The Impact of Increasing the Minimum Legal Drinking Age from 18 to 20 Years in Lithuania on All-Cause Mortality in Young Adults-An Interrupted Time-Series Analysis

doi:10.1093/alcalc/agab076

. 2022 Jul 9;57(4):513-519.

doi: 10.1093/alcalc/agab076.

The Impact of Increasing the Minimum Legal Drinking Age from 18 to 20 Years in Lithuania on All-Cause Mortality in Young Adults-An Interrupted Time-Series Analysis

Alexander Tran¹, Huan Jiang^{1

2}, Shannon Lange^{1

3}, Michael Livingston^{4

5

6}, Jakob Manthey^{7

8

9}, Maria Neufeld^{1

7

10}, Robin Room^{4

11}, Mindaugas Štelemėkas^{12

13}, Tadas Telksnys¹², Janina Petkevičienė^{12

13}, Ričardas Radišauskas^{14

15}, Jürgen Rehm^{1

2

3

7

8

16

17

18

19}

Affiliations

¹ Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada.
² Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 1P8, Canada.
³ Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St, Toronto, Ontario M5T 1R8, Canada.
⁴ Centre for Alcohol Policy Research, Building NR-1, La Trobe University, Plenty Rd. x Kingsbury Rd., Bundoora, Victoria 3086, Australia.
⁵ National Drug Research Institute, Health Sciences, Curtin University, Perth, 6102, Australia.
⁶ Department of Clinical Neuroscience, Karolinska Institutet, Solnavägen 1, 171 77 Solna, Sweden.
⁷ Institute of Clinical Psychology and Psychotherapy, Faculty of Psychologie, Technische Universitat Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany.
⁸ Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany.
⁹ Department of Psychiatry, Medical Faculty, University of Leipzig, Semmelweisstraße 10, 04103 Leipzig, Germany.
¹⁰ WHO Regional Office for Europe, Office for Prevention and Control of Noncommunicable Diseases, Moscow, Leontyevsky Pereulok 9, 125009 Moscow, Russian Federation.
¹¹ Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, Stockholm University, 3rd floor, Sveavägen 160, 113 46 Stockholm, Sweden.
¹² Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181 Kaunas, Lithuania.
¹³ Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181 Kaunas, Lithuania.
¹⁴ Department of Environmental and Occupational Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181 Kaunas, Lithuania.
¹⁵ Institute of Cardiology, Lithuanian University of Health Sciences, Sukilėlių str. 17, 50162 Kaunas, Lithuania.
¹⁶ World Health Organization/ Pan American Health Organization Collaborating Centre, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada.
¹⁷ Faculty of Medicine, Institute of Medical Science, University of Toronto, Medical Sciences Building, 1 King's College Circle, Room 2374, Toronto, Ontario M5S 1A8, Canada.
¹⁸ Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, Ontario M5T 1R8, Canada.
¹⁹ Department of International Health Projects, Institute for Leadership and Health Management, .M. Sechenov First Moscow State Medical University, ITrubetskaya str., 8, b. 2, 119992, Moscow, Russian Federation.

PMID: 34864838
PMCID: PMC9270988
DOI: 10.1093/alcalc/agab076

The Impact of Increasing the Minimum Legal Drinking Age from 18 to 20 Years in Lithuania on All-Cause Mortality in Young Adults-An Interrupted Time-Series Analysis

Alexander Tran et al. Alcohol Alcohol. 2022.

. 2022 Jul 9;57(4):513-519.

doi: 10.1093/alcalc/agab076.

Authors

Affiliations

¹ Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada.
² Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 1P8, Canada.
³ Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St, Toronto, Ontario M5T 1R8, Canada.
⁴ Centre for Alcohol Policy Research, Building NR-1, La Trobe University, Plenty Rd. x Kingsbury Rd., Bundoora, Victoria 3086, Australia.
⁵ National Drug Research Institute, Health Sciences, Curtin University, Perth, 6102, Australia.
⁶ Department of Clinical Neuroscience, Karolinska Institutet, Solnavägen 1, 171 77 Solna, Sweden.
⁷ Institute of Clinical Psychology and Psychotherapy, Faculty of Psychologie, Technische Universitat Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany.
⁸ Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany.
⁹ Department of Psychiatry, Medical Faculty, University of Leipzig, Semmelweisstraße 10, 04103 Leipzig, Germany.
¹⁰ WHO Regional Office for Europe, Office for Prevention and Control of Noncommunicable Diseases, Moscow, Leontyevsky Pereulok 9, 125009 Moscow, Russian Federation.
¹¹ Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, Stockholm University, 3rd floor, Sveavägen 160, 113 46 Stockholm, Sweden.
¹² Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181 Kaunas, Lithuania.
¹³ Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181 Kaunas, Lithuania.
¹⁴ Department of Environmental and Occupational Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181 Kaunas, Lithuania.
¹⁵ Institute of Cardiology, Lithuanian University of Health Sciences, Sukilėlių str. 17, 50162 Kaunas, Lithuania.
¹⁶ World Health Organization/ Pan American Health Organization Collaborating Centre, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada.
¹⁷ Faculty of Medicine, Institute of Medical Science, University of Toronto, Medical Sciences Building, 1 King's College Circle, Room 2374, Toronto, Ontario M5S 1A8, Canada.
¹⁸ Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, Ontario M5T 1R8, Canada.
¹⁹ Department of International Health Projects, Institute for Leadership and Health Management, .M. Sechenov First Moscow State Medical University, ITrubetskaya str., 8, b. 2, 119992, Moscow, Russian Federation.

PMID: 34864838
PMCID: PMC9270988
DOI: 10.1093/alcalc/agab076

Abstract

Aims: To determine the effect of an alcohol policy change, which increased the minimum legal drinking age (MLDA) from 18 years of age to 20 years of age on all-cause mortality rates in young adults (18-19 years old) in Lithuania.

Methods: An interrupted time series analysis was conducted on a dataset from 2001 to 2019 (n = 228 months). The model tested the effects of the MLDA on all-cause mortality rates (deaths per 100,000 individuals) in three age categories (15-17 years old, 18-19 years old, 20-22 years old) in order to control for general mortality trends in young adults, and to isolate the effects of the MLDA from other alcohol control policies. Additional models that included GDP as a covariate and a taxation policy were tested as well.

Results: There was a significant effect of the MLDA on all-cause mortality rates in those 18-19 years old, when modelled alone. Additional analyses controlling for the mortality rate of other age groups showed similar findings. Inclusion of confounding factors (policies on alcohol taxation, GDP) eliminated the effects of MLDA.

Conclusions: Although there was a notable decline in all-cause mortality rates among young adults in Lithuania, a direct causal impact of MLDA on all-cause mortality rates in young adults was not definitively found.

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Figures

**Figure 1**
Mortality rate in Lithuania in the age group 18- and 19 year olds, 2001–2019, Raw all-cause mortality rate (deaths per 100,000) of all 18–19 year olds, with MLDA Policy shown as dashed black line.

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References

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[1] Babor TF, Caetano R, Casswell S, et al. (2010) Alcohol: No Ordinary Commodity. Research And Public Policy, 2nd edn. Oxford: Oxford University Press.

[2] Babor TF, Caetano R, Casswell S, et al. (2010) Alcohol: No Ordinary Commodity. Research And Public Policy, 2nd edn. Oxford: Oxford University Press.

[3] Beard E, Marsden J, Brown J, et al. (2019) Understanding and using time series analyses in addiction research. Addiction 114:1866–84. - PubMed

[4] Beard E, Marsden J, Brown J, et al. (2019) Understanding and using time series analyses in addiction research. Addiction 114:1866–84. - PubMed

[5] Brown SL. (1998) Associations between peer drink driving, peer attitudes toward drink driving, and personal drink driving 1, 2. J Appl Soc Psychol 28:423–36.

[6] Brown SL. (1998) Associations between peer drink driving, peer attitudes toward drink driving, and personal drink driving 1, 2. J Appl Soc Psychol 28:423–36.

[7] Carpenter C, Dobkin C. (2011) The minimum legal drinking age and public health. J Econ Perspect 25:133–56. - PMC - PubMed

[8] Carpenter C, Dobkin C. (2011) The minimum legal drinking age and public health. J Econ Perspect 25:133–56. - PMC - PubMed

[9] Carpenter C, Dobkin C. (2015) The minimum legal drinking age and crime. Rev Econ Stat 97:521–4. - PMC - PubMed

[10] Carpenter C, Dobkin C. (2015) The minimum legal drinking age and crime. Rev Econ Stat 97:521–4. - PMC - PubMed

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The Impact of Increasing the Minimum Legal Drinking Age from 18 to 20 Years in Lithuania on All-Cause Mortality in Young Adults-An Interrupted Time-Series Analysis

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The Impact of Increasing the Minimum Legal Drinking Age from 18 to 20 Years in Lithuania on All-Cause Mortality in Young Adults-An Interrupted Time-Series Analysis

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