Minimum drinking age laws

Evidence Rating

Strategies with this rating are most likely to make a difference. These strategies have been tested in many robust studies with consistently positive results.

Disparity Rating

No impact on disparities likely

Community Conditions

Alcohol and drug use

Societal Rules

Laws and policies

Authors

Lead: Ben Case

Contributor(s): Bomi Kim Hirsch

Acknowledgements: Kate Austin Stanford, Alison Bergum, Kiersten Frobom, Jane Sachs, Bianca Silva-Gordon

Date Last Updated

June 17, 2021

Minimum legal drinking age (MLDA) laws specify the legal age when an individual can purchase alcoholic beverages. In the U.S., the age in all states is currently 21 years (CDC-MLDA).

What could this strategy improve?

Expected Benefits

Our evidence rating is based on the likelihood of achieving these outcomes:

Reduced impaired driving
Reduced alcohol-related crashes

Potential Benefits

Our evidence rating is not based on these outcomes, but these benefits may also be possible:

Reduced underage drinking
Reduced emergency room visits
Reduced hospital utilization
Reduced suicide
Reduced arrests

What does the research say about effectiveness? -+

There is strong evidence that current minimum legal drinking age (MLDA) laws reduce alcohol-impaired driving and alcohol-related crashes (DeJong 2014, Fell 2016, CG-Motor vehicle injury, Wagenaar 2002) as well as associated injuries among 18- to 20-year-old drivers (CG-Motor vehicle injury). Dedicated efforts to prevent alcohol sales to minors, especially compliance checks on retail alcohol outlets, increase effectiveness of the laws (Wagenaar 2002).

The implementation of a nationwide MLDA of age 21 has led to significant decreases in alcohol-related fatal traffic crashes (CG-Motor vehicle injury, Fell 2016, IOM-Underage drinking 2004). The National Highway Traffic Safety Administration estimates that MLDA saved about 500 lives annually from 2013 to 2017 (NHTSA-MLDA 2019). Current MLDA laws appear to decrease alcohol consumption among young people (Wagenaar 2002, DeJong 2014). Historical increases in minimum legal drinking age are associated with a reduction in binge drinking among youth at age 18 and increases in binge drinking for male youth ages 18-22 (Jager 2015). The age 21 MLDA has been associated with reductions in emergency department visits and hospital admissions among those under age 21 (Carpenter 2017), and reductions in suicide (Xuan 2016, DeJong 2014) and arrests among youth (Carpenter 2015, IOM-Underage drinking 2004).

Compared to age 21 MLDA laws, exposure to permissive MLDA laws (e.g., allowing alcohol purchase for those age 20 and under) during adolescence was associated with an increased likelihood of alcohol-related chronic disease mortality across a lifespan (Plunk 2016), but not associated with drug use or dependence into adulthood (Krauss 2015). The effects of MLDA changes on teen fertility and alcohol consumption appear to vary by race and socio-economic status in women ages 15-23 (Cintina 2015).

Implementation Examples -+

Although 21 is the minimum legal drinking age in all states, many states have exceptions to this law (e.g., on private premises, with parental consent, for religious purposes, etc.). As of June 2021, 20 states had no exceptions to the minimum legal drinking age for consumption of alcohol (APIS). The California Evidence-Based Clearinghouse for Child Welfare offers a toolkit, “Communities Mobilizing for Change on Alcohol” that supports reducing rates of underage drinking through changes in the policies and practices of communities (CMCA).

Implementation Resources -+

APIS - Alcohol Policy Information System (APIS). Welcome to the Alcohol Policy Information System.

CMCA - California Evidence-Based Clearinghouse for Child Welfare. Communities Mobilizing for Change on Alcohol (CMCA).

UW WAPP - University of Wisconsin-Madison Law School. Wisconsin Alcohol Policy Project (WAPP): Preventing underage drinking.

Citations -+

* Journal subscription may be required for access.

APIS - Alcohol Policy Information System (APIS). Welcome to the Alcohol Policy Information System.

Carpenter 2015 - Carpenter C, Dobkin C. The minimum legal drinking age and crime. Review of Economics and Statistics. 2015;97(2):521-524.

Carpenter 2017 - Carpenter C, Dobkin C. The minimum legal drinking age and morbidity in the United States. Review of Economics and Statistics. 2017;99(1):95-104.

CDC-MLDA - Centers for Disease Control and Prevention (CDC). Alcohol and public health: Age 21 minimum legal drinking age (MLDA).

CG-Motor vehicle injury - The Guide to Community Preventive Services (The Community Guide). Motor vehicle injury prevention.

Cintina 2015 - Cintina I. The effect of minimum drinking age laws on pregnancy, fertility, and alcohol consumption. Review of Economics of the Household. 2015;13(4):1003-1022.

CMCA - California Evidence-Based Clearinghouse for Child Welfare. Communities Mobilizing for Change on Alcohol (CMCA).

DeJong 2014* - DeJong W, Blanchette J. Case closed: Research evidence on the positive public health impact of the age 21 minimum legal drinking age. Journal of Studies on Alcohol and Drugs, Supplement. 2014;(s17):108-115.

Fell 2016* - Fell JC, Scherer M, Thomas S, Voas RB. Assessing the impact of twenty underage drinking laws. Journal of Studies on Alcohol and Drugs. 2016;77(2):249-260.

IOM-Underage drinking 2004 - Institute of Medicine (IOM), National Research Council (NRC), Committee on Developing a Strategy to Reduce and Prevent Underage Drinking, Board on Children, Youth, and Families (BCYF). Reducing underage drinking: A collective responsibility. (Bonnie RJ, O’Connell ME, eds.). Washington, D.C.: National Academies Press; 2004.

Jager 2015 - Jager J, Keyes KM, Schulenberg JE. Historical variation in young adult binge drinking trajectories and its link to historical variation in social roles and minimum legal drinking age. Developmental Psychology. 2015;51(7):962-974.

Krauss 2015 - Krauss MJ, Cavazos-Rehg PA, Agrawal A, Bierut LJ, Grucza RA. Long-term effects of minimum legal drinking age laws on marijuana and other illicit drug use in adulthood. Drug and Alcohol Dependence. 2015;149:173-179.

NHTSA-MLDA 2019 - National Center for Statistics and Analysis, National Highway Traffic Safety Administration (NHTSA). Lives saved in 2017 by restraint use and minimum-drinking-age laws. Washington, D.C.: National Highway Traffic Safety Administration, U.S. Department of Transportation (U.S. DOT); 2019.

Plunk 2016 - Plunk AD, Krauss MJ, Syed-Mohammed H, et al. The impact of the minimum legal drinking age on alcohol-related chronic disease mortality. Alcoholism: Clinical and Experimental Research. 2016;40(8):1761-1768.

UW WAPP - University of Wisconsin-Madison Law School. Wisconsin Alcohol Policy Project (WAPP): Preventing underage drinking.

Wagenaar 2002 - Wagenaar AC, Toomey TL. Effects of minimum drinking age laws: Review and analyses of the literature from 1960 to 2000. Journal of Studies on Alcohol. 2002;(Suppl 14):206-25.

Xuan 2016* - Xuan Z, Naimi TS, Kaplan MS, et al. Alcohol policies and suicide: A review of the literature. Alcoholism: Clinical and Experimental Research. 2016;40(10):2043-2055.