Talking Points: A Call to Action on the NAS Report on Underage Drinking

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 year.1

  • 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 ineffective.

  • 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 strategy.

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 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.


September 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.  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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