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How much is “too much”? A Review of the Evidence on Youth Drinking Risks

Canada's National Youth Council defines "youth" as those who are 15-24 years of age. Compared to adults 25 years and older, youth are the population mostly likely to engage in risky drinking patterns typically characterized by the consumption of high quantities of alcohol per occasion (Stockwell, Zhao , & Thomas, 2009) and are more likely to experience acute alcohol-related harms, such as injuries and poisonings (Makela and Mustonen, 2000). Further, research comparing risk of injury for a given dose of alcohol by age shows that when consuming the same amount of alcohol as older adults, youth are more likely to experience alcohol-related harm (e.g. Keall, Frith, & Patterson, 2002; Peck Gebers, Voas, Romano, 2008; Cherpital, Tam, Midanik. Caetano, Greenfield, 1995). This evidence marks youth as a particularly vulnerable population.

This vulnerability stems from developmental changes including greater sensitivity to ethanol-related brain impairments (Clark, Thatcher, & Tapert, 2008), lower tolerance, and increased propensity for risk taking as a result of increased sensation seeking and delay maturation of self-regulatory competence (Steinberg, 2008). Together this evidence demands we consider carefully what can be defined as "low-risk" or "too much" alcohol for youth and design health messages that are realistic and specific to this age group.

Of some 34 countries who have issued low-risk drinking guidelines, Canada is the first to acknowledge this heightened vulnerability and offer lower detailed quantitative recommendations for youth, including distinct recommendations for those from the legal drinking age to 24 years. These recommended "low-risk" levels come from recent studies that showed the risk of acute alcohol-related harms, including physiological (e.g. passing out, sexually transmitted infections, self-harm, injuries), psychological (e.g. doing something you regretted, relationship problems), behavioural (e.g. drinking and driving, risky sexual behaviour, polysubstance use) and legal problems (e.g. getting into trouble with the law) increased considerably for youth when alcohol consumption exceeded 1-2 drinks per occasion (Thompson, Stockwell, & MacDonald, 2012; Gruenewald, Johnson, Ponicki, & LaScala, 2010).

However, it is important to acknowledge that the guidelines offer different messages for those at different ends of the youth age spectrum. Before the legal drinking age, the guidelines encourage delayed onset of drinking, but if it is initiated, guidelines recommend no more than one or two drinks, no more than once or twice a week to reduce drinking risks.

Once youth reach the legal drinking age, the guidelines suggest daily limits of no more than 2 drinks per occasion for women and 3 for men (more stringent limits than the adult guidelines). Further, the guidelines go beyond recommendations about the numbers of standard drinks and also provide advice about how to alter the context of drinking (e.g. drink slowly, eat while drinking, parental supervision). Thus abiding by the numeric and the contextual recommendations is likely to reduce youth's alcohol-related risks further.

The guidelines should not be perceived as encouragement of youth alcohol consumption and "low-risk" does not imply "no risk". The guidelines are intended to be an educational tool that provides specific information necessary for youth to make informed choices about their drinking and reduce their alcohol-related risks.The challenge is that few youth (particularly those between 19-24 years) are currently drinking at these recommended levels. However, with appropriate dissemination these guidelines could be helpful in shaping young people's attitudes and drinking behaviour, and contribute to a shift in cultural norms about drinking patterns.

 

To view the guidelines, please visit: 

http://www.ccsa.ca/Eng/Priorities/Alcohol/Canada-Low-Risk-Alcohol-Drinking-Guidelines/Pages/default.aspx

 

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Dialogue of the Conversation | Shared Resources | Conversation Recap

 

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Comments 33

 
Guest - Melissa Knowler (Rennison) on Tuesday, 30 October 2012 10:04

Wow - what great comments! I was so happy to see that some people started to touch on the subject of alcohol advertising and youth. I find it appalling the amount of positive alcohol messaging that can be found so readily by teens - radio, t.v., magazines, social media, sponsorship etc. We are fighting against billion dollar marketing companies who have convinced our youth that drinking is cool, a way to have fun, be popular, get that girl/guy you have your eye on, and have ZERO negative outcomes. Although we may know this is an unrealistic expectation of alcohol, do you think teens get that? How can we better regulate advertising? It's obvious that the current self-regulation of marketing companies is failing miserably. Even if a complaint brings action to a contravening advertisement, it's likely that they ad has been visible long enough to do the damage. What kind of impact does advertising have on the suggested guidelines for youth? How can we fight these persuasive and in-your-face messages? How can our moderation or delay messages get to teens? I wish I had more answers and less questions...

0
Wow - what great comments! I was so happy to see that some people started to touch on the subject of alcohol advertising and youth. I find it appalling the amount of positive alcohol messaging that can be found so readily by teens - radio, t.v., magazines, social media, sponsorship etc. We are fighting against billion dollar marketing companies who have convinced our youth that drinking is cool, a way to have fun, be popular, get that girl/guy you have your eye on, and have ZERO negative outcomes. Although we may know this is an unrealistic expectation of alcohol, do you think teens get that? How can we better regulate advertising? It's obvious that the current self-regulation of marketing companies is failing miserably. Even if a complaint brings action to a contravening advertisement, it's likely that they ad has been visible long enough to do the damage. What kind of impact does advertising have on the suggested guidelines for youth? How can we fight these persuasive and in-your-face messages? How can our moderation or delay messages get to teens? I wish I had more answers and less questions...
Guest - Diane Buhler on Tuesday, 30 October 2012 10:29

There seems to be a common thread running here about context; that does pose a challenge to guidelines - both Patricia and Melissa's comments address this. If the connection between drinking and getting wasted/ fun (raised by Terry earlier) weren't so "in your face" we might have a better chance of introducing limited alcohol consumption to youth, within the parameters of the guidelines.

0
There seems to be a common thread running here about [b]context[/b]; that does pose a challenge to guidelines - both Patricia and Melissa's comments address this. If the connection between drinking and getting wasted/ fun (raised by Terry earlier) weren't so "in your face" we might have a better chance of introducing limited alcohol consumption to youth, within the parameters of the guidelines.
Guest - Cindy Andrew on Tuesday, 30 October 2012 14:15

Great dialogue! While there certainly isn't one solution (if life was only so simple eh?!), you might be interested in the "iMinds" (www.iminds.ca) health literacy related learning resources that the Centre for Addictions Research of BC has developed for schools (gr. 4-10). The recent blog post on Resilience-based drug education (see it at: http://www.carbc.ca/HelpingSchools/ToolsResources/DrugEducationBlog.aspx) will also be of interest.

0
Great dialogue! While there certainly isn't one solution (if life was only so simple eh?!), you might be interested in the "iMinds" (www.iminds.ca) health literacy related learning resources that the Centre for Addictions Research of BC has developed for schools (gr. 4-10). The recent blog post on Resilience-based drug education (see it at: http://www.carbc.ca/HelpingSchools/ToolsResources/DrugEducationBlog.aspx) will also be of interest.
Guest - Patricia on Tuesday, 30 October 2012 16:09

Thanks for the link to the BC Resilience-based drug education Cindy. At Parent Action on Drugs we have also been actively integrating resiliency and strength based approaches with youth. We have recently added this approach to our peer leadership drug prevention program (CBC) where we encourage teens to help younger students recognize and develop thier own strengths.

This approach is also very helpful when working with parents, who often have reservations and concerns about how to talk to their teens about alcohol use.

0
Thanks for the link to the BC Resilience-based drug education Cindy. At Parent Action on Drugs we have also been actively integrating resiliency and strength based approaches with youth. We have recently added this approach to our peer leadership drug prevention program (CBC) where we encourage teens to help younger students recognize and develop thier own strengths. This approach is also very helpful when working with parents, who often have reservations and concerns about how to talk to their teens about alcohol use.
Guest - Diane Buhler on Tuesday, 30 October 2012 15:36

I have been reviewing the study by Kara Thomson, Tim Stockwell and Stuart MacDonald, Is there a "low-risk" drinking level for youth? What strikes me is that they found (from the Healthy Youth Survey data in Victoria BC) that among the sample of 16 - 23 year olds, almost 10% of those below the legal drinking age (19) limited their quantity to 1-2 drinks and an additional 9% limited their quantity to 3-4 drinks. So we do have a population that drinks moderately, in the guideline range, plus a population that could potentially be persuaded to do so.

The other aspect that resonates is that the health-harmful effects and risks associated with drinking increases incrementally with every drink over two drinks. That's a pretty major correlation. In fact, within this study we see no difference in associated harms between under 2 drinks and abstainers!

I think there is a huge degree of significance in this finding. We definitely need MORE studies of this nature to ensure that the evidence is strong, but right now I think there is something to go on. I know that I will be conveying this incremental relationship concerning additional drinks and increased risk as we develop and review our resources at Parent Action on Drugs.

My own experience is that despite the "get wasted = have great times" culture, youth very much want accurate information!

0
I have been reviewing the study by [b]Kara Thomson, Tim Stockwell and Stuart MacDonald[/b],[i] Is there a "low-risk" drinking level for youth? [/i] What strikes me is that they found (from the Healthy Youth Survey data in Victoria BC) that among the sample of 16 - 23 year olds, [b]almost 10% of those below the legal drinking age (19) limited their quantity to 1-2 drinks and an additional 9% limited their quantity to 3-4 drinks[/b]. So we do have a population that drinks moderately, in the guideline range, plus a population that could potentially be persuaded to do so. The other aspect that resonates is that the [b]health-harmful effects and risks associated with drinking increases incrementally with every drink over two drinks. [/b] That's a pretty major correlation. In fact, within this study we see no difference in associated harms between under 2 drinks and abstainers! I think there is a huge degree of significance in this finding. We definitely need MORE studies of this nature to ensure that the evidence is strong, but right now I think there is something to go on. I know that I will be conveying this incremental relationship concerning additional drinks and increased risk as we develop and review our resources at Parent Action on Drugs. My own experience is that despite the "get wasted = have great times" culture, youth very much want accurate information!
Guest - Claudia on Wednesday, 31 October 2012 10:31

Thanks Kara for getting the conversation started on this very interesting topic! Lots of great sharing of resources/information and various perspectives based on our experiences in working with youth and in the arena of alcohol policy.

A couple of comments I have with regards to underage youth and LRDG’s are that I totally understand the perspective of a harm reduction approach but to be honest I really don’t see youth turning to the LRDG’s for their information on alcohol. We really do live in a culture where alcohol is highly valued and ingrained as part of our everyday lives. We drink to celebrate, socialize or relax; to drinking when we feel sad or had a bad day-both extremes of life. On that note, I do think that we really need a multi strategy approach that addresses alcohol policy and not to recite what is already clearly articulated in numerous documents/resources including ANOC, my top 3 policy pieces would include availability, advertising/sponsorship and pricing (Granted they are all important). The alcohol industry really does manage to sell people a bill of goods. Be whatever you want to be: fun, sporty, seductive, popular and even healthy with low carb organic beer or protein vodka (who knew…). They have even managed to successfully circumvent the advertising regulations as Melissa has pointed out.

I think youth tend to engage in high risk behaviors whether it be drugs, alcohol, sexual activity etc. as they are somehow trying to fit in/feel comfortable inside their skin, and it is a time of not only risk taking and everything we know about the teenage brain but also finding ones identity (which the alcohol industry is happy to help out with…). One thing I have heard from youth in so many words is that the worst thing of all is to feel invisible. The alcohol industry through its branding of products really does provide a sense of identity and belonging, not to mention the “buzz” one experiences when consuming the product. Somehow the short term consequences of drunkenness (vomiting, hangover, injuries, embarrassing moments etc.) not to mention the long term consequences are overlooked. Clearly health messaging is not the key as while information is definitely important, it in and of itself will not move us forward when it comes to alcohol and youth. We have seen this in the tobacco experience as well.

In addressing youth and alcohol, I think we need to use a youth engagement approach as well as integration of resiliency which was also highlighted. Here is an interesting site developed by youth that has some interesting stories including one youth sharing her own experience with alcohol http://fringethebinge.wordpress.com/ I also love the line in the blog on the following site http://carbc.ca/HelpingSchools.aspx “In conclusion, drug education should follow the lead of Martin Luther King Jr. who did not proclaim, “I have a nightmare.” …

Thanks everyone for the interesting information you have all shared!

0
Thanks Kara for getting the conversation started on this very interesting topic! Lots of great sharing of resources/information and various perspectives based on our experiences in working with youth and in the arena of alcohol policy. A couple of comments I have with regards to underage youth and LRDG’s are that I totally understand the perspective of a harm reduction approach but to be honest I really don’t see youth turning to the LRDG’s for their information on alcohol. We really do live in a culture where alcohol is highly valued and ingrained as part of our everyday lives. We drink to celebrate, socialize or relax; to drinking when we feel sad or had a bad day-both extremes of life. On that note, I do think that we really need a multi strategy approach that addresses alcohol policy and not to recite what is already clearly articulated in numerous documents/resources including ANOC, my top 3 policy pieces would include availability, advertising/sponsorship and pricing (Granted they are all important). The alcohol industry really does manage to sell people a bill of goods. Be whatever you want to be: fun, sporty, seductive, popular and even healthy with low carb organic beer or protein vodka (who knew…). They have even managed to successfully circumvent the advertising regulations as Melissa has pointed out. I think youth tend to engage in high risk behaviors whether it be drugs, alcohol, sexual activity etc. as they are somehow trying to fit in/feel comfortable inside their skin, and it is a time of not only risk taking and everything we know about the teenage brain but also finding ones identity (which the alcohol industry is happy to help out with…). One thing I have heard from youth in so many words is that the worst thing of all is to feel invisible. The alcohol industry through its branding of products really does provide a sense of identity and belonging, not to mention the “buzz” one experiences when consuming the product. Somehow the short term consequences of drunkenness (vomiting, hangover, injuries, embarrassing moments etc.) not to mention the long term consequences are overlooked. Clearly health messaging is not the key as while information is definitely important, it in and of itself will not move us forward when it comes to alcohol and youth. We have seen this in the tobacco experience as well. In addressing youth and alcohol, I think we need to use a youth engagement approach as well as integration of resiliency which was also highlighted. Here is an interesting site developed by youth that has some interesting stories including one youth sharing her own experience with alcohol http://fringethebinge.wordpress.com/ I also love the line in the blog on the following site http://carbc.ca/HelpingSchools.aspx “In conclusion, drug education should follow the lead of Martin Luther King Jr. who did not proclaim, “I have a nightmare.” … Thanks everyone for the interesting information you have all shared!
Guest - Melissa Knolwer (Rennison) on Wednesday, 31 October 2012 11:30

Great comments Claudia! I completely agree with you around a youth engagement approach - much like tobacco has used (and done well with). I wanted to share a project we did in collaboration with our sexual health promotion group at the health unit that highlighted information for youth regarding alcohol and sexual health in a fun and unique way. The project was created by youth for youth with health unit staff as supports. The "Adventures in Sex City Level 2" was a springboard from the first level that dealt specifically with Sexually Transmitted Infections. http://www.healthunit.com/sectionList.aspx?sectionID=378 push the PLAY button at the center top and then select Game 2 "Alcohol and Substance Misuse". Enjoy!

0
Great comments Claudia! I completely agree with you around a youth engagement approach - much like tobacco has used (and done well with). I wanted to share a project we did in collaboration with our sexual health promotion group at the health unit that highlighted information for youth regarding alcohol and sexual health in a fun and unique way. The project was created by youth for youth with health unit staff as supports. The "Adventures in Sex City Level 2" was a springboard from the first level that dealt specifically with Sexually Transmitted Infections. http://www.healthunit.com/sectionList.aspx?sectionID=378 push the PLAY button at the center top and then select Game 2 "Alcohol and Substance Misuse". Enjoy!
Guest - Andrea Zeelie on Wednesday, 31 October 2012 11:29

The guidelines outline that “Youth should delay their drinking until their late teens, as alcohol is harmful to the development of the brain and body.” Age at first use of alcohol also appears to be a predictor of alcohol abuse and dependence of alcohol later in life. But what does “late teens” mean? Is this dependent on the maturity and other specific characteristics of each teen?

In the United Kingdom, age limits are specifically spelt out. In 2009 chief medical officer (at the time), Sir Liam Donaldson, stated that 15 is the absolute age limit for youth to initiate drinking. In general, terms seems to be much more spelt out in the UK (http://www.drinkaware.co.uk/children-and-alcohol/parents/the-law)

0
The guidelines outline that “Youth should delay their drinking until their late teens, as alcohol is harmful to the development of the brain and body.” Age at first use of alcohol also appears to be a predictor of alcohol abuse and dependence of alcohol later in life. But what does “late teens” mean? Is this dependent on the maturity and other specific characteristics of each teen? In the United Kingdom, age limits are specifically spelt out. In 2009 chief medical officer (at the time), Sir Liam Donaldson, stated that 15 is the absolute age limit for youth to initiate drinking. In general, terms seems to be much more spelt out in the UK (http://www.drinkaware.co.uk/children-and-alcohol/parents/the-law)
Guest - Patricia on Wednesday, 31 October 2012 12:16

I have found the last two days of conversation quite informative!

I am wondering if anyone has experience discussing the guidlines with youth and what their perspectives are?

0
I have found the last two days of conversation quite informative! I am wondering if anyone has experience discussing the guidlines with youth and what their perspectives are?
Guest - Ashley on Wednesday, 31 October 2012 16:50

What great comments and conversation! It's feels good to confirm that I'm not the only one struggling with this, I also tend to have more questions than answers.

I had the opportunity to discuss the LRDG's with a small portion of our youth group, it turned out to be a very interesting conversation that everyone became engaged in quite quickly. I thought I would share some of their key messages with you.

1) Should we have guidelines for youth?
I have to say before I even ended this question the youth all answered no. After I explained what the guidelines looked like and how they might be beneficial some agreed they have potential but didn't address the actual issue and what is really going on (ie-binge drinking and drinking to only get drunk).

2) Can they actually reduce drinking? Should we expect them to?
They had trouble envisioning how the guidelines would reduce drinking. One of their key statements was that youth that drink often have a mentality that it's normal acceptable behaviour (within their family lives and peer group), this doesn't change regardless of the knowledge of a suggested guideline. Other things would be more crucial in changing behaviours, such as parents and being involved in negative situations that involve alcohol, basically something more concrete that involved boundaries and consequences that meant something to them.

3) How do we market the guidelines to young people in a way that doesn’t condone drinking?
They felt the reality of the situation is that most teens in grade 12 DO drink (also confirmed by the OSDUS data) therefore we need to respond to the reality of the situation. They wanted to hear more messages about reducing risk rather than "do not drink". They also felt by teaching safety that condoning drinking wasn't implied, rather the opposite actually. If we are sending messages of how to be safe then they acknowledge that there is potential risk associated with consuming alcohol.

4) What should the role of government, health services and parents be? Who is responsible for message delivery?
Very interesting!! All the youth identified their parents as key players when making their choice to drink or not. Sounds like they all have parental monitoring, boundaries and very positive relationships with their parents that would welcome these types of conversations. Also interesting- their parents all were ok with an occasional drink, encouraged healthy limits and always debriefed with them if they felt they went over their limits. In contrast to that they mentioned their friends who don't have an open dialogue with their parents tend to drink and binge drink often.

All in all it was a very informative conversation and the youth really felt like the issue was close to home. They identified that they hear about drinking on a daily basis and it's a prominent issue in their school setting. They also identified a need to change this culture and norm...

Hope everyone enjoyed the youth voice!

0
What great comments and conversation! It's feels good to confirm that I'm not the only one struggling with this, I also tend to have more questions than answers. I had the opportunity to discuss the LRDG's with a small portion of our youth group, it turned out to be a very interesting conversation that everyone became engaged in quite quickly. I thought I would share some of their key messages with you. 1) Should we have guidelines for youth? I have to say before I even ended this question the youth all answered no. After I explained what the guidelines looked like and how they might be beneficial some agreed they have potential but didn't address the actual issue and what is really going on (ie-binge drinking and drinking to only get drunk). 2) Can they actually reduce drinking? Should we expect them to? They had trouble envisioning how the guidelines would reduce drinking. One of their key statements was that youth that drink often have a mentality that it's normal acceptable behaviour (within their family lives and peer group), this doesn't change regardless of the knowledge of a suggested guideline. Other things would be more crucial in changing behaviours, such as parents and being involved in negative situations that involve alcohol, basically something more concrete that involved boundaries and consequences that meant something to them. 3) How do we market the guidelines to young people in a way that doesn’t condone drinking? They felt the reality of the situation is that most teens in grade 12 DO drink (also confirmed by the OSDUS data) therefore we need to respond to the reality of the situation. They wanted to hear more messages about reducing risk rather than "do not drink". They also felt by teaching safety that condoning drinking wasn't implied, rather the opposite actually. If we are sending messages of how to be safe then they acknowledge that there is potential risk associated with consuming alcohol. 4) What should the role of government, health services and parents be? Who is responsible for message delivery? Very interesting!! All the youth identified their parents as key players when making their choice to drink or not. Sounds like they all have parental monitoring, boundaries and very positive relationships with their parents that would welcome these types of conversations. Also interesting- their parents all were ok with an occasional drink, encouraged healthy limits and always debriefed with them if they felt they went over their limits. In contrast to that they mentioned their friends who don't have an open dialogue with their parents tend to drink and binge drink often. All in all it was a very informative conversation and the youth really felt like the issue was close to home. They identified that they hear about drinking on a daily basis and it's a prominent issue in their school setting. They also identified a need to change this culture and norm... Hope everyone enjoyed the youth voice!
Guest - Andrea Zeelie on Thursday, 01 November 2012 10:11

Thank you for sharing this important perspective with us. This is an excellent way to close this discussion!

0
Thank you for sharing this important perspective with us. This is an excellent way to close this discussion!
Guest - Andrea Zeelie on Thursday, 01 November 2012 10:05

What a wonderful conversation!

On behalf of HC Link and Parent Action on Drugs, I'd like to thank you all conversation participants for sharing your insight, comments, questions, experiences, and resources.

The initial posting will be updated with a conversation summary, highlighting some of the major conversation threads, as well as listing the shared resources.

0
What a wonderful conversation! [b]On behalf of HC Link and Parent Action on Drugs, I'd like to thank you all conversation participants for sharing your insight, comments, questions, experiences, and resources. [/b] The initial posting will be updated with a conversation summary, highlighting some of the major conversation threads, as well as listing the shared resources.
Guest - Kayla Menkhorst on Monday, 05 November 2012 23:21

Hello,
I just wanted to add my thoughts to this discussion as what would be classified as a "youth" and also as a Youth Coordinator.

I personally think that these guidelines have many grey areas... By following these guidelines to youth 15-18, we are condoning alcohol use although the LEGAL drinking age is 19 (where applicable)... Yes, I believe in the guidelines, that youth who are of legal drinking age should be taught these guidelines and made aware of risks associated with drinking. Do I think a 15 year old, who sees this is always capable of distinguising that if they choose to drink, they should follow these guidelines? No. I see them as thinking well if a few is okay, then what harm can doing a few more every now and then do, or if I just get drunk every few weeks then it will be fine.

I think that the marketing of these guidelines is a straight contradiction to the laws that are put into place for those under legal drinking age, and therefore will create more confusion and grey areas than necessary... For example, when I am running any program, for any age group, it is zero tolerance for alcohol (among other things). Yet if these youth are being told that at 16 years of age they can drink under moderation with parental supervision, how can I implement my rules if they are "having just one?"

From another perspective, youth at the younger ages aren't aware or willing to think of what 'one drink' means... meaning their one drink can have 3 ounces of liquor.

I know there are good points either way, and yes I believe education is important and the best way to reach out to youth as compared to saying yes or no, but in this case, for the age group under legal drinking age, I feel it would cause more of a contraversy than a positive. For those 19-24, this is the perfect educational tool.

0
Hello, I just wanted to add my thoughts to this discussion as what would be classified as a "youth" and also as a Youth Coordinator. I personally think that these guidelines have many grey areas... By following these guidelines to youth 15-18, we are condoning alcohol use although the LEGAL drinking age is 19 (where applicable)... Yes, I believe in the guidelines, that youth who are of legal drinking age should be taught these guidelines and made aware of risks associated with drinking. Do I think a 15 year old, who sees this is always capable of distinguising that if they choose to drink, they should follow these guidelines? No. I see them as thinking well if a few is okay, then what harm can doing a few more every now and then do, or if I just get drunk every few weeks then it will be fine. I think that the marketing of these guidelines is a straight contradiction to the laws that are put into place for those under legal drinking age, and therefore will create more confusion and grey areas than necessary... For example, when I am running any program, for any age group, it is zero tolerance for alcohol (among other things). Yet if these youth are being told that at 16 years of age they can drink under moderation with parental supervision, how can I implement my rules if they are "having just one?" From another perspective, youth at the younger ages aren't aware or willing to think of what 'one drink' means... meaning their one drink can have 3 ounces of liquor. I know there are good points either way, and yes I believe education is important and the best way to reach out to youth as compared to saying yes or no, but in this case, for the age group under legal drinking age, I feel it would cause more of a contraversy than a positive. For those 19-24, this is the perfect educational tool.