Drink like a man? Modified Poisson analysis of adolescent binge drinking in the US, 1976–2022

This study estimates temporal trajectories and sociodemographic disparities in underage adolescent binge drinking in the United States over the past four decades. By compiling 47 waves of national representative data from the Monitoring the Future (MTF) study between 1976 and 2022, we analyzed two types of adolescent binge drinking behaviors, past-two-week excessive drinking and drunkenness in the past 30 days, using the innovative modified Poisson (mixture) approach to grouped and right-censored counts (GRC). The overall decrease in incidence rates was attributable to substantial reductions in the risks of excessive drinking (45.77% in 1980 and 12.62% in 2022) and drunkenness (35.12% in 1998 and 14.81% in 2022). However, at-risk adolescents only showed mild reductions in incidence rates over time. While males consistently drank more often and were at a higher risk of binge drinking and drunkenness than females, the sex disparities tended to converge over time. The modified Poisson approach is a useful tool to estimate incidence, risk, and at-risk incidence in epidemiological studies with GRC counts. The alarming high incidence rates of at-risk adolescents, especially males, warrant further investigation.