Journal of General Internal Medicine

, Volume 27, Issue 2, pp 179–184 | Cite as

Young Adults at Risk for Excess Alcohol Consumption Are Often Not Asked or Counseled About Drinking Alcohol

  • Ralph W. Hingson
  • Timothy Heeren
  • Erika M. Edwards
  • Richard Saitz
Original Research



Excessive alcohol consumption is most widespread among young adults. Practice guidelines recommend screening and physician advice, which could help address this common cause of injury and premature death.


To assess the proportion of persons ages 18–39 who, in the past year, saw a physician and were asked about their drinking and advised what drinking levels pose health risk, and whether this differed by age or whether respondents exceeded low-risk drinking guidelines [daily (>4 drinks for men/>3 for women) or weekly (>14 for men/>7 for women)].


Survey of young adults selected from a national internet panel established using random digit dial telephone techniques.


Adults age 18–39 who ever drank alcohol, n = 3,409 from the internet panel and n = 612 non-panel telephone respondents.

Main Measures

Respondents were asked whether they saw a doctor in the past year; those who did see a doctor were asked whether a doctor asked about their drinking, advised about safe drinking levels, or counseled to reduce drinking.

Key Results

Of respondents, 67% saw a physician in the past year, but only 14% of those exceeding guidelines were asked and advised about risky drinking patterns. Persons 18–25 were the most likely to exceed guidelines (68% vs. 56%, p < 0.001) but were least often asked about drinking (34% vs. 54%, p < 0.001).


Despite practice guidelines, few young adults are asked and advised by physicians about excessive alcohol consumption. Physicians should routinely ask all adults about their drinking and offer advice about levels that pose health risk, particularly to young adults.


alcoholism and addictive behavior communication patient education prevention 



This article is dedicated to Helen Marie Witty, who at age 16 was fatally injured by a young alcohol-impaired driver. Dr. Ralph Hingson had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. This study was supported in part by the National Institute on Alcohol Abuse and Alcoholism Center Grant P60AA13759.

Conflict of Interest

Drs. Ralph Hingson, Tim Heeren, and Erika Edwards have no conflicts of interest to report. Dr. Richard Saitz reports having been a consultant for online alcohol-related screening and brief intervention education projects supported by National Institutes of Health (NIH) grants to Medical Directions and Inflexxion and for NIH grants to the RAND corporation, Kaiser Permanente, the University of Massachusetts, and Brandeis University. Dr. Saitz also has been compensated by Beth Israel Deaconess Hospital and the National Institute on Alcohol Abuse and Alcoholism for serving on data and safety monitoring boards. He is compensated for educational work by the Massachusetts Medical Society, the British Medical Journal Group, and the American Society of Addiction Medicine. He has developed educational materials for Fusion medical education and consulted for Saatchi and Saatchi Healthcare on alcohol dependence treatment. He has or anticipates being compensated as a speaker on alcohol and drug topics by multiple government agencies, academic institutions, and professional societies. He has also provided expert opinion on legal cases involving identification and management of alcohol and drug related problems.


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Copyright information

© Society of General Internal Medicine (outside the USA) 2011

Authors and Affiliations

  • Ralph W. Hingson
    • 1
  • Timothy Heeren
    • 2
  • Erika M. Edwards
    • 2
  • Richard Saitz
    • 2
    • 3
  1. 1.Division of Epidemiology and Prevention ResearchNational Institute on Alcohol Abuse and AlcoholismBethesdaUSA
  2. 2.Boston University School of Public HealthBostonUSA
  3. 3.Clinical Addiction Research and Education (CARE) Unit, Section of General Internal MedicineBoston Medical CenterBostonUSA

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