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Starting Older, Drinking Less—Massachusetts

In the 1990s, Massachusetts reported some of the highest rates of underage drinking and youngest ages of first alcohol use in the nation. But thanks to comprehensive prevention efforts orchestrated by the state’s Bureau of Substance Abuse Services (BSAS) and supported by its Interagency Council on Substance Abuse and Prevention (ICSAP), Massachusetts is reporting significant success: More of the state’s youth are postponing their first use of alcohol until later ages. State leaders credit underage drinking prevention Town Hall Meetings, sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), for contributing to declining youth access to alcohol and growing public support for environmental prevention measures. Data drawn from two reports released in June 2012, Health and Risk Behaviors of Massachusetts Youth, 2011 and A Profile of Health Among Massachusetts Middle and High School Students, 2011, show that the age of first alcohol use is steadily increasing in the Bay State, while rates of lifetime alcohol use are falling among both middle school and high school students. For example, in 2003, 25 percent of Massachusetts high school students reported that they had begun drinking before age 13; by 2011, this number had declined to 15 percent. Given that underage drinking costs Massachusetts residents $1.4 billion (2010), it is expected that this trend will result in considerable cost savings.

Measuring the impact of Town Hall Meetings on changing underage drinking patterns is tricky. Every 2 years, state prevention leaders in Massachusetts have noted 2- to 3-point percentage point changes in a positive direction in their Youth Risk Behavior Survey underage drinking data in the years since the SAMHSA-supported Town Hall Meetings began. While acknowledging that multiple influences may affect prevalence, Steve Keel, the state’s National Prevention Network member, sees Town Hall Meetings and public education campaigns as essential in building community support for environmental policy changes that reduce teens’ and children’s exposure to alcohol. Town Hall Meetings are a key means by which the state informs community leaders and members about the most powerful prevention actions available. “Without public awareness there is little support for prevention; without prevention, there is regression and the numbers begin going the wrong way,” Keel said. “You can see this where funding for tobacco prevention messages has been cut and smoking rates are going up again.” Because of the influence Town Hall Meetings appear to be having, BSAS is looking for ways to support the events on an annual basis in order to sustain momentum generated by every-other-year SAMHSA sponsorship.

Locally, Massachusetts Town Hall Meetings on underage drinking provide strong support for (1) the primary focus of the state’s SAMHSA Block Grant to prevent underage drinking among youth between the ages of 12 and 18 and (2) BSAS’ efforts to foster environmental prevention statewide. Some communities used the town hall event as an educational vehicle to increase public understanding of the consequences of underage drinking and the best approaches to prevent it. Others pursued specific prevention objectives. Many of the state’s 2012 Town Hall Meetings alerted audiences to the potential legal consequences of permitting underage drinking contained in the state’s social host law.

In some places, Massachusetts Town Hall Meetings are a catalyst for policy change. In North Adams, for example, influence from Town Hall Meetings has led to a doubling of the number of annual compliance checks conducted, from twice yearly to four times per year. After years of thwarted community efforts to persuade the local transportation authority to pass rules to protect youth from alcohol advertising on buses and at bus shelters, the city of Boston made this the topic of a persuasive community dialogue at its event. Transportation officials got the message and were soon onboard with appropriate policies and procedures.

Recognizing the value of increased youth involvement in the planning and presentation of underage drinking messages to communities, BSAS partners with its state chapter of Students Against Destructive Decisions (SADD) and urges participating community-based organizations to include local SADD members in their planning and on their programs. Getting parents and teens to work together to prevent underage drinking can be a daunting challenge. But in Danvers, Town Hall organizers came up with a strategy that got everyone’s attention: Only students whose parents had attended the local underage drinking Town Hall Meeting were allowed to attend the senior prom!

A major contribution to the success of Town Hall Meetings in Massachusetts comes from the hands-on participation of the state’s lieutenant governor, Timothy P. Murray. He chairs ICSAP, which coordinates substance abuse prevention across 19 state agencies, with underage drinking prevention among its key objectives. On April 24, 2012, Lieutenant Governor Murray hosted a kickoff event at the Massachusetts State House to launch the 50-plus Town Hall Meetings scheduled to take place in the state. “Massachusetts is proud to join states across the country for this Town Hall Meeting series to help raise awareness and help prevent underage drinking,” he told the crowd of more than 120. But the lieutenant governor’s support for the SAMHSA-sponsored Town Hall Meetings goes well beyond this kind of one-time event. As ICSAP chair, he has made an ongoing commitment to prevention, and as his office learned the dates of local Town Hall Meetings in the state, the lieutenant governor contacted media in the host communities to generate increased media coverage and audience participation. In addition, Lieutenant Governor Murray produced an introductory video to be used at events across Massachusetts.

Massachusetts also provides significant added support to SAMHSA’s resources to help communities plan and organize effective underage drinking Town Halls. BSAS staff members are assigned to monitor community planning of events and direct a communications contractor in the delivery of training and technical assistance. A free How-To-Hold-a-Town-Hall-Meeting webinar gets community-based organizations up to speed in the planning process and offers one-on-one help to those who are new to the process or facing particular challenges. Meanwhile, BSAS makes sure all Town Hall Meeting host organizations understand the state’s underage drinking prevention objectives and are equipped to educate audiences about evidence-based environmental prevention.

Their future depends on you: Working together to prevent underage drinking BrochureAs part of a 2012 Town Hall Meeting support package mailed to each community-based organization invited to host an event, BSAS published Their future depends on you: Working together to prevent underage drinking, an eye-catching brochure that informs Massachusetts residents about how they can take action to help prevent underage alcohol use. Various brochures and booklets were available free of charge to the communities, with some available in Spanish, Portuguese, and Haitian Creole. Posters promoting a series of statistics and solutions to underage drinking that could be used during and after the 2012 Town Hall Meetings also were developed. A special Town Hall order form for other free underage drinking prevention materials available from the Massachusetts Health Promotion Clearinghouse was included, along with two underage drinking videos for Town Hall Meeting viewing.

The Massachusetts state leaders in preventing underage drinking believe that their Town Hall Meetings are succeeding in increasing citizen support for effective prevention policies in the state. But, cautions Steve Keel, there is a continuing need to educate the public about underage drinking. Without a sustained effort, there would be little messaging to counter pro-alcohol messages that youth and adults receive from alcohol industry advertising and marketing.

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