TA BLE OF CONTENTSGEN ER A L R EQU I R EM EN TS OF ACT 85 OF 2006. 5EX ECU TI V E SU M M A RY . . 5A M U LTI-AGENCY PU BLIC H EA LT H EFFORT. 7STAT US OF U N DER AGE A N D DA NGEROUS DR I N K I NG. 9COVID-19 Pandemic and Alcohol Consumption. 9Levels and Trends of Alcohol Use According to the Pennsylvania Youth Survey.10Pennsylvania Department of Transportation (PennDOT) Crash Statistics.11National Highway Traffic Safety Administration Data.11PROGR A MS A N D ST R AT EGI ES A DDR ESSI NG U N DER AGE A N D H IGH-R ISK DR I N K I NG. 13Pennsylvania Liquor Control Board (PLCB).13Pennsylvania State Police Bureau of Liquor Control Enforcement (BLCE).18Pennsylvania Department of Drug and Alcohol Programs (DDAP). 20Pennsylvania Department of Education (PDE). 23Pennsylvania Department of Transportation (PennDOT). 23Pennsylvania Commission on Crime and Delinquency (PCCD). 24Municipal Police Officers’ Education & Training Commission (MPOETC). 24Institute for Law Enforcement Education (ILEE). 25Students Against Destructive Decisions (SADD). 26Pennsylvania's State System of Higher Education (PASSHE) Alcohol and Other Drug (AOD) Coalition .26Commonwealth Prevention Alliance (CPA). 28A PPEN DI X: ACT 85 OF 2006. . 313R EPORT ON U N DER AGE A N D H IGH-R ISK DR I N K I NG

GEN ER A L R EQU I R EM EN TS OF ACT 85 OF 20 06Since Feb. 1, 2007, the Pennsylvania Liquor Control Board (PLCB) has been required to prepare a biennial report on underagealcohol drinking and high-risk college alcohol drinking in this commonwealth. The report is presented to the House LiquorControl Committee and the Senate Law and Justice Committee. Details of the report include current levels and trends related tounderage and high-risk drinking, current state preventative programs and current science that better defines the problems andsuggests proven prevention strategies.EX ECUTIV E SUMM A RYThis report, prepared by the PLCB as mandated by Act 85 of 2006, is a resource regarding the status of underage and high-riskdrinking of alcohol within the commonwealth.Research has shown that the human brain is not fully developed until a person enters his/her mid- to late-20s.1 Because the arearesponsible for planning and controlling impulses, the prefrontal cortex, isn’t fully developed, teens are more likely to engagein risky behaviors without considering the consequences of their actions.2 When drinking starts at a young age, youth are morelikely to become dependent on alcohol,3 and misuse can be accompanied by the indirect dangers of alcohol use, including alcoholpoisoning, car crashes, assaults, risky sexual activity, drug use and other dangerous behaviors. The 2018 Report to Congress on thePrevention and Reduction of Underage Drinking states that alcohol is the most frequently used substance among Americans underage 21. Alcohol is used more often than tobacco, marijuana or other illicit drugs, with 19% of 12- to 20-year-olds reportedly usingalcohol in the previous 30-days.4The PLCB has been addressing underage and dangerous drinking since its formation; specifically, the mission of the Bureau ofAlcohol Education is to provide leadership and resources that will reduce alcohol misuse in Pennsylvania. As problem drinking hasevolved over time, so too have the programs and partnerships developed by the PLCB in the interest of social responsibility andpublic health and well-being.The PLCB understands the importance of alcohol education, especially amidst the unique challenges the commonwealth facesduring the COVID-19 pandemic.Today, for example: S ince the PLCB is a responsible retailer of alcohol, its Fine Wine & Good Spirits (FW&GS) store associates are the first lineof defense against underage drinking. FW&GS personnel are trained to verify the age of those purchasing alcohol, conductingabout 1 million age checks annually, and look for signs of visible impairment. T he PLCB’s Responsible Alcohol Management Program (RAMP) provides training and resources to liquor licensees andtheir employees so they may understand and employ responsible alcohol management practices. Training for servers andsellers, as well as owners and managers, addresses how to detect fraudulent identification and visibly intoxicated persons andprovides guidance on establishing policies governing safe and responsible alcohol service. The PLCB also provides postersand training materials to licensees to address the issues of underage and high-risk drinking.“The Teen Brain: 7 Things to Know,” U.S. Department of Health & Human Services, National Institute of Mental Health, 2020, Accessed 3 February 2021 via eenbrain-7-things-to-know/20-mh-8078 teenbrain 508 159672.pdf.1 2.Ibid.3. “Underage Drinking,” U.S. Department of Health & Human Services, National Institute on Alcohol Abuse and Alcoholism, October 2020, Accessed 3 February 2021 via inking/UnderageFact.htm.4. “Report to Congress on the Prevention and Reduction of Underage Drinking,” U.S. Department of Health & Human Services, Substance Abuse and Mental Health Services Administration, 2018, Accessed 17December 2020 via gress/2018/report main/stop act rtc.pdf.5R EPORT ON U N DER AGE A N D H IGH-R ISK DR I N K I NG

T he PLCB awards Reducing Underage and Dangerous Drinking Grants to schools, community organizations, municipalities,law enforcement organizations, nonprofit organizations, for-profit organizations and institutions of higher education to fundprograms that focus on strategies to discourage and reduce both underage and dangerous drinking. Grant projects includeincreased police patrols, social norms campaigns, college alcohol assessment surveys, online alcohol education programs andpeer training, to name a few. T he PLCB uses grant funding from the National Alcohol Beverage Control Association (NABCA) to further its mission byproviding learning opportunities for staff and community partners. Initiatives include hosting a free conference, attendingstatewide trainings and events, partnering with like-minded organizations to develop needs assessments and sponsoring instate conferences. S ince 1992, the PLCB’s annual Alcohol Awareness Poster Contest has encouraged students in kindergarten through 12thgrade to develop posters with positive messages about alternatives to underage drinking. The contest has provided studentswith an opportunity to learn about the dangers of underage drinking and identify healthy, fun and alcohol-free activities. T he PLCB’s award-winning Alcohol Awareness for Student Leaders and Influencers Training, formerly the ResidentAssistant Training Program, is customized for each college campus to provide resident assistants and student leaders – thoseon the front lines as new college students encounter the unique challenges of campus life – the tools they need to effectivelyguide and help other students through experiences with alcohol. T he PLCB’s award-winning media campaign, Know When. Know How.SM, is a statewide, research-based education andprevention effort that empowers Pennsylvania parents of children ages 8 to 12 with the tools, resources and confidence neededto engage in meaningful conversations with their kids about the dangers of alcohol from an early age, before trial or use ofalcohol begins.With the passage of laws in 2016 that increased convenience and access relative to alcohol, the beverage alcohol landscape inPennsylvania continues to transform. Today, more than 1,300 private retailers have the ability to sell limited quantities of bothbeer and wine to go, including more than 1,000 grocery and convenience stores. Increased visibility of alcohol in these places canpresent teachable moments for parents, providing a natural opportunity for parents to open the conversation about alcohol and makeclear that alcohol use by their children and other minors is not allowed by law, nor is it acceptable.It is widely understood and scientifically accepted that the earlier in life a person begins drinking alcohol, the more likely the personis to experience alcohol problems throughout life. It is central to the reduction of underage and dangerous drinking to acknowledgethat parents and guardians have significant and unique influence over their children’s decisions regarding alcohol. Prevention mustbe a joint effort, not only from various state agencies, but also from schools, student leaders, law enforcement, parents, guardiansand other influencers.Underage drinking and its negative consequences experienced by youth, families, communities and society remain problems,despite decades of efforts to combat them. This report intends to present underage and high-risk drinking information within thecontext of research identifying the problems, review the agencies and programs across the commonwealth actively engaged in theprevention of underage and high-risk drinking and review emerging prevention techniques to better address the unique challengesposed by this critical public health issue.6R EPORT ON U N DER AGE A N D H IGH-R ISK DR I N K I NG

A M U LT I - AG ENC Y PU BL IC H E A LT H EF FORTMany state agencies and organizations provided the PLCB with information and assistance in the coordination of this report.These organizations and agencies play an active role in researching, identifying and addressing issues of underage anddangerous drinking within the Commonwealth of Pennsylvania. The PLCB gratefully acknowledges the information and effortsprovided by the following: Pennsylvania State Police Bureau of Liquor Control Enforcement (BLCE) Pennsylvania Department of Drug and Alcohol Programs (DDAP) Pennsylvania Department of Education (PDE) Pennsylvania Department of Transportation (PennDOT) Pennsylvania Commission on Crime and Delinquency (PCCD) Municipal Police Officers’ Education & Training Commission (MPOETC) Institute for Law Enforcement Education (ILEE) Students Against Destructive Decisions (SADD) Pennsylvania's State System of Higher Education (PASSHE) Commonwealth Prevention Alliance (CPA)Additionally, the following national organizations play a key role in assisting state initiatives:National Alcohol Beverage Control Association (NABCA):Founded in 1938, NABCA is the national association representing states that directly control thedistribution and sale of beverage alcohol. NABCA’s mission is to support member jurisdictionsin their efforts to protect public health and safety and ensure responsible and efficient systemsfor beverage alcohol distribution and sales. NABCA provides research, analytics and regulatoryinformation related to alcohol policy.National Liquor Law Enforcement Association (NLLEA):Established in 1988, NLLEA is a national association of law enforcement personnel dedicated to theenforcement of liquor laws and regulations. The NLLEA is committed to improving the standards andpractices of liquor law enforcement, the professional development of its members and recognition ofthe role and achievements of liquor law enforcement in protecting and promoting public safety.7R EPORT ON U N DER AGE A N D H IGH-R ISK DR I N K I NG


STAT US OF U N DER AGE A N DDA NGEROUS DR I N K I NGUnderage alcohol consumption results in thousands of deaths annually through results of motor vehicle crashes, violence, suicideand alcohol poisoning, to name a few. Underage drinking can also lead to impaired brain function and decreased academicperformance, as well as increase the chances of developing an alcohol use disorder as an adult. By age 20, one-third of youngpeople reported binge drinking, defined as four drinks for a female or five for a male in a single drinking session, at least oncein the past month.5 Research indicates that efforts are most effective when youth receive consistent messages regarding theconsequences of underage drinking from parents and families, law enforcement, healthcare providers, community organizations,schools and universities and governments.6 This report discusses initiatives taken in Pennsylvania to address alcohol use amongthe underage and college population in Pennsylvania.COVID-19 Pandemic and Alcohol ConsumptionThe COVID-19 pandemic forced colleges and universities across the country to close and transition to remote learning. Todetermine how this unique event affected students, researchers at a public university in northeast Ohio asked students abouttheir past 30-day use of alcohol. Responses from 1,958 students showed an increase in the frequency and amount of alcoholconsumed. Students with greater levels of depression and anxiety reported more alcohol consumption compared to their peerswith fewer mental health symptoms.7In another study, researchers from The Center of Alcohol and Substance Use Studies at Rutgers University found that drinkingbehaviors following campus closures varied for students based on residency. Students who went from living with peers (on oroff campus) back to their parents’ houses drank fewer days per week, consumed fewer drinks per week and had fewer drinks perday compared to students continuing to live with peers or parents. The study also noted that students continuing to reside withpeers or parents’ post-campus closure consumed alcohol more frequently and in greater quantity.8Nielsen reported alcohol sales were up 54% in late March 2020 compared to the previous year.9 Among 2,200 U.S. adults polledin early April 2020, 16% reported drinking more during the pandemic. Of these individuals, nearly one in five GenXers, thoseborn between 1965 and 1980, were drinking more; whereas one in four Millennials, those born between 1981 and 1996, saidtheir alcohol consumption increased.10 Feelings of boredom, loneliness and anxiety generally prompted excessive drinkingduring lockdowns. To stay connected while remaining at home, friends and coworkers held cocktail parties via social mediachat rooms, again leading to their drinking more alcohol than usual and potentially binge drinking and/or alcohol abuse.11Dr. George F. Koob, director of the National Institute on Alcohol Abuse and Alcoholism, says that “using alcohol to dampenemotional misery tends to make people more miserable and motivates them to drink again. It is not a safe or lasting solution forthe emotional strain many people are experiencing during the pandemic.”12“Report to Congress on the Prevention and Reduction of Underage Drinking,” U.S. Department of Health & Human Services, Substance Abuse and Mental Health Services Administration, 2018, Accessed 17December 2020 via gress/2018/report main/stop act rtc.pdf.5 “2019 Pennsylvania Youth Survey State Report,” May 2020, Accessed 08 December 2020 via nsylvania-Youth-Survey-(PAYS)-2019.aspx.6 Lechner, W. V., Laurene, K. R., Patel, S., Anderson, M., Grega, C., & Kenne, D. R. (2020). Changes in alcohol use as a function of psychological distress and social support following COVID-19 relatedUniversity closings. Addictive Behaviors, 110. Accessed July 17, 2020, via S0306460320306572.7 White, H. R., Stevens, A. K., Hayes, K., Jackson, K. M. (2020). Changes in alcohol consumption among college students due to COVID-19: Effects on campus closure and residential change. Journal ofStudies on Alcohol and Drugs, 81. Accessed 16 December 2020 via American Heart Association News. (2020, July 1). COVID-19 pandemic brings new concerns about excessive drinking. Accessed 16 July 2020, via ng.9 Piacenza, J. (2020, April 6). Cooped up at home, millennials most likely among all adults to turn to food, alcohol. Morning Consult. Accessed 16 July 2020, via social-distancing-millennials-eating-drinking.10 Polakovic, G. (2020, April 14). Pandemic drives alcohol sales — and raises concerns about substance abuse. USC News, Accessed 16 July 2020, via abuse-stress-relapse-usc-experts/.11 Bote, J. (2020, August 14). Americans are drinking more amid the COVID-19 pandemic, but experts ward any relief is temporary. USA Today, Accessed 26 August 2020 via andemic/3373800001/.12 9R EPORT ON U N DER AGE A N D H IGH-R ISK DR I N K I NG

Additionally, job loss, uncertainty and fear are triggers for substance use and a driving force for suicide and domestic violence.Stay-at-home orders disrupted access to social supports like therapists, churches and recovery groups, increasing the potentialfor relapse.13Home delivery of alcohol – whether through direct shipping, third-party delivery drivers or deliveries made directly from theretail license holder – has the potential to increase access and availability for those under the legal drinking age of 21.14 Withmore than half of states permitting home deliveries of at least one type of beverage alcohol and more than 40 permitting thedirect shipment of at least one beverage type, concerns over youth access to alcohol is on the rise, requiring alcohol regulatoryauthorities and law enforcement to come up with new and innovative ways to monitor these sales to prevent youth access.15To address alcohol sales and deliveries, NLLEA has established a direct-to-consumer workgroup comprised of content expertsfrom law enforcement, alcohol regulators and public health officials from across the nation. The workgroup has been gatheringdata in an effort to develop best practice guidance and protocols for home delivery of alcohol.Levels and Trends of Alcohol Use According to the Pennsylvania Youth SurveySince 1989, the Pennsylvania Youth Survey (PAYS) has been conducted every other year in the commonwealth. The survey isdesigned to gather information about youth knowledge, attitudes and behaviors towards alcohol, tobacco and other drug use.The survey focuses on students in grades 6, 8, 10 and 12. Since 2013, three Pennsylvania organizations, PDE, DDAP and PCCD,support the administration of PAYS by providing funding to eliminate the cost to any school or district.16PAYS is administered in students everyday learning environment, in a method determined by each school. The completion ofthe survey is voluntary; students may skip any question they do not wish to answer or opt out of the survey entirely. Studentsare made aware that their responses will remain anonymous and confidential, and that the individual information they providecannot be obtained. The results of the survey are reported in aggregate at the local, county and state levels.The 2019 PAYS was administered to 294,340 public and private school students in Fall 2019, resulting in 280,944 valid locallevel reports for the PAYS statewide sample. Beyond that, 470 public, charter and private schools received community-levelsummary reports.The 2019 PAYS results are available online at PAYS County Reports – County level PAYS summary reports. PAYS Statewide Profile Report – State summary results. PAYS Full Detailed Report – Detailed analysis of the results for the state.Polakovic, G. (2020, April 14). Pandemic drives alcohol sales — and raises concerns about substance abuse. USC News, Accessed 16 July 2020, via abuse-stress-relapse-usc-experts/.13 The Associated Press, Durbin, D. (2020, August 24). Number of states allowing to-go cocktails has surged from 2 to 33 during coronavirus. Fortune, Accessed 23 March 2021 via go-cocktails-surges-liquor-laws-coronavirus/.14 Morton, H. (2020, July 22). Direct shipment of alcohol state statutes. National Conference of State Legislatures. Accessed 24 March 2020 via tes.aspx.15 16“2019 Pennsylvania Youth Survey State Report,” May 2020, Accessed 08 December 2020 via nsylvania-Youth-Survey-(PAYS)-2019.aspx.10R EPORT ON U N DER AGE A N D H IGH-R ISK DR I N K I NG

PennDOT Crash StatisticsAlcohol-related crashes in Pennsylvania decreased to 9,380 in 2019 from 9,811 in 2018 – the lowest total in the last five years. In2019, alcohol-related fatalities also decreased to 299 from 331 in 2018 and were the third-lowest total in the last five years.17Although alcohol-related crashes accounted for approximately 8% of the total crashes in 2019, they resulted in 28% of all fatalcrashes. Alcohol-related crashes were 4.9 times more likely to result in fatal injury than those not related to alcohol (3% of thealcohol-related crashes resulted in fatal injury, compared to 0.6% of crashes that were not alcohol-related).National Highway Traffic Safety Administration DataThe National Highway Traffic Safety Administration (NHTSA) compiles data regarding crash fatalities and the prevalence ofalcohol impairment among fatal crashes. The following table provides data for Pennsylvania and the U.S., as compared to the statewith the lowest percentage of alcohol-impaired driving fatalities for each year. While Utah has been one of the best states for severalyears, it is worth noting that Pennsylvania had 41 fewer alcohol-related fatalities – a 12.1% reduction – from 2018 to 2019.18Alcohol-Impaired Driving Fatalities: Pennsylvania, US and *Best StateYear2012TotalFatalities inall 2014NumberPennsylvania*Utah2013Alcohol-Impaired Fatalities:(BAC .08 )*Utah“Pennsylvania Crash Facts and Statistics,” Pennsylvania Department of Transportation, 2019, Accessed 01 December 2020 via s/2019 CFB linked.pdf.17 “Overview of Motor Vehicle Crashes in 2019,” U.S. Department of Transportation, National Highway Traffic Safety Administration, December 2020, Accessed 06 January 2021 via ation/813060.18 11R EPORT ON U N DER AGE A N D H IGH-R ISK DR I N K I NG


PROGR A MS A ND STR ATEGIES A DDR ESSINGU N DER AGE A N D H IGH-R ISK DR I N K I NGUnderage and dangerous use of alcohol are issues addressed by many state and local agencies, as well as community groupsand nonprofit and for-profit organizations. Often, evidence-informed practices are most successful in combating the problem.Organizations often cooperate or collaborate to ensure programs successfully reach target populations. Thus, programs andinitiatives addressing underage and high-risk drinking fall into these broad categories: enforcement programs, professionaltraining, youth training, community-based programs, family-based initiatives, school-based initiatives and advertising and media.Pennsylvania Liquor Control Board (PLCB):Through its Bureau of Alcohol Education, the PLCB is committed to providing informationabout responsible alcohol consumption. The bureau’s mission is to deliver no-use and zerotolerance messages to those under the age of 21, encourage responsibility and moderationfor any adult age 21 and over who chooses to drink alcohol and promote responsible alcoholservice and practice among licensees and those who serve beverage alcohol in Pennsylvania.Programs and StrategiesPLCB-Funded EnforcementIn fiscal years 2018-19 and 2019-20, the PLCB provided a total of 62.1 million in funding to the BLCE, the organization primarilyresponsible for enforcement of liquor laws.Reducing Underage and Dangerous Drinking (RUDD) GrantThe PLCB offered a one-year grant for the 2019-20 RUDD Grant cycle, awarding 816,630 to 50 grant recipients.For the two-year 2020-22 RUDD grant cycle, the PLCB awarded a record 2.8 million to 84 recipients. Grants are awardedto schools, community organizations, municipalities, law enforcement organizations, nonprofit organizations, institutions ofhigher education and for-profit institutions to fund programs that focus on strategies to discourage and reduce both underage anddangerous drinking. Community law-enforcement organizations use funding for targeted underage patrols, training, outreach and equipment. C ommunity and nonprofit organizations fund initiatives such as MADD’s Power of Parents and Parents Who Host Lose theMost , Project Northland, public service announcements and enforcement efforts. P rimary and secondary schools fund various programs aimed at reaching students, such as social norms media campaigns,guest speakers and impaired driving simulation activities. C ollege and university recipients enable schools to develop strategies to reduce underage and dangerous drinking throughsurveys and assessments, enforcement efforts, attendance at alcohol education conferences, training for resident assistants,peer education programs and evidence-informed programs like EVERFI AlcoholEdu and SafeColleges. For-profit organizations focus on peer-to-peer outreach and public service announcements.The complete list of 2020-22 grant recipients and projects is available at ProgramsThe Bureau of Alcohol Education offers training opportunities to institutions of higher education, law enforcement organizationsand liquor license holders.13R EPORT ON U N DER AGE A N D H IGH-R ISK DR I N K I NG

The “Alcohol Awareness for Student Leaders and Influencers Training,” formerly known as the Resident Assistant TrainingProgram, is offered to colleges and universities, free of charge, at their request, for all student leaders, including but not limited toGreek Life chapter leaders, team captains, resident assistants, tutors and club leaders. This comprehensive training is designed toprovide student leaders with the resources and knowledge to educate and influence their peers to abstain from underage drinkingand to inform responsible consumption for those over 21. Topics include alcohol’s effects on the human body; the unique challengesof the college environment related to drinking, binge drinking and alcohol poisoning; liquor laws and medical amnesty; andresponsible drinking for those over 21.“Understanding the Liquor Laws and Alcohol Related Offenses in Pennsylvania Training” provides an overview of thecommonwealth’s laws and immunities regarding underage drinking, the current environment of the liquor laws and the resourcesand authorities of the PLCB and BLCE. Since 2019, this training is required for all RUDD law enforcement grantees.The Responsible Alcohol Management Program (RAMP) gives licensees the tools they need to serve alcohol responsibly. In2000, RAMP was established as a voluntary program. In 2006, Act 26 mandated RAMP certification for licensees found guiltyof sales to minors or visibly intoxicated persons (VIPs). RAMP may also be required as part of a conditional licensing agreement.Additionally, wine expanded permit holders must comply with all aspects of RAMP.The following five steps must be completed for certification of the premises to be granted:Owner/Manager Training – This training is offered free to license owners and PLCBapproved managers and covers topics such as liability, how to develop and implement housepolicies, responsibilities of licensees and information covered in server/seller training. TheOwner/Manager Training, whether online or in-class, is facilitated by the PLCB. This trainingis required for newly approved managers of certain license types.Server/Seller Training – At least 50% of the licensee’s alcohol service st

schools and universities and governments.6 This report discusses initiatives taken in Pennsylvania to address alcohol use among the underage and college population in Pennsylvania. COVID-19 Pandemic and Alcohol Consumption The COVID-19 pandemic forced colleges and universities across the country to close and transition to remote learning. To