**Katherine J. Karriker-Ja**ff**e 1,\*, Christina C. Tam 1, Won Kim Cook 1, Thomas K. Greenfield <sup>1</sup> and Sarah C.M. Roberts <sup>2</sup>**


Received: 13 September 2019; Accepted: 19 November 2019; Published: 21 November 2019

**Abstract:** Background: Gender inequality and cultures of binge drinking may increase the risk of second-hand harms from alcohol. Methods: Using the 2014–2015 National Alcohol Survey and 2015 National Alcohol's Harm to Others Survey (N = 7792), we examine associations of state-level gender equality measures (contraceptive access, abortion rights, women's economic equality) and binge drinking cultures (rates of men's and women's binge drinking) with individual-level indicators of second-hand harms by drinking strangers and partners/spouses. Results: In main effects models, only male binge drinking was associated with greater odds of harms from drinking strangers. There were significant interactions of gender equality with male binge drinking: High male binge drinking rates were more strongly associated with stranger-perpetrated harms in states low on contraceptive access or abortion rights compared to states high on these measures. Conversely, male binge drinking was more strongly associated with spouse/partner-perpetrated second-hand harms in states with more economic equality, compared to states lower on this measure. Conclusions: Detrimental effects of high male binge drinking rates may be modified by gender equality. Targeted interventions may reduce alcohol-related harms experienced by women in states with high rates of male binge drinking. Restrictions in access to contraception and abortion may exacerbate harms due to men's drinking.

**Keywords:** alcohol's harms to others; gender equality; drinking cultures
