Important strengths of the study include the nationally representative data with the ability to examine demographic and regional differences across multiple recent years. Limitations of the study are, first, that high school dropouts were not included in the sampling frame. Because 5+ binge drinking tends to be higher among those who have early school difficulties,60 our prevalence estimates may be conservative compared to a full population of 18-year-olds. Second, the same measures of binge drinking were used for males and females, although gender differences in average size and metabolism of alcohol mean that the same number of drinks is likely riskier for girls than boys. Finally, the available data were based on adolescent self-report of their consumption of 5, 10, or 15 or more drinks “in a row”, although an exact definition was not given. It also may be difficult for respondents to remember the number of drinks consumed at these high levels. Of course, this limitation comes with the benefits of large national samples. Future research should document the contexts of drinking, duration of the drinking occasion, and consequences
