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the industry has misled its customers for decades, and that aggressive regulation is needed to prevent young people from using tobacco and otherwise to protect the public health. It is generally believed that the tobacco industry has targeted young people to maintain demand for tobacco products as older consumers quit or die, notwithstanding the industry’s professed efforts, in the wake of the Master Settlement Agreement, to discourage underage use of their products. In short, public health officials and the major tobacco companies are not on the same side, and “big tobacco” is regarded as the enemy of the public’s health.

In contrast, the alcohol industry is diverse and uniformly acknowledges the dangers of underage drinking. Alcohol experts generally assume that the level of adult demand for alcohol products will not be substantially affected, over the long term, by reducing underage consumption—although getting young people to wait will obviously reduce the overall level of consumption. Thus, while the commercial interests of the alcohol industry are not perfectly aligned with the public health, they are not as antagonistic to the public health as the interests of the tobacco industry. In any case, a strategy for preventing and reducing underage drinking will have a much better chance for success if it attracts the active cooperation, and at least the acquiescence, of various segments of the alcohol industry.

The effectiveness of any policy focused explicitly on reducing underage drinking will be limited by the existence of a large legitimate practice of drinking and by the power of a large industry responding to legitimate consumer demand. When alcohol is available in many home liquor cabinets, the success of strategies to discourage young people from buying at package stores will be much different than in a world where relatively few parents have stocks of alcohol. The widespread legal use of alcohol in the society affects not only cultural and individual attitudes toward drinking, but also the extent to which any youth-oriented control regime can be effective in reducing opportunities for youths’ access to alcohol and drinking opportunities. One can establish a clear-cut boundary between acceptable drinking and unacceptable drinking at conceptual, policy, and legal levels, but it must be understood not only that different communities will construct that boundary differently as a matter of policy but also that the scope created for legal drinking has a profound, practical effect on the effectiveness of other policy instruments in discouraging unwanted, underage drinking.

In sum, the committee set about its task of developing a strategy for preventing and reducing underage drinking while being fully aware of the complexity of defining the public interest in this area and mindful of the severe constraints within which the strategy must be framed and implemented.

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