Xiao Zhang MPH; Myriam Forster MPH, PhD; Christopher Rogers MPH, PhD; Steve Graves PhD; Timothy Grigsby PhD; Jennifer Unger PhD; Mikaela Rojas MPH;
 
 
Background: Alcohol is the most widely used substance among United States adolescents with 21% of youth ages 14-15 having had at least one drink and 9% of high school students reporting past-month binge drinking. Building on prior work, this study investigated the relationship between alcohol retailer proximity and density around participant homes and multiple alcohol-related outcomes, adjusting for a comprehensive set of covariates: participant demographics (i.e. ethnicity, age, sex), family environment (i.e. parents/caregivers alcohol/drug use history, parent-adolescent communication), and neighborhood environmental vulnerability.

Methods: Data are baseline responses (N=3,047) from a diverse sample of adolescents enrolled in a school-based study assessing risk and protective factors associated with health and developmental outcomes. Participant addresses were geocoded and merged with spatial data on neighborhood vulnerability, alcohol retailers, distance and density measures were calculated. GLMs tested hypothesized relationships between distance to nearest alcohol retailer (<800 meters), density (number of retailer within 5/km2) and alcohol use, early alcohol initiation (before age 14), and past-month binge drinking.

Results: On average, students were 15.9 (SD=1.9) years old and evenly divided by sex (48% male) with 30% identifying as White followed by African American (28%), Hispanic (18%), Multiethnic (17%), and Asian (7%). Over 1 in 5 students (23%) reported alcohol use; 56% of whom were early initiators and 24% reported binge drinking. Distance to the nearest alcohol retailer and retailer density were significantly associated with several alcohol use behaviors. Youth who lived over 800 meters away from a retailer had lower odds of alcohol use (AOR:0.8, 95%CI:0.60, 0.99) while greater retailer density was associated with higher odds of both alcohol use (AOR:1.2, 95%CI:1.06, 1.41) and binge drinking (AOR:1.5, 95%CI:1.10, 2.07).

Conclusion: Results highlight that policies restricting the distance and density of alcohol retailers in residential areas with high youth populations are strategies that could reduce underage alcohol use.