According to international data from the World Health Organization, European teens ages 15 to 19 tend to report greater levels of binge drinking than American teens.
This continues into adulthood. Total alcohol consumption per person is much higher in most of Europe. Drinkers in several European countries — including the UK, France, Belgium, Denmark, Sweden, and Iceland — are also more likely to report binge drinking than their US counterparts.
Younger teens in Europe appear to drink more, as well. David Jernigan, an alcohol policy expert at Johns Hopkins University, studied survey data, finding that 15- and 16-year-old Americans are less likely to report drinking and getting drunk in the past month than their counterparts in most European countries.
I’m hesitant to place a lot of faith in this report. Since underage drinking is quite verboten in America, I would strongly doubt that American teenagers are being perfectly honest in their self-reported consumption of alcohol. Given that Europe doesn’t have a history of prohibition like America does, and given that there is less of a stigma associated with alcohol in Europe, I would tend to doubt that European youth have anywhere near the same incentive to hide alcohol consumption on self-report surveys. As such, I’d take this finding with a grain of salt.
But perhaps most tellingly, liver cirrhosis death rates in 2012 were significantly higher in several European countries than in America: The US's age-adjusted rate for men 15 and older was 14.9 per 100,000 people, while the UK's rate was 16, France's was 16.4, Germany's was 18.8, and Denmark's was 20.2. This is likely a result of excessive drinking in youth and adulthood.
"If you look at youth drinking, the US ends up with a much healthier drinking culture simply because our young people start drinking later," Jernigan told me.
Alternatively, American youth don’t binge-drink as much because it’s harder to hide. They might not necessarily be starting later, just starting with less.
The basic conclusion from looking at all these countries' experiences: Stricter alcohol policies can reduce deaths. This is true when looking at the drinking age, alcohol taxes, how alcohol is distributed, and so on. These policies won't eliminate alcohol deaths, but they will reduce them.
This is the crucial part. No law or regulation will completely eliminate a given behavior, generally speaking. Even the harshest penalties for disobedience aren’t completely effective at eliminating that which is banned. Murder has been illegal from time immemorial, and generally punished with swift brutality, yet there has never been a time or society that was completely free of murder. The same goes for fraud, theft, rape, kidnapping, and so forth. Stricter punishments for crime will, at best, lead to marginal reductions in occurrence.
In keeping with this, the fundamental question of every system of justice should be: at what cost? While reducing alcohol and drug abuse is a good goal, the real question is how much reducing the rate of abuse costs. Moreover, an outright ban of a given substance may not reduce drug use in general, but shift consumption from one product to one that’s legal. It may be the case that youth who cannot buy alcohol will instead use junk food as a substitute, leading to a higher rate of obesity instead of cirrhosis, in much the same way that spice and bath salts are used as substitutes for illegal drugs.
Moreover, sticks may not be as effective as carrots. Threatening punishment may do less to disincentivize drug use than rehab, and may be less cost-effective as well. Thus, while the higher drinking age in America, coupled with the fairly tough punishments for those who enable underage drinking, may lead to fewer alcohol-related problems, it is hardly a given that this particular approach is a particularly cost-effective way of attaining its goal.
Nonetheless, this research establishes an important point. Namely, that the efficacy of regulation is not as potent as you would assume. A truly wise person will realize that rules will only have a marginal effect in altering people’s behavior. As such, it is good to not become too enamored of regulation.