Spring Break and Underage Drinking

As the cold and dreary winter weather wears on, many adolescents eagerly await the arrival of spring. For some, spring indicates a time for planting flowers. For others, spring is marked by the start of the baseball season. For many families, spring is a time for celebrating holidays. However, for high school and college students across the U.S., spring is marked by a singularly important ritual — Spring Break.

The origins of spring break can be traced as far back as the days of the ancient Greeks and Romans. During this time period, rituals associated with welcoming spring included festivals known for dancing and excessive drinking. During the mid-1900s, college students often traveled during spring break to Fort Lauderdale and other coastal Florida cities to enjoy warm weather and water sports. Today, the image of spring break has evolved into one of high school and college students traveling, relaxing and celebrating, and is often associated with public images of overconsumption and wild behavior. An entire industry has been created to accommodate spring break: tourist agencies, cruise lines and hotels specifically market spring break packages for high school and college students. In this way, spring break has grown into a multimillion dollar travel event.

This book offers answers to commonly asked questions, tips for helping to make the decision on your child's spring break and guidance on how to have a conversation with your teen on the topic. Additionally, we have included some planning and safety tips that may be helpful if your child does decide to travel for spring break.

Who travels over spring break and where do they go?

It is difficult to find exact spring break student travel data. However, some destination-specific travel information is available. For example, in the late 1980s, an estimated 400,000 college students visited one Florida resort city over a six-week period from late February to early April.1 In 2004, a reported 170,000 high school and college students visited a single Mexican resort city.2 Thus, given that there are numerous popular spring break destinations, it is likely that more than 500,000 students travel during spring break each year.

Due to ease of travel and proximity, many students choose to stay within U.S. borders for spring break. Student travel Web sites advertise spring break packages to the following domestic destinations: Las Vegas, Miami/South Beach, Panama City, South Padre Island as well as ski resorts in Colorado. However, there is also a large population of students who travel to Mexico and the Caribbean islands, partly in response to their relaxed underage drinking and public alcohol consumption laws. Popular destinations include the resort cities of Cabo San Lucas, Puerto Vallarta, Cancun, Mazatlan and Acapulco, as well as the Bahamas, Barbados and Costa Rica. Additionally, some teens are traveling to Europe over spring break. While the majority of spring breakers are college students, high school seniors are
also traveling to many of these destinations.

What is an alternative spring break?

While the vacation-style spring break is often the first thing that comes to mind, there are many students who take their school break traveling with family, giving back to the community or attending campus-arranged events. For some students, spring break is an opportunity to donate time or become more involved within their communities. Over the past several years, these alternative spring breaks have become increasingly popular. Some colleges and universities provide opportunities for students to participate in events; national organizations will arrange for students to help with environmental causes or contribute to rebuilding a community during spring break.

Even in alternative spring break settings, however, groups of young people may gather together during evenings and weekends when not participating in the main activities. It is important to remember that alcohol may be a part of these gatherings as well.

What is the data regarding spring break and underage drinking?

It is likely that many parents of high school and college students still have fond memories of their own spring break vacations. Therefore, parents may encourage their children to travel and enjoy the well-deserved time away from school and/ or work. However, it is important for parents to remember that spring break can mean that groups of students gather together and drink alcohol, which can leave adolescents and young adults at risk for injuries, medical complications and even death.

Given the understanding of spring break as a time to relax, let loose and party, parents should not be surprised to hear that many students consume alcohol while on break. Indeed, many students are traveling to countries where the legal drinking age is 18, therefore, their alcohol consumption may not be illegal. However, the actual quantity of alcohol consumed is still alarming and a reason for concern. In one survey of over 400 college undergraduates spending spring break in a popular Florida resort city, males reported drinking an average of 18 alcoholic beverages the previous day while females reported having an average of 10 drinks the previous day. Furthermore, more than half of the males and 40% of the females surveyed reported drinking until becoming sick or passing out.3

In a second recent survey, conducted by the American Medical Association (AMA), 83% of female respondents reported that they had friends who drank the majority of nights while on spring break. Nearly all females reported that it was easy to get alcohol while on spring break and 40% reported access to free or cheap alcohol was an important factor in their decision to travel over spring break.4

Why do teens and young adults often drink alcohol while on spring break?

There are a number of different theories as to why spring break tends to be a period of heavy alcohol use among high school and college students. One theory is that when on vacation and away from one's home or school setting, behavioral norms are adjusted. So, students may adopt behaviors while on break that they would not undertake when in a more familiar setting. Another theory is that stories about spring break on television and in the movies have made heavy drinking over spring break seem normative. Thus, students may feel pressure to drink to live up to the images that surround them. A third theory is that students, unlike adults, are prone to heavy, event-specific alcohol use. Two recently published studies have demonstrated that traveling with friends over spring break is in itself a risk factor for heavy drinking, while staying at home or traveling with family protects against these behaviors.9, 10

What are the medical dangers associated with excessive drinking?

The direct health consequences of alcohol have been described extensively in our previous books (www.HealthAllianceonAlcohol.com). The following is a brief review of the health effects of alcohol. After one or two drinks, most males and females will feel tipsy and have decreased inhibitions. If already in a party atmosphere, many will become louder, more sociable or livelier. At this level of intoxication, reflexes are slightly delayed, making driving more dangerous and increasing the likelihood of an accident. After three to four drinks, most males and females will be noticeably drunk. Speech will be slurred and reflexes will be more significantly delayed. For some, this level of intoxication leads to more aggressive or violent behavior. For students on spring break, this can lead to fighting, disorderly conduct and/or problems with the police. As more drinks are consumed, alcohol can irritate the stomach, cause severe inflammation of the pancreas, damage the liver and other internal organs. After five or more drinks are consumed, nausea and vomiting are common. Eventually, high levels of alcohol in the blood can lead to neurological depression or passing out. In the most severe cases, toxic levels of alcohol in the blood result in coma and death.

What other risky behaviors are associated with alcohol use among teens and young adults?

Drinking to excess is disconcerting not only because of the direct medical effects of alcohol on the body, but also because heavy drinking is associated with other risky or dangerous behaviors. Even after one or two drinks, males and females are noted to have decreased inhibitions. Alcohol use has been associated with both unwanted and unprotected sexual activity. Several studies have shown alcohol use among students on spring break to be associated with high-risk sexual encounters. In the AMA survey cited, a majority of respondents thought that women used alcohol as an excuse for outrageous behavior. Sixty percent of women reported they had friends who had unprotected sex while on spring break. Twenty percent of women surveyed reported they later regretted sexual activity that had occurred while on break and 12% felt forced or pressured to have sex. 4 Another recent survey found that compared to their behavior while on campus, students spending spring break in a single Florida resort city were less likely to use a condom and were more likely to report multiple partners over their vacation. Furthermore, for those with multiple partners, alcohol use was associated with being even less likely to use a condom. 5 A third study found that both peer influences and alcohol intake were associated with having casual sex over spring break.6

Further alcohol-related dangers include accidents, violence (perpetration and victimization) and problems with the law. Motor vehicle accidents are always a concern when youth have been drinking. Indeed, two-thirds of all motor vehicle fatalities are alcohol related. In addition, drinking on hotel balconies, before jet skiing, swimming or driving off-road vehicles, have all been associated with serious or fatal injuries. Alcohol-related arrests, fighting and even riots are not uncommon among spring break vacationers. Such problems have led many U.S. cities to discourage student spring break travelers and promote their cities as family destinations. However, drunken and unruly behavior among spring break travelers is not only a problem within U.S. borders. According to the U.S. Department of State, more than 2,500 American citizens are arrested abroad per year. Arrests can be due to narcotics possession, public drunkenness or drinking and driving.7According to the U.S. Consulate, in one popular Mexican vacation region, during spring break in 2002, there were 2 deaths, 360 arrests, 4 injuries requiring medical evaluation and 1 sexual assault among U.S. student visitors.8

What are some other spring break options for parents to consider?

Staying at home:

Some parents may decide not to allow their child/children to travel during this time period. Students who are still living at home might not be able to travel without their parents financial support. Be aware, however, that even if your child stays at home, it is still their time to let loose and relax. A lot of unsupervised time with friends could mean alcohol may be a part of that time. It might be a good idea to schedule activities around the local area for your teen or young adult.

Planning a family vacation:

Another option for parents wanting to dissuade their children from travel over spring break is to plan a family vacation for that time. While teens and young adults enjoy traveling with friends, they often
may prefer to spend quality time with their family in a fun and relaxed setting. Another option is to travel together with a number of families. Look for destinations that are family oriented. A review of
destination-specific tourism board Web sites can help parents determine whether potential vacation sites are family friendly.

Traveling with a chaperone:

Parents may choose to allow their teen to travel during spring break if supervised by a chaperone. Having adults available for spring break vacationers as they travel can provide some guidance while traveling and offer a certain amount of insight. Try to ensure that the chaperone is dealing with a reasonably sized group and is aware of your expectations. If your child is traveling with a group that has a tour guide as the chaperone, make sure that you feel comfortable with the organization and
the responsible person(s).

Planning an alternative spring break experience:

Some parents may encourage their high school or college- aged children to opt for an alternative spring break. These programs are considered to be safer than traditional spring break travel. However, even on these alternative spring breaks there is potential for students to drink heavily during the evenings or on weekends. Alternative spring break options may be advertised through individual colleges or universities. National organizations such as Break Away and Habitat for Humanity also offer alternative spring break options for students across the U.S. Individual community-based organizations, churches and other religious-based organizations may also offer alternative spring break opportunities for high school and college students. Parents are encouraged to research individual programs and talk to students who have participated in these programs in past years to determine the amount of
supervision and safety of the environment.

tips for parents of spring breakers

If your child is traveling regardless of the style of spring break experience in which your child participates it is important to help make a plan that will help keep him/her safe on the trip.

Tips for parents of all travelers:

Be consistent when discussing your expectations of how your child should behave while away on spring break. Research the company arranging the travel is it reputable? How many students are in the travel group? Do you know any of the people traveling with your child? Know your child's itinerary including airline information or planned driving routes, where he/she will be staying and the names and contact information for all travel companions. Touch base with the parents of your child's travel companions to make sure that you all have the same information. Designate planned times for your child to call home and check in. If you do not hear from your child at these times, call his/her cell phone, his/her friends' cell phones and/or his/her hotel room until you locate your child; do not be timid. Make sure your child is aware of the dangers of heavy drinking, including the risks of accidents, violence and unwanted or unprotected sexual activity. Remind your child of activities that are illegal underage drinking, public drinking, open container laws, use of fake IDs, public debauchery and possession of marijuana or other illicit drugs. Stress that you may not be able to protect him/her if he/she is arrested when away from home, especially in foreign countries. Sit down together and learn the laws of the destination. Encourage your child to use a buddy system and not to remain alone at parties, clubs or other social settings. Be sure he/she understands that this means people you know and trust, not people you have just met. Discuss with your child the possibility that his or her friends may be drinking alcohol, and encourage your child to keep a watchful eye on those who appear to be drinking too much. Encourage your child to speak up if he/she is worried. A friend who is feeling nauseated or vomiting or behaving aggressively has likely already had too much to drink and should be encouraged to stop drinking. A person with warning signs of severe alcohol intoxication, such as noticeably slurred speech, vomiting combined with excessive sleepiness or slow, shallow breathing needs immediate help. Remind your child to seek help if he/she finds that a friend is in danger and to be careful to make good and safe decisions for him/herself.

tips For parents of international travelers:

The U.S. Department of State encourages all student travelers to register their travel plans with the State Department's Web site: http://travelregistration.state.gov. Travel registration will make it easier for parents to contact their student traveler in case of emergency. The student traveler should also have contact information for all local embassy locations.

If your child's cell phone does not have international coverage, purchase prepaid international calling cards and designate times for your child to be in his/her hotel room and available to receive phone calls from you. It is also possible to rent a local phone that works in the destination country. Before he/she leaves, be sure your student traveler is familiar with dialing international phone numbers as it can be confusing if he/she hasn't done so before. Be aware of local customs and laws U.S. travelers in foreign countries are subject to the laws of the host country and punishments for seemingly minor offenses can be severe. When purchasing gifts, remember customs laws coming back into the U.S. Certain foods, plants, etc. will be confiscated if they do not meet government requirements. Protect the passport. Make sure that he/she has it every day, if not on his/her person at all times. If a passport is lost or stolen, make sure your child knows what to do. Further information regarding safety tips for international spring break travelers and destination-specific information is available on the U.S. Department of State Web site: http://travel.state.gov.

Now that we know some of the facts about spring break and student travel, let's move on to some sample conversations. Remember, it is important to start these conversations early and to repeat topics over time. While it may seem as though your teen is not listening, he or she is almost always interested in what you have to say. How to discuss spring break with your child will vary based on your child's age or developmental maturity.

What are the stages of adolescent development and how does this influence how you talk to your teen?

Briefly, let's review the developmental stages of adolescence. Developing one's own moral code and establishing an identity, separate from parents, is a major task of adolescence.

Early adolescence (ages 11-14)

is the first stage of this separation from parents. This period is marked by wanting to look and act like one's friends and having difficulty with impulse control. While teens in this age group are not likely to vacation without their families, they may be easily influenced by images on television or by the actions of older siblings or cousins.

Middle adolescence (ages 15-17)

is characterized by further distancing from parents and trying to gain acceptance by peers. During middle adolescence, teens often display feelings of omnipotence and immortality. Testing limits and taking risks are normal behaviors during this stage of development. These teens will want to take a spring break trip with friends. It is up to individual families to determine if their middle teen is ready to vacation without adult supervision.

Late adolescence (ages 18-21)

Is when most young adults have established their own identity and their own moral code. These young adults are more confident and better able to delay gratification. However, this is the age group most likely to travel over spring break and therefore most likely to encounter dangers while away.

Discussions with your early teen (ages 11-14)

It is never too early to talk to your child about spring break safety. At this age, from television and movies, your child is likely to be exposed to different images of spring break; some may include overconsumption, underage drinking or sexual behavior. It is good to watch these shows or movies with your child, and then to discuss afterward how risky these behaviors really are. Young teens are quite impressionable; if you share with your child how alcohol can make you physically ill and put you at risk for accidents and problems with the law, they will remember.It can also be a time to highlight positive attributes of the alternative spring break. This is especially important to think about if your child spends time with older siblings, cousins or older friends. If your child hears these older role models bragging about wild spring break travels, they will want to emulate this behavior, but the same could be true with positive experience as well. Use stories in the news to remind your early teen children about the risks of drinking and associated problems or to highlight the good work of a community project. If you are interested in reserving spring break for a family vacation, try to establish the tradition when your children are younger and they may be more likely to continue to want to vacation with you as they get older.

Discussions with your middle teen (ages 15-17)

As your child approaches middle adolescence, it is important to continue to talk about the risks of traveling on a spring break vacation that includes heavy drinking and partying. Children during middle adolescence may feel that they are mature enough to travel with peers, without adult supervision. It is up to individual families to decide if their middle adolescent children are ready for such responsibility. If allowing a middle teen child to travel, we encourage parents to plan ahead — know your child's itinerary, establish planned times to check in and set clear expectations regarding drinking and other dangerous behaviors while traveling. If you decide your child is ready for travel on his/her own, remind him/her that there are dangers and encourage your child to use a buddy system whenever possible. Discuss peer pressure and how to resist it. Even if traveling to most international destinations, teens in this age group are not legally permitted to drink. The legal and other unhappy consequences of underage drinking should be emphasized. It may be helpful to role-play with your child how to ask for help if, while on vacation, a dangerous situation arises.

Discussions with your late teen (ages 18-21)

Young adults in this age group are the most likely to travel over spring break. In general, while late teens are the most capable of setting limits and not being swayed by peer pressure, this is the age group that encounters the most trouble over spring break. If allowing a late teen to travel with friends over spring break, make sure planning includes reviewing the details mentioned earlier. Maybe you can research some of the details together. If your child is traveling to an international destination where he/she may be legally permitted to drink alcohol, it is important to review the physical dangers of heavy drinking, signs of alcohol poisoning and expectations regarding drinking and other risky behaviors while on break. Parents should know their teen's travel itinerary and establish times when their child needs to check in at home. Teens should be reminded that activities such as swimming, diving, biking and driving can all be dangerous when mixed with alcohol. Teens and parents should anticipate potential problems or difficulties and arrange a safety plan to manage these problems.

In conclusion, spring break is often considered a rite of passage for high school and college students. Parents play an important role in keeping their children safe over spring break as every other day. They can choose to plan family vacations or help identify alternative spring break options for their children. If allowing a high school or college student to travel with friends over spring break, parents can be clear about expectations regarding drinking and other behaviors and can establish plans to remain in contact while their child/children are away. By beginning the conversations early, clearly and regularly communicating expectations, and knowing the facts, you can help your children to stay safe on spring break.

Health Alliance on Alcohol

A national education initiative on underage consumption of alcohol through parent/child communications.

NewYork-Presbyterian Healthcare System

The NewYork-Presbyterian Healthcare System, the largest secular not-for-profit nongovernmental health care system in the U.S., is committed to providing high quality, cost-effective, and accessible care to communities throughout the greater New York metropolitan region. The System, made up of 33 acute care hospitals, 100 ambulatory sites, four residential health care facilities, three specialty institutions, two rehabilitation hospitals and more than 18,500 affiliated physicians, serves one in four patients in the greater New York metropolitan area. The System is also the largest not-for-profit employer in New York City.

White Plains Hospital Center

White Plains Hospital Center (WPHC) is a 292-bed voluntary, not-for-profit health care organization with the primary mission of offering high quality, acute health care and preventive medical care to all people who live in, work in, or visit Westchester County and its surrounding areas. Centers of Excellence include the Dickstein Cancer Treatment Center, The William & Sylvia Silberstein Neonatal & Maternity Center, The Ruth and Jerome A. Siegel Stroke Center and The Westchester Orthopaedic Institute. The Hospital has the busiest Emergency Department in Westchester County, treating more than 45,000 patients a year. White Plains Hospital Center is a five-time winner of the Consumer Choice Award, an honor given to the nation’s top hospitals by the National Research Corporation. WPHC is a member of the NewYork-Presbyterian Healthcare System and the Stellaris Health Network, Inc. For additional information, visit www.wphospital.org.

Morgan Stanley Children's Hospital of NewYork-Presbyterian

Ranked by U.S. News & World Report as one of the top six children's hospitals in the country, Morgan Stanley Children's Hospital of NewYork-Presbyterian offers the best available care in every area of pediatrics including the most complex neonatal and critical care and all areas of pediatric subspecialities in a family-friendly and technologically advanced setting. Building a reputation for more than a century as one of the nation's premier children's hospitals, Morgan Stanley Children's Hospital of NewYork-Presbyterian is affiliated with Columbia University College of Physicians and Surgeons, and is New York City's only hospital dedicated solely to the care of children and the largest provider of children's health services in the tristate area with a longstanding commitment to its community. Morgan Stanley Children's Hospital of NewYork- Presbyterian is also a major international referral center, meeting the special needs of children from infancy through adolescence worldwide. For more information, visit www. nyp.org.

Heineken USA

Heineken USA is the nation's premier beer importer and a subsidiary of Heineken International (Netherlands), the world's most international brewer. The company and its affiliates are firmly committed to promoting responsible consumption of alcoholic beverages. Among other distinctions, Heineken was the first brewer in the world to place a responsible consumption message on all of its bottles and cans. Heineken USA was also the first alcohol company to place a responsibility message on all of its television, radio, and print advertising. Please visit www.EnjoyHeinekenResponsibly.com.

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