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characteristics of underage drinkers. It includes data on the prevalence of alcohol use and drinking behavior by gender, race, and ethnicity as well as comparisons of youth and adult drinking patterns. Chapter 3 provides an account of the social consequences and costs of underage drinking.

Chapter 4 offers a context for the underlying reasons, motivations, social influences, and risk factors that influence young people’s decisions about drinking. The chapter explores the specific motivations and influences relevant to young people’s drinking behavior and attempts to answer why some young people choose to drink and do so intensively while others choose to drink moderately or not at all. The chapter also discusses the social environment in which young people are immersed and the ways that community and social factors affect underage drinking.

Part II, Chapters 5 through 12, presents the committee’s recommended strategy to prevent and reduce underage drinking. In each of these chapters, the committee summarizes what is known about the effectiveness of existing programs or interventions in the pertinent domain and presents its conclusions and recommendations. The committee has tried to be realistic in assessing the potential effectiveness of efforts to prevent and reduce underage drinking. The committee assumes that most adults in the United States will continue to use alcohol and that most drinkers will begin their alcohol use sometime before they are 21, despite laws and policies to the contrary. Within that constraint, however, there is substantial room for preventing and reducing underage drinking in the United States, and this part of the report explores various tools that can be used in this effort.

At the heart of the committee’s proposed strategy is the effort to foster a collective societal acceptance of responsibility for reducing underage drinking. Although continued efforts to speak directly to young people about the dangers of alcohol use are an important component of the committee’s proposed strategy, the committee believes that the highest priority should be given to changing the attitudes and behaviors of adults. Adults often facilitate or enable underage drinking directly by supplying alcohol to young people, by failing to take effective precautions to prevent it, or by sending the message that alcohol use is to be expected. Few programs currently seek to influence parents to alter their behaviors and attitudes toward youth drinking as a way of reducing youth access to alcohol, changing permissive social norms about underage drinking, and galvanizing community action.

In Chapter 5 we explain our interpretation of the committee’s charge and some of the key assumptions underlying the strategy, including the criteria for assessing effectiveness and cost. This chapter is the foundation for the rest of the report. In Chapter 6 we discuss development of a national media effort as a major component of a campaign aimed at educating parents and other adults about underage drinking and ways adults can help

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