NAS Report Call to Action
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, 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
Research suggests that underage
drinking accounts for up to 20 percent of all alcohol consumption in the United
States.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 percent of beer drinkers account for 80 percent of beer consumption.5
The vast majority of drinkers, who consume alcohol minimally, only account
for 20 percent of the market.
Time to End Decades of
Complacency and Federal Inaction on Underage Drinking
Alcohol (beer in particular) is by
far the number one drug of choice for youth, and it kills six times more
young people than all illicit drugs combined.6 Yet, federal
efforts to prevent and reduce underage drinking have been sorely
under-funded, woefully fragmented, fundamentally invisible and largely
The federal government's efforts to
combat illicit drugs are backed by a well-funded, cohesive, publicly
articulated national drug-control strategy. That strategy is
coordinated by the Office of National Drug Control Policy (ONDCP), an
executive-department agency that reports directly to the President.
Since the mid-1990s, Congress has appropriated billions of dollars to that
agency, including hundreds of millions of dollars for a national youth
anti-drug media campaign. Nothing remotely resembling such a concerted
effort has ever existed to address underage drinking or alcohol abuse.
Media campaigns are powerful public
health tools. 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 NAS report
found that despite progress throughout the 1980s, youth drinking rates have
been relatively stable since the early 1990s, with 30-day prevalence rates
for high school seniors hovering at approximately 50 percent. The
report also noted that kids are beginning to drink at younger ages than ever
-- the average age when children have their first drink is now 11 years for
boys and 13 for girls.
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 allocation pales in
comparison with the $18 billion our government spends on the drug
war, the $53 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
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
Underage youth are 60 times more
likely to see a commercial for an alcoholic beverage than are to see an
industry-funded "responsibility" ad.7
The industry’s "responsibility"
messages have never been proven effective. Some say they 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.
If the alcoholic-beverage industry
is sincere in its commitment to prevent underage drinking, it will embrace
public efforts to educate young people and parents about alcohol, including
an independent national media campaign to prevent underage drinking.
Such a campaign would not be about
stigmatizing drinkers, alcohol, or alcohol producers. It would not be
about communicating simplistic and self-defeating "responsible drinking"
messages that heighten youth rebellion and interest in alcohol. It
would 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.
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.
3. McGinnis, J.M. & Foege, W.H.
(1993). Actual causes of death in the United States. JAMA.
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. Grunbaum, J.A., Kann, L.,
Kinchen, S.A., Williams, B., Ross, J.G., Lowry, R. & Kolbe, L. (2002).
Youth risk behavior surveillance: United States, 2001. In:
Surveillance Summaries, June 28, 2002. MMWR 2002;51(No.
SS-4):1-62. Young, S.E., Corley, R.P., Stallings, M.C., Rhee, S.,
Crowley, T.J. & Hewitt, J.K. (2002). Substance use, abuse and
dependence in adolescence: Prevalence, symptom profiles and correlates.
Drug and Alcohol Dependence. 68:309-322.
7. 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:
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