Callaghan Russell C, Sanches Marcos, Gatley Jodi M, Stockwell Tim
Northern Medical Program, University of Northern British Columbia (UNBC), 3333 University Way, Prince George, British Columbia V2N 4Z9, Canada; Human Brain Laboratory, Centre for Addiction and Mental Health (CAMH), 33 Russell Street, Toronto, Ontario M5S 2S1, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street, Health Science Building, Toronto, Ontario M5T 3M7, Canada.
Biostatistical Consulting Unit, Centre for Addiction and Mental Health (CAMH), 33 Russell Street, Toronto, Ontario M5S 2S1, Canada.
Drug Alcohol Depend. 2014 May 1;138:137-45. doi: 10.1016/j.drugalcdep.2014.02.019. Epub 2014 Feb 26.
Given the recent international debates about the effectiveness and appropriate age setpoints for legislated minimum legal drinking ages (MLDAs), the current study estimates the impact of Canadian MLDAs on mortality among young adults. Currently, the MLDA is 18 years in Alberta, Manitoba and Québec, and 19 years in the rest of Canada.
Using a regression-discontinuity approach, we estimated the impacts of the MLDAs on mortality from 1980 to 2009 among 16- to 22-year-olds in Canada.
In provinces with an MLDA of 18 years, young men slightly older than the MLDA had significant and abrupt increases in all-cause mortality (14.2%, p=0.002), primarily due to deaths from a broad class of injuries [excluding motor vehicle accidents (MVAs)] (16.2%, p=0.008), as well as fatalities due to MVAs (12.7%, p=0.038). In provinces/territories with an MLDA of 19 years, significant jumps appeared immediately after the MLDA among males in all-cause mortality (7.2%, p=0.003), including injuries from external causes (10.4%, p<0.001) and MVAs (15.3%, p<0.001). Among females, there were some increases in mortality following the MLDA, but these jumps were statistically non-significant.
Canadian drinking-age legislation has a powerful impact on youth mortality. Given that removal of MLDA restrictions was associated with sharp upturns in fatalities among young men, the MLDA likely reduces population-level mortality among male youth under the constraints of drinking-age legislation. Alcohol-control policies should target the transition across the MLDA as a pronounced period of mortality risk, especially among males.
鉴于近期国际上关于法定最低饮酒年龄（MLDAs）的有效性和合适年龄设定的争论，本研究估计了加拿大法定最低饮酒年龄对青年成人死亡率的影响。目前，艾伯塔省、曼尼托巴省和魁北克省的法定最低饮酒年龄为18岁，加拿大其他地区为19岁。
采用回归间断点方法，我们估计了法定最低饮酒年龄对1980年至2009年加拿大16至22岁人群死亡率的影响。
在法定最低饮酒年龄为18岁的省份，略高于法定最低饮酒年龄的年轻男性全因死亡率显著且突然上升（14.2%，p = 0.002），主要是由于一大类伤害（不包括机动车事故）导致的死亡（16.2%，p = 0.008）以及机动车事故导致的死亡（12.7%，p = 0.038）。在法定最低饮酒年龄为19岁的省份/地区，法定最低饮酒年龄之后男性的全因死亡率立即出现显著跃升（7.2%，p = 0.003），包括外部原因导致的伤害（10.4%，p < 0.001）和机动车事故（15.3%，p < 0.001）。在女性中，法定最低饮酒年龄之后死亡率有一些上升，但这些跃升在统计学上不显著。
加拿大饮酒年龄立法对青年死亡率有重大影响。鉴于取消法定最低饮酒年龄限制与年轻男性死亡率急剧上升有关，法定最低饮酒年龄可能在饮酒年龄立法的限制下降低了男性青年的总体死亡率。酒精控制政策应将法定最低饮酒年龄的过渡作为死亡率风险显著的时期加以关注，尤其是在男性中。
