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Reducing Underage Drinking: A Collective Responsibility
seen most sharply when one compares underage drinking with illegal drug use and underage smoking. The goal of the nation’s policy toward illegal drugs and tobacco—abstention by everyone—is both unambiguous and widely, if not universally, embraced. Thus, the nation aims to discourage and suppress nonmedical use of marijuana, cocaine, and other controlled substances by everyone (whatever their age) through a comprehensive legal regime prohibiting the manufacture, distribution, and possession of these drugs for nonmedical purposes. Even though tobacco products, by contrast, are lawfully available to adults, the nation’s clearly expressed goal is to discourage tobacco use by everyone, by preventing initiation and promoting cessation. The messages to young people and adults in these two contexts are identical: indeed, because few people take up smoking as adults, the overall success of the nation’s anti-tobacco policy depends substantially on the success of its efforts to prevent initiation among young people.
The task of developing a strategy for preventing and reducing alcohol use among young people, in contrast, faces an uncertain policy goal. A strong cultural, political, economic, and institutional base supports certain forms of drinking in the society. Unlike the goals for illegal drugs and tobacco, the nation does not aim to discourage or eliminate alcohol consumption by adults. It is probably a fair characterization to say that the implicit aims of the nation’s current alcohol policy are to discourage excessive or irresponsible consumption that puts others at risk, while being tolerant of moderate consumption (at appropriate places and times) by adults (especially in light of the possible health benefits of moderate use for some populations over 40). For example, as long as others are not endangered or offended, attitudes toward intoxication (per se) vary according to religious beliefs and personal moral standards. In short, current alcohol policy rests on a collective judgment, rooted in the Prohibition experience, that the wisdom and propriety of alcohol use among adults should be left to the diverse moral judgments of the American people. This is not to say that everyone supports this stance of government neutrality. Many public health experts would like to take steps (short of prohibition) to suppress alcohol consumption as a way of reducing alcohol problems, and some conservative religious groups would take a more aggressive public stance against intoxication itself. However, the current stance of tempered neutrality seems to be widely accepted and therefore fairly stable.
In this policy context, the message to young people as well as adults about alcohol use is both subtle and confusing. The message to young people is “wait” or “abstain now,” rather than “abstain always,” as it is with tobacco and illegal drugs. Unlike the policies for those other products, the ban on underage alcohol use explicitly represents a youth-only rule, and its violation is often viewed as a rite of passage to adulthood. The problem