underage drinking essay

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Page title The Consequences of Underage Drinking

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Children who drink alcohol are more likely to:

Frequent binge drinkers (nearly 1 million high school students nationwide) are more likely to engage in risky behaviors, including using other drugs such as marijuana and cocaine.

Get bad grades

Children who use alcohol have higher rates of academic problems and poor school performance compared with nondrinkers.

Suffer injury or death

In 2009, an estimated 1,844 homicides; 949,400 nonfatal violent crimes such as rape, robbery, and assault; and 1,811,300 property crimes, including burglary, larceny, and car theft were attributed to underage drinking.

Engage in risky sexual activity

Young people who use alcohol are more likely to be sexually active at earlier ages, to have sexual intercourse more often, and to have unprotected sex.

Make bad decisions

Drinking lowers inhibitions and increases the chances that children will engage in risky behavior or do something that they will regret when they are sober.

Have health problems

Young people who drink are more likely to have health issues such as depression and anxiety disorders.

Last Updated: 04/14/2022

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• v.42(1); 2022

Alcohol and the Adolescent Brain: What We’ve Learned and Where the Data Are Taking Us

This article is part of a Festschrift commemorating the 50th anniversary of the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Established in 1970, first as part of the National Institute of Mental Health and later as an independent institute of the National Institutes of Health, NIAAA today is the world’s largest funding agency for alcohol research. In addition to its own intramural research program, NIAAA supports the entire spectrum of innovative basic, translational, and clinical research to advance the diagnosis, prevention, and treatment of alcohol use disorder and alcohol-related problems. To celebrate the anniversary, NIAAA hosted a 2-day symposium, “Alcohol Across the Lifespan: 50 Years of Evidence-Based Diagnosis, Prevention, and Treatment Research,” devoted to key topics within the field of alcohol research. This article is based on Dr. Tapert’s presentation at the event. NIAAA Director George F. Koob, Ph.D., serves as editor of the Festschrift.

The past 50 years of research supported by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) have resulted in an accumulation of invaluable data to address the multifaceted problems surrounding underage drinking. Youth use of alcohol remains a pervasive social and public health concern in the United States and a leading cause of disability and mortality during adolescence. 1 , 2 Alcohol use in adolescence has a distinct pattern from adult drinking, whereby adolescents may have fewer drinking occasions but consume relatively high levels per occasion, referred to as binge or heavy episodic drinking and defined as consuming four or more standard ethanol consumption units on an occasion for females and five or more for males. 3 – 5 Highly prevalent among youth in Western countries is an intermittent pattern of heavy alcohol consumption that typically is associated with social leisure occasions on weekend nights. 6 Moreover, adolescent alcohol use, along with smoking and illicit drug use, has undergone changes in prevalence and patterns in recent decades. For example, alcohol use peaked in the mid-1990s, with approximately 50% of 12th graders reporting past-month alcohol use, followed by a steady long-term decline to 30% in 2018. In 2020, the downward trend reversed course, with 34% of 12th graders reporting past-month alcohol use. 1 Recent reports indicate that prevalence estimates for 2021 will need to account for impacts of the COVID-19 global pandemic on underage substance use behavior and availability. 7

High-risk alcohol consumption patterns and associated problems alone increase risk for adverse outcomes—such as motor vehicle accidents, high-risk sexual behaviors, other illicit substance use, and mental health challenges—for adolescents who drink. These risks are further compounded by the fact that adolescence is a period of crucial brain development and maturation. 8 , 9 Neuroimaging studies have provided clear evidence that the brain (a) continues to develop throughout adolescence and into adulthood, and (b) undergoes important structural and functional changes in synaptic plasticity and neural connectivity during adolescence. 10 , 11 These changes and the enormous plasticity of the teen brain make adolescence a time of both great risk and great opportunity. 11

This article begins with an overview of typical adolescent brain development, followed by a summary of four key themes in the current understanding of alcohol and the adolescent brain: (1) predictors of underage drinking; (2) consequences of alcohol on adolescent brain structure and function; (3) moderating and confounding factors, including age of onset, sex disparities, family history, co-use of other substances, and mental health comorbidities; and (4) reversibility of and recovery from alcohol misuse. The article concludes with a discussion of where the data lead us to reach the next milestones in NIAAA-supported research.

Typical Adolescent Brain Development

The brain of an adolescent, much like teenage behavior, undergoes significant developmental changes. This neurodevelopment continues after adolescence, typically until around age 25. 12 – 15 The maturational processes in the brain occur in stages, with more basic functions (e.g., motor and sensory functions) maturing first and areas such as the lateral temporal and frontal lobes, which are responsible for higher cognitive function (e.g., decision-making, attention), developing later in adolescence. 13 The prefrontal cortex is one of the last brain regions to complete its maturation. Its rate of change does not plateau until the third decade of life, in concert with typical developmental trajectories of cognitive abilities, such as decision-making, attention, and cognitive control. 16 – 18 The late maturation of the prefrontal cortex has been linked to risky behavior during adolescence, particularly if the limbic subcortical system develops earlier. 16

Executive functioning typically matures during this developmental stage, 19 coincident with gray matter reductions and white matter growth. 20 , 21 Functional magnetic resonance imaging (fMRI) studies of executive behaviors have demonstrated increasing prefrontal activity and better inhibitory control with adolescent age. 22 Challenges in executive functioning have been observed in adolescents with a family history of alcohol use disorder (AUD), 23 repeated childhood trauma experiences, 24 and poor sleep, 25 all of which also have been identified as risk for adolescent binge drinking and AUD. 17 , 26 , 27 Deficits in control circuitry have been linked to impulsivity, sensation seeking, and alcohol use into early adulthood. 28

One of the studies investigating adolescent alcohol use and its effects is coordinated by the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA), which is conducting a multisite longitudinal study supported by funding from NIAAA and other National Institutes of Health partner institutes. Launched in 2012, this five-site consortium recruited a community cohort of 831 diverse adolescents ages 12 to 21 from five U.S. regions (Durham, North Carolina; Palo Alto, California; Pittsburgh, Pennsylvania; Portland, Oregon; and San Diego, California). Half the sample was enriched for key characteristics conveying risk for heavy drinking among adolescents (i.e., family history of substance use disorder, youth externalizing or internalizing symptoms, and having tried alcohol by age 14). Most of the sample (85%) reported very limited alcohol use at project entry; the remaining 15% exceeded typical age thresholds for alcohol at project entry in this cohort-sequential design. 29 At project entry and annually thereafter, participants received neuroimaging (high-resolution structural, diffusion, and resting-state fMRI scans), neurocognitive testing, detailed substance use and mental health interviews; provided urine samples for drug testing as well as saliva samples for genetics and pubertal hormone assays; and completed various self- and parent reports on personality, behaviors, and environment. 29 NCANDA will continue to examine the interactive effects of typical development as well as adolescent alcohol use and executive dysfunction into early adulthood.

Resting-state fMRI findings from NCANDA and other studies have shown that intrinsic functional networks subserving cognitive control and limbic circuitry develop across adolescence and may be influenced by adolescent heavy drinking. 24 , 30 , 31 Moreover, the adverse effects of alcohol may be more prominent in girls than in boys. 32

Predictors of Underage Drinking

Being able to identify youth at higher risk for alcohol misuse could lead to early intervention and ultimately help reduce the significant personal and public health burden of AUD; however, relatively few studies have explored individual-level precursors of adolescent alcohol use. Prospective longitudinal studies of substance-naïve youth are uniquely positioned to identify factors predating the onset of alcohol use. Squeglia et al. identified several markers of alcohol initiation by age 18 in 137 adolescents. 27 These markers included demographic and behavioral factors (e.g., male sex, higher socioeconomic status, early dating, more externalizing behaviors, positive alcohol expectancies), lower executive functioning, thinner cortices, and less brain activation in diffusely distributed brain regions.

NCANDA seeks to expand on these findings using a greater number of measurements in a large sample to lead to more accurate individual-level forecasting. The consortium is employing machine learning models, which can avoid multiple-comparison correction and reduce measures to a single, individual-level prediction. 33 , 34 NCANDA developed a model that distinguished youth who drink heavily from those who drink little or no alcohol, based on patterns of macrostructural and microstructural imaging metrics in multiple brain regions. 35 The analyses suggested delayed development of white matter connectivity among the older youth in the sample who drank heavily, as well as increased risk of subsequent heavy drinking in youth with more externalizing symptoms. These findings fit closely with those from the IMAGEN Consortium, which found that variability in personality, cognition, life events, neural functioning, and drinking behavior features predicted Alcohol Use Disorders Identification Test scores at ages 14 and 16. 36

Neural Consequences of Underage Heavy Drinking

Gray matter volume.

Unlike white matter, gray matter volume peaks in the primary school-age years, around age 10. 11 Squeglia et al. reported that youth who drank heavily ( n = 75) (defined using modified Cahalan quantity × frequency criteria 37 , 38 ) showed accelerated reductions in gray matter volumes in cortical lateral frontal and temporal areas compared to those who drank no or little alcohol ( n = 59). 39 These results were largely unchanged with co-use of marijuana and other drugs; also, similar patterns of developmental trajectory abnormalities existed in males and females. This finding was replicated in the NCANDA cohort, which examined the influence of alcohol use on gray matter structure in 483 adolescents ages 12 to 21 both before and 1 to 2 years after the onset of heavy drinking. 13 For youth with no or low alcohol consumption, gray matter volumes declined throughout adolescence, with rates slowing in many brain regions in later adolescence. However, youth who initiated heavy drinking exhibited a steeper decline in frontal gray matter volumes. For both youth with no or low alcohol consumption and those with heavy drinking, cannabis use did not influence gray matter volume trajectories.

These findings were confirmed in a recent analysis spanning five time points in the NCANDA study and using linear mixed-effects models. 40 A greater number of past-year binge drinking episodes was linked to greater decreases in gray matter volumes in 26 of 34 bilateral Desikan-Killiany cortical parcellations tested. The strongest effects were noted in frontal regions as well as among younger adolescents; moreover, the effects largely attenuated in later adolescence. The gray matter volumes decreased most for individuals with greater numbers of binge-drinking episodes and recent binge drinking. These findings provide yet more evidence that adolescent binge drinking is linked to a greater risk of more prominent gray matter reductions during adolescence. 40

Functional MRI studies further suggested that adolescents with histories of heavy drinking showed aberrant patterns of activation in response to cognitively challenging tasks, 41 , 42 including tasks of working memory and inhibition. In adolescents with a history of 1 to 2 years of heavy drinking, the aberrant activation was not linked to detectable deficiencies in task performance. However, if heavy drinking persisted longer, reduced task performance was often evident in the adolescents. 43 , 44 This pattern of results suggested that the brain may be able to compensate for subtle neuronal insults for a period of time, but if drinking patterns persist and become heavier, the brain may no longer be able to compensate and may be vulnerable to the effects of repeated and sustained heavy doses of alcohol.

White Matter Volume and Integrity

Throughout adolescence, white matter volume increases and matures, resulting in myelination that increases speed of neuronal transmission and modulates the timing and synchrony of neuronal firing patterns that convey meaning in the brain. 11 Squeglia et al. reported that adolescents who drank heavily showed attenuated white matter growth of the corpus callosum and pons relative to adolescents who did not drink. 39 Pfefferbaum et al. indicated that among those in the NCANDA sample who consumed no or little alcohol, white matter regions grew at faster rates in younger age groups and slowed toward young adulthood. 13

To examine the potential for a neurotoxic effect of alcohol use on adolescent development of white matter, Zhao et al. conducted a whole-brain analysis of fractional anisotropy of NCANDA participants ages 12 to 21 at baseline. 45 For 63 adolescents who initiated heavy drinking, the researchers examined white matter quality before and after drinking onset and compared it to the white matter maturation trajectory of 291 adolescents with no or low alcohol consumption. Results showed deterioration of white matter integrity in youth who drank heavily compared with age- and sex-matched controls. Moreover, the slope of this reduction over time corresponded with days of drinking since the study entry. 45 Within-subject analyses contrasted developmental trajectories of youth before and after they initiated heavy drinking. These analyses suggested that drinking onset was associated with, and appeared to precede, disrupted white matter integrity. This disruption was greater in younger adolescents than in older adolescents, and was most pronounced in the genu and body of the corpus callosum. 45 It is possible that these brain structure changes may occur concomitantly with modifications in certain neurotransmitter and hormone secretion systems, which markedly influence the refinement of certain brain areas and neural circuits. 46

Neurocognition

Along with altered development and maturation of gray and white matter, studies have reported neurocognitive consequences of underage drinking, such as impairments in attention, 47 verbal learning, 48 , 49 visuospatial processing, 47 , 50 and memory. 49 Neurocognitive deficits linked to moderate to heavy drinking during this critical developmental period may lead to direct and indirect changes in neuromaturational course, with effects that may extend into adulthood. Squeglia et al. examined neurocognitive function in adolescents who drank heavily, moderately, or not at all, based on the Cahalan classification system. 51 Their findings suggested that initiation of moderate to heavy alcohol use and incurring hangovers during adolescence may adversely influence neurocognitive functioning. For females, more drinking days in the past year predicted a greater reduction in performance on visuospatial tasks, in particular visuospatial memory, from baseline to follow-up. For males, a tendency was seen for more hangover symptoms in the year before follow-up testing to predict a relative worsening of sustained attention. 51

Alcohol Cue Reactivity

Another set of studies demonstrated that youths who drank heavily exhibited greater brain activation while viewing alcohol advertisements 25 , 52 – 54 than while viewing ads for nonalcoholic beverages. 52 Adolescents are exposed to alcohol advertising materials on a daily basis in many countries. As studies in adults with AUD have shown atypical responses to alcohol-related materials, 55 Tapert and colleagues used fMRI analyses to determine whether similar response patterns existed in adolescents who drink. 52 The study included 15 adolescents ages 14 to 17 with AUD and 15 demographically similar adolescents who drank infrequently. The participants were shown pictures of alcoholic and nonalcoholic beverage advertisements during neuroimaging. Adolescents with histories of heavy drinking showed greatly enhanced neural activation while viewing the pictures of alcoholic beverages compared with pictures of nonalcoholic beverages. The extent of alcohol-related activation was greatest for those with the highest levels of monthly alcohol intake (see Figure 1 ). In contrast, youth with limited drinking histories showed similar levels of activation while viewing the two beverage picture types. These results demonstrated pronounced alcohol cue reactivity in heavy drinking teens, particularly in reaction to alcohol advertising materials.

Brains of youths who drank heavily activated strongly in response to seeing alcohol advertisements but showed little brain response to nonalcoholic beverage ads; this difference (i.e., signal contrast) was smaller in youth who drank lightly. The difference in brain response was greatest in adolescents with the highest consumption levels and was especially strong in the left hemisphere (positive affect), limbic, and visual cortex areas. Source: Tapert et al., 2003. 52

Factors Contributing to Adolescent Alcohol Use

Age of onset.

Studies examining longer-term impacts of adolescent alcohol misuse have yielded mixed results. Some studies reported a maturing-out without significant consequences in adulthood, while others found ongoing effects on mental health, physical health, and social functioning, as well as higher levels of alcohol use and AUD. 56 Analyses using data from the National Longitudinal Alcohol Epidemiologic Survey determined that 40% of those initiating alcohol use before age 15 were diagnosed with AUD at some point in their lives compared to only 10% of those who delayed the onset of drinking until age 21 or later. 57

The first study of adolescents (ages 12 to 15 at baseline; N = 215) to assess the association between age of adolescent drinking onset and neurocognitive performance found that earlier age of drinking onset predicted poorer performance on tasks requiring psychomotor speed and visual attention. Similarly, an earlier age of onset of regular (weekly) drinking predicted poorer performances on tests of cognitive inhibition and working memory. 58 This study suggested that early onset of drinking increased risk for subsequent neuropsychological dysfunction.

Sex Disparities

Several studies have reported that the associations between alcohol and brain structure and function differ by sex, especially in adolescents engaging in binge drinking. While not conclusive across the literature, female adolescents who engaged in binge drinking appeared to show effects such as blunted activation in frontal, temporal, and cerebellar cortices compared to females who did not drink, whereas male adolescents who engaged in binge drinking showed the opposite activation pattern. 59 Female adolescents ages 15 to 17 meeting criteria for AUD showed larger prefrontal cortex volumes than female controls, while male adolescents with AUD had smaller prefrontal cortex volumes than male controls. 60 A similar finding was observed for white matter.

Family History of AUD

Having a family member with AUD is associated with almost double the risk of initiating drinking in early adolescence. 57 Using fMRI, Spadoni et al. observed greater neural activity during rest and reduced activity during an active baseline condition were linked to denser family history of AUD. 61

Mental Health Comorbidities

Adolescence is the peak time for both onset of substance misuse and emergence of mental illness, including anxiety disorders, bipolar disorder, major depression, eating disorders, and psychosis. 10 The National Survey on Drug Use and Health (NSDUH) estimated that 20% of adolescents had a mental illness that persisted into adulthood. 2 Moreover, adolescents with a past-year major depressive episode were more likely to be current binge alcohol users (6% vs. 4%). 2 However, it remains unclear how comorbid mental health problems contribute to and exacerbate the neurobiological effects of alcohol misuse. 4 Frontal and temporal cortical thinning may predict increased vulnerability to development of adolescent depression. In the NCANDA sample of 692 adolescents without a history of depression, the 101 youth who transitioned into depression were found at study baseline to have thinner cortices in the superior frontal cortex, precentral and postcentral regions, and superior temporal cortex, beyond effects attributable to age and sex. 62 , 63

Adverse Childhood Events

Childhood trauma and post-traumatic stress symptoms have been shown to confer increased risk for adolescent and adulthood AUD, mental illness, and physical health problems. 64 , 65 Youth with trauma exposure showed thinner frontal cortices, and those with chronic post-traumatic stress disorder (PTSD) had smaller orbital frontal cortices 66 and less superior posterior cortical and cerebellar gray matter volume. 67 These observations indicate that trauma may be associated with structural brain aberrations.

NCANDA has also examined the relationship between childhood trauma and subsequent adolescent alcohol use. 68 In a sample of 392 NCANDA participants, adverse childhood event history was linked to greater self-reported executive dysfunction spanning four annual follow-ups. Greater childhood trauma also was linked to less connectivity in sensorimotor and cognitive control networks (i.e., the bilateral dorsal anterior cingulate cortex, right anterior insula, right intraparietal sulcus, and bilateral pre- and postcentral gyri hub regions) at baseline. This reduced connectivity explained the relationship between executive dyscontrol and subsequent increased frequency of adolescent binge drinking (see Figure 2 ). 24

Note: Y1–Y4, Year 1 through Year 4. Source: Silveira et al., 2020. 24

Sleep patterns change substantially during adolescence and emerging adulthood. 69 Lack of sleep, going to sleep relatively late, and large weekend-weekday sleep differences all are risk factors for alcohol use in adolescents and young adults. 70 Similarly, in the NCANDA sample, sleep difficulties in adolescence predicted later substance use problems. 71 The reverse has also been seen, with acute and chronic alcohol intake altering sleep structure and electroencephalography patterns 72 in older adolescents 73 and adults. 69 NCANDA will continue to longitudinally examine whether these changes remain evident into adulthood and how alcohol use influences sleep neurobiology.

Use of Other Substances

Co-use of multiple substances may influence the relationship between alcohol use and neural integrity. For example, during a spatial working memory task, adolescents with co-occurring AUD and cannabis use disorder showed less inferior frontal and temporal neural activation but a greater medial frontal response compared to adolescents with AUD alone. 74 Co-use of alcohol with cannabis also may adversely influence executive functioning. 75 Given the high rates of co-occurring alcohol and other substance use during adolescence, 76 future well-powered studies will benefit from detailed analyses of various combinations of substances of abuse on neural and neurocognitive outcomes.

Recovery From Consequences of Adolescent Heavy Drinking

In adults with AUD, improvements in attention and concentration, reaction time, and memory are generally seen after 2 to 8 weeks of abstinence; 77 however, executive functioning, processing speed, visuospatial, and verbal skills appear more resistant to recovery, 78 and spatial processing deficits may persist for years. 79 Younger adults tend to recover more quickly and completely than older adults (i.e., over age 50). 80 As mentioned previously, preliminary evidence suggested that adolescent heavy drinkers showed greater response to alcohol cues, 54 more emotional reactivity and poorer distress tolerance, 81 and poorer visuospatial performance compared with adults. 82 These effects remitted after a month of abstinence, indicating that some deficits are linked to alcohol intake and may be transitory. However, executive dysfunction 81 and negative mood states 83 did not remit within 4 weeks of abstinence, suggesting that these differences may have predated the onset of heavy drinking or may take more time to recover. As reported by Infante et al., cortical gray matter volume decreases were greater in proximity to reported drinking episodes in a dose-response manner, suggesting a causal effect and raising the possibility that normal growth trajectories may recover with alcohol abstinence. 40 However, other studies have suggested that impaired visuospatial functioning following adolescent AUD persisted even after reduced levels of use. 84

Where Do the Data Lead Next?

Longitudinal studies with large, diverse, representative samples of youth and a range of detailed measures are key to helping understand the behaviors that convey disadvantages to adolescent and young adult development and outcomes. To date, a handful of large-scale multisite studies are being conducted to gain insight into the consequences of adolescents transitioning into and out of substance use. These include the largest long-term study of brain development in the United States, the Adolescent Brain Cognitive Development (ABCD) Study, which is currently underway; NCANDA; the IMAGEN study in Europe; the Pediatric Imaging, Neurocognition, and Genetics (PING) study; and the Lifespan Human Connectome Project (HCP) study. NCANDA has already been able to confirm impressions from prior smaller studies that adolescent heavy drinking appears linked to accelerated gray matter decline, 40 disrupted functional connectivity, 30 and reduced cognitive performance. Determining the degree to which these effects remit or persist with alcohol abstinence or reduced use will be a key next step in this line of work.

Acknowledgments

This research was supported by the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health with co-funding from the National Institute on Drug Abuse, the National Institute of Mental Health, and the Eunice Kennedy Shriver National Institute of Child Health and Human Development grants: U01AA021681, U01AA021690, U01AA021691, U01AA021692, U24AA021695, U01AA021696, and U24AA021697. We would like to thank the entire team of investigators and staff at the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) as well as our research participants for making this work possible.

Disclosures

The authors declare no competing financial or nonfinancial interests.

Publisher’s Note

This article was based on a presentation at the NIAAA 50th Anniversary Science Symposium, “Alcohol Across the Lifespan: 50 Years of Evidence-Based Diagnosis, Prevention, and Treatment Research,” held on November 30–December 1, 2020. Links to the videocast are available on the NIAAA 50th Anniversary Science Symposium agenda webpage.

Opinions expressed in contributed articles do not necessarily reflect the views of the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health. The U.S. government does not endorse or favor any specific commercial product or commodity. Any trade or proprietary names appearing in Alcohol Research: Current Reviews are used only because they are considered essential in the context of the studies reported herein.

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The NIAAA is the lead agency for U.S. research on the causes, consequences, prevention and treatment of alcohol use disorder and alcohol-related problems.

National Institute on Alcohol Abuse and Alcoholism (NIAAA)

Underage drinking research initiative.

About the Underage Drinking Research Initiative

The Underage Drinking Research Initiative (UDRI) is a key program of NIAAA. The goal of this initiative is to better understand the factors that compel youth to begin drinking, continue drinking, and progress to harmful use, abuse, and dependence. We seek to understand and address underage drinking within the context of overall development, and to help improve prevention and treatment interventions.

Factors we consider include:

• Environment

A working group of NIAAA staff comprises the UDRI. Over a number of years, the UDRI also worked with a multidisciplinary steering committee of experts both from within and outside NIH, representing numerous fields of study including:

• Adolescent development
• Child health
• Brain imaging
• Neuroscience
• Prevention research
• Public policy
• Health communications

NIAAA continues to call upon these experts as appropriate for specific UDRI projects.

Our Progress

Since launching in 2004, the Underage Drinking Research Initiative has added to our understanding of youth drinking by:

• Developing an Underage Drinking Screening Guide , a tool that guides pediatricians and other clinicians through a screening process to assess alcohol use in children and adolescents
• Bringing together college presidents to inform them about the latest research on college drinking, and to help them develop strategies for reducing drinking on campus
• Developing Parenting to Prevent Childhood Alcohol Abuse ,  a publication for parents offering the latest research on the influence parents have on their children’s choices about alcohol
• Developing and sponsoring a supplement to the April 2008 issue of Pediatrics to present the results of our collaborative work. The supplement includes 7 papers addressing various aspects of the complex relationship between development and underage drinking.
• Collaborating with the Office of the U.S. Surgeon General on its Call to Action to Prevent and Reduce Underage Drinking , a major initiative to promote public awareness of underage drinking and its consequences, and outline steps that can be taken to prevent and reduce this widespread public health problem. The Surgeon General called on NIAAA to provide the scientific background and research for the report. 

Learn More about Underage Drinking Issues:

• Underage Drinking .
• College Drinking .
• Underage Drinking Research Initiative Committee
• The Interagency Coordinating Committee on the Prevention of Underage Drinking (ICCPUD)

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Underage Drinking Essay, Video and Poster Contest

As part of the Alabama Alcoholic Beverage Control Board’s efforts to educate young people about the dangers of alcohol and discourage underage and binge drinking, the ABC Board’s Under Age, Under Arrest initiative is holding an essay and video contest for middle- and high-school students. The topic of the contest is “The Danger of Underage Drinking,” and entries should convey a message about the risks or dangers associated with underage and binge drinking.

The contest is open to individuals and school groups in grades 7-12. Entries can be in the essay, video or poster categories, and first-, second- and third-place prizes will be awarded in each category. Winners will be judged by the ABC Board in conjunction with Mothers Against Drunk Driving (MADD) Alabama.

The following prizes will be awarded in each category:

First Place: $300

Second Place: $200

Third Place: $100

In addition, the first-place winning video may be used as a public service announcement for TV use and will be featured on the ABC Board’s website. First-, second- and third-place winners in the essay, video and poster categories will be shared via social media and featured on the Under Age, Under Arrest website, www.alabcboard.gov/underage-underarrest .

Entry Deadline

To qualify, entries must be received by 5 p.m. March 29, 2024. Winners will be announced in April during Alcohol Awareness Month.

Contest Rules

Essay Category

Essays should be 1,500 words or less. Entrants can be an individual student or a team of students in grade 7-12. Entries should be emailed to [email protected] . Each entry must include a completed entry form.

Video Category

Videos should be in the form of a 60-second commercial. Entrants can be an individual student or a team of students in grade 7-12. Each entry must include a completed entry form. In addition, a completed parental consent form is required for each individual and each member of a team submitting a video. Each entry must also include a “work cited” page. (Please click here for additional video contest rules.) Entries, along with entry and parental consent forms and “work cited” page, should be emailed to  [email protected] .

Video Contest Rules

Poster Contest

Poster entries should be formatted to fit a 24-inch-by-36-inch poster, and designs should be sent electronically via email in .jpg form. Entrants can be an individual student or a team of students in grade 7-12. Entries should be emailed to  [email protected] . Each entry must include a completed entry form sent in with the poster design.

Essay, video and poster entries submitted to this contest will not be returned. Submission of the video constitutes your approval for promotional such use and exhibition by the ABC Board’s Under Age, Under Arrest initiative.

Entry Form        Parental Consent Form

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First refuelling for Russia’s Akademik Lomonosov floating NPP

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The FNPP includes two KLT-40S reactor units. In such reactors, nuclear fuel is not replaced in the same way as in standard NPPs – partial replacement of fuel once every 12-18 months. Instead, once every few years the entire reactor core is replaced with and a full load of fresh fuel.

The KLT-40S reactor cores have a number of advantages compared with standard NPPs. For the first time, a cassette core was used, which made it possible to increase the fuel cycle to 3-3.5 years before refuelling, and also reduce by one and a half times the fuel component in the cost of the electricity produced. The operating experience of the FNPP provided the basis for the design of the new series of nuclear icebreaker reactors (series 22220). Currently, three such icebreakers have been launched.

The Akademik Lomonosov was connected to the power grid in December 2019, and put into commercial operation in May 2020.

Electricity generation from the FNPP at the end of 2023 amounted to 194 GWh. The population of Pevek is just over 4,000 people. However, the plant can potentially provide electricity to a city with a population of up to 100,000. The FNPP solved two problems. Firstly, it replaced the retiring capacities of the Bilibino Nuclear Power Plant, which has been operating since 1974, as well as the Chaunskaya Thermal Power Plant, which is more than 70 years old. It also supplies power to the main mining enterprises located in western Chukotka. In September, a 490 km 110 kilovolt power transmission line was put into operation connecting Pevek and Bilibino.

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Reducing Underage Drinking: A Collective Responsibility (2004)

Chapter: 1. introduction: the challenge, 1 introduction: the challenge.

A lcohol use by children, adolescents, and young adults under the legal drinking age of 21 produces human tragedies with alarming regularity. Motor vehicle crashes, homicides, suicides, and other unintentional injuries are the four leading causes of death of 15- to 20-year-olds, and alcohol is a factor in many of these deaths. Indeed, so many underage drinkers die in car crashes that this problem, by itself, is a major national concern. In relation to the number of licensed drivers, young people under age 21 who have been drinking are involved in fatal crashes at twice the rate of adult drivers (National Highway Traffic Safety Administration, 2002a).

Car crashes are the most visible and most numbing consequences of underage drinking, but they represent only a small proportion of the social toll that underage drinking takes on the present and future welfare of society. Other damaging problems include dangerous sexual practices that lead to both serious disease and unwanted pregnancies, unintentional injuries, fights, and school failures that lead to expulsions or withdrawals. Levy et al. (1999) estimated that in 1996 underage drinking led to 3,500 deaths, 2 million nonfatal injuries, 1,200 cases of fetal alcohol syndrome, and 57,000 cases of treatment for alcohol dependence. Worse yet, underage drinking reaches into the future by impeding normal development and constricting future opportunities. Conservatively estimated, the social cost of underage drinking in the United States in 1996 was $52.8 billion (Pacific Institute for Research and Evaluation, 1999).

For many children, alcohol use begins early, during a critical developmental period: in 2002, 19.6 percent of eighth graders were current users of alcohol (use within the past 30 days), which can be compared with 10.7 percent who smoked cigarettes and 8.3 percent who used marijuana. Among each older age cohort of high school students, the prevalence, frequency, and intensity of drinking increase, contributing to increasing rates of educational failure, injury, and death as children move from grade to grade. By the time young people are seniors in high school, almost three-quarters (71.5 percent) report having drunk in the past year, almost half (48.6 percent) are current drinkers, and more than one-quarter (28.6 percent) report having had five or more drinks in a row in the past 2 weeks (Johnston et al., 2003). Among 18- to 22-year-olds, 41.4 percent of full-time college students and 35.9 percent of other young adults report heavy drinking (Substance Abuse and Mental Health Services Administration, 2002). Heavy childhood and teenage drinking injures the developing brain and otherwise interferes with important developmental tasks. In addition, children and adolescents who begin drinking early are more likely than others to wind up with alcohol problems throughout their adult lives.

The public is certainly aware of these problems, especially drunk driving by teens. However, recent surveys demonstrate that parents underestimate the prevalence and intensity of alcohol use by their own children and by the underage population (see Chapter 6 ). Moreover, as measured by media attention and government expenditures, public concern about teenage alcohol use has not been remotely commensurate with the magnitude of the problem. A telling measure of the current societal response is the large gap in the federal government’s investment in discouraging illicit drug use among teenagers and in discouraging underage drinking, given that the social damage from underage alcohol use far exceeds the harms caused by illicit drug use. In fiscal 2000, the nation spent approximately $1.8 billion on preventing illicit drug use (Office of National Drug Control Policy, 2003), which was 25 times the amount, $71.1 million, targeted at preventing underage alcohol use (U.S. General Accounting Office, 2001). The amount spent on preventing underage drinking also appears to be less than the amount spent on preventing tobacco use: in fiscal 2000, the Office of Smoking and Health, only one of many agencies in the Department of Health and Human Services concerned with smoking prevention, spent approximately $100 million. In addition, the states spent a great deal more, including funds generated by the agreement that settled the states’ Medicaid reimbursement suits against the tobacco companies.

There are signs that public attention to underage drinking is increasing and that the public recognizes the need to address the problem more aggressively than has thus far occurred. A recent study on public attitudes toward

underage drinking (Wagenaar et al., 2002) shows almost universal recognition of this problem. In fact, 98 percent of adults polled said they were concerned about teen drinking and 66 percent said they were “very concerned.” Moreover, a majority of respondents favored strong regulatory actions, such as additional controls on alcohol sales and advertising that would “make it harder for teenagers to get alcoholic beverages.” In 1999, Mothers Against Drunk Driving (MADD) added the goal of reducing underage drinking to its mission statement, and its activities and public statements increasingly reflect this focus (e.g., Mothers Against Drunk Driving, 2002). Underage drinking has also won the attention of the spouses of the nation’s governors, many of whom have come together to form the Leadership to Keep Children Alcohol Free, in collaboration with the Robert Wood Johnson Foundation (RWJF) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA, part of the National Institutes of Health). In collaboration with the American Medical Association (AMA), the RWJF has also provided long-term support to 12 community and 10 university-based coalitions with the specific mission of reducing and preventing underage drinking. The AMA has itself also become increasingly active on the issue of underage drinking, calling for tighter regulation of alcohol availability, higher excise taxes, and restrictions on alcohol advertising. Members of the alcohol industry also have continued their efforts to discourage underage drinking through responsible drinking campaigns and approaches such as server, parent, and youth-oriented education and involvement in prevention efforts on college campuses.

Underage drinking has also begun to attract increased government attention in Washington. The U.S. Federal Trade Commission (FTC), at the request of Congress, recently reviewed the alcohol industry’s advertising and marketing practices. Its report (U.S. Federal Trade Commission, 1999) called on alcohol companies to move toward the “best practices” in the industry “to reduce underage alcohol ad exposure.” In 2003 Congress called on the FTC to revisit its inquiry into alcohol advertising and youth and to investigate if and how the recommendations issued in its 1999 report have been implemented by the alcohol industry. Advocacy groups have also urged Congress to include underage alcohol use in the major media campaign being waged against illegal drug use under the auspices of the Office of National Drug Control Policy.

THE COMMITTEE STUDY

In 2001 Congress responded to the increasing level of public concern about underage alcohol consumption by appropriating funds for a study by The National Academies. Acting through the NIAAA and the Substance

Abuse and Mental Health Services Administration of the U.S. Department of Health and Human Services (HHS), Congress requested 1 The National Academies to undertake an examination of the pertinent literature, to “review existing federal, state, and nongovernmental programs, including media-based programs, designed to change the attitudes and health behaviors of youth,” and to “develop a cost effective strategy for reducing and preventing underage drinking.” Based on consultations with several of the Academies’ standing advisory boards, members of the Academies, and the Academies’ governing bodies, the final statement of task directs the committee to examine programs ranging from environmental interventions (e.g., taxation, access restrictions) to programs focusing directly on the attitudes and behavior of young people (see Appendix A for the full statement of task).

In response, the Board on Children, Youth, and Families (BCYF) of the National Research Council and the Institute of Medicine of the National Academies established a committee of 12 members with special expertise in key domains relating to underage drinking. To supplement the expertise of its members, the committee commissioned a set of papers to provide systematic reviews of the scientific literature on determinants of underage drinking and effective ways of reducing it. Topics explored in these papers include the demographics of underage drinking; its economic and social costs; adolescent decision making and risk and protective factors; and the effectiveness of various prevention programs and approaches, including media campaigns, school-based education, pricing, and access. Draft papers were presented at public meetings in October and November 2002 (see Appendixes B and C ) and subsequently reviewed and revised. 2

Numerous programs with the common goal of reducing underage drinking have been implemented at the national, state, and local levels, by governments and nonprofit and grassroots organizations. At the federal level, the Departments of Health and Human Services (HHS), Justice, and Transportation operate several programs that specifically target underage drinking. Seven other federal agencies fund efforts that include underage alcohol use within a broader mandate (U.S. General Accounting Office, 2001). Similarly, numerous state-level agencies administer programs to reduce underage drinking. In most states, the health, human service, transportation, criminal justice, and education departments play some role. State alcohol beverage control bodies also play a role. Many communities, colleges and universities, and grassroots organizations across the country have initiated

efforts to reduce underage drinking and its associated problems in their communities. The alcohol industry also has implemented a range of efforts with the goal of reducing underage drinking.

The committee reviewed the 2001 report of the General Accounting Office on federal programs. This report focused on federal funding that targets underage drinking or includes underage drinking within a broader mandate. It does not include evidence on the effectiveness of specific programs. For the programs operated by the Departments of Transportation and Justice, the report provides general information on the types of activities funded—traffic safety and enforcement of underage drinking laws, respectively. No information is provided on the HHS-funded programs or activities, the largest overall funder of targeted underage drinking activities (see Chapter 12 ), probably because the funds generally do not represent a national program but, rather, funding for select state or local programs or research aimed at specific aspects of the problem. Although HHS has funded evaluations of specific state and community-level programs, the committee is not aware of any national-level HHS evaluations, or national evaluations of the Department of Transportation program. Each of the federal agencies have initiatives to highlight promising practices, based on varying levels of evidence. Evaluations of state or local programs that receive federal funding that are available in the literature, are reflected in the papers prepared for the committee’s study.

The largest single federal program that targets underage drinking is the Enforcing the Underage Drinking Laws (EUDL) Program, operated by the Department of Justice’s Office of Juvenile Justice and Delinquency Prevention (OJJDP). A national evaluation of this program is in its fourth year, with only very preliminary outcomes information now available (see Chapter 9 ). The training and technical assistance center funded by the EUDL program produces a variety of materials that highlight best practices, many of which were reviewed by the committee.

The committee also reviewed written materials submitted by numerous organizations and individuals and considered both written and oral information presented at a public meeting held on November 21, 2002, by a wide range of organizations and people (see Appendix C ). This input highlighted programs or approaches considered effective by diverse communities and provided insights into their attitudes and experiences. The judgments provided through this process regarding effectiveness of particular programs or interventions were primarily subjective or based on informal evaluations.

Industry representatives provided extensive materials that were reviewed by the committee on the multiple activities they fund to reduce underage drinking. Included were descriptive materials such as summaries, brochures, pamphlets, videos, and guidebooks; testimonials from commu-

nity representatives on the utility of specific activities, and an evaluation of Alcohol 101, an industry-funded college-based intervention (see Chapter 7 for further discussion of these activities).

The committee’s basic charge is to provide science-based recommendations about how best to prevent and reduce underage drinking. Based on its expertise, consideration of public input, and review of the available scientific literature, including the papers written for the committee, the committee identified eight categories of programs or interventions and presents the evidence for each in the relevant chapter:

media campaigns designed to discourage underage drinking directly, to affect the behavior of adults, and to build a broader public awareness of the nature and magnitude of the problem ( Chapter 6 for adult-oriented campaigns and Chapter 10 for youth-oriented campaigns);

measures to curtail or counteract activities by individuals or businesses, including alcohol marketing practices, that tend to encourage or facilitate underage drinking (Chapters 7 and 8 );

measures restricting youth access to alcohol in both commercial and noncommercial settings, together with programs enforcing these laws ( Chapter 9 );

measures to reduce alcohol-related social harms by enforcing compliance with underage drinking restrictions, such as zero tolerance laws and other programs to reduce alcohol-related traffic injuries and criminal behavior ( Chapter 9 );

educational activities undertaken by schools, colleges and universities, faith-based institutions, healthcare organizations, alcohol companies, parent associations, and other entities designed to discourage underage drinking ( Chapter 10 );

community-based initiatives designed to tailor comprehensive approaches to the specific underage drinking problems of local communities ( Chapter 11 );

screening, counseling, and treatment programs to assist underage drinkers who have developed alcohol problems ( Chapter 11 ); and

methods of increasing the price of alcohol to underage purchasers, including increases in excise taxes ( Chapter 12 ).

It is important to recognize that implementation of any national “strategy” will depend on the cooperative actions of thousands of organizations and millions of individuals who have their own ideas about what is likely to be effective and valuable. These organizations include agencies at all levels of government (federal, state, and local) with an interest in underage drinking (e.g., alcoholic beverage control commissions, schools, and agencies responsible for law enforcement, substance abuse prevention, social ser-

vices, and public health). It also includes all the companies and establishments involved in producing, distributing, and selling alcohol—including distillers, vintners, breweries, package stores, and bars—as well as the advertising agencies that advise companies about how to position their products in different segments of the markets they seek to reach. It includes entertainment companies and other organizations that shape popular culture and affect young people’s attitudes about alcohol. A key role in any national response to the problem is played by parents who set models of drinking behavior for their children and who can affect the conditions under which their children have access to alcohol products. Of course, youths themselves make important decisions—not only about their own drinking, but also about how they view the drinking of their friends and peers.

The scope of the current efforts of many national, state, local, and nongovernmental group initiatives to prevent underage drinking or the consequences of drinking, particularly drinking and driving, is impressive. These programs include educational interventions, media campaigns, and activities to support enforcement of minimum drinking age laws. Young people themselves have organized efforts to discourage drinking among their peers. While few of these activities have been evaluated in any formal way, a successful national strategy will require the continued involvement, wisdom, and experience of the range of people and organizations that have been committed to preventing and controlling underage drinking.

A CHALLENGING TASK

The committee was charged with “developing a cost-effective strategy for preventing and reducing underage drinking.” As we set about this important task, it soon became evident that preventing and reducing underage alcohol use poses unusual challenges. Four of those challenges are the pervasiveness of drinking in the United States, the need for a broad consensus for a national strategy, ambivalence about goals and means, and commercial factors.

Pervasiveness of Drinking

Alcohol is readily available to adults (those over 21) through a large number of outlets for on-premise or off-premise consumption. About half of U.S. adults currently drink alcohol; among drinkers , the mean number of drinking days per month in 1999 was approximately eight. 3

Notwithstanding the legal ban, alcohol is also readily available to underage drinkers. In recent surveys of high school students, 94.7 percent of twelfth graders and 67.9 percent of eighth graders reported that alcohol is “fairly” or “very” easy to get (Johnston et al., 2003). Purchase surveys reveal that from 30 to 70 percent of outlets may sell to underage buyers, depending in part on their geographic location (Forster et al., 1994, 1995; Preusser and Williams, 1992; Grube, 1997). Focus groups have also indicated that underage youths typically procure alcohol from commercial sources and adults or at parties where parents and other adults have left the youths unchaperoned (Jones-Webb et al., 1997; Wagenaar et al., 1993). Wagenaar et al. (1996) reported that 46 percent of ninth graders, 60 percent of twelfth graders, and 68 percent of 18- to 20-year-olds obtained alcohol from an adult on their last drinking occasion. Commercial outlets were the second most prevalent alcohol source for youths 18 to 20. For younger adolescents, the primary sources of alcohol are older siblings, friends and acquaintances, adults (through third-party transactions), and at parties (Harrison et al., 2000; Jones-Webb et al., 1997; Schwartz et al., 1998; Wagenaar et al., 1993). National surveys of college student drinking find that a large percentage of college youth report they do not have to pay anything for alcohol, presumably because they are at a party where someone else is supplying the alcohol (Wechsler et al., 2000).

American culture is also replete with messages touting the attractions of alcohol use, which often imply that drinking is acceptable even for people under 21. Recent content analyses of television showed that alcohol use was depicted, typically in a positive light, in more than 70 percent of episodes sampled from prime-time programs shown in 1999 (Christensen et al., 2000), and in more than 90 percent of the 200 most popular movie rentals for 1996-1997 (Roberts et al., 1999b). Roberts et al. (1999b) also found that 17 percent of 1,000 of the most popular songs in 1996-1997 across five genres of music that are popular with youth contained alcohol references, including almost one-half of the rap music recordings. Positive images are also disseminated by the alcohol industry, which spent $1.6 billion on advertising in 2001 and at least twice that amount in other promotional activity. Thus, overall, young people are exposed to a steady stream of images and lyrics presenting alcohol use in an attractive light.

Need for Consensus

An effective strategy to reduce a behavior as pervasive and widely facilitated as underage drinking will depend on a public consensus about both goals and means, which will require an unequivocal commitment from a broad array of public and private institutions. If the nation is to succeed in promoting abstention or reduced consumption by minors in a country

that has more than 120 million drinkers, the need to do so has to be understood and embraced by many people in a position to reduce drinking opportunities for minors. An effective strategy will depend on adoption of public policies by authoritative decision makers about how to use tax money and public authority—for example, whether to use federal dollars to fund a national media campaign, how to enforce existing state laws banning sales to underage drinkers, or how local school boards should discipline students who drink. The process of enacting such policies will require some degree of public consensus, but this is only the start.

Ultimately, the effectiveness of government policies will depend on how enthusiastically a great many public and private agencies join in the effort to implement them. If parents, animated by a national media campaign, join local police and school boards in concerted efforts to discourage underage drinking and if alcohol distributors join with regulatory agencies to find means to deny underage drinkers easy access to alcohol, then the impact of government policies will be increased. In short, a public consensus to deal determinedly and effectively with underage drinking is needed not only to generate support for adopting strong policies, but also to make them effective. Conversely, both enactment and implementation will be seriously impeded if the public is divided or ambivalent about the importance of reducing underage drinking.

It is here that the greatest challenge lies. In the nation’s diverse society, communities have differing beliefs and sensibilities about the consumption and social meaning of alcohol use in general, as well as about what should be expected and demanded of young people during the transition between childhood and adulthood. These differences contribute to varying beliefs, varying public policies, and varying individual practices regarding underage access to alcohol. Although the vast majority of families would agree that the nation as a whole has a powerful interest in reducing the negative consequences of underage drinking on society and on the youths themselves, individuals, families, groups, and communities all have different views on the wisdom and propriety of various approaches to the problem.

In this respect, surveys that show that certain steps by governments (e.g., increasing alcohol excise taxes or restricting advertising) are widely supported obscures disagreements about whether young people should be severely punished for using alcohol, whether parents should be punished for allowing parties with alcohol for youth in their homes, or whether the legal drinking age should be 21.

Ambivalence About Goals and Means

The problem of mustering a societal consensus to achieve an objective as subtle, complex, and contested as reducing underage drinking can be

seen most sharply when one compares underage drinking with illegal drug use and underage smoking. The goal of the nation’s policy toward illegal drugs and tobacco—abstention by everyone—is both unambiguous and widely, if not universally, embraced. Thus, the nation aims to discourage and suppress nonmedical use of marijuana, cocaine, and other controlled substances by everyone (whatever their age) through a comprehensive legal regime prohibiting the manufacture, distribution, and possession of these drugs for nonmedical purposes. Even though tobacco products, by contrast, are lawfully available to adults, the nation’s clearly expressed goal is to discourage tobacco use by everyone, by preventing initiation and promoting cessation. The messages to young people and adults in these two contexts are identical: indeed, because few people take up smoking as adults, the overall success of the nation’s anti-tobacco policy depends substantially on the success of its efforts to prevent initiation among young people.

The task of developing a strategy for preventing and reducing alcohol use among young people, in contrast, faces an uncertain policy goal. A strong cultural, political, economic, and institutional base supports certain forms of drinking in the society. Unlike the goals for illegal drugs and tobacco, the nation does not aim to discourage or eliminate alcohol consumption by adults. It is probably a fair characterization to say that the implicit aims of the nation’s current alcohol policy are to discourage excessive or irresponsible consumption that puts others at risk, while being tolerant of moderate consumption (at appropriate places and times) by adults (especially in light of the possible health benefits of moderate use for some populations over 40). For example, as long as others are not endangered or offended, attitudes toward intoxication (per se) vary according to religious beliefs and personal moral standards. In short, current alcohol policy rests on a collective judgment, rooted in the Prohibition experience, that the wisdom and propriety of alcohol use among adults should be left to the diverse moral judgments of the American people. This is not to say that everyone supports this stance of government neutrality. Many public health experts would like to take steps (short of prohibition) to suppress alcohol consumption as a way of reducing alcohol problems, and some conservative religious groups would take a more aggressive public stance against intoxication itself. However, the current stance of tempered neutrality seems to be widely accepted and therefore fairly stable.

In this policy context, the message to young people as well as adults about alcohol use is both subtle and confusing. The message to young people is “wait” or “abstain now,” rather than “abstain always,” as it is with tobacco and illegal drugs. Unlike the policies for those other products, the ban on underage alcohol use explicitly represents a youth-only rule, and its violation is often viewed as a rite of passage to adulthood. The problem

is exacerbated because the age of majority is higher for alcohol than it is for any other right or privilege defined by adulthood (e.g., voting, executing binding contracts). Explaining convincingly—to young people as well as adults—why alcohol use is permissible for 21-year-olds but not for anyone younger is a difficult but essential task for reducing or preventing underage drinking.

There is also confusion about whether messages to young people should emphasize abstention, perhaps drawing together alcohol, tobacco, and illegal drugs, or whether messages should focus on the dangers of intoxication and heavy drinking. Many people believe that abstention messages are more appropriate (and more likely to be effective) for younger teens than for older teens and college students.

This overall debate raises the same question posed by all wait rules: What is the age of demarcation between childhood and adulthood (see, generally, Zimring, 1982; Kett, 1977). The argument has been given a raw edge by the trend, in recent years, to curtail the jurisdiction of juvenile courts and to prescribe severe punishments, including the death penalty, for teenagers who commit crimes (Fagan and Zimring, 2000).

Commercial Factors

Alcohol is a $116 billion-per-year industry in the United States, catering to the tastes and needs of the more than 120 million Americans who drink. All states generate revenue from the sale of alcohol, either through excise taxes or product mark-ups, and 18 states participate in the alcohol market through retail and/or wholesale monopolies over distribution of certain alcoholic beverages. A strategy to suppress underage alcohol use must somehow be implemented in the very midst of a society replete with practices and messages promoting its use, and with a strong sector of deeply vested economic interests and the accompanying political and economic power. A significant level of underage use is inevitable under these circumstances—as an inevitable spillover effect, even if unintended by the industry—no matter what strategy is implemented. Foster et al. (2003) recently estimated that underage drinkers account for 19.7 percent of all drinks consumed and 19.4 percent of the revenues of the alcohol industry (about $22.5 billion). On the basis of the committee’s independent calculations, we conclude that youth consumption falls somewhere between 10 and 20 percent of all drinks and accounts for a somewhat lower, although still significant, percentage of total expenditures (see Chapter 2 ).

Although a similar challenge confronts tobacco control policy makers in the effort to prevent youthful use of tobacco products, the potency and impact of tobacco industry activity are gradually being lessened by the growing consensus that tobacco is a deadly and disapproved product, that

the industry has misled its customers for decades, and that aggressive regulation is needed to prevent young people from using tobacco and otherwise to protect the public health. It is generally believed that the tobacco industry has targeted young people to maintain demand for tobacco products as older consumers quit or die, notwithstanding the industry’s professed efforts, in the wake of the Master Settlement Agreement, to discourage underage use of their products. In short, public health officials and the major tobacco companies are not on the same side, and “big tobacco” is regarded as the enemy of the public’s health.

In contrast, the alcohol industry is diverse and uniformly acknowledges the dangers of underage drinking. Alcohol experts generally assume that the level of adult demand for alcohol products will not be substantially affected, over the long term, by reducing underage consumption—although getting young people to wait will obviously reduce the overall level of consumption. Thus, while the commercial interests of the alcohol industry are not perfectly aligned with the public health, they are not as antagonistic to the public health as the interests of the tobacco industry. In any case, a strategy for preventing and reducing underage drinking will have a much better chance for success if it attracts the active cooperation, and at least the acquiescence, of various segments of the alcohol industry.

The effectiveness of any policy focused explicitly on reducing underage drinking will be limited by the existence of a large legitimate practice of drinking and by the power of a large industry responding to legitimate consumer demand. When alcohol is available in many home liquor cabinets, the success of strategies to discourage young people from buying at package stores will be much different than in a world where relatively few parents have stocks of alcohol. The widespread legal use of alcohol in the society affects not only cultural and individual attitudes toward drinking, but also the extent to which any youth-oriented control regime can be effective in reducing opportunities for youths’ access to alcohol and drinking opportunities. One can establish a clear-cut boundary between acceptable drinking and unacceptable drinking at conceptual, policy, and legal levels, but it must be understood not only that different communities will construct that boundary differently as a matter of policy but also that the scope created for legal drinking has a profound, practical effect on the effectiveness of other policy instruments in discouraging unwanted, underage drinking.

In sum, the committee set about its task of developing a strategy for preventing and reducing underage drinking while being fully aware of the complexity of defining the public interest in this area and mindful of the severe constraints within which the strategy must be framed and implemented.

UNDERLYING ASSUMPTIONS

In conducting its work, the committee did not begin with a blank slate. Instead, we were asked to develop a national strategy given the basic framework of the nation’s current policy toward underage drinking. That policy aims to delay drinking by young people as long as possible and forbids lawful access to alcohol for people under 21.

Some people argue that the delay strategy is misguided and that the legal drinking age should be lower than 21 (typically 18). According to this view, allowing drinking at younger ages would mitigate youthful desire for alcohol as a “forbidden fruit”; would provide opportunities to “learn” to drink, thereby reducing harms; and would bring the age at which youth are allowed to drink into alignment with the age at which they can join the military, vote, and participate in other aspects of adult life. Whatever the merits of this view, the committee believes that Congress intended us to work within the framework of current law, anchored in the National Minimum Drinking Age Act of 1984, and that reconsideration of the 21-year-old drinking age, and of the premises on which it is predicated, is beyond our mandate. Moreover, as a practical matter, the current policy framework, though disputed by some, rests on a strong scientific foundation, is widely accepted, and is certain to be preserved for the foreseeable future.

Because the current policy framework provides the foundation for the committee’s work, and for the strategy recommended in this report, it is useful to summarize it here and to highlight its basic rationale.

Evolution of Current Policy

Until the last decades of the 19th century, society relied largely on nonlegal mechanisms of social control to constrain youthful drinking. However, in the wake of urbanization, immigration, and industrialization, alcohol came under tighter control, including bans against selling it to people under the legal age (Mosher et al., 2002). After the repeal of Prohibition in 1933, it became settled that decisions about alcohol control rested with the states, and the structure of modern alcohol regulation took shape.

Until 1970, the minimum drinking age in most states was 21. Between 1970 and 1976, 21 states reduced the minimum drinking age to 18, and another 8 states reduced it to 19 or 20 (usually as part of a more general statutory reform reducing the age of majority to 18) (Wagenaar, 1981). Proposals to restore a higher age were soon introduced, however, largely because alcohol-related automobile crashes had significantly increased among teenagers and young adults. Of the 29 states that lowered their drinking age, 24 raised the age again between 1976 and 1984. By that time, only three states allowed 18-year-olds to drink all types of alcoholic bever-

ages, while five others (including the District of Columbia) allowed 18-year-olds to drink beer and light wine while setting the age limit for distilled spirits and wine with high alcohol content at 21. Thirteen states set a uniform age of 19, and four others allowed 19-year-olds to drink beer and set the limit at 21 for other alcoholic beverages. Four states set the age at 20 for all alcohol, and the remaining 22 states set a uniform age of 21 (Bonnie, 1985).

In 1984 Congress enacted the National Minimum Drinking Age Act, as recommended by the Presidential Commission on Drunk Driving, using the threat of withholding 10 percent of federal highway funds to induce states to set the minimum drinking age at 21 for all alcoholic beverages. All states eventually complied and have a variety of mechanisms in place to enforce this restriction

The Goal of Delay

The explicit aim of existing policy is to delay underage alcohol use as long as possible and, even if use begins, to reduce its frequency and quantity as much as possible. Most people recognize that drinking itself is not the issue. Rather, the underlying challenge is protecting young people while they are growing up. Children and adolescents need to be protected in the first instance from the immediate harms that can occur when they are drinking. But they also need to be protected from the possibility that they will mortgage their own future prospects by initiating practices that could cause them permanent harm during a critical developmental period and that could lead to patterns of drinking that will worsen as they grow older.

The question is how best to go about that protective task. As indicated, some people argue that the most sensible approach is to permit drinking by young people (at least older teens) rather than trying to suppress it. In their view, a “wait” rule is not the best way to reduce the problems associated with underage drinking—at least in a society in which it is bound to occur with considerable frequency anyway. They would allow youthful drinking and focus on supervision rather than drinking per se (at least for older adolescents). In their view, a “learner’s permit” for drinking is preferable to a prohibition that drives underage drinking into the shadows and sacrifices the opportunity for supervision. A learner’s permit approach could be implemented in a variety of ways, such as by permitting youth access to only certain kinds of alcohol during the learning period (analogous to a graduated driving license) and by prescribing particular requirements for adult supervision.

If the drinking age were lowered, the critical question is whether the intensity of youthful drinking, and the accompanying problems, would decrease, as contended by proponents of the learner’s permit approach.

Admittedly, the current approach may create incentives for heavy unsupervised drinking on the occasions where alcohol is available. However, as discussed in Chapter 9 , young people who drink tend to do so heavily even in societies with a learner’s permit approach.

In addition, a substantial body of scientific evidence shows that raising the minimum drinking age reduced alcohol-related crashes and fatalities among young people (Cook and Tauchen, 1984; U.S. General Accounting Office, 1987; Wagenaar and Toomey, 2002) as well as deaths from suicide, homicide, and nonvehicle unintentional injuries (Jones et al., 1992; Parker and Rebhun, 1995). Increasing the minimum drinking age to 21 is credited with having saved 18,220 lives on the nation’s highways between 1975 and 1998 (National Highway Traffic Safety Administration, 1998). Voas, Tippetts, and Fell (1999), using data from all 50 states and the District of Columbia for 1982 through 1997, concluded that the enactment of the uniform 21-year-old minimum drinking age law was responsible for a 19 percent net decrease in fatal crashes involving young drivers who had been drinking, after controlling for driving exposure, beer consumption, enactment of zero tolerance laws, and other relevant changes in the laws during that time.

These findings reinforce the decision by Congress to act in 1984. In short, current national policy rests on the view, supported by substantial evidence, that delaying drinking reduces problem drinking and its consequences. The nation’s legislators and public health leaders have reached the nearly uniform judgment that the benefits of setting it at 21 far exceed the costs of doing so.

The Instrumental Role of the Law

Our earlier comparison among alcohol, tobacco, and illegal drugs raises another important preliminary question—about the role of the law in the prevention of underage drinking. It is possible to imagine an official policy aiming to delay and discourage underage drinking that does not rely in any way on the coercive authority of the state to implement this policy: instead of banning underage access to alcohol by law, society might rely entirely on parenting, education, community expectations, and other mechanisms of social control to suppress youthful drinking and, for older teens, to transmit the desired drinking-related norms and to encourage adults to refrain from supplying youths with alcohol or otherwise facilitating their drinking. Various forms of social disapproval, including social and economic sanctions (e.g., not patronizing stores or bars that serve minors) can be imagined.

In contrast, the United States has decided that there must be laws against supplying alcohol to young people and that it should also be illegal for young people to possess or use alcohol, at least in public. Thus, because

the law plays such a central role in the nation’s policy toward underage drinking, it is essential to clarify the functions that these laws should reasonably be expected to serve.

At the outset, it should be emphasized that a secular society seeks to delay underage drinking because it is dangerous to youths and others, not because it is inherently evil or wrong. The ban on underage drinking is an age-specific prohibition, implying that the aim is to delay alcohol use, not to condemn it or inoculate against it. For this reason, the prohibition is distinctly instrumental in nature and is not grounded in the moral disapproval that characterizes many legal prohibitions. To use a traditional legal classification, underage drinking is an example of a prohibition that is malum prohibitum (wrong because it is prohibited) rather than malum in se (wrong in itself). Punishment for an underage drinker, or even for an adult facilitator, is not an expression of public moral condemnation as is, for example, punishment for child sexual abuse or robbery.

Enforcement of prohibitions against immoral behavior serves the twin goals of reducing the harmful behavior and condemning and punishing the perpetrator for the transgression. The prohibition of underage drinking does not aim to serve this second (retributive) objective in any strong sense. Its aim is exclusively instrumental. Consequently, the measure of the prohibition’s effectiveness, and of the social policy it implements, has to be whether it reduces or avoids the dangerous consequences associated with youthful drinking.

Law is a blunt instrument. It is not self-executing, and it requires the affirmative support of a substantial proportion of the population and of those who are expected to enforce it. These characteristics of a law are particularly important for instrumental prohibitions, such as the ban against underage drinking, because the level of compliance will depend heavily on the willingness of a large number of individuals to adhere to the law simply because they accept its moral authority to command their obedience. That is, a legal norm of this kind, which affects so many people in so many everyday social and economic contexts, cannot be successfully implemented based on deterrence (the threat of punishment) alone. It must rely heavily on the “declarative” or “expressive” function of the law: by forbidding the conduct, it aims to shape people’s beliefs and attitudes about what is acceptable social behavior and thereby to draw on their disposition to obey.

Since the ultimate goal is to protect youths (and others within the zone of danger) from harmful consequences, one might wonder whether it is possible to implement an underage alcohol policy by focusing exclusively on the dangerous behavior rather than the drinking itself. In theory, it might be possible to define the prohibited conduct exclusively in relation to the magnitude of the risk: for example, “don’t drive a car after having had alcohol” or “don’t give alcohol to a youth who intends to drive a car or is

otherwise likely to behave dangerously.” However, any such dangerous drinking prohibitions are extremely difficult to implement successfully and would not exert a sufficient deterrent by themselves to prevent the risky behaviors associated with underage alcohol use. As the nation’s lawmakers have concluded, only a categorical prohibition of underage access to alcohol has any realistic chance of doing that, especially in a large industrial society in which the risks are pervasive (and magnified by developmental vulnerability) and where young people have large periods of time outside parental supervision and outside the reach of formal social controls. It is also relevant to note that at least one of the risks associated with underage drinking is intrinsic to the drinking itself—the permanent damage of alcohol consumption on the adolescent brain (see Chapter 3 ).

Given an age-based categorical prohibition aiming to serve exclusively instrumental aims, other policy judgments are needed regarding the scope of the restrictions, the severity of the prescribed sanctions, and the resources and tools that should be used to enforce the law. Banning commercial distribution of alcohol to underage persons is an essential element of the prohibition, but what about noncommercial distribution? Even if noncommercial distribution is banned, what about parental distribution to their own children in their own home? (Many states do not prohibit this distribution.) Is it also necessary to penalize young people who purchase or consume alcohol? Even in their own homes? What enforcement strategies should be used? And how severe should the sanctions be? These issues are addressed in Chapter 9 . The answers require careful assessment of the possible benefits (in reducing harms associated with underage drinking) and the costs of any particular strategy. The degree of public support and the difficulty of enforcement bear on both the potential effectiveness and on the possible costs.

A POPULATION PERSPECTIVE

In requesting the National Academies to develop a strategy for reducing and preventing underage drinking, Congress clearly anticipated that we would do so from a public health perspective, reviewing the etiology and consequences of alcohol use by the underage population and assessing the effectiveness of interventions that might be deployed to reduce the prevalence of drinking in this population, particularly the patterns of consumption most clearly associated with alcohol problems. (The outcomes of interest in assessing the effectiveness of interventions are discussed in Chapter 5 .) Recognizing that underage drinking substantially increases the short-term risks of death, injury, and other harms, as well as long-term risks of alcoholism and other dysfunction, a population-oriented strategy aims to lower the mean level of risk in the underage population in order “to shift

the whole distribution of exposure in a favorable direction,” typically by “altering some of society’s norms of behavior” (Rose, 1985, p. 371). Accordingly, we emphasize the population-oriented tools of primary prevention, rather than the individually oriented methods of secondary or tertiary prevention. Thus, identification and treatment of youths with drinking problems, or at high risk for developing such problems, and the challenge of instilling habits of responsible drinking as young people mature are addressed only incidentally in this report. These issues are important for improved policy and practice, but they are peripheral to our basic charge—delaying underage drinking and reducing its prevalence.

In developing a strategy to delay and reduce underage drinking, the committee has tried to understand the problem from two angles. First, we looked at the problem from the viewpoint of a young person deciding whether and under what circumstances to use alcohol. Our framework draws on the developing literature regarding adolescent decision making, especially in relation to health and risk behaviors. We pay particular attention to youthful decision-making abilities at various ages in the context of the changing social realities of teenage alcohol use. Some components of a comprehensive strategy must aim to help young people make the right decisions, depending on their age and developmental stage, taking account of the dangers of alcohol use at varying points in development.

It is not enough, however, to try to persuade young people to make the right choices. If the strategy relied exclusively on tools directed at changing the attitudes and behavior of underage youths, it would not have much chance of succeeding. To complement a youth-centered decision-making perspective, the committee also drew on the multidisciplinary perspective used by public policy analysts. This framework combines the disciplines of epidemiology, economics, health communications, law, and other social sciences to envision the array of policy instruments that can be brought to bear on the problem and to assess their probable effectiveness and costs, used alone or in combination.

OVERVIEW OF THE REPORT

Although the committee’s recommended strategy responds to a congressional request, the report is intended for a broad audience, including parents, businesses, alcohol companies, educators, state and local policy makers and legislators, healthcare producers and retailers, practitioners, and community organizers. Our work is presented in two parts.

Part I , Chapters 2 through 4 , provides important contextual information about underage drinking and its consequences and determinants. Chapter 2 discusses key definitions and presents pertinent demographic and epidemiological data regarding the scope of underage drinking and the

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

reduce opportunities for youth drinking. In Chapter 7 we discuss how the alcoholic beverage industry can become a partner in the overall effort by helping to establish and fund an independent nonprofit organization charged with reducing underage drinking and by exercising greater self-restraint in advertising and promotional activity. Our messages to the alcohol industry (and other industries that benefit from a large alcohol market) are clear: Your efforts to satisfy and expand the legitimate adult market for alcohol inevitably spill over to a large underage market. Even if you do not intend to stimulate or satisfy underage demand, you derive financial benefits from it. As a society, we cannot have a substantial impact on underage drinking without your active engagement in this effort. Chapter 8 issues a similar challenge to the entertainment media, urging more attentive self-regulation to reduce exposure of children and adolescents to lyrics and images that portray drinking in an attractive way. The committee believes that market incentives can be used to reward companies, including entertainment media, who take meaningful steps to help reduce underage drinking, and to punish companies that do not. Chapter 9 explores ways to reduce youth access to alcohol through both commercial and noncommercial channels.

Chapter 10 explains why the committee does not recommend a youth-oriented national media campaign at this time, preferring instead a cautious program of research and development. It also addresses educational efforts in schools, colleges, and other settings designed to persuade young people to choose not to drink and to reduce alcohol problems. The chapter also briefly discusses programs for assisting youths with alcohol problems. Chapter 11 reviews the potential advantages of mobilizing communities to implement locally specific efforts to reduce underage drinking.

Chapter 12 identifies several ways in which the federal and state governments can help implement the proposed strategy, including through increases in excise taxes. Regulatory action by the government is not at the center of the committee’s proposed strategy. The major priority, in the committee’s view, is to galvanize the necessary societal commitment to prevent and reduce underage drinking. Thus, the committee focuses its attention on community action, business responsibility, public-private partnerships, and all the other institutional expressions of a genuine social movement. In this context, government has a supportive, but nonetheless indispensable, role—to provide funding (possibly through increased excise taxes on alcohol) and technical support to strengthen and enforce access restrictions, to keep regulatory pressure on the alcohol industry to act responsibly, and to monitor the effectiveness of the overall strategy.

Alcohol use by young people is extremely dangerous - both to themselves and society at large. Underage alcohol use is associated with traffic fatalities, violence, unsafe sex, suicide, educational failure, and other problem behaviors that diminish the prospects of future success, as well as health risks – and the earlier teens start drinking, the greater the danger. Despite these serious concerns, the media continues to make drinking look attractive to youth, and it remains possible and even easy for teenagers to get access to alcohol.

Why is this dangerous behavior so pervasive? What can be done to prevent it? What will work and who is responsible for making sure it happens? Reducing Underage Drinking addresses these questions and proposes a new way to combat underage alcohol use. It explores the ways in which may different individuals and groups contribute to the problem and how they can be enlisted to prevent it. Reducing Underage Drinking will serve as both a game plan and a call to arms for anyone with an investment in youth health and safety.

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‘Total Disgrace’: Anger, Frustration as Mass Heating Failures Across Russia Leave Thousands in the Cold

P ODOLSK, Moscow region – Residents throughout Russia affected by unprecedented winter heating outages in recent days have expressed their frustration and urged local authorities to restore heating in their homes.

In Podolsk, a town some 30 kilometers south of the capital Moscow, at least 149,000 residents — nearly half of its population — were left without heating when a heating main burst at a nearby private ammunition plant.

“It’s a total disgrace. There is no heating and no hot water. We have to sleep in sleeping bags,” Yuri, a local resident, told The Moscow Times.

“I have no words to describe how bad the situation is," said Yuri, who declined to provide his surname. "We have had no heating for almost six days."

Heating issues have affected residents in the Moscow region, where temperatures have plunged to as low as minus 20 degrees Celsius in the past week, as well as people in the Far East Primorye region , the cities of Moscow and St. Petersburg , Penza , the southern Voronezh and Volgograd regions and more.

In the Tver region, a group of residents filmed an appeal to President Vladimir Putin, saying that they “are freezing from the cold” in the village of Novozavidovsky.

“We're literally being killed by the cold,” a woman in the video said, adding that they have been sending requests to local authorities since September after their houses were connected to a boiler room whose power was reportedly insufficient.

“This is some kind of torture and extermination of the population 100 kilometers from Moscow,” she added.

Residents of the Moscow region town of Elektrostal lit a fire in the street to draw the authorities’ attention to the heating problem.

“It’s impossible to stay in our houses. We're freezing!” a group of women in the video said.

Suffering from subzero temperatures, residents are placing the blame on local authorities and utility services for failing to take necessary precautions and not taking action to resolve the situation.

“We are sending complaints everywhere but no one listens to us. We have portable heaters working in every room, but the temperature inside is still 10 degrees Celsius,” Yelena from Podolsk said.

“There is a clinic and a hospital, as well as kindergartens, where there is no heating. And we have no answers, no assistance, no explanation,” Yelena added.

Podolsk authorities opened temporary heating centers and declared a state of emergency.

Local authorities linked the heating problems to the fact that the town is heated by a boiler plant owned by the Klimovsk Specialized Ammunition Plant, a private ammunition factory and one of the largest weapon cartridge production enterprises in the country.

“The facility is under tight security conditions, which limits our ability to oversee winter preparations,” the Moscow region’s Vice Governor Yevgeny Khromushin said last week. “We were unaware of the problem for nearly a day.”

An unidentified Moscow region official and two senior executives at the plant were arrested on suspicion of providing unsafe services, Russia’s Investigative Committee, which probes major crimes, said in a statement Tuesday.

Investigators said that Podolsk’s deputy mayor was accused of misusing authority by issuing a readiness certificate for the boiler house at the plant.

In the neighboring Tver region, the authorities opened a criminal case over the laundering of over 84 million rubles ($938,993) in heating bills paid by residents, the Astra Telegram channel reported this week, citing unidentified sources. According to investigators, the heads of the local water intake and boiler house misappropriated the heating payments for personal use.

Reacting to the heating failures, Putin on Tuesday asked Emergency Situations Minister Alexander Kurenkov to provide heat and electricity to the affected residents.

The outages appear to be the latest effect of several decades of crumbling infrastructure in Russia which have been linked to endemic corruption and mismanagement.

The overall decay of Russia's municipal infrastructure surpassed 70% in 2022, the pro-Kremlin newspaper Izvestia reported .

According to Sergei Pakhomov, head of the State Duma’s Construction, Housing and Utilities Committee, water pipes that were 90 years old or even older were still in use as recently as two years ago in some cases.

Housing, utilities and communal services are a common source of problems for Russians during the winter.

In St. Petersburg, residents regularly complain about extensive ice coverage on city streets and sidewalks, with many people ending up in the hospital over the years due to slipping and falling accidents.

In the Siberian republic of Khakassia, two villages were left without electricity last month due to apparent issues with outdated communication systems.

In the winter of 2020, five people in the Perm region were killed after a pipe burst.

When asked about the latest heating outages, Kremlin spokesman Dmitry Peskov acknowledged the problems and linked them to poor municipal infrastructure, saying that people “had to endure a lot of inconvenience in the cold and without electricity.”

"Despite all the titanic efforts to update all housing and communal services systems, there's still a certain part that remains considerably deteriorated. These programs will continue, but it is impossible to update all pipes and all housing and communal services systems in 10-15 years,” Peskov said.

As for now, residents affected by heating issues appear to lack optimism that the problems will be solved efficiently.

"It's been a week since we've had heating, and the temperature in my apartment is around 11 degrees Celsius,” Podolsk resident Lidiya told The Moscow Times.

“Unfortunately, no one knows when it will be repaired,” she added.

Underage Drinking Essay

Imagine killing your best friend. Imagine smashing him into a telephone pole, crushing his bones and organs and making him bleed to death. Imagine the pain and suffering he would go through. Imagine then going on trial for his death, facing his family and friends and the hateful stares as you walk in the courtroom. Imagine a verdict of guilty and being sentenced to thirty years in prison, thirty long years to sit alone and ponder how you could have been so stupid to kill someone you love. How would a night like this have begun? It probably began like the night of a typical American teenager. You would go pick up a carload of your closest friends and head to the party scene. You have a few drinks, maybe a beer or two …show more content…

Now imagine your freshman year of high school. You get invited to that huge senior party, so of course you go. There are a million different types of drinks there and you are offered a beer by some upperclassmen. You take it and chug it, trying to impress them. They offer you another and another, until finally you pass out. You are put, unconscious in a chair and the party goes on. The next morning someone tries to wake you, but you won't open your eyes. They call 911 and you are taken to the hospital. You are rushed into the ER and 10 minutes later are pronounced dead due to alcohol poisoning. This is how alcohol affects the teenagers of America today. It ruins lives and not only the lives of those who drink . It affects their friends and family. It even affects people they do not know, the thousands of people that are killed each year by drunk drivers. Many teens think they are invincible, that nothing will ever happen to them. They will never drink too much or be in an accident. But many lives are taken away because of underage drinking . These people are killed in an instant, squashed like bugs on a windshield. They never get to grow up and fulfill their dreams. They become that bum on the street, staggering around and yelling obscene comments. They are like the stray dog that never really finds a place in life. So what is the solution to this problem? Stop the underage drinking. Americans today need to wait until

Underage Drinking Essays

• 7 Works Cited

“Automobiles are not ferocious.... it is man who is to be feared,” as Robbins B. Stoeckel remarked, enumerates a simple, yet fundamental concept- a vehicle in itself is a relatively safe, that is, until you put a person behind the controls. Further adding to the danger is the ever prevalent risk of a fellow driver being impaired by the usage of alcohol; perhaps the only thing that may make such a situation even more difficult and dangerous is one who is under the legal alcohol drinking age. Fewer situations are more life threatening than when an underage driver has been illegally consuming alcohol, yet persists in the belief that he or she retains the ability to drive safely. Thoughts along this line are foolish at best and deadly at

The War Against Underage Drinking Essay

A serious epidemic is overtaking this country. Underage drinking is spreading like a virus. It is not just teenagers in college that are drinking; there are numerous kids in high school, middle school, and even elementary school! How have we let it get this far? There is no excuse to be oblivious anymore. Underage drinking is right in front of our faces. It is killing our children. The good news is that this is a problem that can be fixed. There is no way of completely eliminating underage drinking, but it can be greatly reduced. With efforts from the government, parents, and the media, we can diminish underage drinking a great deal. We need to start educating our children that alcohol is a dangerous drug. We need to start setting better

Underage Drinking Research Paper

According to (Edgar Snyder) underage drinkers are most likely to be in higher risk for suicide and homicides car crashes , and other injuries such as burn,falls, and drowning. Throughout the years there has been 1,580 deaths from car vehicles crashes, 1,269 from homicides, 245 from alcohol poisoning, falls, burns, drowning, and 492 from sucicide(Edgar Snyder). Without a doubt underage drinking is a big issue today being consumed today by nearly 11 million in the united states.

Under Age Drinking Essay

“’ Were seeing kids coming in with blood alcohol see levels in the mid-.3s, even .4, which four to five times the legal limit for driving. That’s the level at which 50% of people die,”’ says Dr. Mary Claire O’ Brien, an emergency medicine physician and associate professor at Wake Forest University School of Medicine. Underage drinking has become an issue in young teens. Teens are drinking large amounts of alcohol in short periods of time. The effects of alcohol in adolescents are much more life threating then an adult. In the article “The Underage Drinking “, Emily Listfield acknowledges that binge drinking is common in adolescents, it causes long term effects, physical injury and death.

The Effects of Underage Drinking Essay

Every year, thousands of minors die from the use of alcohol. Many young adults abuse the drinking age policy. It is put in effect for substantial reasons, which contribute in making the safest environment for all. Drinking underage is not only illegal, but also damages one’s health tremendously. Furthermore, drinking in large amounts is extremely dangerous and can cause detrimental things to occur. There have been numerous attempts to create a law to lower the drinking age, but none have gone through. In contrast to what some people may say, the drinking age should not be lowered because it would decrease maturity, promote poor behavior, and damage reputations.

Keeping the Minimum Legal Drinking Age

Furthermore, 21 year olds create less traffic accidents and fatalities than 18 year olds. For example, 21 years olds are more mature and responsible for their own actions than 18 years olds. As a fact, “Excessive alcohol consumption contributes to more than 4,700 deaths among underage youth, that is, persons less than 21 years of age, in the United States each year.” (CDC). Throughout each year, 21 year old drivers tend to be safer on the road than 18 year olds. To prove this, 18 year olds get carried away with drinking while driving and force them to cause trouble with others.

Underage Drinking Essay example

In the article Why the Drinking Age should be Lowered, Ruth Engs believes that the drinking age should be lowered to about 18 or 19. Engs is a Professor at Indiana University in the Health and Sciences department. In this article Engs makes a valid point in that “responsible drinking could be taught through role modeling and educational programs.” Engs also states facts about the different drinking ages in other countries, and that the United States has the highest legal purchasing age for alcoholic beverages in the world.

Keeping The Drinking Age Essay

Teenagers have proven themselves mature and able to handle responsibilities at an early age in the views of some people, but what is ignored is all the consequences of handling over these privileges earlier than necessary.

Essay On Minimum Drinking Age

Congrats, it is your eighteenth birthday! You are now legally mature enough to sign contracts, fly airplanes, accommodate in the military, accommodate on juries, vote, and hold public office. So why are you not able to sit down, relax, and enjoy a nice cold beer after a hard week at work and college? The minimum drinking age of 21 has not made underage drinking obsolete, it has instead inspired underage binge drinking into private and less controlled environments, leading to more health and life-endangering behavior by teenagers.

Breaking The Drinking Age Essay

According to “Underage drinking and the drinking age” at the age of 18 you are considered an adult, however the article suggests most 18 year olds are not mature enough to drink responsibly. Underage drinking is an immense problem that college students and young men and women face. Main states, that although students argue that when they turn 18 and are considered adults, they should be able to legally vote, risk their lives in the military, get married, and legally drink. Depending on where the soldier is stationed depends on whether they can drink or not. Soldiers stationed in the United States drink less because they are under less stress. Many soldiers and young adults use alcohol as a way to cope. Years ago alcohol Prohibition was used to stop the use of alcohol altogether. The availability that underage drinkers have to get their hands on alcohol is high (Main).

The Rising Concerns of Underage Drinking Essay

Alcohol is a drink that possesses a seducing effect to tempt many citizens. Adults worldwide consume countless cans of beers, wine, vodkas, and other alcohol beverages. However, its luring quality has been secretly shared to minors, resulting to a problem called Underage Drinking. This situation has existed for quite some time. In the past, underage drinking was considered a miniscule crime, and wasn’t strictly restrained or monitored. As we continued to remain oblivious, numbers of adolescent drinkers have gradually increased as they used the tolerant rules to their advantage. Now, the problem has become significantly noticeable, and we can no longer neglect it. High school, even middle school students have been found with

According to Carla, “on average 1,100 a year die from alcohol-related traffic crashes and another 300 die in non-traffic alcohol-related deaths”(Main). The U.S. Department of Health and Human Services reported that “relative to adults, young people who drink and drive have an increased risk of alcohol-related crashes because of their relative inexperience behind the wheel and their increased impairment from alcohol (U.S. Dept). It is an obvious argument that no matter what age an individual is, if they are under the influence of alcohol, they are at a higher risk of getting in a car crash but it is more likely for younger people because they do not have a high tolerance as olders do. Many individuals feel that they can overcome those obstacles when driving because they are not in the right state of mind which leads to future accidents or

Under The Drinking Age Essay

The magical number in America is eighteen. This is the age when you are now seen as an adult under the eyes of the law; meaning that you will now be able to: sign up for war and be sent to a different country, vote for the future president, enter clubs ,leave home, marry someone of your choice,choose your life long career and purchase cigarettes which are proven to harm your health. Along with many privileges, there are many expectations that an eighteen year old must meet ,which means responsibility. Now as an adult, they must make every choice in their life, but they are denied the right to legally purchase alcohol. Although, many argue that at the age of eighteen, you are still a “teenager” , above are all of the facts to prove contrary

Persuasive Essay On Underage Drinking

Almost everyone can agree that alcohol should not be given or allowed to children or young adults under a certain age. Alcohol is a substance that is very dangerous and if you used incorrectly or immaturely the consequences can be great danger to the users or the ones around them. The topic of lowering the drinking age has been in discussion for many decades. “Between 1970 and 1976, 29 states lowered their age for drinking alcohol. The results were catastrophic. Highway deaths among teenagers and young adults skyrocketed. Almost immediately, states began raising the minimum drinking age again.” “In 1984, Congress passed the Uniform Drinking Age Act, which required states to have a minimum drinking age of 21 for all types of alcohol

Drinking Age Essay

When teen-agers turn 18, they are told that they are adults and are sent into the world. They go to college, get a job, marry or join the military. They do grown-up things like vote, pay taxes and become parents. But they can't go to the pub for a beer because when it comes to liquor, they are still just kids. Where's the fairness in the 21-and-older drinking law?

Related Topics

• Alcoholic beverage
• Drinking culture
• Adolescence