ALCOHOL1989), and black males suffer the highest rate of
mortality from cirrhosis of the liver (National Insti-
tute on Alcohol Abuse and Alcoholism 1998b).
American Indians and Alaskan Natives have rates
of alcohol abuse and problems several times the
rates in the general population (National Institute
on Alcohol Abuse and Alcoholism 1987).
Catholics, Lutherans, and Episcopalians have
relatively high rates of drinking. Relatively few
fundamentalist Protestants, Baptists, and Mormons
drink. Jews have low rates of problem drinking,
and Catholics have relatively high rates of alcohol-
ism. Irish Americans have high rates of both drink-
ing and alcoholism. Italian Americans drink fre-
quently and heavily but apparently do not have
high rates of alcoholism (see Cahalan et al. 1967;
Mulford 1964). Strong religious beliefs and com-
mitment, regardless of denominational affiliation,
inhibit both drinking and heavy drinking among
teenagers and college students (Cochran and Akers
1989; Berkowitz and Perkins 1986).
Trends in Prevalence of Drinking. There has
been a century-long decline in the amount of
absolute alcohol consumed by the average drinker
in the United States. There was a period in the
1970s when the per capita consumption increased,
and the proportion of drinkers in the population
was generally higher by the end of the 1970s than
at the beginning of the decade, although there
were yearly fluctuations up and down. The level of
drinking among men was already high, and the
increases came mainly among youth and women.
But in the 1980s the general downward trend
resumed (Keller 1958; National Institute on Alco-
hol Abuse and Alcoholism 1981, 1987, 1998).
Until the 1980s, this per capita trend was caused
mainly by the increased use of lower-content beer
and wine and the declining popularity of distilled
spirits rather than a decreasing proportion of the
population who are drinkers.
Alcohol-use rates were quite high in the Unit-
ed States throughout the 1970s and into the 1980s
(see table 2). Since then, there have been substan-
tial declines in use rates in all demographic catego-
ries and age groups. In 1979 more than two-thirds
of American adolescents (twelve to seventeen years
of age) had some experience with alcohol and
nearly four out of ten were current drinkers (drank
within the past month). In 1988, these proportions
had dropped to one-half and one-fourth respec-
tively. In 1997, adolescent rates had dropped even
lower to four out of ten having ever used alcohol
and only two out of ten reporting use in the past
month. Current use in the general U.S. population
(aged twelve and older) declined from 60 percent
in 1985 to 51 percent in 1997. Among the adult
population eighteen years of age and older, cur-
rent use declined from 71 percent in 1985 to 55
percent in 1997. Lifetime use rates have also de-
clined from 88.5 percent in 1979 to 81.9 percent in
1997 (aged twelve and older). Generally, there
have been declines in both annual (past year)
prevalence of drinking (decreases of 3 to 5 per-
cent) and current (past month) prevalence of drink-
ing (decreases of 7 to 10 percent) among high
school seniors, young adults, and older adults.
Although lifetime prevalence is not a sensitive
measure of short-term change in the adult popula-
tion (since the lifetime prevalence is already fixed
for the cohort of adults already sampled in previ-
ous surveys), it does reflect an overall decline in
alcohol use. It should be remembered, however,
that most of this is light to moderate consumption;
the modal pattern of drinking for all age groups in
the United States has long been and continues to
be nondeviant, light to moderate social drinking.The relative size of the reductions in drinking
prevalence over the last two decades have been
rather substantial; however, the proportions of
drinkers remains high. By the time of high school
graduation, one-half of adolescents are current
drinkers and the proportion of drinkers in the
population remains at this level throughout the
young adult years. Three-fourths of high school
seniors and young adults and two-thirds of adults
over the age of thirty-five have consumed alcohol
in the past year (see table 1).Although lifetime use and current use rates
appear to be continuing a slight decline in all
categories, there have been some slight increases
in rates of frequent (daily) drinking among high
school seniors and young adults. While these in-
creases do not approach the rates observed in the
1980s they may indicate that the overall rates are
stabilizing and hint of possible increases in alcohol
use rates in the future.Estimates of Prevalence of Alcoholism. In
spite of these trends in lower levels of drinking,