TO PREVENT AND REDUCE UNDERAGE DRINKING, Lecture notes of Public Health

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To PrevenT and reduce

underage drinking

A Guide to Action

for Communities

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The Surgeon general’S call To acTion

What it Means to YOU

abouT ThiS

Surgeon general’S

call To acTion

The Surgeon General is the Nation’s top doctor and public health officer. The President of the United States appoints the Surgeon General to help protect and promote the health of the Nation.

The Surgeon General lets people across the country know the latest news on how to get healthy and stay healthy. He explains how to avoid illness and injury.

When a health topic needs special attention, the Surgeon General issues a national call to action to everyone in America. The Surgeon General’s Call to Action To Prevent and Reduce Underage Drinking explains why underage alcohol use is a major public health and safety issue. It asks everyone to take action.

About This Guide to Action for Communities

When it comes to tackling public health problems, knowledge is power. When people have the facts and the right tools, they can take action. This guide gives you the knowledge and tools you need to take action against underage drinking. It tells you about underage alcohol use and the damage it can do. And, it suggests ways you can end underage drinking in your community and across the country.

Suggested Citation: U.S. Department of Health and Human Services. The Surgeon General’s Call to Action To Prevent and Reduce Underage Drinking: A Guide to Action for Communities. U.S. Department of Health and Human Services, Office of the Surgeon General, 2007.

All material in this report is in the public domain and may be reproduced or copied without permission from the Federal government. Citation of the source is appreciated.

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As they grow older, the chance that young people will use alcohol grows. Approximately 10% of 12-year-olds say they have used alcohol at least once. By age 13 that number doubles. And by age 15, approximately 50% have had at least one drink. Alcohol dependence is a term doctors use when people have trouble controlling their drinking, and when their consumption of, or preoccupation with, alcohol occurs to the extent that it interferes with normal personal, family, social, or work life. Alcohol dependence rates are highest among young people between ages 18 and 20. And they’re not even old enough to drink legally.

Did You Know?

The greatest influence on young people’s decisions to begin drinking is the world they live in, which includes their families, friends, schools, the larger community, and society as a whole. Alcohol use by young people often is made possible by adults. After all, teens can’t legally get alcohol on their own.

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The FacTS

FAST

FACT

Most young people who start drinking before age 21 do so when they are about 13-14 years old. That’s why it’s important to start talking early and keep talking about underage drinking. And that’s why ALL adults working with young people should send the same message that underage drinking is not okay.



WhaT iS “a drink,”

anYWaY?

A drink can come in many forms. It can be a shot of hard liquor or a mixed drink containing vodka, rum, tequila, gin, scotch, etc. It can also be wine, a wine cooler, beer, or malt liquor. A standard drink is any drink that contains about 14 grams of pure alcohol (about 0.6 fluid ounces or 1.2 tablespoons). This is the amount of alcohol usually found in— One 12-ounce beer One 4- to 5-ounce glass of wine One 1.5-ounce shot of 80 proof liquor

What’s a Standard Drink?

But not all drinks are standard drinks. In fact, different drinks often have different amounts of alcohol. Mixed drinks may contain more than one shot of liquor, and different beers or wines may not have the same amount of alcohol in them, even when the drinks are the same size. For example, some beers and beer products, like “ice” beers, and malt liquors, and some wines, have more alcohol than others.

Remember, the legal drinking age is 21 and underage

drinking can be a threat to health and development.

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Many people don’t know that underage

alcohol use—

Is a major cause of death from injuries among young people. Each year, approximately 5,000 people under the age of 21 die as a result of underage drinking; this includes about 1,900 deaths from motor vehicle crashes, 1,600 as a result of homicides, 300 from suicide, as well as hundreds from other injuries such as falls, burns, and drownings. Increases the risk of carrying out, or being a victim of, a physical or sexual assault. Can affect the body in many ways. The effects of alcohol range from hangovers to death from alcohol poisoning. Can lead to other problems. These may include bad grades in school, run-ins with the law, and drug use. Affects how well a young person judges risk and makes sound decisions. For example, after drinking, a teen may see nothing wrong with driving a car or riding with a driver who has been drinking. Plays a role in risky sexual activity. This can increase the chance of teen pregnancy and sexually transmitted diseases (STDs), including HIV, the virus that causes AIDS. Can harm the growing brain, especially when teens drink a lot. Today we know that the brain continues to develop from birth through the teen years into the mid-20s.

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The reSulTS oF underage

drinking can be grave



The Teen Years Are a Time of Many Changes

Boys physically become young men and girls become young women. Young people move from elementary to middle to high school. Responsibilities increase. For example, teens learn to drive, may get a job, and have more chores, and more homework. Teens spend less time with their parents. They spend more time alone or with friends. They also like to stay up later and sleep in. Teens search for who they really are and who they want to be. They worry about friendships and social groups. And they have growing romantic and sexual interests. The desire for adventure, excitement, and action increases. That’s why many young people want to take more chances, try new things, and be more independent. These changes are important steps on the road to adult life. However, these changes also increase the chance that some young people may turn to alcohol.

Did You Know?

The different “worlds” teens live in can have a big effect on their drinking. Some young people are more involved with family than others. Others turn to their friends first. Still others turn to social groups like sports teams and clubs, faith-based groups or groups of like-minded youth. The Internet, media, music, and videos are also an important part of the world of most teens. All of these affect a young person’s choices about using alcohol.

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FAST

FACT

Factors in an adolescent’s environment affect both the appeal of alcohol and its availability. Among these factors are the social systems within which teens function and with which they interact. Examples of these social systems are parents, friends, family, schools, and the community. The media and the larger social culture, including how alcohol is marketed and portrayed, also contribute to alcohol’s appeal to young people.

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Underage drinking can affect anyone,

including people who don’t drink.

Underage alcohol use can lead to dangerous behavior, property damage, and violence. The results can be injury and even death for the drinker, and for other people nearby. About 45% of people who die in car crashes involving a drinking driver under age 21 are people other than the driver. The effects of underage drinking can be felt by everyone. That makes underage alcohol use everyone’s problem.

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FAST

FACT

Most 6-year-olds know that alcohol is only for adults. Between ages 9 and 13, youth begin to think that alcohol use is okay. That’s why it’s never too early to start talking with young people about the dangers of underage drinking.

Teens say that they rely on adults in their lives more than anyone else to help them make tough decisions and to provide good advice.

underage drinking iS

everYone’S ProbleM

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There is a role for everyone.

Everyone can work together to create a community where young people can grow up and feel good about themselves without drinking. Everyone in the community should deliver the message that underage drinking is not okay. The message should be the same whether youth hear it in school, at home, in places of worship, on the sports field, in youth programs, or in other places where young people gather. Families can help prevent underage drinking by staying involved in their children’s lives. It is important for families to pay attention to what’s happening with their teens. Young people can learn about the dangers of alcohol use. They can change how they and others think about drinking.

It’s time to change how we all think, talk, and act when it

comes to underage drinking. We need to stop accepting it

and to start discouraging it. It’s time to help young people

understand that it is not okay for them to drink alcohol.

The discussion needs to start long before youth start

thinking about drinking.

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ending underage drinking

iS everYone’S job



Change the teen scene.

Create friendly, alcohol-free places where teens can gather. Create programs, including volunteer work, where young people can grow, explore their options, succeed, and feel good about themselves without alcohol. Help teens realize that, like “doing drugs” or smoking, underage drinking is unhealthy and can drastically impact their lives. Let teens involved with underage drinking know that it’s okay to ask for and get help.

Take action.

Work to change community attitudes about underage drinking. Focus as much community attention on underage drinking as on tobacco and drug use. Work with State, Tribal, and local groups to reduce underage drinking. Make it easier for young people who are involved with or at risk for underage drinking to get help. Get the word out about underage drinking laws. The law that makes drinking under age 21 illegal is only one of them. Other laws forbid selling or giving alcohol to youth. Others make it against the law to drink and drive. Work to help ensure these laws are always enforced.

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The Surgeon General’s Call to Action To Prevent and Reduce Underage Drinking was written to improve public knowledge about underage drinking. It encourages action by people and groups nationwide. Each person in America has a role to play to help prevent and reduce underage alcohol use. This Call to Action helps adults across the country rethink underage drinking as we know it today. It provides the tools to get the word out in discussions around the dinner table, in school or campus-based programs, and in communities. It can also inform local, Tribal, State, and national programs and policies. Adults in the community are better able to help protect youth from the dangers of underage drinking when they know how underage drinking affects a young person’s body and brain. People and communities working with individual adolescents or groups of teens can help them choose not to drink. In addition, communities can help create a safer environment for adolescents when they work with parents, schools, health care professionals, local organizations, and policymakers to prevent and reduce underage drinking. This Call To Action is exactly that. It calls on every adult in the country to join with the Surgeon General in a national effort to address underage drinking early and often. Underage alcohol use is everyone’s problem—and its solutions are everyone’s responsibility.

References for “A Guide to Action for Communities” The data, facts, and suggestions presented here come primarily from the Surgeon General’s Call to Action To Prevent and Reduce Underage Drinking, cited on the inside front cover. Other sources of some data presented in this document include: Grant BF, Dawson DA, Stinson FS, Chou SP, Dufour MC, Pickering RP. The 12-month prevalence and trends in DSM-IV alcohol abuse and dependence: United States, 1991-1992 and 2001-2002. Drug and Alcohol Dependence 74:223-234, 2004. Johnston LD, O’Malley PM, Bachman JG, Schulenberg JE. (December 21, 2006). Teen drug use continues down in 2006, particularly among older teens; but use of prescription-type drugs remains high. University of Michigan News and Information Services: Ann Arbor, MI. [On-line]. Available: www.monitoringthefuture.org; accessed 01/03/07. Substance Abuse and Mental Health Services Administration. Results from the 2005 National Survey on Drug Use and Health: National Findings. Rockville (MD): U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration; 2006. Available: www.oas.samhsa.gov/nsduh.htm; accessed 01/03/07.

advancing The

call To acTion

Underage drinking is a public health and safety problem that results in serious personal, social, and economic consequences for adolescents, their families, communities, and the Nation as a whole. Your involvement can make a difference. Many free sources of information are available to help you take action to prevent and reduce underage drinking. Some of the materials can help better educate youth and their families, your colleagues and your community about the dangers of underage drinking and how to help stop it before it starts. To read the entire Surgeon General’s Call to Action To Prevent and Reduce Underage Drinking , be sure to log on to the Surgeon General’s Web site at www.surgeongeneral.gov. For more information about ways you can help to prevent and reduce underage drinking in your community, please check out www.stopalcoholabuse.gov , a comprehensive portal of Federal resources for information on underage drinking and ideas for combating the problem. Another excellent source of information is the Web site of the National Institute on Alcohol Abuse and Alcoholism at http://www.niaaa.nih.gov. General information about underage drinking, its effects on adolescents, families and communities, and what you can do to help stop underage drinking is available through the National Clearinghouse on Alcohol and Drug Information (NCADI), on the Internet at http://ncadi.samhsa.gov/ or by calling (800) 729-6686. The words and images in this Guide to Action were designed to reach a broad audience. Copies of this booklet and the S urgeon General’s Call to Action To Prevent and Reduce Underage Drinking can be downloaded from both of the Web sites noted. To order copies by mail, please contact the National Clearinghouse on Alcohol and Drug Information (NCADI) http://ncadi.samhsa.gov/ or by calling (800) 729-6686.

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