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Recommendation 9-14: States should establish administrative procedures and noncriminal penalties, such as fines or community service, for alcohol infractions by minors.

Youth-Oriented Interventions

Although the proposed strategy focuses mainly on adult attitudes and behavior toward underage drinking and on reducing the availability of alcohol to underage youth, approaches that directly target youth are also needed. A national youth-oriented media campaign to reduce and prevent underage drinking would be premature in the absence of more evidence supporting this approach. However, effective education-oriented approaches in schools and other settings aimed at preventing alcohol use by youths, as well as interventions with youths who have already developed alcohol problems, play a role. Interventions that rely on provision of information alone, or that focus on increasing self-esteem or resisting peer pressure, have not been demonstrated to be effective.

Residential colleges and universities have witnessed serious drinking problems among students under 21. Despite efforts by nearly all campuses to address this problem, heavy drinking has not declined over the past decade. Residential colleges and universities are in a unique position to develop and evaluate comprehensive approaches that address both individual and population-level issues.

Recommendation 10-1: Intensive research and development for a youth-focused national media campaign relating to underage drinking should be initiated. If this work yields promising results, the inclusion of a youth-focused campaign in the strategy should be reconsidered.

Recommendation 10-2: The U.S. Department of Health and Human Services and the U.S. Department of Education should fund only evidence-based education interventions, with priority given both to those that incorporate elements known to be effective and those that are part of comprehensive community programs.

Recommendation 10-3: Residential colleges and universities should adopt comprehensive prevention approaches, including evidence-based screening, brief intervention strategies, consistent policy enforcement, and environmental changes that limit underage access to alcohol. They should use universal education interventions, as well as selective and indicated approaches with relevant populations.

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