focused campaign would involve and the available evidence about the potential effectiveness of such a campaign.
We begin with evidence favoring such a campaign. There is good evidence that youth who disapprove of heavy alcohol use and who see great harm in alcohol use are less likely to drink. For example, among twelfth-grade students in the Monitoring the Future (MTF) Survey in 1998, about half said that there is “great risk” of physical or other harms in having five or more drinks once or twice each weekend. Of those who said there was great risk, about 16 percent said they had had five or more drinks at least once in the previous 2 weeks. Of those who said there was only a moderate, slight, or no risk, 48 percent said they had had five or more drinks in this time frame. This finding leads to the hypothesis that a campaign to convince more youth that there is great risk in heavy drinking would result in a reduction in the amount of heavy drinking. This argument is less relevant regarding any use of alcohol: few youth of any age believe that “any use” of alcohol carries great risk (12 percent of eighth and tenth graders and 8 percent of twelfth graders). Thus, on its face, it would seem quite difficult to convince most youth that such drinking carries great risk.
Support for a youth-focused approach also comes from the latest results from the MTF Survey in 2002, which shows a decline in drinking between 2000 and 2002 for eighth and tenth graders (see Chapter 2). For example, for tenth graders, heavy drinking in the past 30 days declined from 24 percent to 18 percent. Until the past 2 years there had been stability in both any drinking and heavy drinking at all age levels. The recent decline raises the possibility that youth are reconsidering drinking behavior and might be open to further persuasion. This hypothesis might be supported by the idea that it is easier to ride with the current (reinforcing a trend already under way) than to row against it (trying to suppress an emerging or established behavioral trend).
A third support for directly addressing youth and persuading them not to drink comes from the positive evidence from antismoking efforts by individual states and by the American Legacy Foundation. There has been a substantial decline in the prevalence of youth smoking, with 30-day prevalence among twelfth graders declining from a high of 37 percent in 1997 to the 2002 level of 27 percent. There is credible although not definitive evidence that the mass media campaigns have been a substantial force in this decline (Siegel and Biener, 2000; Sly et al., 2001; Siegel, 2002). If it worked for tobacco, why wouldn’t it work for alcohol? (We return to this issue below.)