vices, and public health). It also includes all the companies and establishments involved in producing, distributing, and selling alcohol—including distillers, vintners, breweries, package stores, and bars—as well as the advertising agencies that advise companies about how to position their products in different segments of the markets they seek to reach. It includes entertainment companies and other organizations that shape popular culture and affect young people’s attitudes about alcohol. A key role in any national response to the problem is played by parents who set models of drinking behavior for their children and who can affect the conditions under which their children have access to alcohol products. Of course, youths themselves make important decisions—not only about their own drinking, but also about how they view the drinking of their friends and peers.

The scope of the current efforts of many national, state, local, and nongovernmental group initiatives to prevent underage drinking or the consequences of drinking, particularly drinking and driving, is impressive. These programs include educational interventions, media campaigns, and activities to support enforcement of minimum drinking age laws. Young people themselves have organized efforts to discourage drinking among their peers. While few of these activities have been evaluated in any formal way, a successful national strategy will require the continued involvement, wisdom, and experience of the range of people and organizations that have been committed to preventing and controlling underage drinking.

The committee was charged with “developing a cost-effective strategy for preventing and reducing underage drinking.” As we set about this important task, it soon became evident that preventing and reducing underage alcohol use poses unusual challenges. Four of those challenges are the pervasiveness of drinking in the United States, the need for a broad consensus for a national strategy, ambivalence about goals and means, and commercial factors.

Alcohol is readily available to adults (those over 21) through a large number of outlets for on-premise or off-premise consumption. About half of U.S. adults currently drink alcohol; among drinkers, the mean number of drinking days per month in 1999 was approximately eight.³