• Alcohol;
  • legal drinking age;
  • minors;
  • policy;
  • social movements;
  • underage


  1. Top of page
  8. Declarations of interest
  9. References

Background  The minimum legal drinking age (MLDA) in the United States (U.S.) has raised debate over the past several decades. During the 1970s many states lowered their MLDAs from age 21 to 18, 19, or 20. However, as a result of studies showing that these lower MLDAs were associated with increases in traffic crashes, state-level movements began in the later1970s to return MLDAs to age 21. A new movement has arisen to again lower the MLDA in the U.S.

Aim  The aim is to discuss this current MLDA debate within the context of the long history of the U.S. MLDA.

Methods  A search of research articles, websites, and newspaper articles was conducted to identify key messages and influences related to the MLDA movements.

Results  The complexity of state movements to change their MLDAs is illustrated by the Michigan experience, where strong political forces on both sides of the issue were involved, resulting in the MLDA returning to 21. Because the 21st Constitutional amendment prevents the federal government from mandating a MLDA for all states, a federal policy was proposed to provide incentives for all states to implement age-21 MLDAs. Due largely to strong research evidence, the National Minimum Legal Drinking Age Act was enacted in 1984, stipulating that states set their MLDA to 21 or face loss of federal highway funds. By 1988, all states had an age-21 MLDA.

Conclusion  Any current debate about the MLDA should be informed by the historical context of this policy and the available research.


  1. Top of page
  8. Declarations of interest
  9. References

Following the end of prohibition in the United States in 1933, all states enacted a minimum legal drinking age (MLDA), with most setting the age at 21 years. No changes in legal drinking ages took place until the 1970s, following the social upheaval of the 1960s and the Vietnam War draft lottery, which influenced the decrease in the legal voting age to 18. This led to 29 states lowering their MLDA to 18, 19 or 20 years between 1970 and 1975 [1]. Several years later, however, due to numerous factors including research evidence showing a rise in traffic crashes among 18–20-year-olds, some states that had lowered their MLDA returned it to 21. Michigan was the first in 1978, and 17 states followed between 1980 and 1985. To encourage all states to enact an age-21 MLDA, the federal government enacted the National Minimum Legal Drinking Act which required all states to set the MLDA to 21 by 1986 or face loss of federal highway funds. Although all States prohibit people under the age of 21 from possessing and, in most cases, purchasing and consuming alcoholic beverages (and prohibit adults from furnishing alcoholic beverages to minors), several exceptions are common, such as exception for possession and/or consumption when a parent/guardian or spouse consents and/or is present. By 1988, all states had some form of an age-21 MLDA law.

A new movement emerged during the mid-2000s to question again the value of the age-21 MLDA and suggest that the country may be better served by lowering the MLDA to 18 [2]. Because this movement has resurrected some of the debates surrounding the age-21 MLDA laws that occurred during the 1970s and 1980s, it is important that the current debate is considered in context of prior debates. In the present paper we examine key questions about what is the most appropriate MLDA: who were the leaders in the movement and what were the influences that led to states returning their drinking ages to age 21 and to the Federal government enacting the National Minimum Legal Drinking Act? What were the arguments that were used for and against these pieces of legislation? What role did scientific research play in informing the arguments?

We discuss first the historical movements to establishing an age-21 MLDA across the country. We then place the current movement to reduce the MLDA to age 18 within that context and provide a summary of the similarities and dissimilarities between the historical and current debates.


  1. Top of page
  8. Declarations of interest
  9. References

Enacting policies at any governmental level usually involves a complex multi-stage process. Potential contributing factors to this process may include: (i) salience of the issue or problem to constituents and policymakers; (ii) whether there are groups of individuals and organizations (including researchers, advocates and specialists) willing to work together to support or oppose the policy; (iii) level of public support for the policy; (iv) whether the policy is feasible in a given political and economic climate; and (v) whether politicians find it politically advantageous to support the policy [3]. To illustrate the complexity of the policy process surrounding changes to the MLDA, we provide summaries of the movement to raise the MLDA to 21 in one state, Michigan, in the late 1970s, and the related process at the federal level in the early 1980s.

State-level: Michigan

Wagenaar [1] provides an excellent description of Michigan's experience in raising its legal drinking age in a previous issue of this journal. We summarize his account with special emphasis on the key influences and messages and the role of research findings that shaped the process of the change in the law. Michigan lowered its MLDA to 18 in 1972 as part of a legislative package that also lowered the age of majority from age 21 to age 18. In the years following passage of the age-18 MLDA, evidence began to emerge showing a significant increase in traffic crashes among 18–20-year-olds (e.g. Cook & Tauchen, 1984; Williams et al. 1975) [4,5]. These findings came to the attention of the Michigan Council on Alcohol Problems (MCAP), an organization long concerned about underage drinking, prompting them to lead an effort to return the drinking age in Michigan to 21. Alcohol retailers in Michigan opposed a MLDA increase and engaged in a lobbying campaign with the state legislature. Perhaps as a result of alcohol retailers' lobbying efforts, the legislature was not initially responsive to calls to raise the drinking age. As an alternative strategy, the MCAP started a signature campaign in 1977 to put a proposed state constitutional amendment on the general election ballot to set the MLDA at age 21. MCAP, along with their allies (churches, parent–teacher associations and community volunteers) formed a political action group, the ‘Coalition for 21’, and obtained 325 000 signatures supporting their initiative within a few months. When it became evident that the campaign would collect enough signatures to place the amendment on the ballot, the legislature quickly passed legislation to raise the MLDA to 19 in order to ward off the amendment. The ‘Coalition for 21’ continued their campaign, highlighted by the research-based message that an age-21 MLDA would save 54 lives per year in Michigan. Their efforts resulted in the passing of an amendment to the Michigan state constitution which set the MLDA to 21. The amendment passed by a 57% margin in the 1978 general election. [In the United States, only the people of a state are vested with the power of amendment of the Constitution and that power is plenary (absolute) [6]. In most states, constitutional amendments may be proposed by initiative and referendum, and the requirements governing the passage of statutes by initiative and referendum must be followed in making changes to the state constitution [7]. In Michigan, amending the state constitution can be achieved in one of two ways. Each of these ways requires final approval by the people of the state. The first way is for an amendment to be proposed in the Senate or House of Representatives. Proposed amendments must be agreed to by two-thirds of the members in each house and the majority of electors must then approve the amendment. The second way is by petition of the registered electors of the state. The petition must be signed by registered electors of the state equal in number to at least 10% of the total vote cast for all candidates for governor at the last preceding general election at which a governor was elected. The majority of electors must then approve the amendment [8].]

The amendment was challenged immediately in federal court. Opponents argued that the age-21 amendment was unconstitutional age discrimination [9]. The Michigan federal district court upheld the amendment based on three legal arguments: (i) drinking alcohol is not a fundamental right guaranteed by the US Constitution; (ii) age is not inherently a suspect criteria for discrimination; and (iii) using the drinking age to prevent highway crashes has a rational basis in available scientific evidence.

Despite this ruling, the Michigan Licensed Beverage Association continued to pursue other avenues to lower the MLDA. In 1979 they attempted to place a constitutional amendment to lower the drinking age to 19 on the general election ballot. Although they failed to obtain enough signatures, the legislature passed a resolution by a two-thirds majority vote to put their proposed constitutional amendment on the 1980 general ballot. Two weeks before the election, a new study presented at the annual meeting of the American Public Health Association held in Detroit, Michigan helped to inform the debate—the study found an 18% reduction in late-night single-vehicle crashes and a 31% reduction in police-reported alcohol-related traffic crashes among 18–20-year-olds in the years following the increase in the Michigan MLDA [1]. The study results were well publicized, and in the general election the proposed amendment to lower the MLDA to 19 was defeated with a 62% margin.

Federal-level: the National Minimum Legal Drinking Age Act 1984

In the late 1970s and the early 1980s, largely independent efforts to raise state MLDAs resulted in differing state minimum drinking ages across the United States. This patchwork of drinking ages encouraged underage individuals in states with higher MLDAs to drive across state borders to drink or purchase alcohol in neighboring states that had lower MLDAs, probably contributing to higher rates of traffic crashes among youth aged 18–20. The patchwork of MLDA laws also presented a series of challenges. Emerging scientific evidence indicated that a lower MLDA was associated with more traffic fatalities (e.g. Cook & Tauchen, 1984; Williams et al. 1975) [4,5], and states were reverting increasingly to an age-21 MLDA. However, legislatures in some states were resistant to raising their state MLDA. Consequently, advocates of an age-21 MLDA were faced with a strategic choice. They could continue to build campaigns to raise the MLDA in each of the remaining states or work to influence federal legislation that would create a uniform age-21 drinking across the United States. As the Michigan case study illustrates, enactment of a state policy can be difficult to achieve. Furthermore, working at the federal level would require fewer resources than building campaigns in the remaining states with lower drinking ages. Thus, federal legislation offered a strategic approach to achieving a nation-wide age-21 drinking age.

A strategy to create a nation-wide age-21 MLDA change at the federal level, however, faced a significant hurdle. The 21st amendment of the US Constitution passed in 1933 that repealed prohibition also gave individual states the power to regulate the purchase and possession of liquor within their borders. Hence, the federal government could not create a national age-21 MLDA. Additionally, national government leaders at the time, led by the Republican administration of President Ronald Reagan, generally opposed national regulatory programs in deference to states.

The Reagan Administration, however, did recognize the threat presented by alcohol-impaired driving, and in 1982 President Reagan issued Executive Order 12358 to create the Presidential Commission on Drunk Driving. The group was charged with increasing public awareness of drunk driving, persuading states to attack the problem in an organized and systematic manner, encouraging state and local officials to use the latest techniques and methods to address the problem and generating public support for increased enforcement of drunk driving laws. In 1983, the 32-member Commission, chaired by former Secretary of Transportation John Volpe, issued a report that recommended a three-pronged approach to attack drunk driving: (i) improve education, (ii) enact stronger legislation, and (iii) increase enforcement of existing legislation. A prominent recommendation of the Commission was to encourage all states to raise their MLDA to 21.

During 1983 and 1984 a variety of resolutions and legislation were introduced in the US House of Representatives and the US Senate to encourage the remaining states to raise their MLDA. One piece of legislation that gained momentum followed the recommendations of the Presidential Commission on Drunk Driving and encouraged states to increase their MLDA to 21 through incentives and penalties. The Highway Safety Act of 1966 (Public Law 89-564) provided a rationale and a mechanism to provide such incentives and penalties because it required the Department of Transportation to establish uniform safety standards for state highway safety programs; it also included funds for states to implement these programs. Using the provisions of this Act, new legislation was proposed to allow the Secretary of Transportation to withhold 5% of federal highway construction funds from states that did not have an age-21 MLDA by 1 October 1986, and withhold 10% from states that did not raise their MLDA to 21 by 1 October 1987. At stake was $8 million for the smallest states to $99 million for the largest states [10]. This bill was first passed in the House and then the Senate, both in 1984. A similar strategy had been used in 1974 to establish a 55-miles-per-hour speed limit across states [11].

President Reagan supported individual states choosing to raise their MLDA to 21, but he and his administration did not support initially the proposed legislation to withhold highway funds if a state did not raise its MLDA [10]. Transportation Secretary Elizabeth Dole argued that states that enacted voluntarily an age-21 MLDA would be more likely to enforce the law than states that enacted an age-21 MLDA in response to pressure from the federal government [11]. Reagan and his administration were also federalists, believing in and supporting states' rights. Despite this strong philosophical perspective, President Reagan reversed his position and signed the National Minimum Legal Drinking Age Act into law on 17 July 1984. Marlin Fitzwater, White House spokesman at the time, stated that the Reagan administration had changed its position on the National Minimum Legal Drinking Age Act legislation because ‘. . . we have taken a look at the evidence of the number of lives saved, and the record, and it is so overwhelming it is a case we feel deserves our support, despite our states' rights philosophy’[12]. A driving concern for the administration was the ‘blood borders’ resulting from the patchwork of MLDA laws across the country [12]. According to the New York Times, Reagan saw the problem of drunk driving as a serious problem that could be addressed by government intervention: ‘The problem is bigger than the individual states. It's a grave national problem, and it touches all of our lives . . . With the problem so clear-cut and the proven solution at hand, we have no misgiving about this judicious use of Federal power’[10].

Subsequently, other legislation was introduced to modify or repeal the National Minimum Legal Drinking Age Act but these proposals never gained traction in Congress. Additionally, South Dakota brought an action against the Secretary of the Department of Transportation, asking the courts to declare the uniform national drinking age sanction unconstitutional on the grounds that it violated the 10th and 21st amendments. However, this complaint was dismissed by both the US District Court and the Court of Appeals. The National Minimum Legal Drinking Age Act remains in effect to this day.

Key influences in establishing age-21 MLDA

Between 1977 and 1988, 29 states raised their MLDA to age 21, some voluntarily and some because of financial pressure from the federal government. Each state that raised its MLDA to age 21 has a unique story on how the age-21 MLDA was enacted, each with varying players, legislative processes, victories and defeats. However, these individual cases took place within a national social movement that had a high level of support among the general population and that was supported directly by research.

Factors that may influence the success of a social movement may include the number and diversity of organizations involved as well as the level of inside (e.g. lobbying, advocating) and outside (e.g. grassroots organizing) pressures that are placed on legislators [13]. Mothers Against Drunk Driving (MADD) and Remove Intoxicated Drivers (RID) were two advocacy organizations involved directly in the national debate to increase the drinking age. MADD was formed in 1980 and RID was formed in 1978. Both organizations grew across communities and states during the early 1980s. These organizations included many volunteers who were victims of drinking and driving. They were able to produce grassroots and direct lobbying pressure. In addition to these advocacy organizations, additional support for an age-21 MLDA was garnered through the National Safety Council, the President's Commission on Drunk Driving and the National Transportation Safety Board—organizations that were able to communicate clearly to policymakers the strength of the research evidence in support of an age-21 MLDA [1,14,15].

In addition to the strong research evidence, the social movement to raise the drinking age to 21 also had high public support—one poll indicated that 77% of the public were in favor of the law. Perhaps because of this public support, the drinking age was seen as good policy, and ‘. . . one that you [couldn't] lose on . . .’ during the election year [12]. This public support was important both for members of Congress as well as President Reagan: ‘In dropping his opposition to the measure, the President had said he was persuaded by the evidence that raising the drinking age could save lives. In addition, some of Mr Reagan's re-election strategists . . . made no secret of their hope that the issue [would] help the President's standing among voters’[10].

Key messages for and against an age-21 MLDA

Messages used by proponents of the age-21 MLDA focused primarily on the research findings of the loss of lives resulting from lowering the drinking age and the potential lives that would be saved by returning state MLDAs to age 21. Proponents of the federal legislation also emphasized the loss of lives due to traffic crashes resulting from youth crossing state borders to drink because of differing drinking ages across states.

In contrast, messages of the opponents of the age-21 MLDA included that a lower drinking age should be more effective because youth could be taught how to drink responsibly [1]. Another popular argument was that if 18–20-year-olds fight and die in a war, they should have the right to drink alcohol. Similarly, if 18–20-year-olds have a right to vote and get married as an adult, they should also have a right to drink alcohol. These same arguments were used to oppose an age-21 MLDA during the movements to lower the drinking age in the early 1970s and then to raise the drinking age subsequently in the 1970s and 1980s and appear in the current debate as well. In previous debates about the MLDA, the alcohol industry raised concerns over loss of revenue associated with a higher the drinking age. Similar concerns have not been prominent in the current debate.


  1. Top of page
  8. Declarations of interest
  9. References

Despite strong evidence indicating that the legal drinking age of 21 has reduced alcohol use among individuals under age 21 and saves lives each year, a substantial number of adolescents and young adults drink alcohol and experience problems resulting from their drinking [16]. The focus on problems related to underage drinking has been particularly strong on college campuses [17,18]. A broad array of interventions focused upon changing individual and environmental determinants of drinking have been identified to complement the age-21 MLDA to further reduce underage alcohol use and related problems [19–21]. For example, in 2002 the National Institute on Alcoholism and Alcohol Abuse issued a Call to Action to address drinking on college campuses, based on findings of an expert panel [22]. The panel report found that drinking among college students was a serious problem and issued a set of recommendations to address the problem. Among the recommendations was a call for increased enforcement of minimum drinking age laws, which the panel found to be the ‘most well-studied’ and ‘successful’ alcohol control policy. In 2004 the Institute of Medicine issued a report on ‘Reducing Underage Drinking’ and came to a similar conclusion, finding that increasing the MDLA resulted in fewer traffic casualties and less alcohol consumption [23].

In contrast to these efforts, Dr John McCardell, former president of Middlebury College in Vermont, started a non-profit organization in 2005 called Choose Responsibility (CR) (, which was founded to ‘. . . stimulate informed and dispassionate public discussion about the presence of alcohol in American culture and to consider policies that will effectively empower young adults aged 18–20 to make mature decisions about the place of alcohol in their own lives’. CR argues that the age-21 MLDA is not working and recommends that the drinking age should be lowered and that, alternatively, states should: (i) educate 18–20-year-olds on how to drink alcohol responsibly, using a program similar to driver's education programs, that will be implemented on a state-by-state basis; and (ii) issue a drinking license to individuals who pass a final examination successfully at the end of the 40-hour education program, with the license allowing those individuals to drink alcohol legally in the state in which the license is issued ( As far as we could determine, CR does not appear to have taken a position on the National Institute on Alcohol Abuse and Alcoholism (NIAAA) College Task Force recommendations or the Institute of Medicine recommendations.

As a social advocacy organization, CR has been successful in generating publicity and attention for their proposals through newspaper stories, op-ed pieces, radio, television and webcasts. In July 2008 a new advocacy effort, called the Amethyst Initiative (AI), was introduced by CR. This initiative includes recruiting chancellors and presidents of universities and colleges to support ‘. . . an informed and unimpeded debate on the 21-year-old drinking age’. AI presidents and chancellors have called upon ‘. . . elected officials to weigh the consequences of current alcohol policies and [invited] new ideas on how best to prepare young adults to make responsible decisions about alcohol’ ( One hundred and thirty-five chancellors and presidents have signed onto this initiative as of 11 May 2009. While this group represents a small fraction of all chancellors and presidents of US colleges, the AI has generated significant media attention. Although some of those presidents who have signed this pledge say the initiative is not about lowering the drinking age [24], the Amethyst Initiative website states that ‘Twenty-one is not working’. Many of the messages in this current initiative are similar to those used in previous MLDA debates. These include: (i) individuals who are old enough to die at war should be old enough to drink alcohol; (ii) we should be teaching young adults how to drink responsibly, and (iii) individuals aged 18–20 years are able to get married and vote—thus they should also be trusted to make reasonable decisions about alcohol use. Proponents of the new effort to lower the MLDA also suggest that Europeans have a lower drinking age and fewer alcohol problems.

As in earlier MLDA debates, each of these arguments has been rebuffed or exposed as inaccurate by scientific evidence or long-established legal opinion (see Fell et al. 2008; Toomey et al. 1996; Wagenaar & Toomey, 2000) [25–27]. After passage of the National Minimum Drinking Act, researchers continued to evaluate effects of state changes in MLDAs, making this alcohol control policy the most well-studied alcohol control policy in the United States [28]. Independent reviews of this literature have concluded that when the drinking age was lowered, consumption and traffic crashes increased among 19–20-year-olds and when the drinking was increased to 21, consumption and traffic crashes decreased among this age group [26,29]. The age-21 MLDA is attributed with saving 25 509 lives between 1975 and 2006 just through the prevention of traffic crash deaths [30]. Although much of the research focused upon effects of the age-21 MLDA on traffic crashes, researchers have also found evidence of decreases in other alcohol-related problems, such as suicides [31,32], unintentional injuries [31], educational attainment [33] and vandalism [34,35] associated with the increase in the drinking age.

Dr McCardell has dismissed the research evidence and stated in one notable article that what was striking about the research was ‘. . . how little it conclusively backs up claims about the positive impact of the 21-year-old drinking age’. [36] In addition, he has said that the observed effects attributed to the age-21 drinking age should actually be attributed to other policy changes, enforcement and education ( His conclusions directly contradict conclusions reached in systematic scientific reviews [26,29]. Although Dr McCardell has dismissed methods and findings of research supported by major medical and governmental agencies in this country (e.g. see websites for the Federal Trade Commission, the National Institute on Alcohol Abuse and Alcoholism, the Surgeon General, the National Highway Traffic Safety Administration, the National Transportation Safety Board, the American Medical Association and the Insurance Institute for Highway Safety), he has provided no research evidence to support any of CR's proposals. His organization proposes to model the responsible drinking education program to current driving education programs, but fails to acknowledge current debates about driving education in terms of its potential ineffectiveness (traffic crashes remain the leading cause of death among young people) [37] or implementation problems (lack of standardization of training, etc.) [38].

Interestingly, as a whole, the alcohol industry has been fairly quiet during the current debate about the MLDA, despite being active opponents to returning the MLDA to age 21 [1]. One notable exception is that in 2000, during an address to the National Beer Wholesalers Association convention, Anheuser-Busch chairman August A. Busch III said: ‘We need to listen to those who say that a law that makes it illegal for college students to drink beer is wrong and that it results in the very behavior that we are trying to fight. Bottom line: Instead of pretending that prohibition on college campuses is realistic, we should be investing in helping those young people learn to make healthy and responsible choices’[39].

Reasons why the alcohol industry has not been more vocally supportive of lowering the MLDA are not clear. It is possible that the industry did not suffer significant costs when the drinking age was increased across states, and thus has no clear motivation to work to lower the MLDA again. Another explanation, however, may be that given the strong research evidence in support of the age-21 MLDA and the strong public support for the age-21 MLDA, the alcohol industry fears that there will be ramifications from the public if the industry pushes publicly to lower the MLDA.


  1. Top of page
  8. Declarations of interest
  9. References

The debate in the United States about the appropriate age for the MLDA has frequently drawn comparisons with the drinking age in other countries [40–42], which is often lower than that in the United States. Opponents of the age-21 MLDA often suggest that the lower drinking ages in Europe and elsewhere should serve as a model for the United States. However, rates of high-risk drinking among youth and young adults are higher in most European countries than in the United States [43,44]. European countries including France and Great Britain have raised concerns recently about problems associated with high-risk alcohol use among youth. [45,46] These concerns have also been raised in other countries such as Australia and New Zealand. New Zealand lowered its drinking age from 20 to 18 in 1999. Similar to the experience in the United States with lowering the MLDA, researchers found an increase in alcohol consumption, traffic crashes and alcohol-related visits to the emergency room among older adolescents and young adults following the lowering of the MLDA in New Zealand [40,47].

The changes in the US MLDA had as key elements strong citizen movements, evolving from the social unrest of the 1960s. The importance of these civil movements and public opinion in the MLDA debate may be unique to the representative form of government in the United States. The extent to which MLDA in other countries has been influenced by citizen movements is not well documented, but these factors may play an important role in whether changes in the MLDA in other countries are ultimately enacted.


  1. Top of page
  8. Declarations of interest
  9. References

CR/AI appear to have been successful in creating a new movement to advocate for lowering the MLDA. As with other social movements, this movement is having at least some influence on the political agenda. From January 2007 to December 2008, nine states proposed legislation to lower their MLDAs [48]. However, proposals to lower the drinking age made little progress in each state legislature. As previous experience suggests, whether the current movement to lower the MLDA is ultimately successful may lie in its ability to frame the scientific debate and influence public opinion. However, in these areas the movement to lower the drinking age has yet to be successful. As during the early 1980s, the majority of adults polled between 2005 and 2008 support the age-21 drinking age (52–80% across nation-wide polls) [49–51]. The research supporting the age-21 MLDA that was instrumental in increasing the MLDA to 21 has only grown stronger, while no new research evidence has emerged that would support lowering the MLDA or the approaches proposed by CR.

One benefit of the movement to lower the drinking age may be a renewed focus on the remaining challenges to address underage drinking and its related problems. Research evidence supports a variety of environmental changes on campuses, in communities, in states and at the federal level to enhance the age-21 drinking age. These initiatives include increased enforcement of the MLDA and closing loopholes that provide youth access to alcohol, and raising excise taxes on alcohol [23,25,52–54]. A full and open consideration of all of these proposals will lead to the achievement of a common goal: reducing the serious consequences that alcohol use has on youth.

Dr McCardell and the presidents/chancellors who have signed onto the Amethyst Initiative want to have an unimpeded debate of the age-21 MLDA. It is important to have ongoing discussions about public health policies—to consider their effectiveness as well as potential unintended consequences. An unimpeded debate of the MLDA should be informed by its historical context and available research. The United States has already experimented with its MLDA, allowing researchers to assess effects of lowering and raising the MLDA. The preponderance of research evidence indicates that lowering the drinking age increased consumption and related problems while increasing the drinking age has reduced problems and saved lives [25,26]. It is imperative that the historical debates and research related to the US MLDA experiment are considered fully in any current debates about the appropriate MLDA for the United States or any other country. As noted historian George Santayana stated, ‘Those who cannot remember the past are condemned to repeat it’[55]. Given that lives of many young people are at stake, we cannot afford to forget the high cost the United States already paid when it lowered its MLDA.


  1. Top of page
  8. Declarations of interest
  9. References
  • 1
    Wagenaar A. C. Research affects public policy: the case of the legal drinking age in the United states. Addiction 1993; 88: S7581.
  • 2
    McCardell J. M. What your college presidents didn't tell you. New York Times (Op-Ed) 2004; 13 September. Available at: (accessed 11 May 2009).
  • 3
    Sabatier P. A. Toward better theories of the policy process. Pol Sci Pol 1991; 24: 14756.
  • 4
    Cook P. J., Tauchen G. The effect of minimum drinking age legislation on youthful auto fatalities 1970–1977. J Legal Studies 1984; 8: 16990.
  • 5
    Williams A. F., Rich R. F., Zador P. L., Robertson L. S. Legal minimum drinking age and fatal motor vehicle crashes. J Legal Stud 1975; 4: 21939.
  • 6
    16 Am. Jur. 2d Constitutional Law s 19 (2008); Chevron USA, Inc., et al., v. State of Mississippi, et al., 578 So. 2d 644, 67 Ed. Law Rep. 844 (1991).
  • 7
    6 Am. Jur. 2d Constitutional Law s 30 (2008).
  • 8
    Mich. Const. art. XII, s1, 2 (2008).
  • 9
    Guy R. Opinion, Civil No. 8-73015 and Civil No. 8-73159. U.S. District Court, Eastern District of Michigan, Detroit, Michigan. 22 December 1978.
  • 10
    Weisman S. R. Reagan signs law linking Federal aid to drinking age. New York Times 1984; 18 July: A15.
  • 11
    Hunter M. Commission urges 21 as drinking age. New York Times 1983; 14 December: A24.
  • 12
    Feaver D. B. Reagan now wants 21 as drinking age. Washington Post 1984; 14 June: A1.
  • 13
    Johnson E. W. Social movement, size, organizational diversity and the making of Federal law. Soc Forces 2008; 86: 96793.
  • 14
    Holsendolph E. Safety board asks all states to fix 21 drinking age. Washington Post 1984; Section 1, 6.
  • 15
    Presidential Commission on Drunk Driving. Final Report. Washington, DC, 1983.
  • 16
    Johnston L. D., O'Malley P. M., Bachman J. G., Schulenberg J. E. Monitoring the Future: National Survey Results on Drug Use 1975–2007, vol. I, Secondary School Students. NIH Publication no. 08-6418A. Bethesda, MD: National Institute on Drug Abuse, 2008.
  • 17
    Wechsler H., Lee J. E., Kuo M., Sebring M., Nelson T. F., Lee H. Trends in college binge drinking during a period of increased prevention efforts—findings from 4 Harvard School of Public Health College Alcohol Study surveys: 1993–2001. J Am Coll Health 2002; 50: 20317.
  • 18
    Wechsler H., Lee J. E., Nelson T. F., Kuo M. Underage college students' drinking behavior, access to alcohol, and the influence of deterrence policies—findings from the Harvard School of Public Health College Alcohol Study. J Am Coll Health 2002; 50: 22336.
  • 19
    Larimer M. E., Cronce J. M. Identification, prevention and treatment: a review of individual-focused strategies to reduce problematic alcohol consumption by college students. J Stud Alcohol 2002; Suppl 14: 14863.
  • 20
    Toomey T. L., Lenk K. M., Wagenaar A. C. Environmental policies to reduce college drinking: an update of research findings. J Stud Alcohol Drugs 2007; 68: 20819.
  • 21
    Toomey T. L., Wagenaar A. C. Environmental policies to reduce college drinking: options and research findings. J Stud Alcohol 2002; Suppl 14: 193205.
  • 22
    National Institute on Alcohol Abuse and Alcoholism. A Call to Action: Changing the Culture of Drinking at US Colleges. Report no.: NIH Publication no. 02-5010. Bethesda, MD: National Institutes of Health, 2002.
  • 23
    National Research Council and Institute of Medicine. Reducing Underage Drinking: A Collective Responsibility. Washington, DC: The National Acadamies Press; 2003.
  • 24
    Nelson L. College officials: let's rethink the drinking age. Star Tribune 2008; 20 August.
  • 25
    Fell J. C., Fisher D. A., Voas R. B., Blackman K., Tippetts A. S. The relationship of underage drinking laws to reductions in drinking drivers in fatal crashes in the United States. Accid Anal Prev 2008; 40: 143040.
  • 26
    Wagenaar A. C., Toomey T. L. Effects of minimum drinking age laws: review and analyses of the literature from 1960–2000. J Stud Alcohol 2002; Suppl 14: 20625.
  • 27
    Toomey T. L., Rosenfeld C., Wagenaar A. C. The minimum legal drinking age: history, effectiveness, and ongoing debate. Alcohol Health Res World 1996; 20: 21318.
  • 28
    Wagenaar A. C., Toomey T. L. Alcohol policy: gaps between legislative actions and current research. Contemp Drug Probl 2000; 27: 681733.
  • 29
    Shults R. A., Elder R. W., Sleet D. A., Nichols J. L., Alao M. O., Carande-Kulis V. G. et al. Reviews of evidence regarding interventions to reduce alcohol-impaired driving. Am J Prev Med 2001; 21: 6688.
  • 30
    National Highway Traffic Safety Administration. Traffic Safety Facts 2006: Young Drivers. Report no.: DOT HS 810 817. Washington, DC: US Department of Transportation; 2008.
  • 31
    Jones N. E., Pieper C. F., Robertson L. S. The effect of legal drinking age on fatal injuries of adolescents and young adults. Am J Public Health 1992; 82: 11215.
  • 32
    Birckmayer J., Hemenway D. Minimum-age drinking laws and youth suicide. Am J Public Health 1999; 89: 13658.
  • 33
    Renna F. Teens' alcohol consumption and schooling. Econ Educ Rev 2008; 27: 6978.
  • 34
    Carpenter C. S. Heavy alcohol use and the commission of nuisance crime: evidence from underage drunk driving laws. Am Econ Rev 2005; 95: 26772.
  • 35
    Joksch H. C., Jones R. K. Changes in the drinking age and crime. J Crim Justice 1993; 21: 20921.
  • 36
    Jasik J. An honest conversation about alcohol. Inside Higher Ed, 16 February 2007. Available at: (accessed 11 May 2009).
  • 37
    Subramanian R. Motor Vehicle Traffic Crashes as a Leading Cause of Death in the US, 2003. Report no. DOT HS 810 568. Washington, DC: US Department of Transportation, 2006.
  • 38
    Lonero L. P. Trends in driver education and training. Am J Prev Med 2008; 35: S31623.
  • 39
    Associated Press. Busch III under fire for drinking age comments. Modern Brewery Age, 23 October 2000. Available at: (accessed 11 May 2009).
  • 40
    Kypri K., Voas R. B., Langley J. D., Stephenson S. C., Begg D. J., Tippetts A. S. et al. Minimum purchasing age for alcohol and traffic crash injuries among 15- to 19-year-olds in New Zealand. Am J Public Health 2006; 96: 12631.
  • 41
    Ahlstrom S. K., Osterberg E. L. International perspectives on adolescent and young adult drinking. Alcohol Res Health 2004; 28: 25868.
  • 42
    Kuo M., Adlaf E. M., Lee H., Gliksman L., Demers A., Wechsler H. More Canadian students drink but American students drink more: comparing college alcohol use in two countries. Addiction 2002; 97: 158392.
  • 43
    Grube J. Youth Drinking Rates and Problems: A Comparison of European Countries and the United States. Calverton, MD: Pacific Institute for Research and Evaluation; 2005.
  • 44
    Hibell B., Guttormsson U., Ahlstrom S., Balakireva O., Kokkevi A., Morgan M. The 2007 ESPAD Report: Substance Use Among Students in 35 European Countries. Stockholm: The Swedish Council for Information on Alcohol and Other Drugs; 2009.
  • 45
    Laurence J. Big rise in number of young people killed by heavy drinking. Independent, 26 February 2007. Available at: (accessed 8 June 2009).
  • 46
    Chrisafis A. Prohibition for French teenagers as new laws approved to curb ‘le binge drinking’. Guardian, 13 March 2009. Available at: (accessed 8 June 2009).
  • 47
    Everitt R., Jones P. Changing the minimum legal drinking age—its effect on a central city emergency department. NZ Med J 2002; 115: 911.
  • 48
    McCartt A. T., Hellinga L. A., Kirley B. B. Effects of 21 Minimum Legal Drinking Age Laws on Alcohol-related Driving in the United States. Arlington, VA: Insurance Institute for Highway Safety; 2008.
  • 49
    Cohen J. Poll: public back legal drinking age limit. ABC News. 15 July 2005. Available at: (accessed 11 May 2009).
  • 50
    Gallup. Most Americans oppose lowering legal drinking age to 18 nationwide. Gallup Poll, 27 May 2007. Available at: (accessed 11 May 2009).
  • 51
    Rasmussen Reports. 52% say legal drinking age should remain 21. 26 August 2008. Available at: (accessed 11 May 2009).
  • 52
    Grube J. W. Preventing sales of alcohol to minors: results from a community trial. Addiction 1997; 92: S25160.
  • 53
    Ponicki W. R., Gruenewald P. J., Lascala E. A. Joint impacts of minimum legal drinking age and beer taxes on U.S. youth traffic fatalities, 1975–2001. Alcohol Clin Exp Res 2007; 31: 80413.
  • 54
    Wagenaar A. C., Toomey T. L., Erickson D. J. Preventing youth access to alcohol: outcomes from a multi-community time–series trial. Addiction 2005; 100: 33545.
  • 55
    Santayana G. The Life of Reason, vol. 1, chapter 12. New York: Dover; 1980.