"The HBSC survey results indicated that drinking prevalence and drunkenness were lower on all measures among both boys and girls in the United States compared with boys and girls in Canada and boys in the Netherlands, but there was no difference in drunkenness or age of first drunkenness between American and Dutch girls. The prevalence reported by youth in the United States, with monthly use of 34.0% for males and 29.3% for females, is consistent with other reports (Centers for Disease Control and Prevention, 2006; Johnston et al., 2007), and significantly lower than the prevalence reported by Canadian youth of about 45% for both boys and girls and Dutch youth of 67.9% for boys and 56.2% of girls. Of course, 10th grade Dutch students are close in age to the legal drinking age of 16 in the Netherlands. Also, despite higher drinking prevalence, Dutch girls were less likely to report having been drunk by age 14 suggesting that adolescent drinking and drunkenness do not correspond in all population groups. Overall, these cross-national differences in drinking prevalence are somewhat consistent with the hypothesis that higher legal age, more difficult access, and greater penalties for use may have discouraged adolescent drinking in the United States."


Bruce Simons-Morton, EdD, MPH, William Pickett, PhD, Will Boyce, PhD, Tom F.M. ter Bogt, PhD, and Wilma Vollebergh, PhD, "Cross-National Comparison of Adolescent Drinking and Cannabis Use in the United States, Canada, and the Netherlands," International Journal of Drug Policy, Jan. 2010; 21(1):64-69. doi: 10.1016/j.drugpo.2009.02.003, p. 6.