media campaign to help strengthen public commitment to the goal of reducing underage drinking and to promote adult compliance with youth access restrictions (see Chapter 6).

This chapter begins with a discussion of minimum drinking age laws and specific recommendations about the scope of the laws. It then moves to a discussion of how youths obtain alcohol. Given that youths obtain alcohol from a variety of venues, the committee believes that a range of approaches targeting different venues is necessary. The remainder of the chapter reviews various approaches to improving the effectiveness of access restrictions and summarizes the available evidence in four domains: (1) reducing access through commercial sources; (2) reducing access through noncommercial sources; (3) focused efforts to reduce drinking and driving by underage drinkers; and (4) prescribing and enforcing penalties directly against underage consumers.

Given that it is unreasonable to expect a measurable effect on consumption for any one isolated change in the fabric of access restrictions, most evaluations rely on measuring changes in enforcement behavior or in compliance on the assumption that, over time, increased enforcement will result in increased compliance, and that increased compliance (whether or not attributable to increased enforcement) will lead to reduced access, and in turn to reduced consumption. The level of evidence for specific recommendations varies, as discussed through this chapter. The committee has used its judgment in assessing the plausibility of these connections. In some cases, the committee’s general recommendations include specific details that are based on the informed judgment of the committee. As with all aspects of the proposed strategy, particular interventions should be subjected to ongoing research to enable continued refinement of the strategy based on new empirical evidence.

The committee has assessed the potential value of each intervention not in isolation, but rather as part of a comprehensive set of steps that can be taken to curtail alcohol access to minors—mainly by promoting voluntary compliance, in both commercial and noncommercial contexts, but also by establishing and sustaining a credible threat of enforcement. Although there is robust evidence concerning the effects on consumption of increasing the legal minimum drinking age (and the accompanying, but unspecified, efforts to implement it), there is less evidence on the effects on youth consumption of comprehensive multipronged efforts to strengthen implementation of the underage drinking laws on the kind envisioned in this chapter.¹