four percent, or more than 5 million, drank 5 or more drinks within a two-hour period on at least one occasion in the previous month. Seventy-eight percent, or more than 11.6 million, had consumed alcohol at some point in their lives and 29 percent, or 4.3 million, reported starting to drink before age 13. Thirteen percent, or 1.9 million, drove after drinking in the past 30 days and 31 percent, or 4.6 million, rode with a drinking driver. Five percent, or more than 700,000, drank at school in the past 30 days.
For some, heavy drinking begins even before high school. In 2001, according to the NHSDA, 2 percent of 12-year-olds and 3 percent of 13-year-olds consumed 5 or more drinks on at least one occasion in the past 30 days.
Not only is drinking by persons underage an illegal activity, but persons that age who drink are more likely than those who do not to engage in behaviors that pose a risk to their health and the health of others.
The greatest single mortality risk posed by underage drinking is traffic crashes. Traffic crashes are the leading cause of death in the United States for persons ages 4 to 34 (National Highway Traffic Safety Administration [NHTSA] 2002). According to the Fatality Analysis Reporting System of the NHTSA, in 2001, 39 percent of traffic deaths by those ages 16 to 20 involved a driver, passenger, or pedestrian who had been drinking (2,365/ 6,051) (NHTSA, 2001). Of course it is possible that some of the drinking drivers in those fatal crashes were 21 or older. In 2001, 1,884 drivers under age 21 in fatal motor vehicle crashes had positive blood alcohol levels, including 45 of whom were under age 16. Of those drivers, 1,109 died in those crashes. Many persons other than the drinking driver were also killed in those crashes. In 2001, 1,099 persons other than drinking drivers under age 21 died in fatal crashes when those drivers under age 21 were involved. Six hundred thirty were under age 21, and most of them (587) were passengers either in the vehicle driven by or struck by the drinking driver under age 21.
Epidemiologic research comparing drivers in single-vehicle fatal crashes with drivers operating motor vehicles at similar times on the same roadways who were not involved in fatal crashes has revealed that each 0.02 percent increase in blood alcohol level nearly doubles the risk of single-vehicle fatal crash involvement and that the risk of death increases with each drink