits your special attention.

Effects

In people under age 21, alcohol is a leading contributor to "death from injuries" - the main cause of death in that age group.

Alcohol also plays a significant role in risky sexual behavior including unwanted, unintended and unprotected sexual activity.

It increases the risks of physical and sexual assault.

• Approximately 600,000 students are unintentionally injured while under the influence of   alcohol (Hingson et al. 2005).
• An estimated 700,000 students are assaulted by other students who have been drinking (Hingson et al. 2005).
• About 100,000 students are victims of alcohol- related sexual assault or date rape (Hingson et al. 2005).

The data are evidence-based and science-driven.

The reality is our young people - students at every level - are being harmed by underage drinking.

The Surgeon General’s Call to Action articulates the Federal commitment to the underage drinking issue and outlines the need for action on the state and community level. 

So, what can universities do?

Remember, there is great value to planning and implementing actions that discourage underage drinking.

Give the issue the respect it deserves.

Give underage drinking on campus your attention now.

Your students will be the better for it in ways apparent while they are on campus – and quite possibly long after they have left the university.

More specifically, the federal Call to Action identifies efforts that campus communities can become involved with, such as:

• Community-based efforts to hold accountable university and campus groups that encourage and engage in underage drinking;
• Efforts to reduce easy access to alcohol around college campuses, and
•  Efforts to restrict drinking in public places.

Collaboration

A perception exists that adolescents will as a matter of routine drink alcohol - “no matter what.”

But that perception is wrong.

Remember: when the American people rejected the use of tobacco as a culturally acceptable behavior, the use of those substances declined, and the culture of acceptance shifted to disapproval.

The same change is possible with underage drinking.

In urging you to fully embrace the idea that cultural and attitudinal changes need to take place regarding underage college students and alcohol, I am well aware that you cannot and should not try to make decisions for your students.

Neither you nor I have any desire to “take the fun out of tailgating” whether it is here at Montana State University of any other campus in the United States.

Everyone working to reduce and prevent underage drinking and its consequences is of like mind: we want young people, students to attain all the success possible. 

We are following the evidence where it leads.  And it points the dangers of drinking for young people. 

Changing the Environment

The good news is that you can build appropriate support structures around your underage students.

How can you systematically foster a culture in which alcohol does not play a central role in college life or the college experience?

One way to start is by recognizing that that the early part of one’s freshman year is a time of increased risk for alcohol use.

YOU canprovide appealing, alcohol-free locations (e.g., coffeehouses and food courts) where students can gather with their friends to socialize or study.

YOU canIdentify ways to routinely expand opportunities for students to make spontaneous social choices that do not include alcohol (e.g., by providing frequent alcohol free late night events, extending hours of student centers and athletics facilities, and increasing public service opportunities).

YOU can offer alcohol free dormitories that promote healthy lifestyles.

YOU canprovide easy access to information about alcohol’s effects, the risks of using alcohol, and the school’s alcohol policies.

Lastly, you can provide ready referral and access to brief motivational counseling and treatment for alcohol and mental health problems as appropriate.

I urge you to be aware…be pro-active…and be creative.

I also want you to think about some additional steps:

If you haven’t already - establish, review, and enforce rules against underage alcohol use.

Consequences should be developmentally appropriate and sufficient to ensure compliance.

This will confirm the seriousness with which your institution views underage alcohol use by its students.

Think about eliminating alcohol sponsorship of athletic events and other campus social activities, and

Consider moving to restrict the sale of alcoholic beverages on campus or at campus facilities and concert halls.

I know that holding student groups on campus, - whether fraternities, sororities, athletics teams, or student clubs and organizations - strictly accountable for underage alcohol use at their facilities and during functions that they sponsor is not easy.

And I know that eliminating alcohol advertising in college publications may have serious budgetary consequences.

I also encourage you act individually and collectively to educate parents, instructors, students, and administrators - about the consequences of underage drinking on college campuses.

This includes discussing alcohol’s second hand effects that range from interference with studying to being the victim of an alcohol-related assault or date rape; enlist the support of your student leaders, of student organizations in changing any culture that currently supports alcohol use by underage students.

I also want let you know that there is promising news regarding underage drinking.

A new study published in the July 2008 issue of the journal Accident Analysis and Prevention found that laws making it illegal to possess or purchase alcohol by anyone under the age of 21 had led to an 11 percent drop in alcohol-related traffic deaths among youth; secondly, they found that states with strong laws against fake IDs reported 7 percent fewer alcohol-related fatalities among drivers under the age of 21.

The study was funded by the Substance Abuse Policy Research Program (SAPRP) of the Robert Wood Johnson Foundation.

Closing

In closing, know that the pace of cultural and environmental change is deliberate in the best of circumstances.

And the process of making the kind of change we seek may not be glamorous and is certainty difficult.

I know that working together we can do this.

We can change attitudes and the culture around underage alcohol use.

Let us work together to make it happen.

Now I look forward to taking your questions and hearing from you.