In this chapter we have listed many social, cognitive, and contextual factors that are related to the reasons that adolescents drink. In a culture that promotes alcohol use, it is impossible to isolate one factor as the primary cause. Rather, understanding why adolescents drink is more likely to be found in the confluence of factors. Positive aspects of the normal developmental process (e.g., enhanced cognitive abilities and physical maturation) are directly related to the greater autonomy and freedom from supervision enjoyed by adolescents. However, increases in autonomy lead to more opportunities to obtain and use alcohol. Likewise, normal adolescent development includes focusing on peers and searching for one’s own identity and friendship niche; however, these normal developmental processes lead to trying risky behaviors and conforming to peer norms that often include alcohol use. Thus, the trends that are typically associated with healthy adolescent development also set the stage for increased opportunities for alcohol use. In addition, adolescents are coming of age in the United States are doing so in a culture that promotes and enables underage drinking.

There is little that one can change about the timetable of cognitive and emotional development or personality characteristics, but one can consider interventions for some of the factors that have been related to adolescent alcohol consumption and can be changed. The most likely targets are adolescent, parent, and community attitudes about the acceptance of underage drinking. Media and educational campaigns with this goal, however, must keep in mind many of the factors that have been reviewed in this chapter. For example, messages to adolescents must consider factors such as developmental level; the need to act adult-like, try on new identities, and make decisions with little experience; and adolescents’ peer norms and biased reasoning about these norms.

Communications aimed at parents and others must provide realistic information about the prevalence of underage drinking and the dangers associated with it. In addition, adults must be given clear messages about what they may be doing to enable underage drinking and concrete examples of what they can do to convey their expectations to their children, monitor their children, and provide a community environment that discourages rather than promotes underage drinking.