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America's Most Damaging and Neglected Youth Drug Problem

  • Underage drinking is a public health and safety problem of major proportions for young people and society, and a costly burden on the U.S. economy.  According to the Centers for Disease Control and Prevention, alcohol is a key factor in the three leading causes of death among young people in America: traffic crashes, homicides, and suicides.  Young drivers are involved in alcohol-related traffic crashes more often than any other age group.  And the consequences of underage drinking have huge economic costs -- more than $58 billion per year.1

  • Research suggests that underage drinking accounts for up to 20% of all alcohol consumption in the U.S.2  According to the DHHS, alcohol is the most costly of all drug problems, imposing economic costs of more than $185 billion on the nation each year and causing more than 100,000 deaths.3

  • The average American child tries alcohol before the age of 13.  Youth who drink before they turn 15 are four times more likely to develop alcohol dependence than those who start drinking at 21.4  Underage drinking spawns the future heavy and addicted drinking on which the beer market so heavily depends: the top 20% of beer drinkers account for 80% of beer consumption.5  The vast majority of drinkers, who consume alcohol minimally, only account for 20% of the market.


The Alcoholic-Beverage Industry and Underage Drinking

  • Alcohol producers presently have a defacto monopoly on messages young people receive about alcohol.  They spend some $3 billion dollars a year on sophisticated, seductive product appeals, and a tiny fraction of that amount on "responsibility" messages that are little more than thinly-veiled brand promotions and public relations ploys.

  • Underage youth are 60 times more likely to see a commercial for an alcoholic beverage than they are to see an industry-funded "responsibility" ad.6

  • The industry's "responsibility" messages have never been proven effective, and serve more to inoculate alcohol marketers from potential legal liability and Congressional and regulatory scrutiny than they do to reduce alcohol problems.

  • The alcoholic-beverage industry has an undeniable responsibility to help prevent the misuse of its products.  However, just as tobacco companies shouldn't have primary responsibility for youth smoking prevention, neither should vested interests in the alcoholic-beverage industry have the last -- or loudest -- word when it comes to preventing underage drinking.


Time to End Decades of Neglect on Underage Drinking

  • As a society, we have invested heavily in massive public awareness campaigns designed to deter young people from taking up smoking and experimenting with illicit drugs.  Those campaigns have provided an effective backdrop for a myriad of revolutionary public and private reforms that range from the imposition of advertising restrictions on cigarettes to the prohibition -- even in bars -- of indoor tobacco use.  There is little doubt that they have helped to change the social and political conversation about smoking and drugs, and have empowered citizens and communities to take effective action on behalf of young people and society.

  • In part due to the absence of comparable efforts to combat underage drinking, alcohol use and binge drinking among teens continue at alarmingly high rates.  The latest (2001) National Household Survey data suggest that alcohol use among American youth has even increased.  Ten million 12- to 20-year-olds reported drinking alcohol in the year prior to the survey.  Of those, nearly 6.8 million (19%) reported binge drinking and 2.1 million (6%) were heavy drinkers.  Among the 12- to 17-year-olds, 10.6% binge drink and 2.5% say they're heavy drinkers.  In fact, previous month alcohol use among 12- to 17-year-olds increased more than 5% since 2000; nearly one in five reported alcohol use in the past month.7

  • A 2001 report by the General Accounting Office of the U.S. Congress (Underage Drinking: Information on Federal Funds Targeted at Prevention) found that only $71 million of the federal government's fiscal year 2000 budget was allocated specifically to the prevention of underage drinking.  This minimal commitment pales in comparison with the $18 billion our government spends on the drug war, the $58 billion in estimated annual costs of underage drinking, and the $3 billion alcohol producers spend per year on alcohol advertising and promotion.  Moreover, this small allocation is scattered among disparate federal agencies and multiple programs, developed with little coordination among the agencies and no unifying vision or strategy.

  • We expect that the NAS report will serve to focus public and policy-makers' attention on underage drinking as a significant public health and safety issue.  We hope that debate on the report's findings will help to prompt renewed interest in, leadership for, and commitment to reducing the widespread harms of underage drinking.  If the alcoholic-beverage industry were sincere in its commitment to prevent underage drinking, it would embrace public efforts to educate young people and parents about the risks of alcohol use.

  • The NAS effort to develop a cost-effective national plan to reduce underage drinking is not about prohibition.  It is not about stigmatizing drinkers, alcohol, or alcohol producers.  It is not about communicating simplistic and self-defeating "responsible drinking" messages that heighten youth rebellion and interest in alcohol.

  • It will be about ending our national denial of underage drinking as a major public health and safety issue, increasing public awareness and understanding of the destructive role of alcohol in young people's lives, and strengthening families' and communities' resolve and capacity to combat America's most devastating youth drug problem.


September 4, 2003




1.  Pacific Institute for Research and Evaluation.  Costs of Underage Drinking.  prepared September 5, 2002.


2.  Foster, S.E., Vaughan, R.D., Foster, W.H. & Califano, J.A. (2003).  Alcohol Consumption and Expenditures for Underage Drinking and Adult Excessive Drinking.   JAMA. 289:989-995.


3.  McGinnis, J.M. & Foege, W.H. (1993).  Actual causes of death in the United States.  JAMA.  270(18):2207-2212.


4.  Hingson, R.W., Heeren, T., Jamanka, A. & Howland, J. (2000).  Age of drinking onset and unintentional injury involvement after drinking.  JAMA.  284(12):1527-1533.


5.  Greenfield, T.K. & Rogers, J.D. (1999).  Who drinks most of the alcohol in the U.S.? The policy implications.  Journal of Studies on Alcohol.  60(1):78-89.


6.  Center on Alcohol Marketing and Youth (CAMY). (2003).  Drops in the Bucket: Alcohol Industry "Responsibility" Advertising on Television in 2001.  Research Report.  February 3, 2003.  Online:


7.  Substance Abuse and Mental Health Services Administration. (2002). Results from the 2001 National Household Survey on Drug Abuse: Volume I.  Summary of National Findings.  Office of Applied Studies.  NHSDA Series H-17.  DHHS Publication No. SMA 02-3758.  Rockville, MD.

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