Exposure to alcohol outlets, alcohol access, and alcohol consumption among adolescents

Background: Adolescents who live near more alcohol outlets tend to consume more alcohol, despite laws prohibiting alcohol purchases for people aged < 21 years. We examined relationships between adolescents' exposure to alcohol outlets, the sources through which they access alcohol, and their alcohol consumption. Methods: Participants for this longitudinal study (n = 168) were aged 15-18 years and were from 10 cities in the San Francisco Bay Area. We collected survey data to measure participant characteristics, followed by 1 month of GPS tracking to measure exposure to alcohol outlets (separated into exposures near home and away from home for bars, restaurants, and off-premise outlets). A follow-up survey approximately 1 year later measured alcohol access (through outlets, family members, peers aged < 21 years, peers aged >= 21 years) and alcohol consumption (e.g. count of drinking days in last 30). Generalized structural equation models related exposure to alcohol outlets, alcohol access, and alcohol consumption. Results: Exposure to bars and off-premise outlets near home was positively associated with accessing alcohol from peers aged < 21, and in turn, accessing alcohol from peers aged < 21 was positively associated with alcohol consumption. There was no direct association between exposure to alcohol outlets near home or away from home and alcohol consumption. Conclusions: Interventions that reduce adolescents' access through peers aged < 21 may reduce adolescents' alcohol consumption.