Minimum legal drinking age (MLDA) is a powerful policy tool in preventing youth drinking and short-term alcohol-attributable harm, but studies concerning long-term health associations of MLDA are few and somewhat conflicting.
Using healthcare and census records, Luukkonen et al. assessed alcohol-attributable morbidity and mortality of Finnish cohorts born in 1944–1954. After the Finnish alcohol reform of January 1st, 1969, MLDA was lowered from 21 years to 18 years, which meant that these cohorts were effectively allowed to buy alcohol from different ages (18–21 years). Luukkonen et al. used survival analysis to compare their alcohol-attributable mortality and hospitalisations during ages 27 to 63.
The study finds that being able to purchase alcohol from the age of 18 was consistently associated with increased alcohol-attributable mortality and morbidity in contrast to the cohorts who were not able to buy alcohol until the age of 20 to 21 years. In other words, the cohorts who could purchase alcohol only at the age of 21 had consistently lower alcohol-attributable mortality and morbidity by the age of 63, as compared to cohorts who faced an MLDA of 18.
Overall, comparison of cohorts born only a few years apart suggest that higher MLDA could have protective health effects beyond young adulthood and also underline the importance of late adolescence as a period for establishing lifelong patterns of alcohol use. However, other simultaneous increases in alcohol availability during 1969 probably also contributed to increased alcohol-related harm among the younger cohorts.