Does distance and density of alcohol retailers and influence adolescent alcohol use behavior? Findings from a high school student sample in California
 
Xiao Zhang, Christopher Rogers, Steven Graves, Timothy J. Grigsby, Myriam Forster
 
Background: Alcohol is the most widely used substance among American adolescents, with 20% of youth ages 14-15 having had at least one drink in their lifetime and 9% of high school students reporting past-month binge drinking. To date, few studies have investigated the role of exposure to alcohol retailers, defined as distance to the nearest retailer and retailer density, in adolescent alcohol use behaviors.
 
Methods: Data are survey responses (N=705) of a diverse sample of southern California high school students enrolled in the SHARE project. Participant addresses were geocoded and linked to publicly available alcohol retailer information; distance and density measures were calculated. GLMs tested hypothesized relationships between distance from participants’ home to the nearest alcohol retailer ( 800 meters), retailer density (number of retailers within 2.5/km 2 ), and alcohol use, early alcohol initiation (before age 15), and binge drinking, adjusting for age, sex, ethnicity, and parent alcohol/drug use history.

Results: On average, students were 16 (SD=1.3) years old and evenly divided by sex (48% male). Nearly one third of the sample identified as White (31%) followed by African American (29%), Hispanic (24%), Multiethnic (9%), and Asian (7%). Over 1 in 5 students (23%) reported alcohol use, 15% were early initiators, and 25% acknowledged binge drinking. Distance to the nearest retailer and retailer density were significantly associated with binge drinking; students who lived  800 meters away from a retailer had lower odds of binge drinking (AOR:0.4, 95%CI:0.20, 0.98) while higher density of retailers was associated with higher odds of binge drinking (AOR:1.4, 95%CI:1.05, 1.99).
 
Discussion: Results highlight that initiatives such as limiting the distance and density of alcohol retailers in residential areas with high youth populations and awareness campaigns that educate residents to the potential harms of exposure to alcohol retailers could be beneficial strategies to reduce underage alcohol use.