Underage alcohol consumption is common in the United States and can have harmful outcomes. A comprehensive approach that includes effective policy strategies can prevent underage drinking and related harms.
Underage Drinking is Common
Underage drinking is a significant public health problem in the U.S. Excessive drinking is responsible for about 4,000 deaths and more than 220,000 years of potential life lost among people under age 21 each year. Underage drinking cost the U.S. $24 billion in 2010.
Alcohol is the most commonly used substance among young people in the U.S.
The 2021 Youth Risk Behavior Survey found that among high school students, during the past 30 days
- 23% drank alcohol.
- 11% binge drank.
- 5% of drivers drove after drinking alcohol.
- 14% rode with a driver who had been drinking alcohol.
Rates of current and binge drinking among high school students have generally been declining in recent decades. Although males historically had higher rates, in 2019 and 2021, female high school students were more likely to drink alcohol and binge drink than male high school students.
Underage Drinking is Dangerous
Youth who drink alcohol are more likely to experience
- School problems, such as higher rates of absences or lower grades.
- Social problems, such as fighting or lack of participation in youth activities.
- Legal problems, such as arrest for driving or physically hurting someone while drunk.
- Physical problems, such as hangovers or illnesses.
- Unwanted, unplanned, and unprotected sexual activity.
- Disruption of normal growth or sexual development.
- Physical and sexual violence.
- Increased risk of suicide and homicide.
- Alcohol-related motor vehicle crashes and other unintentional injuries, such as burns, falls, or drowning.
- Memory problems.
- Misuse of other substances.
- Changes in brain development that may have life-long effects.
- Alcohol poisoning.
In general, the risk of youth experiencing these problems is greater for those who binge drink than for those who do not binge drink.
Early initiation of drinking is associated with development of an alcohol use disorder later in life.
Underage Drinking is Associated with Adult Drinking
Studies show a relationship between underage drinking behaviors and the drinking behaviors of adult relatives, adults in the same household, and adults in the same community and state.
- There is a relationship between youth and adult drinking, including binge drinking, in states and communities. A 5% increase in binge drinking among adults in a community is associated with a 12% increase in the chance of underage drinking.
- Among adolescents whose peers drink alcohol, those whose parents binge drink are more likely to drink alcohol than those whose parents do not.
Underage Drinking is Preventable
State alcohol policy environments influence underage drinking, as well as excessive drinking among adults. Comprehensive approaches that include effective population-level policy strategies can reduce underage drinking. The Community Preventive Services Task Force recommends several effective strategies for preventing excessive drinking, including:
- Increasing alcohol taxes.
- Having commercial host (“dram shop”) liability laws.
- Regulating the number and concentration of alcohol outlets.
- Enforcing laws prohibiting alcohol sales to minors.
The Surgeon General’s Report on Alcohol, Drugs, and Health describes other strategies that can complement effective alcohol policies, such as national media campaigns targeting youth and adults, reducing youth exposure to alcohol advertising, and the development of comprehensive community-based programs.