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Timothy S. Naimi, MD, MPH; Robert D. Brewer, MD, MSPH; Ali Mokdad, PhD; Clark Denny, PhD; Mary K. Serdula, MD, MPH; James S. Marks, MD, MPH

JAMA. 2003;289:70-75.

Context  Binge drinking (consuming 5 alcoholic drinks on 1 occasion) generally results in acute impairment and has numerous adverse health consequences. Reports indicate that binge drinking may be increasing in the United States.

Objectives  To quantify episodes of binge drinking among US adults in 1993-2001, to characterize adults who engage in binge drinking, and to describe state and regional differences in binge drinking.

Design, Setting, and Participants  The Behavioral Risk Factor Surveillance System, a random-digit telephone survey of adults aged 18 years or older that is conducted annually in all states. The sample size ranged from 102 263 in 1993 to 212 510 in 2001.

Main Outcome Measures  Binge-drinking prevalence, episodes, and episodes per person per year.

Results  Between 1993 and 2001, the total number of binge-drinking episodes among US adults increased from approximately 1.2 billion to 1.5 billion; during this time, binge-drinking episodes per person per year increased by 17% (from 6.3 to 7.4, P for trend = .03). Between 1995 and 2001, binge-drinking episodes per person per year increased by 35% (P for trend = .005). Men accounted for 81% of binge-drinking episodes in the study years. Although rates of binge-drinking episodes were highest among those aged 18 to 25 years, 69% of binge-drinking episodes during the study period occurred among those aged 26 years or older. Overall, 47% of binge-drinking episodes occurred among otherwise moderate (ie, non-heavy) drinkers, and 73% of all binge drinkers were moderate drinkers. Binge drinkers were 14 times more likely to drive while impaired by alcohol compared with non–binge drinkers. There were substantial state and regional differences in per capita binge-drinking episodes.

Conclusions  Binge drinking is common among most strata of US adults, including among those aged 26 years or older. Per capita binge-drinking episodes have increased, particularly since 1995. Binge drinking is strongly associated with alcohol-impaired driving. Effective interventions to prevent the mortality and morbidity associated with binge drinking should be widely adopted, including screening patients for alcohol abuse in accordance with national guidelines.

Author Affiliations: From the Alcohol Team, Emerging Investigations, and Analytic Methods Branch (Drs Naimi and Brewer); Division of Applied Public Health Training, Epidemiology Program Office (Dr Naimi); and Behavioral Surveillance Branch, Division of Adult and Community Health (Drs Mokdad and Denny); Chronic Disease Nutrition Branch, Division of Nutrition and Physical Activity (Dr Serdula); Office of the Director, National Center for Chronic Disease Prevention and Health Promotion (Dr Marks); Centers for Disease Control and Prevention, Atlanta, Ga.

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