Abuse and Mental Health Services Administration of the U.S. Department of Health and Human Services (HHS), Congress requested1 The National Academies to undertake an examination of the pertinent literature, to “review existing federal, state, and nongovernmental programs, including media-based programs, designed to change the attitudes and health behaviors of youth,” and to “develop a cost effective strategy for reducing and preventing underage drinking.” Based on consultations with several of the Academies’ standing advisory boards, members of the Academies, and the Academies’ governing bodies, the final statement of task directs the committee to examine programs ranging from environmental interventions (e.g., taxation, access restrictions) to programs focusing directly on the attitudes and behavior of young people (see Appendix A for the full statement of task).
In response, the Board on Children, Youth, and Families (BCYF) of the National Research Council and the Institute of Medicine of the National Academies established a committee of 12 members with special expertise in key domains relating to underage drinking. To supplement the expertise of its members, the committee commissioned a set of papers to provide systematic reviews of the scientific literature on determinants of underage drinking and effective ways of reducing it. Topics explored in these papers include the demographics of underage drinking; its economic and social costs; adolescent decision making and risk and protective factors; and the effectiveness of various prevention programs and approaches, including media campaigns, school-based education, pricing, and access. Draft papers were presented at public meetings in October and November 2002 (see Appendixes B and C) and subsequently reviewed and revised.2
Numerous programs with the common goal of reducing underage drinking have been implemented at the national, state, and local levels, by governments and nonprofit and grassroots organizations. At the federal level, the Departments of Health and Human Services (HHS), Justice, and Transportation operate several programs that specifically target underage drinking. Seven other federal agencies fund efforts that include underage alcohol use within a broader mandate (U.S. General Accounting Office, 2001). Similarly, numerous state-level agencies administer programs to reduce underage drinking. In most states, the health, human service, transportation, criminal justice, and education departments play some role. State alcohol beverage control bodies also play a role. Many communities, colleges and universities, and grassroots organizations across the country have initiated