creases in prevalence did not continue into the 1990s because the immediate declarative effect of raising the drinking age had been exhausted by 1992 and media attention to drinking had abated.

There have been modest reductions in the 30-day and annual prevalence rates among high school seniors for the past 5 years. However, current rates are not significantly different than they were in 1993 and remain disturbingly high. Nearly half (48.6 percent) of high school seniors report drinking in the past 30 days—the same proportion as 1993, and significantly more than the proportion of youth that report either using marijuana (21.5 percent) or smoking (26.7 percent) in the past 30 days. The proportion of twelfth graders who report heavy drinking in the past 2 weeks declined slightly over the past several years, but was still higher (28.6 percent) in 2002 than it had been in 1993 (27.5 percent).

Thus, rates have remained essentially stable during the past decade despite a variety of efforts to address underage drinking. Many school districts have offered classroom interventions, the alcohol industry has included a “drink responsibly” message in many of its ads and implemented a variety of other programs, various state and national agencies and nonprofit organizations have implemented interventions aimed at reducing use and have developed and disseminated a variety of informational materials, and grassroots community organizations have carried out diverse efforts. Absent some new intervention, there is no reason to expect any further substantial decline. The problem of underage drinking in the United States is endemic and, in the committee’s judgment, is not likely to improve in the absence of a significant new intervention.

In the following chapters, the committee details the major components of a cost-effective strategy to prevent and reduce underage drinking. The premises of the proposed strategy, its blueprint, and its key components are summarized here.

The committee’s proposed strategy is based on three premises:

• Because alcohol use among adults is widespread, legally acceptable and deeply embedded in U.S. culture, youths receive mixed messages about the acceptability of underage drinking despite the fact that it is illegal. The proper message is that alcohol use by persons under 21 is both illegal and socially disapproved. A variety of institutions can play a role in establishing and sustaining a normative distinction that will reinforce the legal distinc-