Excerpt

In response to a congressional request in the Health and Human Services (HHS) fiscal 2002 appropriations act, the Board on Children, Youth, and Families of the National Research Council and the Institute of Medicine formed the Committee on Developing a Strategy to Reduce and Prevent Underage Drinking. The committee was directed to review a broad range of federal, state, and nongovernmental programs, from environmental interventions to programs focusing directly on youth attitudes and behaviors, and to develop a cost-effective strategy to reduce and prevent underage drinking.

The committee reached the fundamental conclusion that underage drinking cannot be successfully addressed by focusing on youth alone. Youth drink within the context of a society in which alcohol use is normative behavior and images about alcohol are pervasive. They usually obtain alcohol—either directly or indirectly—from adults. Efforts to reduce underage drinking, therefore, need to focus on adults and must engage the society at large.

Contents

• The National Academies
• Committee on Developing a Strategy to Reduce and Prevent Underage Drinking
• Board on Children, Youth, and Families
• Acknowledgments
• Preface
• Executive Summary
  • STRATEGY OVERVIEW
  • THE STRATEGY
• 1. Introduction: The Challenge
  • THE COMMITTEE STUDY
  • A CHALLENGING TASK
  • UNDERLYING ASSUMPTIONS
  • A POPULATION PERSPECTIVE
  • OVERVIEW OF THE REPORT
• I. Underage Drinking in the United States
  • 2. Characteristics of Underage Drinking
    • PATTERNS AND TRENDS
    • OVERALL CONSUMPTION LEVELS
    • CONTEXTS OF UNDERAGE DRINKING
  • 3. Consequences of Underage Drinking
    • CONSEQUENCES OF ACUTE IMPAIRMENT
    • LONG-TERM CONSEQUENCES
    • THE CAUSATION QUESTION
    • SOCIAL COSTS
  • 4. Understanding Youth Drinking
    • WHY DO ADOLESCENTS SAY THEY DRINK?
    • DEVELOPMENTAL FACTORS
    • INDIVIDUAL DIFFERENCES
    • CONTEXTUAL FACTORS
    • CONFLUENCE OF FACTORS
• II. The Strategy
  • 5. Designing the Strategy
    • WHAT CONSTITUTES A “STRATEGY”?
    • WHAT DOES “COST-EFFECTIVE” IMPLY AND REQUIRE?
    • STANDARDS OF EVIDENCE
    • CONNECTING EVIDENCE AND STRATEGY
    • UNDERAGE DRINKING AND LEGAL DRINKING
    • DO WE REALLY NEED A NEW STRATEGY?
    • THE STRATEGY
  • 6. National Media Campaign
    • ADULT ATTITUDES AND KNOWLEDGE ABOUT UNDERAGE DRINKING
    • CAMPAIGN GOAL AND LOGIC
    • POTENTIAL EFFECTIVENESS
    • THE EVIDENCE FOR ACTION
    • DESIGNING THE CAMPAIGN
  • 7. Alcohol Industry
    • THE UNDERAGE MARKET
    • INDUSTRY PROGRAMS TO REDUCE AND PREVENT UNDERAGE DRINKING
    • ADVERTISING AND PROMOTION
    • ACCOUNTABILITY
    • THE SPECIAL CASE OF COLLEGES AND UNIVERSITIES
  • 8. Entertainment Industries
    • MOVIES
    • MUSIC RECORDINGS
    • RETAIL ACCESS TO MOVIES AND RECORDINGS
    • TELEVISION
    • ACCOUNTABILITY
  • 9. Access
    • IMPLEMENTING LAWS ON THE MINIMUM DRINKING AGE
    • HOW YOUNG PEOPLE OBTAIN ALCOHOL
    • ACCESS TO ALCOHOL THROUGH COMMERCIAL SOURCES
    • ACCESS THROUGH NONCOMMERCIAL SOURCES
    • YOUNG DRINKERS AND DRIVING
    • POSSESSION AND PURCHASE
  • 10. Youth-Oriented Interventions
    • A YOUTH-FOCUSED MEDIA CAMPAIGN
    • SCHOOL-BASED APPROACHES
    • RESIDENTIAL COLLEGES AND UNIVERSITIES
    • OTHER INTERVENTION OPPORTUNITIES
    • TREATMENT PROGRAMS
  • 11. Communities
    • COMMUNITY-BASED ACTIVITIES
    • SUCCESSFUL COMMUNITY COALITIONS: TWO PORTRAITS
    • EVIDENCE OF EFFECTIVENESS
    • FUNDING
  • 12. Federal and State Governments
    • FEDERAL AND STATE ACTIVITIES
    • State Programs
    • SURVEILLANCE AND MONITORING
    • EXCISE TAXES
    • RESEARCH AND EVALUATION
    • COSTS AND COST-EFFECTIVENESS OF THE STRATEGY
• References
• Appendixes
  • A Statement of Task
  • B Agenda and Participants October 10-11, 2002 Public Workshop
  • C Agenda and Participants, November 18, 2002 Open Committee Meeting and Public Forum
  • D Other Public Contributors
  • E Biographical Sketches of Committee Members and Staff
• Background Papers
  • 1 The Epidemiology of Underage Drinking in the United States: An Overview
  • 2 Social, Health, and Economic Consequences of Underage Drinking
  • 3 Health Consequences of Adolescent Alcohol Involvement
  • 4 Developmental and Environmental Influences on Underage Drinking: A General Overview
  • 5 Perceptions of Risk and Social Judgments: Biases and Motivational Factors
  • 6 Alcohol Use and Misuse: Prevention Strategies with Minors
  • 7 Supply Side Approaches to Reducing Underage Drinking: An Assessment of the Scientific Evidence
  • 8 Effectiveness of Sanctions and Law Enforcement Practices Targeted at Underage Drinking Not Involving Operation of a Motor Vehicle
  • 9 The Effects of Price on Alcohol Use, Abuse, and Their Consequences
  • 10 Media Intervention Impact: Evidence and Promising Strategies
  • 11 Alcohol in the Media: Drinking Portrayals, Alcohol Advertising, and Alcohol Consumption Among Youth
  • 12 Alcohol Advertising and Promotion
  • 13 Drinking and Coming of Age in a Cross-Cultural Perspective
  • 14 Preventing Underage Drinking in American Indian and Alaska Native Communities: Contexts, Epidemiology, and Culture
  • 15 Teen Treatment: Addressing Alcohol Problems Among Adolescents
  • 16 Youth Smoking Prevention Policy: Lessons Learned and Continuing Challenges

This project, N01-OD-4-2139, Task Order No. 109, received support from the evaluation set-aside Section 513, Public Health Service Act, of the U.S. Department of Health and Human Services.

Suggested citation:

National Research Council and Institute of Medicine (2004). Reducing Underage Drinking: A Collective Responsibility. Committee on Developing a Strategy to Reduce and Prevent Underage Drinking, Richard J. Bonnie and Mary Ellen O’Connell, Editors. Board on Children, Youth, and Families, Division of Behavioral and Social Sciences and Education. Washington, DC: The National Academies Press.

The content of this publication does not necessarily reflect the views or policies of the U.S. Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. government.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.