21st Birthday Card Harm-Reduction Program Effective

College students celebrating their 21st birthdays were randomly assigned to either receive or not receive an alcohol risk-reduction birthday card. Students in both the experimental and control groups completed a survey after their birthday.

Students who received the card reported consuming fewer drinks and reaching lower blood alcohol concentration (BAC) levels on their birthday than did students who did not receive it. Female students who received the card reported consuming 40% fewer drinks and reaching nearly 50% lower BAC levels than women who did not receive it.

Such a harm-reduction program is easily implemented, inexpensive, and can be effective in significantly reducing the harm frequently associated with 21st birthday celebrations.


  • LaBrie, J. W., Migliuri, S., & Cail, J. A night to remember: A harm-reduction birthday card intervention reduces high-risk drinking during 21st birthday celebrations. Journal of American College Health, 2009, 57(6), 659-663.