Alcohol is the most commonly used drug among America’s youth. More young people drink alcohol than smoke tobacco or use marijuana. And young people who drink tend to drink a lot. They have easy access to alcohol, largely from adults. Yet adults tend to underestimate the prevalence of underage drinking, fail to recognize the full range of negative consequences that can result, and assume that drinking is something that other children, not theirs, do (Institute of Medicine and National Research Council, 2001).

Despite minimum legal drinking age laws, actual drinking patterns in the United States suggest that almost all young people use alcohol before they are 21. Those who drink tend to drink much more heavily than adults. Biglan et al. (in press) estimate, based on the National Household Survey on Drug Abuse (NHSDA), that 91 percent of all drinks consumed by teenagers are consumed by those who drink heavily. In addition, the average age of first alcohol use has generally decreased since 1965, indicating that youth are starting to drink at a younger age (Substance Abuse and Mental Health Services Administration, 2003). This early onset and heavy use of alcohol poses serious concerns for healthy, unimpeded development.

According to 2002 Monitoring the Future (MTF) data, almost half (48.6 percent) of twelfth graders reported recent (within the past 30 days) alcohol use. Based on 2001 NHSDA data, more than one in four (28.5