Study: Underage, Heavy Drinkers Consume Half of U.S. Alcohol

Underage and adult excessive drinking account for half of the alcohol beverage industry's sales — $56.9 billion of the total $116.2 billion Americans spend on alcohol each year — according to an analysis by the National Center on Addiction and Substance Abuse (CASA) at Columbia University, published in the February 26th issue of the Journal of the American Medical Association (JAMA).

The study, which analyzed three national data sources, reports that excessive drinking by adults constitutes 30 percent of all alcohol consumed in the U.S., with underage drinking accounting for an additional 20 percent.

The findings are no surprise to alcohol producers, says George Hacker, director of the Center for Science in the Public Interest's Alcohol Policies Project. “They've known all along that underage and excessive drinking accounts for half of their market share,” he said, commenting on the new study. “Regardless of its public stance, the industry considers underage and excessive drinking to be profit centers that need nurturing, rather than problems that need solving.”

The public health community has also long known how the numbers add up, notes David Rosenbloom, director of Join Together, a project of the Boston University School of Public Health. “This isn't news to us or to the alcohol industry. We've known for some time that over half of the booze sold in this country is consumed by a small percentage of the drinking public,” he said.

Research has also consistently shown that an alarming portion of alcohol consumption and sales are linked with underage drinking, Rosenbloom said. He discounts alcohol industry criticism over the numbers as a smokescreen. “The bottom line is that whether the federal government's official estimate of 11.4 percent is right, or the JAMA study is right with its 20 percent figure, the beer industry remains the nation's largest seller of illegal drugs to the nation's youth,” he said.

A spokesperson for the Distilled Spirits Council blasted the study, accusing the researchers of manipulating the data and complaining that the authors defined excessive drinking as more than two daily drinks, Reuters reported February 25. CASA president Joseph Califano responded that the study was subjected to rigorous peer review, and said that the attack merely “reveals their interest in selling people more than two drinks a day.”

Public health experts concur that alcohol — in the form of underage and excessive drinking — is by far the nation's number one drug problem, inflicting massive economic, social and health burdens on society. But Califano, in a joint statement with former First Lady Betty Ford, charged that alcohol producers have long tried to play this down.

“The alcohol industry has consistently underestimated the cost of underage and excessive drinking in the U.S. and this JAMA study gives the American people the facts for the first time,” said Mrs. Ford and Califano. “This JAMA article makes clear that alcohol is a premier drug of abuse in America,” Califano added.

Rosenbloom thinks the study also provides an opportunity to focus on another important issue that alcohol producers and sellers frequently dodge. “The alcohol industry has a financial interest in not being straightforward about defining excessive drinking — answering the question, 'how much is too much?',” he said.

To help individuals answer this question for themselves, Join Together last year launched a confidential online screening tool, To date more than 90,000 visitors to the website have found out if their alcohol consumption is likely to be hazardous or harmful. Visitors also learn what moderate drinking really is — and isn't — and are advised that drinking no alcohol is the safest choice in some circumstances and for some people.

The alcohol industry must also communicate this information to consumers, say public health experts. Backed by statements from three former U.S. Surgeons General, the study authors call for industry-placed warnings about underage and adult excessive drinking, along with the definition of moderate drinking, in its advertising and on product labels. Moderate drinking is defined by the U.S. Departments of Health and Human Services and Agriculture as no more than one drink a day for women and two drinks a day for men.

The JAMA article estimates that, if these guidelines were followed by all Americans and underage drinking were curbed, alcohol industry sales — and profits — would be slashed in half.

The three Surgeons General, along with Mrs. Ford and Mr. Califano, also called for partnerships between the alcohol industry and the public health community (including an industry-endowed but completely independent foundation), public education campaigns, and the elimination of alcohol advertising and marketing targeted to youth.

Alcohol Taxes
Join Together's Rosenbloom says that successful efforts to reduce excessive adult drinking and underage consumption fall into three general categories.

“First, raise taxes. We know that raising the price of alcohol is effective in decreasing consumption, especially underage drinking.” Because excise taxes haven't kept up with inflation, it's actually much cheaper to buy alcohol now than it was 30 years ago, he notes. Alcohol taxes can have an additional benefit: funding prevention and treatment programs.

With states facing severe budget shortfalls, advocates for raising alcohol taxes, like the Center for Science in the Public Interest, think the timing is right for progress. Some states, like Alaska, have already done so; others are pondering the move, though not without vociferous opposition from the alcohol industry. The beer industry, for example, is aggressively lobbying Congress for a nationwide beer tax rollback.

Community Action
“Second, law enforcement and community-based action clearly matter,” continues Rosenbloom. Fighting Back projects in Vallejo and
Santa Barbara, California produced measurable decreases in impaired driving through strategies like engaging retailers in efforts to prevent underage sales, eliminating alcohol sales at gas stations, restricting alcohol advertising, and server training.

Other examples of successful state and local action abound. Milwaukee activists got alcohol billboards taken down in the highest-risk neighborhoods. Local groups in Washington State worked with the broadcasters' association to develop an alcohol counter-advertising program. A successful keg registration program in one Massachusetts community was adopted statewide.

At, the University of Minnesota provides details on a wide range of alcohol control policies proven to reduce underage drinking, numerous practical steps communities can take, and model laws and ordinances.

And Join Together's free publication Save Lives: Recommendations to Reduce Underage Access to Alcohol & Action Steps for your Community offers a wealth of resources, tips and real-world examples of community action.

Parental Involvement is Key
Third, and most important, according to Rosenbloom, is parental responsibility and involvement. “Significant amounts of underage drinking occur right in the home — the kids either raid the family liquor supply or the parents give consent and even actively cooperate,” he said.

Parents should monitor the supply of alcohol in the home, check in with the parents of their children's friends, and refuse to illegally supply alcohol to their teenagers' friends at parties in the home. A recent tragedy in Massachusetts, where a teen died in a single-car crash after leaving a party at such a home, painfully reinforces the importance of that last point, noted Rosenbloom.

“Because parents have the greatest influence on their children, the Surgeons General urge parents to use their influence to encourage their children to stay alcohol free,” said three former top U.S. health officials in their statement accompanying the JAMA article release.

In response to the JAMA article, Join Together Online has created a new Hot Issues page full of links to news, publications, advocacy groups and other resources for action:

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