[Senate Hearing 108-374]
[From the U.S. Government Publishing Office]
S. Hrg. 108-374
UNDERAGE DRINKING: RESEARCH AND RECOMMENDATIONS
=======================================================================
HEARING
BEFORE THE
SUBCOMMITTEE ON SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES
OF THE
COMMITTEE ON HEALTH, EDUCATION,
LABOR, AND PENSIONS
UNITED STATES SENATE
ONE HUNDRED EIGHTH CONGRESS
FIRST SESSION
ON
EXAMINING UNDERAGE DRINKING, FOCUSING ON REDUCING AND PREVENTING
UNDERAGE DRINKING THROUGH A WIDE VARIETY OF GOVERNMENT AND PRIVATE
PROGRAMS FOR THE PURPOSE OF DEVELOPING A NATIONAL STRATEGY
__________
SEPTEMBER 30, 2003
__________
Printed for the use of the Committee on Health, Education, Labor, and
Pensions
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WASHINGTON : 2003
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COMMITTEE ON HEALTH, EDUCATION, LABOR, AND PENSIONS
JUDD GREGG, New Hampshire, Chairman
BILL FRIST, Tennessee EDWARD M. KENNEDY, Massachusetts
MICHAEL B. ENZI, Wyoming CHRISTOPHER J. DODD, Connecticut
LAMAR ALEXANDER, Tennessee TOM HARKIN, Iowa
CHRISTOPHER S. BOND, Missouri BARBARA A. MIKULSKI, Maryland
MIKE DeWINE, Ohio JAMES M. JEFFORDS (I), Vermont
PAT ROBERTS, Kansas JEFF BINGAMAN, New Mexico
JEFF SESSIONS, Alabama PATTY MURRAY, Washington
JOHN ENSIGN, Nevada JACK REED, Rhode Island
LINDSEY O. GRAHAM, South Carolina JOHN EDWARDS, North Carolina
JOHN W. WARNER, Virginia HILLARY RODHAM CLINTON, New York
Sharon R. Soderstrom, Staff Director
J. Michael Myers, Minority Staff Director and Chief Counsel
______
Subcommittee on Substance Abuse and Mental Health Services
MIKE DeWINE, Ohio, Chairman
MICHAEL B. ENZI, Wyoming EDWARD M. KENNEDY, Massachusetts
JEFF SESSIONS, Alabama JEFF BINGAMAN, New Mexico
JOHN ENSIGN, Nevada JACK REED, Rhode Island
Karla Carpenter, Staff Director
David Nexon, Minority Staff Director
(ii)
C O N T E N T S
__________
STATEMENTS
TUESDAY, SEPTEMBER 30, 2003
Page
DeWine, Hon. Mike, a U.S. Senator from the State of Ohio......... 1
Dodd, Hon. Christopher J., a U.S. Senator from the State of
Connecticut.................................................... 4
Bonnie, Richard J., Director, University of Virginia Institute of
Law, Psychology and Public Policy; Patricia Kempthorne, First
Lady of Idaho; Jeff G. Becker, President, Beer Institute; Wendy
J. Hamilton, National President, Mothers Against Drunk Driving;
and David DeAngelis, student, North Haven High School, North
Haven, CT...................................................... 7
ADDITIONAL MATERIAL
Statements, articles, publications, letters, etc.:
Richard J. Bonnie............................................ 34
Patricia J. Kempthorne....................................... 36
Jeff Becker.................................................. 38
Wendy J. Hamilton............................................ 41
David DeAngelis.............................................. 49
Catherine Bath............................................... 50
Brandon Busteed.............................................. 51
Peter H. Cressy.............................................. 54
George A. Hacker and Kimberly Miller......................... 55
Arthur T. Dean............................................... 60
Juanita D. Duggan............................................ 61
Governors Highway Safety Administration...................... 64
Ralph Hingson................................................ 67
Letter to Senator DeWine, dated Sept. 29, 2003, from Ed
Cloonan, President, Independent State Store Union.......... 81
Susan M. Molinari............................................ 81
National Association for Children of Alcoholics.............. 94
James A. O'Hara.............................................. 94
David K. Rehr................................................ 100
Response to Questions of Senator Reed from Richard Bonnie.... 168
Response to Questions of Senator Reed from Jeff Becker....... 169
Response to Questions of Senator Reed from Wendy Hamilton.... 170
(iii)
UNDERAGE DRINKING: RESEARCH AND RECOMMENDATIONS
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TUESDAY, SEPTEMBER 30, 2003
U.S. Senate,
Subcommittee on Substance Abuse and Mental Health
Services,
of the Committee on Health, Education, Labor, and Pensions,
Washington, DC.
The subcommittee met, pursuant to notice, at 10:12 a.m., in
room SD-430, Dirksen Senate Office Building, Senator DeWine
presiding.
Present: Senators DeWine and Dodd.
Opening Statement of Senator DeWine
Senator DeWine. Let me welcome all of you to the second
hearing of the Subcommittee on Substance Abuse and Mental
Health Services. I want to apologize for getting started a
little late. As you know, the Senate was voting and we can't
control the votes around here, at least I can't control the
votes.
We are here today to discuss a very serious issue affecting
the health and well-being of our Nation's young people, an
issue that really has been ignored I think for too long, an
issue that kills thousands of American teenagers. We are here
today to talk about underage drinking and the devastating
impact it is having on this country's young people.
We all know that underage drinking is a significant problem
for youth in this country. We have really known this for as
long time. We have known that underage drinking often
contributes to the four leading causes of death among 15 to 20
year olds, that 69 percent of our young people who died in
alcohol-related traffic fatalities in the year 2000 involved
young drinking drivers; that in 1999, nearly 40 percent of
people under age 21 who were victims of drownings, burns and
falls tested positive for alcohol.
We have known that alcohol has been reported to be involved
in 36 percent of homicides, 12 percent of male suicides, and
eight percent of female suicides involving people under the age
of 21. And we know that underage drinking accounts for 6\1/2\
times more deaths among young people than illicit drug use. Let
me repeat that: we know that underage drinking accounts for
6\1/2\ times more deaths among young people than illicit drug
use.
It should be of little surprise that the 2002 National
Survey on Drug Use and Health, administered by the Substance
Abuse and Mental Health Administration, found that 10.7 million
young people, age 12 to 20, reported drinking alcohol within a
30-day period. Of these, over 7 million were binge drinkers,
binge drinkers defined as those having five or more drinks on
the same occasion at least once in the past 30 days.
Furthermore, about three in ten of our Nation's high school
seniors are not only drinking alcohol, but also are doing so to
extreme excess. In fact, nearly one-third of 12th graders
reported binge drinking.
How did we get where we are today? How did our Nation reach
this point, a point where today 12 percent of eighth graders,
12 and 13 year olds, binge drink? Yes, 12 and 13 year olds.
Add to that the 22 percent of tenth graders, 14 and 15 year
olds, who binge drink. These statistics are frightening. Too
many American kids are drinking regularly, and they are
drinking in quantities that can be of great harm to them and to
society.
Another study reinforces this concern. Monitoring the
Future, 1975-2002, conducted by the National Institute of Drug
Abuse, found that experience with alcohol is ``almost
universal'' among secondary school and college students, in
spite of the fact that it is illegal for almost all of them to
buy alcohol.
This study found that 47 percent of 8th graders, 67 percent
of 10th graders, 78 percent of 12th graders, and 86 percent of
college students have tried alcohol. The National Institute of
Drug Abuse also reported that 95 percent of 12th graders
perceive alcohol as readily available to them.
Again we ask, how did we get here? As a Nation, we clearly
haven't done enough to address this problem. We haven't done
enough to acknowledge how prevalent and widespread teenage
drinking is in this country. We haven't done enough to admit
that it is a problem with very real and very devastating
consequences. We haven't done enough to help teach America's
children about the dangers of underage drinking.
We talk about drugs and the dangers of drug use, as well we
should. But the reality is that we, as a society,. have become
complacent about the problem of underage drinking. This simply
has to change. Our culture has to change. What we tolerate has
to change. What we accept has to change.
In reaction to the binge drinking and drug use problem on
college campuses in particular, I have worked with my friend
and colleague from Connecticut, Senator Lieberman, to write a
bill that would provide grants to States to create or enhance
collaborations with universities, campus communities, local
businesses and nonprofit organizations to change the culture of
abuse and underage use of alcohol that pervades so many of our
Nation's colleges and universities. This would be an important
step toward reducing underage drinking on our college campuses,
but as these statistics have clearly shown, we need to do more
and we need to do it as quickly as possible.
Kids are beginning to drink earlier and earlier, at younger
and younger ages, and they are doing so in ways that could
negatively affect their bodies, their minds, and certainly
their futures.
Our hearing today will include an examination of the
recently released study by the National Academy of Sciences.
That study is entitled, ``Reducing Underage Drinking: A
Collective Responsibility.'' We will examine this study and its
recommendations. The purpose of this study was to develop cost-
effective strategies for reducing and preventing underage
drinking, as directed by Congress in the fiscal year 2002
Labor-HHS Appropriations bill.
In this report, we find 10 main areas of recommendations.
Arguably, the most controversial of these recommendations is to
raise the State and Federal excise tax on alcohol. I must say
that that recommendation is not within the jurisdiction of this
subcommittee and, therefore, I do not expect that we will spend
a whole lot of time on this recommendation, at least today.
Instead, I would like to focus our time today on other
recommendations contained in the report, such as the creation
of an adult-oriented media campaign, improved limits on access
to alcohol for potential underage drinkers, community
interventions to prevent underage drinking, and the role of
media and entertainment in fostering underage drinking.
Before we continue, I want to thank my friend and colleague
from Connecticut, Senator Chris Dodd, for his dedication to
combating the problem of underage drinking. He certainly is a
tireless fighter for America's children and our young people.
He cares about children. He cares about their well-being.
I am privileged, I must say, to have worked with Chris on
many, many issues involving our young people, with the many
pieces of legislation that we have worked together on to
protect children and to promote their health and their welfare.
I know that combating teenage drinking has been and continues
to be very important to Senator Dodd, and I thank him for his
interest in this area and for being with us today.
I would like to thank our guests at this time. First let me
introduce Dr. Richard Bonnie from the University of Virginia
School of Law. Dr. Bonnie is the chairman of the Institute of
Medicine committee that created the NAS report and he has a
wealth of expertise in the fields of mental health and drug
law, public health law, and bioethics. He served as a member of
the National Advisory Council on Drug Abuse from 1975 to 1980,
and was elected to the Institute of Medicine in 1991.
Dr. Bonnie has previously chaired IOM committees on injury
prevention and control, opportunities in dug abuse research,
and has served as vice-chair of the IOM Committee on Preventing
Nicotine Dependence in Youths and Children.
Second, let me introduce Patricia Kempthorne, the First
Lady of Idaho. Mrs. Kempthorne has been tireless in the fight
against underage drinking. She joins 33 other governor's
spouses as a member of the Leadership to Keep Children Alcohol
Free, a coalition of Federal agencies and public and private
organizations dedicated to helping prevent alcohol use in
children from the ages of 9 to 15. This is the only national
effort to focus on this specific age group.
Third, let me introduce Mr. Jeffrey Becker, President of
the Beer Institute. Mr. Becker was appointed President of the
Beer Institute in 1999. He currently serves on the Board of
Directors of the National Commission Against Drunk Driving and
the Techniques of Effective Alcohol Management Coalition.
Before joining the Beer Institute, he was the National Director
of the Techniques of Alcohol Management for the National
Licensed Beverage Association.
Let me introduce also Wendy Hamilton, National President of
Mothers Against Drunk Driving. She began her career in activism
after three separate drunk driving crashes occurred within her
own family. In 1984, after having suffered through the death of
her sister and 22 month old nephew at the hands of a drunk
driver, she joined the local Indiana MADD chapter. In 1995, she
joined the MADD National Board of Directors, where she served
as a national vice president of victim issues, and then as
national vice president of field issues.
Let me at this point invite Senator Dodd to introduce his
witness.
Senator Dodd. Thank you very much, Mr. Chairman. We are
pleased to have David DeAngelis with us from North Haven, CT,
who has been a wonderful young advocate against teenage
drinking. David, we're truly honored to have you here from
North Haven as a representative of the younger people on the
panel. I am delighted to have David with us and truly honored
to have the entire panel.
I would ask to make opening comments at the appropriate
time.
Senator DeWine. Good.
As you all have seen, we are also honored, in addition to
Mrs. Kempthorne, to have other distinguished guests in the
front row. Let me introduce them.
First is Mrs. Bush, the First Lady of Florida, who is with
us today. In addition to Mrs. Bush, we have Vicky Cayetano, the
past First Lady of Hawaii; Theresa Racicot, the past First Lady
of Montana is here; Sherri Geringer, past First Lady of
Wyoming; Mary Herman, past First Lady of Maine; Sharon
Kitzhaber, former First Lady of Oregon; Michele Ridge, past
First Lady of Pennsylvania; Martha Sundquist, past First Lady
of Tennessee; and Sue Ann Thompson, past First Lady of
Wisconsin. We welcome all of you and thank you very much for
being here.
Senator Dodd. That's a potent group. [Laughter.]
Senator DeWine. It is a very potent group. We are delighted
to have all of you. It is so impressive that each one of you
would take your very, very valuable time to join us here today.
If the panel gets stumped, we will turn to you and bring you up
here for the tough questions, because I know you have all dealt
with a lot of tough issues in your States. So if Senator Dodd
or I get stumped, we will just turn to you, right, Chris?
Senator Dodd. Thank you, Mike. Absolutely.
Senator DeWine. Let me now turn to my colleague, Senator
Dodd, for his opening statement.
Opening Statement of Senator Dodd
Senator Dodd. Thank you very much, Mr. Chairman.
I think you should know, Mr. Chairman, that David is
missing a cross-country track meet today to be here with us.
Senator DeWine. He looks like a cross-country track star.
[Laughter.]
Senator Dodd. Thank you very much, Mr. Chairman, for
holding this hearing and for allowing me to come by. I'm not
the ranking member of this subcommittee--Senator Kennedy is--
but he very graciously allowed me to come in his place.
As Senator DeWine has already indicated, he and I have
worked on numerous issues involving children. Having chaired
the Subcommittee on Children and Families for many years and
having been the ranking Democrat on the committee, working with
Mike DeWine has been truly a pleasure on so many issues. I
won't belabor the point here, but there have been numerous
bills that have become law that Mike and I worked on together
and it's truly an honor, a privilege and a pleasure to be with
him again today on this subject matter, which is so vitally
important.
Let me thank as well the First Ladies, former and present,
for being here from your various States. It is tremendously
important that you lend your support to this effort because so
much of it needs to be done at the local and State level. I
think the Federal Government can play a very important role, a
cooperative role here, but ultimately, as we have all learned
over the years, it's what happens on the ground locally that
makes the difference.
Mrs. Kempthorne, it's a pleasure to have you here. We miss
Dirk as a great pal and friend, so it's a pleasure to have you
on the panel with us this morning.
Let me share a few opening thoughts, if I can, Mr.
Chairman, and then we'll get to our panel of witnesses.
As I pointed out, today the subcommittee is examining the
significant problems caused by the consumption of alcohol by
our Nation's young people. The word ``staggering'' doesn't
really do it justice, but the numbers are staggering in my view
of what is going on across the country with is problem.
Alcohol is the most commonly used drug--and I'm preaching
to the choir here; many of you here know this already--is the
most commonly used drug among America's youth. More young
people drink alcohol than smoke tobacco or use marijuana. In
1996, which is the last year we have any reliable numbers on in
this area--which also tells you something about the problem,
where we have to go back almost 7 years to get some decent
national numbers--in 1996 underage drinking caused around 3,500
deaths, more than 2 million injuries, 1,200 infants were born
with fetal alcohol syndrome, and more than 50,000 youths were
treated for alcohol dependency. That was 7 years ago.
In 2002, 20 percent of 8th graders had drunk alcohol in the
previous 30 days. Forty-nine percent of high school seniors are
drinkers, and 29 percent report having had five or more drinks
in a row in the past 2 weeks. The numbers, as I said at the
outset, are staggering.
Earlier this month, the Institute of Medicine released a
comprehensive study, ``Reducing Underage Drinking: A Collective
Responsibility'', that many of our witnesses this morning will
reference in their comments. The important report laid out the
national problems presented by the consumption of alcohol by
young people and established a multitiered national strategy to
reduce the great toll caused by underage drinking. The IOM
report estimates that the social costs associated with underage
drinking are close to $53 billion annually, including $19
billion from automobile accidents and $29 billion from
associated violent crime. Some people aren't impressed with the
numbers of the cost, and those numbers ought to get people's
attention.
While no one can argue with the tragic loss of life and the
significant financial costs associated with underage drinking,
too few of us think of the equally devastating loss of
potential that occurs when our children begin to drink.
Research indicates that children who begin drinking do so at
only 12 years of age. We also know that children that begin
drinking at such an early age develop a pre-disposition for
alcohol dependence later in life.
Such early experimentation can have devastating
consequences and derail a child's potential just as he or she
is starting out on the path to adulthood. The consumption of
alcohol by our children can literally rob them of their future.
As the IOM report makes perfectly clear, the problems
presented by underage drinking are wide-reaching. Mr. Chairman,
similarly, our responses to underage drinking must be equally
far-reaching, in my view. I think that all of us here this
morning would agree that the battle against underage drinking
begins first and foremost with parents and their children.
However, as the IOM report makes perfectly clear, parental
involvement makes up only one part of a needed national
strategy to combat underage drinking. In fact, the IOM calls
for ``a deep shared commitment'' among broad institutions and
constituencies to combat underage drinking; restraint in the
advertising of alcohol; a national media campaign to encourage
adult involvement in efforts to prevent underage drinking;
vigilance in preventing the sale of alcohol to minors; and most
controversial, high excise taxes on alcohol.
While I believe that all of these suggestions have
tremendous merit, I am most convinced that the effort to
prevent underage drinking requires a greatly strengthened
Federal commitment, as Government spending to prevent underage
drinking pales in comparison to that devoted to drug and
tobacco prevention efforts. I don't underestimate the
importance of our commitment in those areas, but when you
compare the numbers and compare the cost of life and the
devastation that occurs, then I think people may get the point
here. In fact, the Federal Government spent $1.8 billion in the
year 2000 to discourage illegal drug use, and only $71 million
to discourage youth drinking. Clearly, there needs to be a
greater sense of balance considering the loss of life and the
problems associated here.
So it is with great hope, Mr. Chairman, that I attend this
morning's hearing with your leadership and your commitment to
this issue. The toll that underage drinking extracts from our
Nation each and every year is a terrible one, a toll far too
great to continue or one to be ignored.
It is my hope that the discussion we have this morning will
provide us with a starting point from where we, as policy
makers, can make a difference. Public health advocates and
representatives from the industry can begin with us to outline
a national strategy to save our Nation's youth from the dangers
of underage drinking.
I want to thank all of our witnesses today, as well as you
did, Mr. Chairman, for being here to share their testimony with
us. I look forward to hearing from them.
Senator DeWine. Senator Dodd, thank you very much.
Dr. Bonnie, why don't we start with you. What we will do is
have a five-minute rule, if you could just kind of summarize
your testimony. We have the written testimony from all of you.
If you can summarize your testimony in five minutes, that will
give us plenty of time to have questions.
STATEMENTS OF RICHARD J. BONNIE, DIRECTOR, UNIVERSITY OF
VIRGINIA INSTITUTE OF LAW, PSYCHOLOGY AND PUBLIC POLICY;
PATRICIA KEMPTHORNE, FIRST LADY OF IDAHO; JEFF G. BECKER,
PRESIDENT, BEER INSTITUTE; WENDY J. HAMILTON, NATIONAL
PRESIDENT, MOTHERS AGAINST DRUNK DRIVING; AND DAVID DeANGELIS,
STUDENT, NORTH HAVEN HIGH SCHOOL, NORTH HAVEN, CT
Mr. Bonnie. Thank you, Mr. Chairman, and Senator Dodd.
As you mentioned, my name is Richard Bonnie and I'm the
John Battle professor of law and Director of the Institute of
Law, Psychiatry, and Public Policy at the University of
Virginia. I did serve as chair of the Committee on Developing a
Strategy to Reduce and Prevent Underage Drinking.
As the chair mentioned, the study was conducted at the
request of the Congress, and we did conduct an intensive study
that involved many components and many efforts to gather
information.
The starting point for our report I want to emphasize is
the current national policy that sets 21 as the minimum
drinking age.
Alcohol use by young people is an endemic problem that is
not likely to improve, in the committee's judgment, in the
absence of significant new interventions. As Senator Dodd
mentioned, many more of the Nation's youth drink than smoke
cigarettes or use other drugs, and young people tend to drink
more heavily than adults, exacerbating the dangers to
themselves and to people around them.
As noted both by Senator DeWine and Senator Dodd, the
prevalence, frequency and intensity of underage drinking is
disturbingly high, and I won't go over the numbers that each of
you has mentioned. The social cost of underage drinking is
enormous and far exceeds the social cost of illegal drug use
and other problem behaviors.
Now, although the public is generally aware of the problems
associated with underage drinking, the Nation's social response
has not been commensurate with the magnitude and seriousness of
this problem. The disparity is evident not only in the fact, as
Senator Dodd mentioned, that the Federal Government spends 25
times more on the prevention of illicit drug use by young
people than on the prevention of underage drinking, but also in
the lack of sustained and comprehensive grassroots efforts to
address the problem in most communities.
Some people think that the key to reducing underage
drinking lies in finding just the right messages to send to
young people to instill negative beliefs and attitudes toward
alcohol use. Others tend to focus on changing the marketing
practices of the alcohol industry in order to reduce young
people's exposure to messages designed to promote drinking.
However, in the committee's view, the problem is much more
complicated than either of these positions would suggest
because alcohol use is deeply embedded in the economic and
cultural fabric of life in the United States. Annual revenues
of the alcohol industry amount to $116 billion.
The challenge then is how to reduce underage drinking in a
context where adult drinking is widespread and commonly
accepted and where billions of gallons of alcohol are in the
stream of commerce. We believe that this will require a broad,
multifaceted effort.
The primary goal of the recommended strategy is to create
and sustain a broad and strong societal commitment to reduce
underage drinking. All of us, acting in concert, including
parents and other adults, alcohol producers, wholesalers and
retail outlets, the entertainment media and community groups
must take the necessary steps to reduce the availability of
alcohol to underage drinkers, to reduce the attractiveness of
alcohol to young people, and to reduce opportunities for
youthful drinking. Underage drinking prevention is everybody's
business.
The report emphasizes that adults must be the primary
targets of this national campaign to reduce underage drinking.
Most adults express concern about underage drinking and voice
support for public policies to curb it. Yet, behind this
concern lies a paradox. Youth often get their alcohol from
adults, and many parents downplay the extent of the problem, or
are unaware of their own kids drinking habits. Thirty percent
of parents whose kids reported drinking heavily within the last
30 days think their kids do not at all.
The sad truth is that many adults facilitate and condone
underage drinking. We need to change the behavior of well-
meaning adults in communities all over the Nation, including
people who are holding drinking parties for their kids in their
homes, in violation of the law, thinking that they are doing
the right thing.
As the centerpiece of the committee's adult-oriented
strategy, our report calls on the Federal Government to fund
and actively support the development of a national media
campaign designed to create a broad societal commitment to
reduce underage drinking, to decrease adult conduct that tends
to facilitate underage drinking, and to encourage parents and
other adults to take specific steps in their own households,
neighborhoods and businesses to discourage underage drinking.
The comprehensive strategy we suggest also includes a
multipronged plan for boosting compliance with the laws that
prohibit selling or providing alcohol to young people under the
legal drinking age of 21. Efforts to increase compliance need
to focus both on retail outlets and on the social channels
through which underage drinkers obtain their alcohol.
The committee also supports specific interventions and
education programs that are aimed at young people, as long as
these programs have been evaluated and found to be effective.
That goes for publicly-supported programs as well as privately-
supported ones.
Community leaders need to mobilize the energy, resources
and attention of local organizations and businesses to develop
and implement programs for preventing and reducing underage
drinking. These efforts should be tailored to specific
circumstances of the problem in their communities. The Federal
Government, as well as public and private organizations, should
encourage and help pay for relevant community initiatives that
have been shown to work.
The alcohol industry also has a vitally important role to
play in the strategy we have proposed. The committee
acknowledges to industry's declared commitment to the goal of
reducing underage drinking and its willingness to be part of
the solution. We believe there is much common ground, and that
opportunities for cooperation are now being overlooked.
Specifically, we urge the alcohol industry to join with
public and private entities to create and fund an independent,
nonprofit foundation that focuses solely on designing,
evaluating, and implementing evidence-based programs for
preventing and reducing underage drinking. Although the
industry currently invests in programs that were set up with
this goal, the results of these programs have rarely been
scientifically evaluated, and the overall level of industry
investment is modest in relation to the revenues that are
generated by the underage market. We think it is reasonable to
expect the industry to do more than it is now doing, and to
join with others to form a genuine national partnership to
reduce underage drinking.
We also urge greater self-restraint in alcohol advertising.
We recognize, of course, that advertising is a particularly
sensitive issue and that the industry has recently taken
important steps forward.
The FTC recently announced that the beer and distilled
spirits trade associations have joined the wine industry to
increase the threshold to 70 percent for the minimum proportion
of adults in the viewing audience. This is a step in the right
direction, but the committee believes that the industry should
continue to reduce underage exposure and should refrain from
marketing practices that have particular appeal to young
people, regardless of whether they are intentionally targeted
at young audiences.
Companies and trade associations in the entertainment
sector also have a responsibility to join in the collective
effort to reduce underage drinking----
Senator DeWine. Could you please wrap it up?
Mr. Bonnie. --and exercise greater restraint in
disseminating images and lyrics that promote or glorify alcohol
use in venues with significant underage audiences.
The Federal Government should periodically monitor these
practices and take a number of other steps that are mentioned
in the report, and which I hope we will have a chance to
discuss later.
Let me just mention, if I might, Senator, just a couple of
points, again about the controversial feature of the
recommendations that we made.
To help pay for the proposed public programs and to help
reduce underage consumption, Congress and State legislatures
should raise excise tax rates on alcohol, especially on beer,
which is the alcoholic beverage that young people drink most
often. Alcohol is much cheaper today, after adjusting for
inflation, than it was 30 or 40 years ago. Higher tax rates
should be tied to the Consumer Price Index to keep pace with
inflation. Research indicates that changes in these tax rates
can decrease the prevalence and harmful effects of drinking
among youths, who tend to have limited discretionary income and
are especially sensitive to price.
In summary, we have proposed a comprehensive strategy that,
taken as a whole, would foster as deep, unequivocal societal
commitment to curtail underage drinking. As a national
community, we need to focus our attention on this serious
problem and accept a collective responsibility to address it.
This is an admittedly difficult challenge, but the committee
believes that our country can do more than it is now doing. The
Nation needs to develop and implement effective ways to protect
young people from the dangers of early drinking while
respecting the interests of responsible adult consumers of
alcohol. The committee's report attempts to strike the right
balance.
Thank you for your interest and the opportunity to testify
to the subcommittee.
[The prepared statement of Mr. Bonnie may be found in
additional material.]
Senator DeWine. Mrs. Kempthorne. Mrs. Kempthorne. Thank
you, Mr. Chairman, Senator Dodd. The Governor does send his
best wishes to you, too.
As First Lady of Idaho, I thank you for this invitation to
speak here today on behalf of 34 current governor spouses and
11 emeritus members of Leadership to Keep Children Alcohol
Free. I would like to acknowledge again myself the commitment
shown by our membership by being here today in support of this
issue.
We are a nonpartisan group, devoted to increasing public
awareness, engaging policy makers, and mobilizing action to
stop childhood drinking. Our specific focus is the 9 to 15 year
old age group. The Leadership to Keep Children Alcohol Free was
established to make childhood drinking prevention a national
health priority. We are here today to emphasize for the
committee the immediate and far-reaching consequences of
childhood drinking and also to offer our recommendations for
action.
On a personal note, as an individual, as a parent, as a
community encourager, a proponent for the health and well-being
of our Nation's children, I would like to thank you and
acknowledge the need for your leadership in addressing this
issue.
During most of my childhood, my father worked for a
distributor of wine and distilled spirits. It was very clear to
me at the time that alcohol was not meant for me as a child.
Growing up, I learned to respect alcohol as an adult beverage,
but also saw some of the effects of the abuse of alcohol.
Witnessing the hurt and confusion caused by the abuse of
alcohol was instructive in helping me make choices about how
much alcohol I consumed. I do not believe that message is clear
in our society today.
So while it is unsettling to think that we have to consider
elementary students when we think about drinking prevention, we
do. The environment surrounding our children often contributes
to their attitudes and expectations about alcohol. Making
healthy life choices starts earlier than when we were children.
Frightening but true, 29 percent of students report they
first drank alcohol--and that's more than a few sips--before
the age of 13. By the 8th grade, more than 12 percent of 13 to
14 year olds surveyed reported having had five or more drinks
in a row, or binge drinking, within the past 2 weeks. They are
drinking with the goal of getting drunk.
Children are our top priority. We expend tremendous energy
ensuring that they are vaccinated, use infant car seats, have
access to educational opportunities and health care. Yet there
is a serious disconnect when it comes to childhood drinking.
Research documents that more than 40 percent of the
children who begin drinking before the age of 15 will develop
alcohol abuse or dependence at some time in their lives. The
adolescent brain is still a work in progress and, therefore,
vulnerable. Science tells us that children who engage in heavy
drinking before the age of 15 show noticeable changes in the
brain, develop fewer learning strategies, and remember less
than nondrinkers.
While parents certainly bear responsibility for their own
children, families do not live in a vacuum. Our homes are not
bunkers from reality. Parental guidance is constantly
challenged by external influences. We are not here to place
blame, but to address a serious public health issue that is
affecting a significant number of our Nation's children. The
responsibility for solving this problem rests with all of us,
including individuals, communities, policy makers and the
industry.
The National Academies of Science and the Institute of
Medicine have identified opportunities for all of us to play a
role in tackling the problem of childhood drinking. We are all
stakeholders in the future of our Nation's children. We need to
be motivated by what is in the best interests of our children.
Cooperation and coalitions, not confrontations, will move us
forward in our common interests of making sure the children of
this Nation are healthy.
On behalf of the Leadership to Keep Children Alcohol Free,
and speaking as a parent, I would respectfully offer four
recommendations for action:
First, please do not let this be the only hearing on this
critical public health issue. Let this ignite a series of
hearings leading to significant deliberations and proposals.
Second, we request that the subcommittee ask the Surgeon
General to issue an independent ``Call to Action on Childhood
Drinking''.
Third, we request that national surveys begin collect data
on alcohol use and attitudes, including brands, that include
children as young as age 9.
Finally, since alcohol is the number one illegal drug when
used by our youth, we urge the subcommittee to support
increased funding for research, prevention and treatment. It is
time to increase the Nation's investment on this issue and to
bring it in line with what is spent on illicit drugs and
tobacco.
Each of us can make a difference to ensure that our
children have a strong foundation for life. Please recognize
this is a serious problem. Our children are drinking alcohol at
a younger and younger age, and that should be a concern for all
of us.
Thank you very much.
[The prepared statement of Mrs. Kempthorne may be found in
additional material.]
Senator DeWine. Mr. Becker.
Mr. Becker. Good morning, Mr. Chairman, and Senator Dodd.
My name is Jeff Becker and I'm the President of the Beer
Institute, the national trade association of America's brewers.
I am pleased to be here to represent the almost 900,000 men and
women employed by our industry.
Our industry has a long and proud tradition of giving back
to the communities where we live and do business, and we share
the commitment of the members of this subcommittee in
addressing illegal underage drinking.
To that point, I want to specifically acknowledge the
important role of community-based beer wholesalers. Beer
wholesalers play a critical role by giving back to their
communities through charitable contributions, implementing
responsibility programs, and importantly, as employers. We
share the same concern that all parents do about the safety of
our children because we are parents, too. We do not want the
business of young people below the legal purchase age.
Let me first address the facts on underage drinking.
According to a recent study by the Department of Health and
Human Services, 82 percent of today's adolescents do not drink.
Other recent Government studies show that teen drinking has
been on the decline. The Department of Transportation reports a
one-third reduction in fatalities among drivers 16 to 20
between 1990 and today.
While many factors explain this success, a critical reason
is greater parental involvement. Brewers have long advocated
and sponsored programs to help parents prevent underage
drinking among teens and college-bound youth. By acknowledging
the important decisions involved with underage drinking and
encouraging their children to respect themselves and the law,
parents have made an enormous difference.
To help parents, we have distributed free of charge more
than five million copies of materials in five different
languages, with useful information to explain why drinking is
inappropriate for youth.
As stated in the Federal Trade Commission report earlier
this month, retailers also play a vital role in stopping
underage drinking by following their State laws and checking
and verifying IDs. Brewers have helped here, too. Our members
have sponsored seller and server training programs for over two
decades. We have provided materials in English, Spanish, Korean
and Vietnamese to teach retailers how to properly check and
spot fake IDs.
In addition, brewers have sponsored programs on college
campuses and have supported research and programs, collectively
known as ``social norms''. These programs are a positive
approach that reminds college students that the large majority
of their peers make healthy and responsible decisions about
drinking.
Since our industry's advertising activities have recently
been the subject of congressional interest, I would like to
briefly touch on some other developments that underscore
brewers' commitment to marking and selling our products to
adults.
Over the last 6 years, the Federal Trade Commission has
conducted four comprehensive reviews of our industry's
advertising practices. The 2003 FTC report unequivocally stated
that beer industry members do not target youth. The FTC report
also discussed a number of changes in our industry advertising
code which was first adopted in 1943. The code has served as
the foundation for our long history of responsible and vigorous
self-regulation of advertising and marketing practices. In
fact, we recently changed our code of advertising to
incorporate some of the best practices of our member companies
and to address several FTC recommendations.
I am pleased to inform you that our members have revised
the standard for advertising placements in television, radio
and magazines. The revised code now requires placement where
the proportion of audience age 21 and older is expected to be
70 percent or higher, which reflects the percentage of adults
in the U.S. population.
We do have some fundamental differences with the National
Academy's recommendations and the process used to develop them.
We believe the key to further progress in reducing underage
drinking lies in family and community-based efforts. We are
disappointed that the National Academy's panel ignored the
clear direction of Congress to evaluate existing Federal,
State, and nongovernmental programs. Unfortunately, the panel
focused heavily on costly and experimental government
solutions. The report does not provide the kind of guidance
Congress sought to determine policy and funding priorities to
further reduce illegal underage access and consumption.
The Academy did recommend to increase excise taxes, and
even though that is not part of the discussion today, it should
come as no surprise that the beer industry opposes such a
measure. We oppose higher taxes because they are not an
effective deterrent to underage drinking. The National
Institute on Alcohol Abuse and Alcoholism's special report to
Congress showed that their research indicates that teens are
not affected by higher taxes. It also exposes methodological
flaws in the research that the Academies use to support their
recommendation.
In closing, I would first like to leave you with this fact.
Brewers fully recognize that underage drinking is a problem
that our society must tackle. We want to be a meaningful part
of the solution to this issue, and by focusing our collective
resources on proven, targeted and effective approaches, we can
make a difference.
As a father of two children, I share the committee's
concern just like every other parent out there, and I very much
appreciate the opportunity to be with you today to discuss
these important issues.
Thank you.
[The prepared statement of Mr. Becker may be found in
additional material.]
Senator DeWine. Mrs. Hamilton.
Mrs. Hamilton. Thank you, Senator.
My name is Wendy Hamilton, National President of Mothers
Against Drunk Driving. I am delighted to be here today to
discuss this important issue.
MADD's mission is to stop drunk driving, support the
victims of this violent crime, and prevent underage drinking. I
would like to thank Chairman DeWine and Senator Dodd for
holding this hearing and for their commitment to protecting
America's youth. MADD looks forward to working with this
committee, the Congress, and with prevention partners like the
Centers for Science in the Public Interest, the Center for
Alcohol Marketing and Youth, and the American Medical
Association to save lives.
There are 10.1 million underage drinkers in this Nation.
The proportion of high school seniors who drink and binge drink
has not changed since 1993. There has been no progress in the
last decade to reduce underage drinking.
A collective memory that we all share are images from a
recent touch football game between suburban Chicago high school
girls that turned into a brutal hazing incident, resulting in
the hospitalization of five students. Younger girls were beaten
and splattered with mud, paint and feces while 100 students and
adult onlookers cheered while waving cups of beer. Sixteen and
17 year old girls were held upside down over a keg of beer
while drinking from the tap. School officials cited alcohol as
a major factor in the violence and police charged two parents
with providing three kegs of beer to minors.
That incident could have occurred in almost any town in
America. Today, teens have easy access to alcohol. Underage
drinking laws are not well enforced, and parents and
communities often look the other way, in many cases even
providing the beer.
There is no such thing as responsible underage drinking.
Young drivers make up seven percent of the driving population,
yet constitute 13 percent of alcohol-involved drivers in fatal
crashes. In the past year, youth drove 11 million times after
drinking, and 40 percent of those who drove after drinking had
passengers. Young drivers are putting themselves and others at
risk.
Nearly 40 percent of youth under age 21 who died from
drowning, burns and fatal falls tested positive for alcohol.
Youth alcohol use is associated with violence and suicidal
behavior. In addition to the human costs, this economic cost to
society is staggering. Conservatively, underage drinking costs
this Nation $53 billion each year. The NAS report provides a
monumental opportunity to stem the Nation's number one youth
drug problem, and my testimony will focus on areas that MADD
believes will have the greatest impact on reducing youth
alcohol use.
In 2000, this Nation spent $1.8 billion on preventing
illicit drug use, which was 25 times the amount targeted at
preventing underage alcohol use. The GAO found that seven
percent of total funds available for alcohol and other drug use
prevention had a specific focus on alcohol and targeted youth.
NAS concludes that the multitude of agencies and initiatives
involved suggest the need for an interagency body to provide
national leadership and provide a single Federal voice on the
issue of underage drinking.
Recommendations 12-1 through 12-6 demonstrate a clear need
for better Government assistance and coordination, beginning
with a Federal interagency coordinating committee, chaired by
the Secretary of HHS. All of these recommendations included in
my written testimony should be implemented by Congress.
Despite the fact that alcohol is the number one youth drug
problem, underage drinking prevention messages are excluded
from the ONDCP anti-drug media campaign. MADD strongly supports
NAS Recommendation 6-1. The Federal Government should fund and
actively support the development of an adult-focused national
media campaign to reduce underage drinking.
Many adults do not recognize the prevalence of or the risks
associated with underage drinking, and many adults even
facilitate kids drinking by providing access to alcohol by not
responding to their kids drinking and by not adequately
monitoring young people's behavior.
Our youth are bombarded with irresponsible alcohol
marketing messages, depicting drinking as cool, sexy, and
glamorous. In 2001, the alcohol industry spent $5 billion on
measured and unmeasured product advertising and promotion. MADD
and the NAS believe stricter standards must be placed on all
alcohol advertising to protect our children from constant
exposure to alcohol messages.
MADD supports all of the NAS recommendations on alcohol
advertising but, in particular, urges action on NAS
Recommendations 7-4 and 12-6, as outlined in my written
testimony.
Limiting youth access to alcohol is a proven way to
decrease underage drinking. Sixty percent of 8th graders and 90
percent of 12th graders report that alcohol is fairly easy to
obtain. MADD strongly supports Recommendation 9-3, that the
Federal Government should require States to achieve designated
rates of retailer compliance with youth access prohibitions as
a condition of receiving grant block funding, similar to the
Synar amendment's requirements for youth tobacco sales.
NAS also underscores the need for expanding youth and
community interventions. MADD strongly supports Recommendation
11-2, which states that Federal funding should be available
under a national program dedicated to community-level
approaches.
MADD's youth programs are based on the latest scientific
research and strive to empower children, teens and parents,
with the knowledge to keep themselves and others safe from
harm. It is imperative that evidence-based prevention efforts,
such as MADD's Youth in Action and Protecting You/Protecting Me
programs, as outlined in my written testimony, receive the
needed support from the Federal Government.
Finally, research shows that increased beer prices lead to
reductions in the levels and frequency of drinking and heavy
drinking among youth and lower crash fatality rates among young
drivers. MADD strongly supports Recommendation 12-7, which
urges Congress and State legislatures to raise excise taxes to
reduce underage consumption and raise additional revenues for
prevention programs. Top priority should be given to raising
beer taxes in particular.
It is time for this Nation to end our complacency about
underage drinking and to take action to end this public health
epidemic. More youth drink than use other illegal drugs, yet
Federal investments to protect and prevent underage drinking
pale in comparison with resources targeted at preventing
illicit drugs.
MADD stands ready to work with Congress, the public health
community and others, to pursue introduction of a
comprehensive, science-based legislative package to reduce and
prevent underage drinking. I urge this committee to use the NAS
report as a road map to create a healthier future for our
children.
Thank you.
Senator DeWine. Mrs. Hamilton, thank you very much.
[The prepared statement of Mrs. Hamilton may be found in
additional material.]
Senator DeWine. Mr. DeAngelis.
Mr. DeAngelis. Good morning. My name is David DeAngelis and
I'm a senior at North Haven High School in North Haven, CT. I
would like to thank Senator Dodd, Chairman DeWine, and the
subcommittee for inviting me to be here this morning. I am
honored to have the opportunity to speak on this issue.
Three summers ago, three classmates and I attended the
Connecticut MADD Power Camp. One speaker left a lasting
impression on us. A drunk driver killed her teenage daughter
and she felt compelled to speak to young people about the
perils of drinking and driving. But the task grew increasingly
difficult. On the way to our group, she prayed to her daughter
for a sign to help her continue. A car passed. The license
plate read ``SAVE 1''.
The four of us left the camp determined to address the
problems of underage drinking in our community and started a
newspaper column titled ``SAVE 1''. We decided to target
adults, hoping to enlighten parents and encourage them to help
their children make the right choices. After the other three
students graduated, I continued to write the articles. I would
like to submit some of them for the record.
Although I received positive feedback about the column, I
sometimes get frustrated. Last spring, I gave a presentation to
parents at my town's middle school and only 30 people showed
up. Trying to remain motivated became a challenge.
Senator DeWine. We have that problem sometimes, too, with
some of our audiences. [Laughter.] Not Senator Dodd, but I do.
[Laughter.]
Mr. DeAngelis. That changed this summer, when I volunteered
as a staffer at Power Camp, and I worked with students to
develop a project for that town. I left the camp optimistic
after watching them rally behind their idea to focus on passing
a local ordinance against serving alcohol to minors at house
parties.
So today I speak before you on the heels of the release of
the NAS report on underage drinking. When I read the report,
especially the committee's proposal for a national, adult-
oriented media campaign, the words ``adult-oriented'' jumped
out at me. Targeting adults is necessary to effectively address
underage drinking. Parents often take on a ``kids will be
kids'' attitude and think that drinking is part of growing up.
Actually, young people try to emulate adults whose social life
revolves around alcohol. Many parents not only condone the use
of alcohol, but also provide liquor to their children and their
children's friends.
Last May, a classmate of mine had an after-prom party where
alcohol was included. To make sure the guests would be safe,
his parents confiscated their car keys. This summer, what
started as a few kids hanging out in a basement turned into a
full-fledged party as more and more kids showed up with beer.
The parents spent the entire evening upstairs, never checking
on the group.
Then there are the times when parents are not home. Kids
party, drink, and do stupid and dangerous things. One girl
hosting a party jumped into her pool fully clothed after
getting drunk. Three times. Another classmate celebrated his
birthday by drinking at a friend's house and then falling down
the stairs.
Underage drinking is not a problem confined to the town of
North Haven. It happens everywhere. This past July, I was here
in Washington for Boys Nation. Standing in the airport, I met
some of the other delegates and casually asked what they like
to do for fun. One promptly replied, ``Drink'' and began
recounting stories that involved getting drunk with his
friends.
A large number of high school students are affected by
underage drinking, including those who have made the decision
not to drink. These kids are often ostracized by students in
the more popular drinking circles and fight daily pressures to
join.
This initiative is extremely important. It will take a
national movement to change the apathetic attitudes of parents.
Blatant disregard for the drinking age simply cannot be
tolerated. The youth of America are receiving the message that
underage drinking is acceptable, not to mention the messages
they receive from the media.
The alcohol industry spends over $1 billion each year on
advertising, portraying drinking as a ticket to good times.
Most disturbing is the fact that alcohol companies advertise
during TV programs viewed predominantly by teenagers. On the
radio, more beer commercials are heard by children than by
adults. These ads are clever, entertaining, and humorous. I can
still recite a radio commercial for Beck's Beer that I heard
almost every day this summer.
When children are not getting bombarded with commercials,
they are seeing images promoting drinking in the shows that
they watch. Who else is watching MTV at 4:00 o'clock in the
afternoon, or at 1:00 o'clock on a Saturday, when shows like
Spring Break, Mardi Gras, or Fraternity Life are aired?
Connecticut has the highest rate of underage drinking. The
average age that children begin drinking is 11 for boys and 13
for girls. The Connecticut Coalition to Stop Underage Drinking
has been at work for the past 7 years addressing these issues,
focusing much of its energy on the role of adults. It has also
begun work on each of the local recommendations in the NAS
report.
But they only scratch the surface of the problem. We, the
entire Nation, need the Federal Government's guidance,
direction and resources. Underage drinking is a national crisis
which is only getting worse. The NAS recommendations are too
valuable to ignore.
Thank you.
[The prepared statement of Mr. DeAngelis may be found in
additional material.]
Senator DeWine. Very good testimony. Thank you very much,
and thank you all.
Mrs. Kempthorne, I was interested in your written testimony
where you talked about the European model. You said that is
certainly not something we should emulate in the United States.
It strikes me how many people that I come across, who kind of
casually say, you know, the Europeans have got it right. You
know, they sort of introduce their kids to alcohol at 14 or 15
and they don't seem to have the problems that we do in the
United States.
Could you comment on that?
Mrs. Kempthorne. I can get you copies of the studies that
really show that, when you look at testing in the United States
and the European countries, looking at the amount of binge
drinking that's being done, the United States is actually lower
than most of them. We think that's because they drink as part
of the family social life, that they don't binge drink later
on. I think you will also find there are many countries out
there that have already started similar types of programs,
because they're seeing this issue really affecting them.
I know one thing, that in Idaho we had seven Balkan
countries come to Idaho to learn about teaching underage
drinking prevention from our school system because of the
problems they were having just in the Balkan countries. So it's
pervasive all over the world. It's definitely a problem. There
is not proof that shows that the European perception of what
the European social life is is actually helping to curtail
underage drinking, or actually the problem of alcoholism, which
we talked about when they start at that age.
Senator DeWine. In fact, according to your testimony, it's
just the opposite.
Mrs. Kempthorne. Absolutely.
Senator DeWine. You talk in your written testimony about
the problem with alcoholism, and if I read it correctly, I
think you also talked about the long-term damage to those who
start drinking earlier than 15.
Mrs. Kempthorne. We know that 40 percent of those who start
drinking earlier than 14 will most likely have an alcohol
dependence or develop alcohol abuse in their lifetime, and that
has been proven, yes.
Senator DeWine. So I guess it's like other forms of
addiction, other problems like smoking cigarettes. If you can
keep a kid from doing it until they reach a certain age,
they're probably okay. You know, the longer you can stop the
from starting, the better off we're going to be.
Mrs. Kempthorne. Yes. The research does show that starting
to drink at 21 does reduce the possibility of becoming
dependent on alcohol, and that's just what they've seen from
the studies. It does prove that.
Senator DeWine. Thank you.
Mr. Becker, you heard Dr. Bonnie's comment--and let me read
it from his written testimony. I want to get your reaction, if
I could.
``Specifically, we urge the alcohol industry to join with
private and public entities to create and fund an independent,
nonprofit foundation that focuses solely on designing,
evaluating, and implementing evidence-based programs for
preventing and reducing underage drinking. Although the
industry currently invests in programs that were set up with
that stated goal, the results of these programs have rarely
been scientifically evaluated.'' I'm putting emphasis on
``scientifically'', but I think that's the intent.
What would be wrong with doing that? Wouldn't that achieve
your stated goal, and wouldn't that also kind of take you guys
off the hot seat in the sense of you wouldn't be subject to
criticism from someone saying gee, these programs aren't
scientifically based, we don't know if they work. You know, you
could create a nonprofit that was an independent nonprofit, and
you could set it up and it would do exactly what Dr. Bonnie
said, and you could adequately fund it. What would be wrong
with that?
Mr. Becker. Well, Senator, I guess I would say several
things about that. First of all, the industry has been and
continues to be involved in a variety of independent
organizations that receive both industry and government
funding. Two of those you mentioned in your introduction of
me--the National Commission Against Drunk Driving and the
Techniques for Effective Alcohol Management Program. Those are
but two of many other things that the industry is involved
with, mostly at the community level.
I think our concern really is about how things are done at
the community level. Our concern on national programs tends to
be a lack of diversity of thought, that a ``one size fits all''
approach we know doesn't work in general, that community-based
programs that take into account the unique circumstances of
either that State or that community tend to be more effective.
We have had long running partnerships with a variety of
different organizations. Frankly, there has been an
unwillingness on the part of some organizations to even work
with our industry. That has been a challenge, particularly over
the last 10 years. This industry will work with anyone who is
truly interested in solving underage drinking. As I mentioned
in my testimony, I am a parent and I live in a community just
south of here. I want to see underage drinking resolved as
well. But I think there needs to be a little more groundwork
done before this industry can commit to that type of a
coalition, including, I think, encouraging some organizations
to work with our industry.
Senator DeWine. Does anybody want to respond to that? Then
I will have a comment. Dr. Bonnie, you're the one who sort of
set this up.
Mr. Bonnie. Yes. Well, I'm actually very encouraged by what
Mr. Becker just said. I think all of us can see that this tends
to be a highly polarized issue and that the industry is
concerned about those who take positions that don't seem to
allow room for a genuine partnership.
As I said, I think there is a tremendous amount in the
report that is very, very consistent with positions that the
industry has taken, focusing on enforcing the underage access
restrictions, focusing on community coalitions, focusing on
effective youth-oriented programs, and concentrating on good
parenting and other issues relating to adults. I think most of
this report is very, very consistent with positions the
industry has taken. There ought to be room for people who have
this common agenda to sit around the table and think about how
the cause can be furthered. So I appreciate Mr. Becker's
response.
Senator DeWine. Let's get right down to it. The reality is
that Mr. Becker's industry is never going to support anything
that talks about raising taxes on their product. So that's a
different issue and we can debate that.
But beyond that, if I listen to him and I listen to you,
and listen to Mrs. Hamilton, and I listen to Mrs. Kempthorne
and Mr. DeAngelis, or I listen to myself, Senator Dodd or any
of us as parents, you know, what in the world do we have to
disagree about? We don't want our kids drinking underage, and
we don't want kids getting in a car who have been drinking, and
we don't want our kids dying. It seems to me that it shouldn't
be this hard. To see this battle go back and forth between the
industry--and it is a legal industry, and it's going to stay
legal. We sort of resolved that issue when we went through
Prohibition. So it is legal and it's going to stay legal.
Now, the question is, we ought to get the industry to spend
as much as we can get them to spend on trying to deal with
underage drinking, and we ought to move forward here, it seems
to me.
Mr. Bonnie. I think so, too. I think it would be a mistake
for the disagreement about the tax issues to obscure and impede
the numerous opportunities that I think you just identified for
collaboration. We can make this an inclusive effort, if we can
just----
Senator DeWine. It seems to me you sort of do what you do
in arbitration, where each side picks a third party and you
sort of move on. You're not going to appoint somebody and they
appoint somebody. You probably get two people removed and then
you end up and get this independent group.
We are not going to settle this today, but it just seems to
me that we ought to move beyond this, and these types of
squabbles are not very productive and they become for the
public, frankly, a little irritating. For parents, they get a
little irritating. We ought to move on and start saving some
kids' lives here.
Frankly, Mr. Becker, it still is a problem. You may have
made some progress, but it is still a problem. We still have
kids dying out there. As Senator Dodd has pointed out, we are
spending an awful lot of money dealing with drugs, as we
should, in this country, but we are not spending enough money
dealing with underage drinking. We ought to start spending more
money on it, and we ought to start focusing more on it. We are
just not doing enough. That is the reality. Whether or not in
the climate we have today, with the budget problems, that we're
going to convince anybody here to do it, I don't know. But we
need to start doing it.
Let me turn it over to Senator Dodd and then I will come
back for some more questions.
Senator Dodd. Thank you, Mr. Chairman. Let me thank all of
you again for your testimony.
First of all, David, I'm very proud of you as your Senator.
Mr. DeAngelis. Thank you.
Senator Dodd. Tell us what might work. I mean, in spending
time with young people, do you know of young people that have
stopped drinking, who were drinking and stopped, and if so,
what motivated them to stop? Or what do you think would work?
What do you think helps? I mean, you have brought up the focus
on adult issues, but give us some more specific examples of
what might work.
Mr. DeAngelis. Well, I don't really know of any kids who
have stopped drinking, but many of my friends have made a
commitment not to drink. I think that just stems from their
strong families lives, of having involved parents, parents who
are there for all their activities, parents who know what their
kids are doing. They have made it clear from an early age that
drinking is illegal and that should be a good enough reason not
to drink, besides all of the health factors and other things
that can happen through underage drinking.
My parents have been extremely supportive of everything I
have done. They have been with me every step of the way. I know
there are other parents out there like that. I believe it is
just a matter of reaching the other parents out there who just
don't get it yet.
Senator Dodd. What sort of messages do you think would
work? You talked about messages. Give me some idea of what
those should be.
Mr. DeAngelis. There is a national campaign about talk to
your kids about smoking marijuana, ads like that, sort of
counteracting the messages that they are receiving now. Just
talk to your kids, spend time with them. Be an involved parent.
I think the more parents have a role in their kids' lives, the
more--Kids want that. Kids want their parents to be with them
and know that they really support them and that they love them.
Senator Dodd. I understand that an awful lot of people
don't have the wonderful luxury of having two parents at home
all the time. A lot of times it is a single mother raising more
than one or two children. The pressures are tremendous, maybe
holding down two or three jobs and trying to keep the family
together economically. The pressures are really tremendous,
particularly for single parents. There are just horrendous
pressures on them.
Mr. DeAngelis. Absolutely. But even so, they are still with
their kids at least some time during the day. Kids look up to
their parents, and a lot of them, without realizing it, want to
be like their parents. And even if there's just a single parent
out there, they will listen to he or she.
Senator Dodd. You mentioned the Beck's Beer ad. What is
that? Do you remember how it goes? [Laughter.]
Mr. DeAngelis. It started off talking about steaks, and
when a steak is cooked all the way through, it is considered
well done. But when a life is well done, it is completely and
totally rare. Something along those lines. It is somehow
related back to beer and how life is best enjoyed sharing
steaks over beer. It was a nice summer ad.
Senator Dodd. I am concerned as well about this.
Mr. Becker, I appreciate some of the changes that have been
made. But in just looking at some of these ads that have been
on--tell me whether these are still on or not. Here is one that
says Game Day. This is the one where Heineken's has a Nintendo
game toy, with two Heineken beer bottles as a part of Game Day.
That is obviously not aimed at adults, is it?
Mr. Becker. Well, sir, I happen to own a Play Station, so I
might not be the best person--[Laughter.]
Senator Dodd. Mr. Becker, get serious with me.
Mr. Becker. No, I'm not trying to make light of it.
Senator Dodd. Well, that is light. That's silly. You're not
going to try to convince me that's for an adult. Really, are
you?
Mr. Becker. Well, sir, I would respectfully suggest that
there are adults who do enjoy doing that, and I----
Senator Dodd. Oh, please. Don't insult me now.
Mr. Becker. I'm not trying to insult you, sir. I am
simply----
Senator Dodd. That's is a child's toy, isn't it?
Mr. Becker. Well, I happen to own one, and so I guess I
would personally suggest that I enjoy it, too.
Senator Dodd. Let me read you another ad and you tell me
whether or not you think this is for an adult. How about the
Bacardi ad, where the young lady in hip-huggers is sitting here
watching--you probably can't see it here, but it's the ad that
shows a young lady pouring Bacardi down here stomach here, and
the young man licking it off her stomach. Who is that designed
to appeal to?
Mr. Becker. Certainly not me, sir. [Laughter.]
Senator Dodd. Yeah. So you're somewhere between the
Nintendo and this, right? [Laughter.]
Look, there have been all sorts of studies done here of the
advertising campaigns. There's reams of it here. The ad we also
saw last year of the two women in a wrestling match in a
fountain. You know, what's going on here? I appreciate the
modest changes that have occurred in the last year or so, but
what's going on with the industry that is clearly--When I read
down the list of programs where the bulk of the beer
advertising has occurred, it has Buffy the Vampire Slayer, Dark
Angel, Gilmore Girls, Survivor, X-Files, Mad TV, the Daley
Show, and Insomniac Music Theater. These are all programs
designed specifically for a very young audience. The bulk of
beer advertising is occurring on those programs.
What is the thinking that's going on?
Mr. Becker. I would disagree with that, and I would base
that disagreement on the 2003 Federal Trade Commission report
that looked at where beer advertisements were placed. Their
conclusion was according to the 50 percent or simple majority
standard that was in our code prior to a few weeks ago, and
there was virtually 99 percent compliance with that code.
As we said when we released our new code, we wanted to make
sure it was clear about where our ads were being placed and to
what audience. We raised that standard to 70 percent.
Senator Dodd. I went back to some of the earlier stuff that
went on in the various magazines, with the percentages of the
people underage. Under that new standard, obviously magazines
like Vibe and Spin, where the percentages of youth readers was
higher, there would be a ban in the advertising. Rolling Stone,
Allure and so forth.
But you get to things like Sports Illustrated, it's 25
percent and you still advertise there. The difference is that
you have over 6 million readers spending $39 million. Sometimes
by reducing these numbers and having merely a percentage, you
get sort of an illusion in terms of whether or not you're
actually appealing to these underage kids in terms of their
drinking habits.
Mr. Becker. I think there is really two issues there,
Senator. One is that clearly the new advertising placement
threshold will create a circumstance where ads won't appear in
some places that they have over the last number of years. I
would say, however, that our members have been advertising,
just as a practice for the last few years, in the 70 percent
range.
But I think the other thing to look at here is what is
advertising and who does it influence. The Roper organization
has done a poll now for over 10 years that has consistently
shown that when young people are asked what their primary
influences on drinking are--and I think we have acknowledged
certainly the role that parents have today, the number one
answer----
Senator Dodd. Fine. I agree with that, too. Don't
misunderstand me. But an awful lot of this has to do with
advertising. Come on. You guys spend millions and millions of
dollars, not because you're VISTA or the Peace Corps. You do it
because it makes good economic sense to do it.
Now, looking at a Coors ad on now, a very prominent
musician, rock star, in a football stadium buying beers for all
of his friends there, that's designed specifically for--you
know, the only people who really know who that is, most of them
are younger people.
Why do you do this? What is the point of advertising to
appeal to that age group when, in fact, you know legally you
can't sell to them? Why do you do it?
Mr. Becker. Well, the ads are only created to appeal to
those people of legal purchase age and older. The fact that
they are interesting----
Senator Dodd. Come on, be honest with me. You're appealing
to try to develop loyalties to certain brands. That's what
people do, don't they?
Mr. Becker. Certainly if it's for people who can legally
purchase and consume the products. But we do not--and I think
the FTC report underscored that quite clearly--we do not target
our ads to young people and do not attempt to make them
appealing to them. I think it's----
Senator Dodd. That ``cat fight'' ad was designed to appeal
to an adult audience?
Mr. Becker. Yes, sir, it was. And I think that the
controversy surrounding that ad, and others, has caused a
circumstance where those companies have pulled those ads
because of the controversy surrounding them. So I do think that
our industry has been very responsive when consumers and others
have raised those issues with us. That is one of the reasons
why we think changing our code to ensure there is no
misperception about where and who we're trying to advertise to
is clearer for people.
Senator Dodd. Mrs. Hamilton, what is your reaction to all
of this?
Mrs. Hamilton. Interesting. Twenty percent of the profits,
up to 20 percent of the profits that the alcohol industry makes
is on the sale of their beverages to underage drinkers. It is
very important for us to remember that the bottom line of this
is profits for their industry.
While I understand that parents need to play a role in
this, parents don't have the information that they need. There
is no evidence that shows that the prevention programs the
industry has put forward are based on science, that it's
effective in reducing underage drinking, when we see, in fact,
that the numbers are status quo.
There is much more that needs to be done. They need to be
more responsible in all parts of advertising, from the Internet
to radio to newspaper. Young people have access to this. They
are seeing it, they're acknowledging it, and they are drinking.
Senator Dodd. Talk to me a bit about the single parent
issue. David talked about obviously a wonderful family and a
lot of involvement. There are a lot of pressures obviously on
other families, given their makeup and so forth, to be able to
have that kind of time.
I wonder if any work has been done on that. Mrs.
Kempthorne, you might respond to this as well. Sometimes we
imagine sort of the traditional family, which is very different
than what many of us grew up with today. How do we work with
that family? Are there some unique and effective programs that
have been more successful with today's family, the single
parent family, with two parents working three or four jobs in
some cases?
Mrs. Hamilton. Families are very different from 20 years
ago, when I was raising mine, and there are more challenges
that are facing them, being in the workforce. It is important
for us to get the messages out, the real messages, the truth
about how alcohol affects children.
I would also like to submit for the record Alcohol and the
Brain, how drinking in youth affects thinking skills. I don't
think parents have this kind of information.
Senator DeWine. That will be made a part of the record, as
well as what Mr. DeAngelis had for the record. We will make
that part of the record, too.
[The information may be found in additional material.]
Mrs. Hamilton. In addition, the elementary school program
that MADD has been focused on in the last several years,
Protecting You/Protecting Me, goes into elementary schools to
teach children about alcohol's effects on the developing brain,
where to sit in a car, when they're driving with someone, to
make good decisions, and the skills that they need to make good
decisions. That has been named a model program by the Federal
Government.
There is much more work that needs to be done. We're
working with the First Ladies Initiative on some programs.
Education is key to parents. They need to understand the
consequences because, quite frankly, they don't. They still
think this is a ``right of passage'' in this country.
Senator Dodd. Ms. Kempthorne, do you want to comment?
Mrs. Kempthorne. I agree with Mrs. Hamilton, and I also did
want to say that the parents do need help. Parents are trying
to get that message out. Being a parent of 20-somethings, I
have just been through that and still finishing going through
that, you give the message. You tell the kids that it's
illegal, you tell the kids that they will want to do it because
they have a genetic predisposition to it.
But that doesn't have half as much meaning as the new
friend they met the other day who is going to have a six-pack
of beer at their house, so why don't you come over. It's okay
because their parents are there, but the kids are downstairs in
the basement and they're upstairs.
I also agree with Mr. DeAngelis, that it is really each
child making that decision. That's why we start as young as we
do. We have got to teach them how to make these decisions
before that friend hands them the beer when they're 12 years
old and says, ``Hey, it's no big deal. Nobody will ever know.''
Other things are happening. In the schools now, they don't
even want you to bring water or sodas because the kids are
mixing alcohol with it. Many schools won't let them come in. We
don't believe that as a parent. That can't be true. But it
really is true. Our children find that there's a message out
there that it's okay because parents really don't get it, you
know. They really don't get it. I have heard these messages.
And it isn't just the advertising. It is media of all
sorts. Our children have grown up getting messages from many
more sources than us as parents. Sometimes it feels like we're
the counterculture pushing against everything else that's
telling them what is okay, and we say we want you to have a
healthy, productive life, and yes, have fun, and what they see
is how to have fun is to consume alcohol. It will at least make
it happen a little quicker.
The other thing about single parents, we know now that most
parents are in the workplace. I think it's over 80 percent of
parents with children 18 or under are in the workplace. So yes,
it's a challenge. Who's taking care of the children and who's
giving them the message?
Senator Dodd. Just on a final note, as a father of a 2 year
old, I'm just envisioning the problems coming down the road. A
sister of mine has 15 grandchildren, and she was saying the
other day something very smart. She said, you know, parents
have a choice. Not all do, but they have a choice. They
normally will say they'll stay out of the workforce, or one or
the other will, when they're very, very young, and when they
reach school age, 10 or 12, then I'll go back to work.
It's really just backwards.
Mrs. Kempthorne. Absolutely.
Senator Dodd. In many ways, children, as long as they're
being loved and cared for and fed, and have done all the normal
things when they're very young, they will make it okay. It's
when they get around 10 or 12 that they really need you. Too
often parents decide they're on their own and are really okay,
but in fact the opposite is true.
We have this notion somehow that they really need you more
when they're infants and less so when they reach the preteen
years. I see you're nodding in agreement with that notion as
well.
Mrs. Kempthorne. Absolutely. Experience.
Senator Dodd. Thank you.
Mr. DeAngelis. I would like to briefly add to that, if I
may.
As far as the water bottles, I know of a classmate of mine
where this is absolutely true. He showed up at the North Haven
affair a couple of weeks ago with a water bottle filled with
vodka, so it does happen. It is not something that is just a
myth.
Senator Dodd. Thank you.
Senator DeWine. I just have a couple more questions.
Mr. Becker, you were talking with Senator Dodd about the
code. I'm a little confused about the code. How is that
enforced? That is your own code, is that right?
Mr. Becker. Yes, sir, it is.
Senator DeWine. How is that enforced?
Mr. Becker. The code is enforced when----
Senator DeWine. Do you all enforce that yourselves?
Mr. Becker. No, sir. It's a voluntary code. When we receive
a complaint from an individual or an organization, we refer
that complaint to that specific brewer. That brewer then
responds to the complainant directly. That process has served
us very well, and I think if you looked at that process and at
not only the quick response that our members have but the
response of the complainant, we believe that's been a very
effective tool thus far.
Senator DeWine. So it is a code that each brewery says
they're going to live up to, right?
Mr. Becker. At a minimum. The industry code, each company
also does----
Senator DeWine. Hopefully they will live up to it.
Mr. Becker. Correct.
Senator DeWine. So that's why the general counsel of the
Beer Institute said that ``It's not our job to enforce it.''
Mr. Becker. It's not our job to enforce the code, but it is
our job to oversee the code, to convey the complaints directly
to the brewer----
Senator DeWine. Because he said ``the code is not going to
work if we become the judge.'' That was a quote in the paper.
Mr. Becker. Well, I agree with him. As an association, we
cannot be the subjective judge of the complaints. The company
itself has to look at what it's doing and has to look at that
complaint and decide----
Senator DeWine. Each company decides how it interprets that
and goes back and forth with the complainant then; is that how
it works?
Mr. Becker. That's correct, Senator.
Senator DeWine. Let me get back to this. I don't want to
belabor the point, but Mrs. Hamilton made a comment again
talking about the scientific basis of some of the things that
we're doing. I just want to make one more comment and then I
will get off it.
It seems to me that you have been subject to criticism,
that some of the things you have done have not had a scientific
basis to them. I'm not judging today whether that is true or
not true, but it seems to me you can certainly get rid of that
criticism by setting up this independent group that Dr. Bonnie
is talking about. It seems to me that is something you all
should explore. I really think you ought to look at that.
Mr. Becker. Well, Senator, I guess I would take issue with
the fact that our programs are not evaluated.
Senator DeWine. That's the point. I understand you would
take issue with it, and I appreciate that. Again, I don't think
we are going to get anywhere debating that today. You know, you
take issue with it and some people criticize it. That is sort
of my point.
My point is you get rid of that criticism by setting up an
independent group, you fund it, you take credit for funding it,
but it is independent. You get rid of the criticism and you let
somebody else take the flak and the criticism. You say, ``Look,
we funded it, we made a good faith effort to do this. We have
the same interest that MADD does; we have the same interest
that every other parent does in this country. We want to stop
underage drinking and we have put in a good faith effort and
we're putting x-million dollars into this every single year.
Get off our back.'' That's what I would do if I were you. I
would get it out of my ballpark.
This is just a suggestion, just as a citizen. It's a little
suggestion, that's all.
Mr. Becker. I appreciate that Senator.
Senator DeWine. And you won't be up here listening to us
yell at you.
Mr. Becker. I certainly do appreciate that, Senator. But
since you mentioned----
Senator DeWine. How hard is that?
Mr. Becker. Since you mentioned ``ballparks'', I would like
to briefly say that one example----
Senator DeWine. You're not going to bring up how my Reds
are doing this year, are you? [Laughter.]
Mr. Becker. No. Sadly, I really couldn't tell you how your
Reds are doing. I know the Red Sox are better than they used to
be.
I would say that the team coalition that we participated
in, and a significant effort with major league baseball to
train people in stadiums, has been evaluated and has been
demonstrated to have made the fan experience more enjoyable.
That is to say, they have had fewer problems. That is just one
of the programs that has been evaluated, that the industry has
been participating in. So to say we have not evaluated our
programs is not correct.
Senator DeWine. OK. OK.
One of the suggestions that has been made, and one of the
things I would like your comments on, is the idea that the
Federal Government should fund and start putting some
significant money into advertising that would deal with
underage drinking. Dr. Bonnie, I believe that was one of your
recommendations.
Mr. Bonnie. Yes.
Senator DeWine. Let me go quickly through the panel because
we are about out of time. Why don't you kick that off, and then
I will go to Mrs. Kempthorne and go right down the panel. Just
real quickly make your comments on that.
Mr. Bonnie. If I could put that into a larger context,
maybe picking up on some points that were made here----
Senator DeWine. That would be good. You've got a minute,
though, 1 minute.
Mr. Bonnie. I think Senator Dodd observed at some earlier
point that this is really about the culture. I kind of
sympathize in a certain respect with Mr. Becker here. He's been
on the hot seat about this and the industry is obviously an
important part of the culture.
But this is bigger than the industry. I think we need to
keep that in mind. The report emphasizes this is a collective
responsibility. We all have a role to play here. We do need to
give parents the help that they have been seeking in trying to
deal with this. We need to built coalitions at the grassroots
level. I mean, this is much bigger than the industry. I think
the media campaign that we recommended is the cornerstone of
that effort, really, to galvanize the public engagement in this
effort by recognizing the seriousness of the problem.
I should take note, by the way, that Judy Cushing, who was
a member of our panel, is here. She is the head of the Oregon
Partnership and that's what she does with her work. I think we
just need to try to strengthen her hand and the hands of people
like that.
In that context, I just want to make one comment on this
advertising issue. Obviously, advertizing is a difficult policy
problem. I think it's important for all of us that are trying
to find how we're going to affect the messages that kids and
parents and everyone receives, to acknowledge that there is a
commercial difficulty that the industry has in terms of trying
to get at the young adult audience, the audience that is in
their early 20s. That's a legitimate interest that they have to
advertise to that audience, and obviously, there is going to be
the spill-over problem in terms of the messages getting to the
younger kids. They have acknowledged that this is an issue that
they have to try to deal with, and I think they are taking one
step at a time and they need to continue. We need to keep the
pressure on them to take one step at a time.
The Government role in this is to make sure that we monitor
what is going on in terms of the brand usage of kids and the
exposure of kids to these messages, so that the industry can be
held accountable to the public by having that information made
available. That was a core part of the recommendations as well.
So I think that that needs to be emphasized. That's really the
approach in dealing with the advertising issue.
Senator DeWine. When you came up with your recommendation
about the anti-drinking advertising--if I may call it that--did
you look at what States are doing? Do we have any experience
level in what the States are doing, are any of the 50 States
putting significant money into this? Is anybody doing this?
Mr. Bonnie. If you want to compare, for example, with the
tobacco area, where I think we do have----
Senator DeWine. No, I don't. I want to look at it and see
if anybody is doing it in regard to underage drinking with
alcohol. Is anybody doing it, any State doing it significantly?
Is anybody putting money----
Mr. Bonnie. Not at a substantial level, as far as I know.
Senator DeWine. Nobody is doing it with any significant
amount of money?
Mr. Bonnie. Not a significant amount of money. But we need
to pay attention to making sure that we've got evidence-based,
for whatever is done--Again, the committee also emphasized that
we have the evidence available for this, that we need a lot
more research to be done on the messages that are going to work
with kids, if we're talking about kid-oriented advertising.
Senator DeWine. Right. We have seen how difficult that is
to do with drugs.
Mr. Bonnie. Exactly. And we have to be careful----
Senator DeWine. We have a trial-and-error with drugs and we
have seen that we've spent a lot of money and sometimes it
doesn't work, but sometimes it does. It's tough.
Mr. Bonnie. Let's do the research before we implement
hundreds of millions of dollars in a campaign.
Senator DeWine. Mrs. Kempthorne, in regard to that type of
advertising, do you have a reaction to that?
Mrs. Kempthorne. Yes. The part that confuses me is how on
one side they spend so much money on advertising, and then you
will see a quote that says advertising really doesn't change
behavior. I don't understand why on the one side they do, but
then they go against it and say they want to do advertising
that promotes not drinking. I'm still confused on where that
comes from.
From a State level, no, we have not put money into stopping
underage drinking. But I do know in adolescent pregnancy
prevention that the advertising we have done has made a
significant difference, but we have targeted it specifically,
sometimes to parents, sometimes to boys, sometimes to girls. It
is a ten-year long plan to figure out how we do that, and we
have seen a significant statistical drop.
The other thing that would be important as we look at their
codes, what they consider fulfilling their code and what, as a
parent, I may consider fulfilling their code, when I see those
I don't think that's what I want my children to see. But I'm
not even sure, as a 51 year old adult, that's what I want to
see, either. So I would like to be more of a participant and a
player. I don't know how they do their focus groups on what the
advertising is, but we need to bring all the parties together
to decide what is effective advertising.
Senator DeWine. Mr. Becker.
Mr. Becker. Well, Senator, to the specific issue,
advertising can influence an adult consumer's decision to buy a
brand. What it has not been demonstrated to do is to sell more
beer than it ordinarily would. I think the evidence on that is
very clear, and I would be happy to provide that for the
committee.
To your specific question, however, on the adult media
campaign, I will go back to what Dr. Bonnie said. I think the
evidence suggests that campaigns that have been done can be
counterproductive, or campaigns can send a message that may not
change someone's behavior.
Our industry believes that today it is premature for us to
express support for a media campaign because we don't have
details, such as message, etc. Having said that, however, we
are open to further discussion. I think as you have very well
outlined, Mr. Chairman, we are all in this together. This
industry has and will continue to support effective solutions
to underage drinking.
Senator DeWine. Mrs. Hamilton.
Mrs. Hamilton. Senator, you asked at the beginning in your
opening remarks how did we get here. I think more importantly
is where we go from here, now that we have this incredible
document that has been prepared by the NAS.
What we absolutely have to do is have an adult media
campaign that is going to focus on adults, to tell them the
consequences of what happens when young people are drinking and
what happens when they provide alcohol. We need to have a
central Federal agency that is coordinating these efforts.
Five years ago, when we started focusing on underage
drinking, when we added the prevention of underage drinking to
our mission, we couldn't find that research. We couldn't find
those documents. We had to wade through everything. Communities
need that information available through a web, through a
central agency with their States, so they can get access to
community programs that work, that are evidence-based. And we
absolutely need enforcement on the 21 drinking age laws.
Senator DeWine. Mr. DeAngelis.
Mr. DeAngelis. Adults are essential to reducing the
problem. That is why 2 years ago we started the column to
target adults. Because at our 4 days at Power Camp, we tried to
get at the root of the problem and we kept coming back to the
roles of adults. We felt the best way we could reach them was
through a column.
Advertising on a national level would reach so many more.
TV is such a huge part of our culture, it will at least start
to make an impression on our minds. Whether it affects their
behavior from day one, probably not. But over a period of time,
it can really make a difference.
Senator DeWine. The last question--and I will go right down
the line.
Other than advertising, if there was one thing we could do
nationwide, one thing, what would that be?
Mr. Bonnie. Other than the media campaign you mean?
Senator DeWine. Yes, other than advertising and media
campaigns that we just discussed. What else, one thing?
Mr. Bonnie. I think I would say that the second priority in
this--and I guess you have put aside the tax issue at the
beginning. So among the other recommendations, I think we----
Senator DeWine. I'm not saying we shouldn't do that. That's
not in the jurisdiction of this committee, but we can address
that some other day.
Mr. Bonnie. There is a whole series of recommendations here
about strengthening compliance with the underage drinking
prohibition, and I think that is the next set of issues. That
involves steps that are taken at the national level and
involves steps that are taken at the State level, in terms of
State level enforcement, and it involves empowering community
coalitions to be able to put social pressures on the retailers.
This is not only about law enforcement. It's about
education to promote compliance. So I would say that's the
second main recommendation.
Senator DeWine. Good. Mrs. Kempthorne.
Mrs. Kempthorne. All politics is local, building community
coalitions and really making it happen at the grassroots level.
Senator DeWine. Mr. Becker.
Mr. Becker. I would like to echo that sentiment, that
community-based coalitions do work. I would also like to
commend the students for coming up with this well thought out
idea, that we really do need to help parents and adults with
better information, to empower them to do a better job of
parenting.
Senator DeWine. Ms. Hamilton.
Mrs. Hamilton. Enforcement of the 21 minimum drinking age
law, just as Dr. Bonnie said, and Mrs. Kempthorne. It's
critical.
Senator DeWine. Mr. DeAngelis.
Mr. DeAngelis. The same thing, compliance checks. When we
go out and do compliance checks, we're not trying to trick the
package store owners. We go in there and try to buy liquor, and
see if they ask for and check IDs. It's very straightforward,
and oftentimes they don't. You just need to keep plugging away
with that, because they have to learn at some point.
Senator DeWine. Senator Dodd, your last comments.
Senator Dodd. Thanks, Mr. Chairman. I thank all of you
again.
I just come back to the point that I think someone made
earlier. The IOM, not an insignificant organization, the
Institute of Medicine, estimates that the social cost of just
underage drinking--we haven't talked about the medical cost of
just drinking, but just underage drinking--is $53 billion a
year, and $19 billion a year alone just in automobile accidents
and health related costs, and $29 billion associated with
violent crime. We need to keep those numbers in mind here. This
is a staggering problem here. It's not small. In fact, the
numbers go up and down a bit.
You can make a difference. I have always used the example
of Mothers Against Drunk Driving. I think it began with one
woman in the basement of her home, as I recall the history. I
hope I'm right about that because I have used that story over
and over again, about how one person who decided to make a
difference has made a difference in many ways.
Certainly what we have done with smoking in this country
today. When you think back just a few years ago, these
committee rooms, we smoked as members of committees up here. If
you got on an airplane, every place you went to there was
smoking. And yet, because there was a determined effort
recognizing the health costs to it, the advertising campaigns,
all of the efforts made, we have made real headway on that
issue. And there were tremendous voices against it, about
choices and parental involvement and so forth. But by reducing
the association with smoking as being something that was
culturally acceptable, it made you more attractive, all of that
was part of it. It was in the movie industry, on television,
everywhere you went, it was all part of an effort to say this
was okay, in a sense.
Now, I know that drinking is certainly very much a part of
our culture. No one is recommending a constitutional amendment
here to change this. But the idea somehow that we just sort of
accept this because it's part of the embedded fabric of the
country is something we've got to challenge, particularly when
kids are involved.
So, Mr. Becker, my point with you is, I'm not picking on
you particularly here, except that I know when you write these
ads--you know, you spend a lot of money doing this. You mall
test these things. You do focus groups. You don't just do an ad
and put it out on television. People have tested it, who is it
going to appeal to. You spend a lot of money putting those ads
on television.
The question is, when you're sitting and making that
decision about putting these ads on--you have one here that
shows, obviously--I don't know how old this girl is. She
doesn't look 21 to me. They're in the car, rear view mirror,
the radio is on, necking, a nice finish. It's a Michelob ad.
You know, maybe 21-5 and so forth. I'm not arguing someone
isn't that.
But the appearance of that child in that situation, someone
made a decision. They didn't pick someone looking a little
older. They picked someone looking younger. Again, you're here,
and obviously there are multifaceted aspects of this. I
acknowledge that completely. But the fact of the matter is,
millions of dollars are being spent to appeal to these kids.
That's a fact, in my view.
So I'm trying to get the industry to be far more
responsible about this, and I encourage you to consider what
the chairman has offered here as a way of getting involved in
this.
The reason these numbers got changed and you went up to 35
was because there was a tremendous reaction to those ads on
television. That's why it happened. By your own admission,
that's what occurred. People were outraged by what they saw on
television. So the industry responded to consumer reaction. It
wasn't a law passed here, and it wasn't a regulation adopted.
It was the industry responding to what they saw as a very
dangerous situation if they didn't change those ads.
So I'm encouraging you to do what the chairman has
suggested. Get together with these people. Sit down and try and
work this out. You don't want industry members promoting this
stuff on television with these kinds of ads. I think it's going
to hurt you terribly. I may be one voice up here right now. I
guarantee you there will be a sense of collective outrage about
this if you keep doing it. Then steps will be taken that go far
beyond suggesting getting together to support a foundation. You
mark my words, it will happen.
The smoking industry and tobacco industry never believed it
would happen, and it did. I'm telling you, it will happen with
this industry if you don't smarten up and stop this stuff.
Thank you, Mr. Chairman.
Senator DeWine. Let me thank all of you very much.
You know, politics is about choices. As parents, we worry
about things. My wife, Fran, and I have eight children. The
youngest is 11 and the oldest is 35. As parents, you worry
about your kids. I think that with the mass culture we have
today, and with the 24 hour news, sometimes we get off and
worry about the wrong things. You sort of calculate what you
should be worrying about.
I believe one of the things we have learned, if you just
look at the statistics, what you learn is that many times we
worry about the wrong things. One of the things that has come
from this hearing is that, if you want to worry about something
that really matters in society today, as parents, at least if
you believe the statistics, you ought to worry about underage
drinking. If that message can come from this hearing, it's the
right message.
Getting back to the priority issue, politics and
government, we do not put enough priority at the Federal level
on underage drinking. We don't worry enough about it. We don't
care enough about it, because the reality is that it's a major
killer of our young people. We need to take from this hearing a
new dedication to do something about it.
We do spend a lot of money today worrying about illicit
drug use. I don't know anybody in this Congress who has spent
more time on that than I have. I started worrying about that
when I was a county prosecutor many, many years ago. And
Senator Dodd is worried about it and has spent a lot of time on
this. He and I worry about illegal drugs coming into this
country, and I think both of us are going to continue to worry
about that, as we should.
But if you look at how much money we have spent on that
versus underage drinking, it pales in comparison. That doesn't
mean we shouldn't worry about the drug problem, but it does
mean we should start worrying a little bit more, a lot more,
about underage drinking.
Senator Dodd recited the number of kids who are killed.
Mrs. Hamilton recited the number of kids who are killed in cars
because of drinking, the number of suicides that are possibly
facilitated because somebody has been drinking, the accidental
deaths that are caused because someone is drinking, the college
campus deaths that occur because someone has been drinking, the
binge deaths that occur. You can just go on and on and on.
These are not accidents. They are preventable. So we need to
take this information today and see what we can do about it.
Senator Dodd and I are going to be talking on this
committee about what we can do from this testimony. So we
appreciate it. We appreciate all of you coming in, the First
Ladies and former First Ladies, we thank you for taking the
time to be here today from all across the country. We
appreciate it, and all the rest of our panelists.
Thank you very much.
[Additional material follows:]
ADDITIONAL MATERIAL
Prepared Statement of Richard J. Bonnie
Good morning, Mr. Chairman and Members of the Subcommittee. My name
is Richard Bonnie. I am the John S. Battle Professor of Law and
Director of the Institute of Law, Psychiatry and Public Policy at the
University of Virginia. I served as chair of the Committee on
Developing a Strategy to Reduce and Prevent Underage Drinking of the
National Research Council and the Institute of Medicine. The National
Research Council is the operating arm of the National Academy of
Sciences, National Academy of Engineering and the Institute of
Medicine, chartered by Congress in 1863 to advise the government on
matters of science and technology.
The report of this committee was produced in response to a
Congressional request to develop a strategy to reduce and prevent
underage drinking. The committee reviewed a wide variety of government
and private programs for the purpose of developing a comprehensive
national strategy. We relied on the available scientific literature,
commissioned papers, testimony and submissions from the public, and the
expertise of committee members in public policy, public health, youth
interventions, and substance abuse. Our starting point was the current
national policy setting 21 as the minimum legal-drinking age.
Alcohol use by young people is an endemic problem that is not
likely to improve in the absence of significant new interventions. Many
more of the nation's youth drink than smoke cigarettes or use other
drugs. And, young people tend to drink more heavily than adults,
exacerbating the dangers to themselves and people around them. In the
2002 Monitoring the Future survey, a Federally sponsored study, nearly
one-in-five 8th graders and almost half of 12th graders reported
drinking in the last month. More than a quarter of high school seniors
reported that they had five or more drinks in a row in the last 2
weeks. One-in-eight 8th graders reported the same thing. These
underlying rates have remained basically unchanged for a decade. The
social cost of underage drinking has been estimated at $53 billion each
year, including $19 billion from traffic crashes alone. While traffic
crashes are perhaps the most visible consequences of this problem,
underage drinking is also linked with violence, suicide, academic
failure, and other harmful behaviors. Heavy drinking also threatens
youth's long-term development.
Although the public is generally aware of the problems associated
with underage drinking, the nation's social response has not been
commensurate with the magnitude and seriousness of the problem. This
disparity is evident not only in the fact that the Federal Government
spends 25 times more on prevention of illicit drug use by young people
than on prevention of underage drinking, but also in the lack of
sustained and comprehensive grassroots efforts to address the problem
in most communities.
Some people think that the key to reducing underage drinking lies
in finding the right messages to send to young people to instill
negative beliefs and attitudes toward alcohol use. Others tend to focus
on changing the marketing practices of the alcohol industry in order to
reduce young people's exposure to messages designed to promote
drinking. However, the problem is much more complicated than either of
these positions would suggest because alcohol use is deeply embedded in
the economic and cultural fabric of life in the United States. Annual
revenues in the alcohol industry amount to $116 billion. The challenge,
then, is how to reduce underage drinking in a context where adult
drinking is widespread and commonly accepted and where billions of
gallons of alcohol are in the stream of commerce. We believe that will
require a broad, multifaceted effort.
The primary goal of the committee's recommended strategy is to
create and sustain a strong societal commitment to reduce underage
drinking. All of us, acting in concert--including parents and other
adults, alcohol producers, wholesalers and retail outlets,
entertainment media, and community groups--must take the necessary
steps to reduce the availability of alcohol to underage drinkers, to
reduce the attractiveness of alcohol to young people, and to reduce
opportunities for youthful drinking. Underage drinking prevention is
everybody's business.
The report emphasizes that adults must be the primary targets of
this national campaign to reduce underage drinking. Most adults express
concern about underage drinking and voice support for public policies
to curb it. Yet behind the concern lies a paradox: Youth often get
their alcohol from adults. And many parents downplay the extent of the
problem or are unaware of their own kids' drinking habits. Thirty
percent of parents whose kids reported drinking heavily within the last
30 days, think their kids do not drink at all. The sad truth is that
many adults facilitate and condone underage drinking. We need to change
the behavior of well-meaning adults in communities all over the
nation--including people who are holding drinking parties for kids in
their homes in violation of the law.
As the centerpiece of the committee's adult-oriented strategy, our
report calls on the Federal Government to fund and actively support the
development of a national media campaign designed to create a broad
societal commitment to reduce underage drinking, to decrease adult
conduct that tends to facilitate underage drinking, and to encourage
parents and other adults to take specific steps in their own
households, neighborhoods and businesses to discourage underage
drinking.
The comprehensive strategy we suggest also includes a multi-pronged
plan for boosting compliance with laws that prohibit selling or
providing alcohol to young people under the legal drinking age of 21.
Efforts to increase compliance need to focus on both retail outlets and
social channels through which underage drinkers obtain their alcohol.
For example, we urge State authorities to require all sellers and
servers of alcohol to complete State-approved training as a condition
of employment, and to increase the frequency of staged underage
purchases by which they monitor retailer compliance with minimum
drinking-age laws. The Federal Government should require States to
achieve specified rates of retailer compliance with youth-access laws
as a condition of receiving Federal funds. And States should beef up
efforts to prevent and detect the use of fake IDs by minors who want to
buy alcohol.
The committee also supports specific intervention and education
programs aimed at young people as long as those programs have been
evaluated and found to be effective. A good start in identifying
evidence-based school programs has already been made by the Department
of Education and the Substance Abuse Mental Health Services
Administration in the Department of Health and Human Services. A recent
report sponsored by the National Institute on Alcohol Abuse and
Alcoholism has done the same for programs aimed at college students.
Community leaders need to mobilize the energy, resources and
attention of local organizations and businesses to develop and
implement programs for preventing and reducing underage drinking. These
efforts should be tailored to specific circumstances of the problem in
their communities. The Federal Government as well as public and private
organizations should encourage and help pay for relevant community
initiatives that have been shown to work.
The alcohol industry also has a vitally important role to play in
the strategy we have proposed. The committee acknowledges the
industry's declared commitment to the goal of reducing underage
drinking and its willingness to be part of the solution. We believe
that there is much common ground, and that opportunities for
cooperation are now being overlooked. Specifically, we urge the alcohol
industry to join with private and public entities to create and fund an
independent, non-profit foundation that focuses solely on designing,
evaluating, and implementing evidence-based programs for preventing and
reducing underage drinking. Although the industry currently invests in
programs that were set up with that stated goal, the results of these
programs have rarely been scientifically evaluated, and the overall
level of industry investment is modest in relation to the revenues
generated by the underage market. We think it is reasonable to expect
the industry to do more than it is now doing, and to join with others
to form a genuine national partnership to reduce underage drinking.
We also urge greater self-restraint in alcohol advertising. We
recognize, of course, that advertising is a particularly sensitive
issue. However, a substantial portion of alcohol advertising reaches an
underage audience or is presented in a style that tends to attract
youth. For example, alcohol ads on TV often appear during programs
where the percentage of underage viewers is greater than their
percentage in the overall U.S. population. Building on an important
1999 report by the Federal Trade Commission, the committee's report
urges industry trade associations to strengthen their advertising codes
to prohibit placement of commercial messages in venues where a large
portion of the audience is underage. For many years, the industry trade
association codes permitted ad placements in media where adults were at
least 50 percent of the audience. The FTC recently announced that the
beer and distilled spirits trade associations have joined the wine
industry to increase the threshold to 70 percent for the minimum
proportion of adults in the viewing audience. This is a step in the
right direction, but the committee believes that the industry should
continue to move toward a higher threshold of adult viewers. In
addition, trade associations and alcohol companies should create
independent, external review boards to investigate complaints about ads
and enforce codes. Furthermore, alcohol companies, advertising firms,
and commercial media should refrain from marketing practices that have
particular appeal to young people, regardless of whether they are
intentionally targeted at youth audiences.
Companies and trade associations in the entertainment sector also
have a responsibility to join in the collective effort to reduce
underage drinking, and to exercise greater restraint in disseminating
images and lyrics that promote or glorify alcohol use in venues with
significant underage audiences. Officials in the music, TV, and film
industries should use rating systems and codes similar to those used by
some industries for drug abuse to reduce the likelihood that large
numbers of young listeners and viewers will be exposed to unsuitable
messages about alcohol consumption--even when adults are expected to
make up the majority of the audience.
The Federal Government should periodically monitor advertising
practices in the alcohol industry and review representative samples of
movies, television programs, music recordings, and videos that are
offered at times or venues likely to have significant underage
audiences. This work should be conducted by the U.S. Department of
Health and Human Services, and reported to Congress and the general
public on a regular basis. The department also should issue a
comprehensive report to Congress each year summarizing trends in
underage drinking, and reporting on progress in implementing the
proposed strategy and in reducing the problem. A Federal interagency
coordinating committee, chaired by the Secretary of HHS, should be
formed to provide national leadership and to better organize the
multiple Federal activities in this area. HHS also should create a
National Training and Research Center on Underage Drinking and collect
more detailed data, including data on brands preferred by youth. State
policy-makers should designate an agency to spearhead and coordinate
their activities.
To help pay for the proposed public programs and to help reduce
underage consumption, Congress and State legislatures should raise
excise tax rates on alcohol--especially on beer, which is the alcoholic
beverage that young people drink most often. Alcohol is much cheaper
today, after adjusting for inflation, than it was 30 to 40 years ago.
Higher tax rates should be tied to the Consumer Price Index to keep
pace with inflation. Research indicates that changes in these tax rates
can decrease the prevalence and harmful effects of drinking among
youths, who tend to have limited discretionary income and are
especially sensitive to changes in price.
In summary, we've proposed a comprehensive strategy that, taken as
a whole, would foster a deep, unequivocal societal commitment to
curtail underage drinking. As a national community, we need to focus
our attention on this serious problem and accept a collective
responsibility to address it. This is an admittedly difficult
challenge, but the committee believes that our country can do much more
than it is now doing. The nation needs to develop and implement
effective ways to protect young people from the dangers of early
drinking while respecting the interests of responsible adult consumers
of alcohol. The committee's report attempts to strike the right
balance.
Thank you for your interest and the opportunity to testify to the
subcommittee. I'd be happy to answer any questions you may have about
the committee's report.
Prepared Statement of Patricia J. Kempthorne, First Lady of Idaho
As the First Lady of Idaho, thank you for your invitation to speak
to you today on behalf of the 34 current Governors' spouses and 11
Emeritus members of the Leadership to Keep Children Alcohol Free
national initiative.
I would like to acknowledge the support shown by many of our
members who are here today in commitment to this issue.
We are a non-partisan group devoted to increasing public awareness,
engaging policy makers, and mobilizing action to stop childhood
drinking. Our specific focus is the 9-15 year-old age group. The
Leadership to Keep Children Alcohol Free was established to make
childhood drinking prevention a national health priority. In addition
to their role as Governors' Spouses, Leadership members are
prosecutors, judges, educators, business leaders, substance abuse
prevention specialists, and parents. Many of us have witnessed through
our respective professions or personally the devastation early alcohol
abuse can inflict on individuals, families, and society. We are here
today to emphasize for the Committee the immediate and far reaching
consequences of childhood drinking and also to offer our
recommendations for action.
We are pleased that the Subcommittee on Substance Abuse and Mental
Health Services understands the need to address underage drinking in
all its complexity, including early onset of alcohol use by the most
vulnerable members of our society--children.
On a personal note as a parent, as a community encourager, and as a
proponent for the health and well-being of children I would like to
express my thanks to the committee and acknowledge the need for your
leadership in addressing this issue. During most of my childhood my
father worked as a distributor of wine and distilled spirits. It was
very clear to me at the time that alcohol was not meant for me as a
child. Growing up I learned a respect for alcohol as an adult beverage
but also saw some of the effects of the abuse of alcohol on members of
my community. Seeing the hurt and confusion caused by the abuse of
alcohol was instructive in helping me make choices in my life. I do not
believe today the message in our society is as clear.
While it is unsettling to think that we have to consider elementary
students when we think about drinking prevention, we do. The
environment surrounding our children often contributes to their
attitudes and expectancies about alcohol. In addition, drinking
initiation most often begins at the age of 13. We know from research
that behaviors adopted during adolescence set a lifelong trajectory.
Before you say ``but I've never seen a drunk 12 year old'', let me
share some statistics. More than 29 percent of students report that
they first drank alcohol (more than a few sips) before age 13. By the
eighth grade (that's 13-14 year olds), more than 12 percent report
having had five or more drinks in a row, that's binge drinking within
two weeks prior of being surveyed. They are drinking with the goal of
getting drunk.
Children are our top priority. We expend tremendous energy ensuring
that they are vaccinated, use infant car seats, and have access to
educational opportunities. Yet there is a serious disconnect when it
comes to childhood drinking.
Some propose that the solution is to adopt the so-called European
model in which drinking age laws and attitudes are more liberal. The
argument is that these policies and attitudes in turn foster more
responsible styles of drinking by young people. That is a myth.
In a study conducted in 1995, 15-16 year-olds in 22 European
countries were asked about consuming five or more drinks in a row.
Compared with the U.S., only a single country, Portugal, had a lower
percentage of kids report this behavior. In addition, the World Health
Organization report released in 2002 states that one in four deaths
among European men aged 15-29 years is alcohol related. This is not the
model we should emulate. Moreover, governments around the world,
including in Europe, are beginning to take action to address underage
drinking.
The phone call in the middle of the night is the fear of every
parent. What may not be immediately obvious, but just as devastating,
are the long-term irreversible consequences of heavy drinking during
adolescence.
Research documents that forty percent of kids who begin drinking
before the age of 15 will develop alcohol abuse or dependence at some
point in their lives. The adolescent brain is still a work in progress
and therefore vulnerable. More recent research demonstrated that
children who engaged in heavy drinking by age 15, showed noticeable
changes in the brain and that these children developed fewer learning
strategies and remembered less than non-drinkers. In addition, those
who begin drinking before age 14 are 12 times more likely to be injured
after drinking, 7 times more likely to be in motor vehicle crash, and
11 times more likely to be in a physical fight. Alcohol use also leads
to other risky behaviors with life changing consequences such as
unplanned pregnancies or infectious sexually transmitted diseases. And
finally, 28 percent of suicides and attempted suicides by children can
be attributed to alcohol.
Starting to drink at an early age poses risk not only for those who
drink, but there is a second-hand negative effect on the non-drinking
adolescent.
While parents certainly bear responsibility for their own children,
families do not live in a vacuum; our homes are not bunkers from
reality. Parental guidance is constantly challenged by external
influences. We are not here to place blame but to address a serious
public health issue that is affecting a significant number of our
nation's young people. The responsibility for solving this problem
rests with all of us--individuals, families, schools, communities,
policy-makers, opinion-leaders, retailers, and the industry. The
National Academies of Science and the Institute of Medicine have
identified opportunities for all of us to play a role in tackling the
problem of underage drinking as we are all stakeholders in the future
of our nation's youth. We need to be motivated by what is in the best
interests of our youth.
On behalf of the Leadership to Keep Children Alcohol Free and
speaking as a parent, I would respectfully offer four recommendations
for action:
1) Please do not let this be the only hearing on this critical
public health issue, but rather the impetus for a series of hearings
leading to significant policy deliberations and proposals.
2) We request that the Subcommittee ask the Surgeon General to
issue an independent evaluation and ``Call to Action on Childhood
Drinking'' and that the resulting report be released in a timely way.
3) We request that national surveys begin to collect data on
alcohol use and attitudes that include children as young as age 9.
4) When used by our youth alcohol is the number one illegal drug.
Therefore, we urge the Subcommittee to support increased funding for
research, prevention, and treatment. It is time to increase the
nation's investment on this issue and to bring it in line with what is
spent on illicit drugs and tobacco.
Each one of us can make a difference to ensure that our nation's
children have a strong foundation for life. Delaying the start of
alcohol use is a critical step in doing so. Please do not be swayed by
those who argue this is not a serious problem. Our children are
drinking at younger and younger ages and that should be a concern for
all of us.
Thank you.
Prepared Statement of Jeff Becker
Good morning Mr. Chairman and distinguished Senators. My name is
Jeff Becker and I'm the president of the Beer Institute, a national
trade association of America's brewers. I am pleased to represent
almost 900,000 men and women employed by our industry, including those
who work in two of our nation's largest breweries in the Buckeye State.
Our industry has a long and proud tradition of giving back to the
communities where we live and do business, and we share the commitment
of the members of this Subcommittee to combat illegal underage
drinking.
Our commitment stems from two areas. First, it is no surprise to
learn that many in our ranks are parents themselves--they share the
concerns of all parents in this regard. But equally important, we do
not like to see illegal underage consumption of the products that our
members take such great care to make for adults of legal purchase age.
We are joined in our commitment to be part of the solution to underage
drinking by a large percentage of small and large businesses in the
United States that would not be successful without a license to sell
alcohol beverages. I can assure you that we have enlisted the
commitment and the talents of personnel from our member companies, beer
wholesalers, and retailers across the nation in the ongoing challenges
posed by illegal underage drinking. We do not want the business of
young people below the legal purchase age.
That phrase ``ongoing challenges'' is not a glib cliche, because
each year, a new group of young people enter high school and college.
Each year, our children are allowed more freedom in our highly mobile
and open society. Some are allowed to take the bus or train to explore
their cities. Some get a driver's license that allows them to travel to
the next town for a school dance or a movie. Let us not forget that
some of them, as young as 18, are off in Iraq and Afghanistan serving
our country at war. The fact that our youth don't stop growing is only
one of the fundamental challenges that confront parents, educators, law
enforcement officials, and yes members of the beer industry. The stakes
are high, and a second challenge is to get these disparate groups
working together to find long and short-term ways to reduce illegal
underage drinking.
Have our efforts, along with those of many others, made a
difference? Let's look at the facts. While underage drinking has not
disappeared, teen drinking and teen drunk-driving fatalities have
declined significantly over the last two decades. According to the U.S.
Department of Health and Human Services, 82 percent of today's
adolescents do not drink.\1\ Similarly, according to the University of
Michigan survey called ``Monitoring the Future,'' sponsored by the
National Institute on Drug Abuse, the percentage of high school seniors
who report having a drink in the last 30 days was 30 percent lower in
2002 than it was in 1982.\2\ And beer drinking by college freshmen fell
37 percent in the same time frame according to the American Council on
Education and researchers at the University of California at Los
Angeles.\3\
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\1\ National Household Survey of Drug Abuse, available at http://
www.samhsa.gov/oas/p0000016.htm.
\2\ Available at http://monitoringthefuture.org.
\3\ The American Freshman Survey (2002), sponsored by UCLA and the
American Council on Education, available at http://www.gseis.ucla.edu/
beri/freshman.htm.
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In addition, the United States Department of Transportation reports
that fatalities in crashes involving drunk drivers aged 16 to 20 have
fallen 60 percent between 1982 and 2000. That progress has been
achieved even though the number of 16 to 20 year olds licensed to drive
has increased over 10 percent over the last decade to more than 12.6
million.\4\
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\4\ National Highway Traffic Safety Administration, U.S. Dept. of
Transportation (2002).
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While many factors explain this success, and there is still
significant room for improvement, we believe that one of reasons for
the progress of the last 20 years is that industry, government, and
communities have cooperated to create programs that work. Brewers have
committed hundreds of millions of dollars and substantial human, media,
political and other resources to create effective anti-underage
drinking programs.
A critical area in which I believe we have broad societal agreement
is the importance of active parental involvement to prevent underage
drinking. Brewers have long advocated and sponsored programs to
facilitate parental discussions about drinking with their young
children as well as their college-bound teens. By acknowledging the
temptation associated with underage drinking and encouraging their
children to respect themselves and the law, parents can make an
enormous difference. Brewer materials for parents are available in five
languages with useful information to explain why drinking is
inappropriate for youth. These efforts are effective because they draw
on the strong influence parents have over their children's decisions
about drinking.
For over a decade, according to a national poll conducted by the
Roper Research organization, youth have identified their parents as the
most powerful influence in their decision to drink or to refrain from
drinking. I should point out that advertising has always been one of
the choices offered in the survey. Every year, it has ranked dead last
as an influential factor by the most important group in this
discussion: youths themselves.
Because young people have so plainly told us that parents are the
most effective way to reach them on the issue of underage drinking, we
strongly believe in providing information and encouragement to help
parents exercise this influence. And we do. Over the last several
years, our members have distributed over 5 million pieces of material--
guidebooks, videos, and others--to parents across the U.S. Brewers have
also maintained on-going national advertising campaigns and
comprehensive websites dedicated to this issue.
In addition to programs aimed at parents, our members sponsor or
fund specific programs for those who sell our products in supermarkets,
convenience stores, stadiums, concert venues, restaurants, and other
retail outlets. As stated in the FTC Report to Congress released
earlier this month, retailers play a vital role in stopping underage
drinking by following their State laws and by checking and verifying
IDs. Our members sponsor programs and provide materials in English,
Spanish, Korean, and Vietnamese for servers of alcohol to teach them
how to properly check IDs and to spot fake IDs. The Beer Institute and
our members also disseminate ``NAT ID'' and other point-of-sale
materials that remind customers that the establishment will ask for
proper identification. In cooperation with retailers, police
departments, county sheriffs, and other State and local agencies,
brewers also have worked aggressively to help retailers and servers
prevent the illegal underage purchase of alcohol.
Over the last decade, brewers have joined the National Highway
Traffic Safety Administration, Major League Baseball, and other
professional sports leagues in the TEAM Coalition to address underage
drinking and abusive consumption at games and other major outdoor
events.
And, at the college level, we have supported campus programs that
focus student attention on education and awareness, emphasizing
personal responsibility and respect for the law--which means not
drinking if you are under 21, and drinking responsibly if you are above
the legal drinking age and choose to drink. These programs include,
among others, support for National Collegiate Alcohol Awareness Week
programming, a nation-wide awareness effort that is taking place this
month on hundreds of campuses across the country. Our industry has also
supported research and programs collectively known as social norms, a
positive approach that reminds college students that the large majority
of their peers make healthy and responsible decisions about drinking.
Last year, the National Institute on Alcohol Abuse and Alcoholism
(NIAAA) issued a comprehensive report on alcohol abuse on campus, a
section of which categorized social norms and other approaches
supported by the industry as effective or promising.\5\
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\5\ Task Force of the National Advisory Council on Alcohol Abuse
and Alcoholism, A Call to Action: Changing the Culture of Drinking at
U.S. Colleges, NIAAA, 2002, p. 24.
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And finally, in addition to the other programs I have discussed,
brewers have created diverse national advertising campaigns including
``Live Responsibly,'' ``Let's Stop Underage Drinking Before It
Starts,'' and ``21 Means 21.''
The recent Federal Trade Commission Report on alcohol beverage
industry self regulation reviewed industry-sponsored programs favorably
and pointed out that they are developed by professionals in the fields
of education, medicine, or alcohol abuse and that they follow
approaches recommended by alcohol research.\6\
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\6\ Federal Trade Commission, Alcohol Marketing and Advertising--A
Report to Congress, September, 2003, p. 21.
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Since our industry's advertising activities have recently been the
subject of Congressional interest, I would like to briefly touch on
some other developments that underscore our commitment to market and
sell our products to adults of legal purchase age. The FTC's 2003
Report unequivocally stated that beer industry members do not target
underage consumers. Critics seek to use advertising as a lightning rod
to divert attention from the real issues. Perhaps it is because they
question the larger issue of beer's respected place in American
society. But let's face it: drinking beer is not the only adult
activity that youth should not engage in. In fact, this is just one of
the many rules that society imposes on young people as they pass
through maturity on their way to adulthood. And the most effective way
to keep youth from engaging in adult behavior is not to pretend that
adult products don't exist or that advertising causes people under 21
to drink. The way to address this issue is to help youth navigate
through an adult world where there are many things--driving a car,
voting in an election--not just drinking, that are not appropriate for
them until they reach an age of maturity.
At the same time, our advertising is intended for adults, and our
members voluntarily undertake extensive steps to avoid advertising and
marketing that could be perceived as directed at youth. Self-regulation
in this area is very important from a public policy perspective.
The 2003 FTC report further reinforces a statement from a 1999
agency report on alcohol beverage advertising: ``Self-regulation is a
realistic, responsive and responsible approach to many of the issues
raised by underage drinking. It can deal quickly and flexibly with a
wide range of advertising issues and brings the accumulated experience
and judgment of an industry to bear without the rigidity of government
regulations.'' \7\ The FTC has conducted four comprehensive reviews of
industry advertising practices over the last 5 years.\8\ The FTC
recently indicated that, ``Self-regulation practices in the alcohol
industry have shown improvement since issuance of the 1999 Report . .
.'' \9\ Its September 2003 report cited improvements in the area of ad
placement, noting that industry members had shown 99 percent compliance
with industry standards governing placement of broadcast
advertising.\10\ The FTC report discusses a number of important changes
in our industry advertising code, which I will touch on in a moment. In
the interest of full disclosure, the FTC also included some cautionary
comments about advertising content and other issues, and we take the
Commission's advice seriously.
---------------------------------------------------------------------------
\7\ Self-Regulation in the Alcohol Industry: A Review of Industry
Efforts To Avoid Promoting Alcohol To Underage Consumers, A Report to
Congress from the Federal Trade Commission (Sept. 1999), at p. 4.
Furthermore, our review of the internal company documents did not find
evidence that the products and their advertising are targeted to
consumers under 21.'' \7\ The Bureau of Alcohol, Tobacco and Firearms
agreed these beverages ``were placed appropriately with other alcohol
beverages in retail outlets, and that available point of sale
advertising was not targeting consumers under age 21.'' \7\
\8\ The FTC has initiated the following: Orders to file special
reports to several major industry members in 1998; the 1999 report
cited above in footnote 7; 2001 investigation of advertising and
marketing of flavored malt beverages; and Alcohol Marketing and
Advertising--A Report to Congress, September, 2003
\9\ Federal Trade Commission, Alcohol Marketing and Advertising--A
Report to Congress, September, 2003, p. 22.
\10\ Id.
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In addition to the latest FTC report, the National Academies
September report to Congress recognized the importance of self-
regulation. The report does highlight the age-old scholarly debate over
advertising and underage drinking, which clearly indicates that
advertising is not a significant factor in underage drinking or the
decision to drink at any age. Beyond that discussion, however, the
National Academies panel states, ``The industry has the
prerogativeindeed, the social obligation--to regulate its own practices
in promotional activities that have a particular appeal to youngsters,
irrespective of whether such practices can be proven to ``cause''
underage drinking.'' [emphasis in original] \11\
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\11\ National Research Council and Institute of Medicine of the
National Academies, Reducing Underage Drinking--A Collective
Responsibility, p. 137.
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We do have some fundamental differences with the National Academies
recommendations and the process used to develop them. We believe the
key to further progress in reducing underage drinking lies in family
and community-based efforts. We are disappointed that the National
Academies panel ignored the clear direction of Congress to evaluate
existing Federal, State, and non-governmental programs. The panel
focused heavily on costly and experimental government solutions with a
cursory review of existing programs, including many State efforts that
combine education and enforcement to address unique challenges in
different areas of our nation. The report does not provide the guidance
Congress sought to determine policy and funding priorities to further
reduce illegal underage access and consumption. This is unfortunate.
For over 50 years, Beer Institute's members have maintained
socially responsible business practices including a policy of vigorous
self-regulation of advertising and marketing. First adopted in 1943,
the beer industry's advertising code has evolved over time to respond
to societal and technological developments. We want our intentions to
be clear to our consumers as well as to those who do not drink. Our
primary goal as an industry is to reach out to those who can legally
purchase our products with tasteful, contemporary advertising that
increases awareness of our members' brands. Our ads are enjoyed by
millions of Americans and rated highly in numerous surveys of adult
consumers. Consistent with our longstanding policies, the Beer
Institute Code was recently revised to incorporate some of the best
practices of our member companies and to address several FTC
recommendations.
I am pleased to inform you that our members have revised the
standard for advertising placements in television, radio, and magazines
to require placements only where the proportion of the audience above
age 21 is reasonably expected to be 70 percent or higher. This standard
reflects the demographics of the US population, in which approximately
70 percent of the public is age 21 or older. We have also expanded our
code provisions covering marketing at or near college campuses and
product placement in television programs and movies. The 2003 FTC
report discusses these revisions in detail, and a copy of our full code
is included with this testimony.
Although the recent National Academies recommendation to increase
excise taxes is not part of our discussion here today, it is well known
that the beer industry opposes such a measure; and I would like to take
a brief moment to explain why. We oppose higher excise taxes because
they are not an effective deterrent to abusive consumption or illegal
underage drinking. A tax increase would force responsible adults on a
budget--a large number of consumers who enjoy our products--to pass up
the purchase of a six pack because it becomes less affordable. The
science on this issue was examined by the NIAAA in its 10th Special
Report to Congress. Their conclusion is that no consensus exists in
this debate. Research conducted by Thomas Dee, and funded by the NIAAA,
indicates that teens are not affected by higher taxes. In fact, Dee's
research exposes methodological flaws in the research that the National
Academies cited in support of raising excise taxes. If the research
used to support higher beer taxes is flawed, we are surprised that the
underage drinking committee ignored this important fact. Further, we
note that Henry Weschler's research on the effects on college students
is also cited in the NIAAA report, which concludes, ``The results
suggested that alcohol prices were a less salient determinant of the
drinking behavior of college students than they were in other
populations.'' Finally, a study coauthored by one of the National
Academies' panelists indicates that the effects of tax increases may be
``considerably smaller than suggested in previous literature.'' \12\
The bottom line is that we do not support this recommendation because
there is no scientific consensus to show that it will reduce teen
drinking. It is also regressive and unfair to responsible adult
consumers.
---------------------------------------------------------------------------
\12\ Cook, P.J. and Moore, M.J., ``Environment and Persistence in
Youthful Drinking Patterns,'' in Risky Behavior Among Youths, An
Economic Analysis, edited by Jonathan Gruber, University of Chicago
Press, National Bureau of Economic Research, 2001, pp. 375-437.
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In closing, I'd like to leave you with this last fact. Brewers
fully recognize that underage drinking is a problem that our society
must embrace and tackle. We hope that we will be given the
consideration to be a meaningful part of that fight, through our
demonstrated commitment to this issue. As the father of two children,
and I share this committee's concern--just like every other parent out
there. Thank you for the opportunity to discuss these important issues.
Prepared Statement of Wendy J. Hamilton, National President, Mothers
Against Drunk Driving
INTRODUCTION
Good morning, my name is Wendy Hamilton and I am the National
President of Mothers Against Drunk Driving. MADD's mission is to stop
drunk driving, support the victims of this violent crime and prevent
underage drinking. I am honored to be here today to testify on the
critical public health issue of illegal youth alcohol use.
I would like to take this opportunity to thank Chairman DeWine and
Senator Dodd for holding this hearing today and for their continued
commitment to protecting America's youth. Senators, your leadership has
been and will be so important in bringing underage drinking prevention
to the forefront of our nation's policy agenda.
I would also like to recognize and thank Senators Arlen Specter,
Robert Byrd, Tom Harkin, John Warner, Harry Reid, and Representatives
Lucille Roybal-Allard, Frank Wolf and Zach Wamp for requesting the
National Academy of Sciences (NAS) report and for their efforts to
reduce underage drinking. MADD looks forward to working with this
committee and with Congress to develop prevention policies that provide
adequate attention and funding--and employ effective strategies--to
save young lives.
Today's hearing is truly historic--never before has the Federal
Government considered action to develop a comprehensive strategy to
prevent underage drinking, even though underage alcohol consumption is
the nation's number one youth illegal drug problem. The NAS has
assembled the nation's top public health researchers to examine a
problem that has been overlooked for far too long. NAS has done an
outstanding job cataloguing research and making science-based
recommendations that if implemented will save lives.
The public health and safety community has been pursuing action at
the Federal level for many years on this issue, but only now has the
necessary national dialogue begun. With this committee's leadership,
the national spotlight will finally shine on this sorely neglected
issue.
THE PROBLEM
Without question, alcohol is the most widely used drug among
America's youth. It is illegal for people under the age of 21 to drink
alcohol, and yet currently there are 10.1 million underage drinkers in
this nation (2002 National Household Survey On Drug Use and Health).
Alcohol kills 6.5 times more kids than all other illicit drugs combined
and is a major factor in the three leading causes of death of America's
teens: motor vehicle crashes, homicides and suicides. Underage drinking
does not just harm the drinker: half of the people who die in traffic
crashes involving underage drinking drivers are people other than the
drinking drivers. Underage drinking is not harmless fun. There is no
such thing as ``responsible'' underage drinking.
Progress was made in the 1980's, most notably with the raising of
the minimum drinking age to 21--a law that has saved over 20,000 young
lives. But we still have a national mentality that accepts underage
drinking as a mere ``rite of passage,'' and underage drinking rates
remain inexcusably high and have not improved for the past decade.
According to 2002 Monitoring the Future data, nearly half (48.6
percent) of all high school seniors report drinking in the last 30
days, a much larger proportion of youth than those who report either
using marijuana (21.5 percent) or smoking (26.7 percent). The
proportion of high school seniors who report drinking in the last 30
days was the same in 2002 as it was in 1993. Additionally, 29 percent
of seniors report having five or more drinks on at least one occasion
in the past two weeks, a percentage virtually unchanged since 1993.
To bring these statistics to life, I would like to raise a recent
incident involving youth alcohol use that made national news. A Sunday
morning touch football game between suburban Chicago high school girls
turned into a brutal hazing incident resulting in the hospitalization
of five students, one with a broken ankle and another who needed 10
stitches in her head. Video tape of the event revealed that younger
girls were beaten, splattered with paint and had mud and feces thrown
in their faces. About 100 students were involved, including onlookers
who cheered while waving cups of beer before the camera.
In one segment of the home video, sixteen and seventeen year old
girls are seen being held upside down over a keg of beer by several
boys while they drink straight from the tap. In another segment,
several girls can be seen pounding on one girl with their fists while
they push her down into the mud.
School officials cited alcohol as a major factor in the violence,
and in the weeks that followed, police charged two parents with
providing three kegs of beer to minors.
As the nation watched these broadcasts in horror, many teens likely
did not bat an eye. The Chicago incident could have been filmed in
almost any town. Today, teens have easy access to alcohol. They are
saturated with irresponsible alcohol ads. Underage drinking laws are
not well enforced. And, parents and communities often look the other
way when kids drink, in many cases even providing the beer. We've all
heard the line: ``Well, at least they're not using drugs.'' The fact
is, alcohol IS the illegal drug of choice for kids.
DRUNK DRIVING AND OTHER ALCOHOL-RELATED CONSEQUENCES ASSOCIATED WITH
YOUTH ALCOHOL USE
The consequences of youth alcohol use are staggering. Research
demonstrates that the younger someone starts drinking, the more likely
they are to suffer from alcohol-related problems later in life,
including alcohol dependence and drunk driving. Children who drink
before age 15 are four times more likely to become alcohol dependent
than those who delay drinking until they are 21.
More than 17,000 people are killed each year in alcohol-related
crashes and approximately one-half million are injured. In 2000, 69
percent of youth killed in alcohol-related traffic crashes involved
underage drinking drivers. Although young drivers make up a mere 7
percent of the driving population, they constitute 13 percent of the
alcohol-involved drivers in fatal crashes.
The 1999 National Survey of Drinking and Driving Among Drivers Age
16-20 revealed that youth drove 11 million times after drinking in the
past year. Their average blood alcohol level was .10 percent, three
times the level of all drivers who drove after drinking. Forty percent
of youth who drove after drinking had a least one passenger in the
vehicle. Clearly young drivers are putting themselves at risk, but they
are also putting others at risk. Society has an obligation to protect
motorists from the risky behavior of underage drinkers. Society also
has an obligation to protect kids from themselves.
Alcohol is also implicated in a large portion of deaths and
injuries caused by dangers other than drinking and driving. According
to the NAS, nearly 40 percent of youth under age 21 who died from
drowning, burns and falls tested positive for alcohol. Youth alcohol
use is also associated with violence and suicidal behavior. Individuals
under 21 commit 45 percent of rapes, 44 percent of robberies, and 37
percent of other assaults, and it is estimated that 50 percent of
violent crime is alcohol-related.
Sexual violence, as well as unplanned and unprotected sexual
activity, is another consequence of youth alcohol use. A 2002 National
Institute on Alcohol Abuse and Alcoholism (NIAAA) study titled ``A Call
to Action: Changing the Culture of Drinking at U.S. Colleges'' found
that each year more than 70,000 students aged 18-24 are victims of
alcohol-related sexual assault or date rape. Additionally, the report
found that 600,000 students were assaulted by another drinking college
student annually.
Long-term consequences of youth alcohol use have become more and
more clear as research on the adolescent brain continues to emerge. The
human brain continues to develop into the early 20's. Studies show that
heavy alcohol use by youth has disproportionately negative effects on
the physical development of the brain, and that alcohol use during
adolescence has a direct affect on brain functioning.
In addition to the human costs associated with underage drinking,
the economic cost to society is staggering. It is conservatively
estimated that underage drinking costs this nation $53 billion dollars
each year, including $19 billion from traffic crashes and $29 billion
from violent crime. The NAS points out that this estimate is ``somewhat
incomplete'' and ``does not include medical costs other than those
associated with traffic crashes'' and other potential factors
contributing to the social costs of underage drinking. The NAS
concludes that ``the $53 billion appears to be an underestimate of the
social costs of underage drinking.'' (p. 70)
NATIONAL ACADEMY OF SCIENCES PROVIDES ROADMAP FOR THE NATION
The NAS report provides a significant and groundbreaking
opportunity to help put the nation's number one youth drug problem on
the national policy agenda and gives our nations' leaders the impetus
for concrete action. All of the NAS recommendations should be seriously
considered by Congress, the Administration, and State and local
leaders. The NAS strategy includes components that will involve leaders
at all levels of government, community activists, parents, educators,
businesses, law enforcement, youth and society at large.
The NAS roadmap includes ten main components:
1. National Adult-Oriented Media Campaign
2. Partnership to Prevent Underage Drinking
3. Alcohol Advertising
4. Entertainment Media
5. Limiting Access
6. Youth-Oriented Interventions
7. Community Interventions
8. Government Assistance and Coordination
9. Alcohol-Excise Taxes
10. Research and Evaluation
While MADD supports the NAS report in its entirety, my testimony
will focus on areas MADD believes will have the greatest impact on
reducing youth alcohol use.
national efforts to combat underage drinking woefully inadequate
While illicit drugs and tobacco youth prevention have received
considerable attention and funding from the Federal Government,
underage drinking has consistently been ignored. NAS confirms this:
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.'' (p. 14)
Not only is there minimal funding available to States and local
communities specifically targeted to reduce youth alcohol use, there is
also no coordinated national effort to reduce and prevent underage
drinking.
In May 2001 the General Accounting Office (GAO) released a report
outlining Federal funds aimed at preventing underage drinking. The
report provided concrete evidence that: (1) the Federal Government's
approach to youth alcohol use prevention is disjointed and (2) funding
for youth alcohol prevention is woefully inadequate.
GAO found that multiple Federal agencies play some role in underage
drinking prevention, and that only a very small portion--7 percent--of
total funds available for alcohol and other drug use both had a
specific focus on alcohol and identified youth or youth and the broader
community as the specific target population. Specifically, among the
Departments of Health and Human Services, Justice and Transportation, a
mere $71.1 million focused on youth or alcohol and youth and the
broader community.
Citing the GAO and additional research, the NAS report concludes
the following:
. . . there is no coordinated, central mechanism for disseminating
research findings or providing technical assistance to grantees or
others interested in developing strategies that target underage
drinking . . . the committee is not aware of any ongoing effort to
coordinate all of the various Federal efforts either within or across
departments. The multitude of agencies and initiatives involved
suggests the need for an interagency body to provide national
leadership and provide a single Federal voice on the issue of underage
drinking. (p. 236-237)
The NAS report also adds that ``community efforts are most likely
to succeed if they have strong and informed leadership'' and that
``resources are needed for training and leadership development for
coalition and task force members as well as key decision makers.'' (p.
237-238)
NAS Recommendations 12-1 through 12-6 demonstrate a clear need for
better ``Government Assistance and Coordination'' at the national level
in order to reduce underage drinking. MADD strongly supports
implementation of NAS Recommendations 12-1 through 12-6:
12-1: A Federal interagency coordinating committee on prevention of
underage drinking should be established, chaired by the secretary of
the U.S. Department of Health and Human Services.
12-2: A National Training and Research Center on Underage Drinking
should be established in the U.S. Department of Health and Human
Services. This body would provide technical assistance, training, and
evaluation support and would monitor progress in implementing national
goals.
12-3: The secretary of the U.S. Department of Health and Human
Services should issue an annual report on underage drinking to Congress
summarizing all Federal agency activities, progress in reducing
underage drinking, and key surveillance data.
12-4: Each State should designate a lead agency to coordinate and
spearhead its activities and programs to reduce and prevent underage
drinking.
12-5: The annual report of the secretary of the U.S. Department of
Health and Human Services on underage drinking should include key
indicators of underage drinking.
12-6: The Monitoring the Future Survey and the National Survey on
Drug Use and Health should be revised to elicit more precise
information on the quantity if alcohol consumed and to ascertain brand
preferences of underage drinkers.
NATIONAL ADULT-ORIENTED MEDIA CAMPAIGN
Six years ago, Congress allocated $1 billion dollars to the White
House Office of National Drug Control Policy (ONDCP) for an anti-drug
media campaign designed to prevent youth drug use. Despite the fact
that alcohol is the number one youth drug problem--both then and now--
underage drinking prevention messages were excluded from the campaign.
MADD and other members of the public health and safety community
pressed to have underage drinking prevention messages included in the
ONDCP campaign. In May 1999, an amendment sponsored by Representatives
Lucille Roybal-Allard (D-CA) and Frank Wolf (R-VA) was introduced that
would change the authorizing legislation to allow ONDCP to begin
including such messages. The proposed amendment came under attack and
was eventually defeated due to intense pressure from the alcohol lobby.
Since 1998, Congress has considered creating a separate media
campaign to prevent underage drinking, but those attempts also failed
due to behind the scenes opposition from the alcohol industry. The
alcohol industry instead pressured Congress to request a study as a
means to delay action on a media campaign. The Congressional directive
to NAS to develop a comprehensive strategy to prevent underage drinking
dates back several years to repeated attempts by the public health and
safety community to establish a media campaign that addresses youth
alcohol use.
When the alcohol industry learned that the NAS might recommend
prevention measures it opposes, alcohol interests tried to
inappropriately influence the content of the report, fault the NAS
expert panel, and criticize and discredit the findings while they were
being formulated. Before the NAS report was even released, the beer
industry took out full-page ads in Roll Call, the Hill, Congress Daily
and other Capitol Hill publications in an attempt to discredit the
report findings. The beer industry complained that they did not have
enough influence on the NAS report.
MADD believes that the alcohol industry, and in particular the beer
lobby, has not earned credibility on the issue of underage drinking
prevention. As the nation attempts to get serious about employing
effective, science-based strategies to curb the nation's number one
youth drug problem, MADD urges the alcohol industry to stop its
baseless opposition to proven public health measures and to stop
relying on underage drinking as a source of revenue.
It is unacceptable that the alcohol industry has been the sole
source of messaging to parents and teens on underage drinking. Congress
decided that it wasn't a good idea to let tobacco companies be the sole
voice in educating the public on smoking prevention. We believe the
same should hold true for the alcohol companies on underage drinking.
MADD commends the NAS for calling for a national advertising
campaign to prevent underage drinking and strongly supports NAS
Recommendation 6-1:
6-1: The Federal Government should fund and actively support the
development of a national media effort, as a major component of an
adult-oriented campaign to reduce underage drinking.
The goals of the national media campaign, as explained by NAS,
would be to instill a broad societal commitment to reduce underage
drinking, to increase specific actions by adults that are meant to
discourage underage drinking, and to decrease adult conduct that
facilitates underage drinking.
The need for a comprehensive public education campaign aimed at
underage drinking prevention is undeniable as most parents and teens
are unaware of the dangers associated with youth alcohol use. Many
parents do not recognize the prevalence of or the risks associated with
drinking for their own children, and many parents even facilitate their
underage children's drinking by giving kids access to alcohol, by not
responding to children's drinking, and by not adequately monitoring
their children's behavior.
NAS also concludes that an adult-oriented national media campaign
is also important because it would support local efforts to reduce
underage drinking. It is important not only because of what it will
accomplish on its own, but also because its effects bolster local
efforts.
REDUCING YOUTH EXPOSURE TO ALCOHOL ADVERTISING
Underage youth are bombarded with irresponsible alcohol marketing
messages depicting alcohol consumption as cool, sexy and glamorous. The
establishment of a national media campaign to prevent underage drinking
is particularly important given the fact that in 2001 the alcohol
industry spent 1.6 billion dollars on product advertising in the
``measured media'' (including magazines, newspapers, outdoor
advertising, and radio and television). According to the Federal Trade
Commission (FTC), at least twice that amount was spent on unmeasured
promotion, including sponsorships and product placement in
entertainment media and other venues.
A recent study by the Center on Alcohol Marketing and Youth (CAMY
2003) reported that in 2001 the alcohol industry spent $23.2 million
dollars to air 2,379 ``responsibility'' messages, while in contrast the
industry spent $812.2 million on 208,909 product advertisements. There
were 179 product ads for every ad that referred to the legal drinking
age. Quite significantly, a typical ``responsibility'' ad is branded
with the alcohol company name, which leads many public health experts
to conclude that ``responsibility'' ads are simply another means to
promote brand recognition and loyalty.
MADD is not against alcohol advertising, but it is imperative that
stricter standards be put in place to protect our children from
constant exposure to alcohol messages. Although beer is the favorite
alcoholic beverage among young people, the beer industry has advertised
for years with little or no restrictions or standards from the
networks. Strong alcohol advertising restrictions must be mandatory for
all segments of the alcohol industry--including ads for beer, wine,
liquor and malt-based beverages.
According to the Office of Juvenile Justice and Delinquency
Prevention, underage drinkers consume about 10 percent of all the
alcohol purchased in the United States, or 3.6 billion drinks annually.
NAS reports that underage drinkers consume anywhere from 10 to 20
percent of all alcohol purchased in the U.S. Beer is the most common
drink consumed in most cases of heavy drinking, binge drinking, drunk
driving and underage drinking.
Now ``malternatives'' or ``alcopops'' have climbed onto the
advertising bandwagon to capture more of the youth market (such as
Smirnoff Ice, Bacardi Silver, and Skyy Blue). MADD is deeply concerned
with the growing number of ads for liquor-branded, malt-based beverages
that have a flavor and marketing plan that appeals to our kids. Just
like beer, the distilled spirits industry is being given a ``free
pass'' to establish brand recognition and loyalty among youth. NAS
states that:
A particularly troubling illustration of the youth-specific
attractions of an alcohol marketing campaign concerns so-called
``alcopops,'' sweet, flavored alcoholic malt beverages. Recent survey
data suggest that these products are more popular with teenagers than
with adults, both in terms of awareness and use. (p. 135)
Greater restrictions are also needed for print advertising. Despite
the alcohol industry's claims, CAMY reports that young people under 21
are reached at a higher proportion to their numbers in the population
by alcohol ads. Our youth see far more beer, distilled spirits and
malternative advertising in magazines than adults. In 2001 alone,
nearly one-third of all measured magazine alcohol ads were placed in 10
publications with a youth audience of 25 percent or more.
NAS points out that the dispute over whether alcohol advertising
``causes'' underage drinking is simply an ``unnecessary distraction''
from the most important task at hand: the alcohol industry must do a
better job of refraining from marketing products or engaging in
promotional activities that appeal to youth. NAS concludes that if the
industry fails to respond in a meaningful way to this challenge, the
case for government action becomes compelling.
MADD supports all of the NAS recommendations on alcohol
advertising, but in particular MADD urges action on NAS Recommendations
7-4 and 12-6:
7-4: Congress should appropriate the necessary funding for the U.S.
Department of Health and Human Services to monitor underage exposure to
alcohol advertising on a continuing basis and to report periodically to
Congress and the public. The report should include information on the
underage percentage of the exposed audience and estimated number of
underage viewers for print and broadcasting alcohol advertising in
national markets and, for television and radio broadcasting, in a
selection of large local or regional markets.
12-6: The Monitoring the Future (MTF) Survey and the National
Household Survey on Drug Use and Health (NSDUH) should be revised to
elicit more precise information on the quantity of alcohol consumed and
to ascertain brand preferences of underage drinkers.
Both of these recommendations call for basic public health
surveillance that is essential to identify and prevent the over-
exposure of our youth to alcohol advertising. The availability of such
data is needed to understand the actual youth impact of new products
and the advertising campaigns that promote them.
LIMITING ALCOHOL ACCESS TO YOUTH
Limiting youth access to alcohol is a proven way to decrease
underage drinking. Most notably, increasing the minimum drinking age to
21 has been one of the most effective public health policies in
history, resulting in a significant decrease in fatal traffic crashes,
DWI arrests, and self-reported drinking by young people. However, the
law alone does not preclude youth from gaining access to alcohol.
General deterrence through sanctions, improved enforcement, and public
awareness of enforcement is needed in order to effectively implement
restrictions on youth alcohol use.
The NAS report points out that ``[i]t is apparently not difficult
for youth who want to drink to readily obtain alcohol. A majority of
high school students, even eighth graders, report that alcohol is
`fairly easy' or `very easy' to get, with the proportion increasing
from eighth to tenth to twelfth grade.'' For eighth graders, 60 percent
report that alcohol is fairly easy or very easy to obtain, while for
twelfth graders the percentage is more than 90 percent. The NAS also
reports that the ``alcohol most favored by underage drinkers is beer.''
A critical component of a comprehensive strategy to reduce underage
drinking is to enact and strengthen laws designed to limit youth
alcohol consumption. Although every State defines the legal minimum
drinking age at 21, State laws vary in scope in terms of restrictions
relating to underage purchase, possession, or consumption of alcohol
and for the use of false identification. These weaknesses, as NAS
points out, compromise the effectiveness of minimum drinking age laws.
The NAS recommendations to limit youth alcohol use focus on
enacting and strengthening laws to: (1) reduce access through
commercial sources; (2) reduce access through non-commercial sources;
(3) reduce drinking and driving by underage drinkers; and (4) prescribe
and enforce penalties on adult providers and underage drinkers.
In addition to closing loopholes in age 21 laws as mentioned above,
NAS suggests, and MADD agrees, implementing key approaches to meeting
these goals, including:
Imposing more stringent penalties on retail licensees for
violation of laws against sales to minors;
Strengthening compliance check programs in retail outlets;
Strengthening or enacting dram shop laws;
Regulating internet sales and home delivery of alcohol;
Holding adults responsible for illegal consumption of
alcohol by minors;
Implementing beer keg registration laws to deter the
purchase of kegs of beer for consumption by minors;
Strengthening enforcement of zero tolerance laws;
Implementing the use of routine sobriety checkpoints to
increase the deterrence of underage drinking and driving.
Enforcement of State and local laws has proven to be a highly
effective tool in underage drinking prevention. Tougher enforcement of
laws aimed at reducing underage drinking is greatly needed, and
Congress can provide the impetus for action. In particular, MADD
strongly supports NAS Recommendation 9-3:
9-3: The Federal Government should require States to achieve
designated rates of retailer compliance with youth access prohibitions
as a condition of receiving block grant funding, similar to the Synar
Amendment's requirements for youth tobacco sales.
As part of a comprehensive strategy to reduce underage drinking,
Congress should also provide additional resources to law enforcement in
order to improve enforcement of underage drinking laws.
EXPANDING YOUTH-ORIENTED AND COMMUNITY INTERVENTIONS
The NAS report underscores the need for expanding youth-oriented
and community interventions, including: intensive research and
development for a youth-focused national media campaign to prevent
underage drinking; funding for and implementation of evidence-based
education interventions, with priority given to those that incorporate
effective elements and those that are part of comprehensive community
programs; and improving assessment and treatment programs.
MADD strongly supports NAS Recommendation 11-2:
11-2: Public and private funders should support community
mobilization to reduce underage drinking. Federal funding for reducing
and preventing underage drinking should be available under a national
program dedicated to community-level approaches to reducing underage
drinking, similar to the Drug Free Communities Act, which supports
communities in addressing substance abuse with targeted, evidence-based
prevention strategies.
MADD's youth programs are rooted in the latest scientific research
and strive to empower children, teens and parents with knowledge so
that individuals will be able to keep themselves and others safe from
harm. Programs encourage good decision-making and engage youth in
specific interventions designed to reduce underage drinking.
One of MADD's most successful community based youth programs is
called Youth In Action (YIA). MADD's YIA program partners young people
with community adult leaders to work toward ``environmental''
prevention strategies. Projects focus on strengthening enforcement of
underage drinking laws and policy change. YIA teams have been trained
in more than 40 communities across the country. Their partnerships with
local law enforcement agencies, schools and community leaders have
helped pass key underage drinking legislation and saved young lives.
Youth In Action focuses on the community environment that condones
underage drinking, from the store clerk who doesn't check IDs, to the
police officer who might pour out the beer and send teens home, to an
adult who doesn't mind buying beer for a kid who slips him an extra
$10--YIA teams look for community solutions instead of focusing their
attention on their peers. Youth In Action teams engage in very specific
interventions because research says these projects work. YIA teams
across the country conduct:
Alcohol Purchase Surveys--A young looking 21 year old
attempts to purchase alcohol without an ID. No actual purchase is made.
It is merely a survey to see if the clerk would have sold alcohol to a
presumed minor without ID.
Compliance Checks--With the help of the police, young
people act as underage buyers. They are instructed to go through with
the sale, whether the clerks ask for ID or not. The police may cite or
arrest the store clerk.
Shoulder-Tap Surveys--With law enforcement present to
ensure safety, a young person (or group of young people) approach
strangers outside an alcohol retailer to see if these adults would
willingly purchase alcohol for them because they are too young to
legally buy. Those that answer yes receive instead of money, a card
outlining the law and penalty for furnishing alcohol to a minor. Those
that refuse to purchase alcohol are handed a card thanking them for
serving their community by refusing to provide alcohol to a minor.
Law Enforcement Recognition Programs--YIA teams publicly
thank local law enforcement officials who are working to prevent
underage drinking. This can be done many ways: a formal banquet, a
media event, or even just by bringing food to officers at the station
or out on location where police officers are working on the job. Either
way, this is a unique opportunity for teens to thank police officers
for doing their job.
Roll Call Briefings--YIA teams set up meetings with their
local police departments to make presentations at shift change
meetings. Two or three YIA members go to the police station with an
adult leader to encourage police officers to enforce the Zero Tolerance
Law. Many YIA teams have printed cards or notepads to hand out
outlining the law and declaring their support for it.
Two weeks ago while visiting New Orleans to attend the MADD
National Conference, 20 young activists from YIA teams from across the
country spent a Thursday night determining youth accessibility to
alcohol in the ``Big Easy'' by measuring the number of adults willing
to purchase alcohol for those under 21. The ``shoulder tap'' survey
revealed that it is relatively easy for youth to get alcohol in New
Orleans. Additionally, to help enforce the minimum drinking age law,
YIA teams spoke at 10 New Orleans Police Department roll call briefings
to demonstrate to law enforcement officers that young people believe
that the enforcement of the 21 minimum drinking age law will change
behavior and save lives.
Protecting You/Protecting Me (PY/PM) is another program developed
by MADD in response to educators, parents, and community leaders
seeking an alcohol-use prevention program for elementary school
students that could be incorporated in to the core curriculum. PY/PM
was named a Model Program by the U.S. Department of Health and Human
Services, Substance Abuse and Mental Health Services Administration
(SAMHSA), Center for Substance Abuse and Prevention (CSAP).
PY/PM includes the latest brain research, provides all curriculum
and training materials necessary for national replication and includes
an evaluation component, which continually demonstrates significant
results.
The PY/PM curriculum teaches first through fifth graders basic
safety skills, alcohol's effects on the developing brain and shows kids
how to protect themselves by making good decisions, such as what to do
when riding in a car with an unsafe driver. The curriculum is designed
to fill the gap in current prevention programs that have not yet
incorporated the latest research on children's brains and the
developmental risks associated with exposure to alcohol before the age
of 21.
The goal of the curriculum is to prevent injury and death of
children and youth due to underage consumption of alcoholic beverages,
and vehicle-related risks, especially as passengers in vehicles in
which the driver is not alcohol-free.
Evaluation of PY/PM has shown that students receiving the lessons
are:
more knowledgeable about their brains
more media literate
less likely to ride with a driver who is not alcohol-free
less likely to drink when they are teenagers
PY/PM is endorsed by the American Academy of Pediatrics and the
National Association of Elementary School Principals. By the end of
2003, nearly 200,000 elementary students will be exposed to MADD's PY/
PM's lessons in over 1,200 schools across the country.
INCREASING ALCOHOL EXCISE TAXES
Research shows that alcohol taxes and price affect youth alcohol
consumption and associated consequences. Studies demonstrate that
increased beer prices lead to reductions in the levels and frequency of
drinking and heavy drinking among youth and lower traffic crash
fatality rates among young drivers.
MADD strongly supports NAS Recommendation 12-7:
12-7: Congress and State legislatures should raise excise taxes to
reduce underage consumption and to raise additional revenues for this
purpose. Top priority should be given to raising beer taxes, and excise
tax rates for all alcoholic beverages should be indexed to the consumer
price index so that they keep pace with inflation without the necessity
of further legislative action.
Revenue generated from increased alcohol excise taxes could be
designated, as NAS suggests, to fund a broad prevention strategy to
reduce underage drinking. NAS concludes that ``the long downward slide
in the actual cost of these taxes to consumers has considerably
exacerbated the underage drinking problem.'' (p. 246)
Despite the public health ramifications, the alcohol industry
continues to push for lower alcohol excise taxes. In 1991, for the
first time in 40 years, the Federal excise tax on beer was raised from
$9 per barrel to $18 per barrel (or 16 cents per six-pack to 32 cents
per six pack).
MADD is strongly opposed to H.R. 1305 and S. 809, legislation
seeking to ``roll-back'' the 1991 beer tax increase. The National
Bureau of Economic Research has estimated that the 1991 increase saves
600 young lives each year in reduced traffic crashes. Similarly, MADD
is strongly opposed to H.R. 2950 and S. 1457, legislation seeking to
roll-back the Federal excise tax on distilled spirits to its pre-1985
level.
CONCLUSION
It is time for our nation--from parents to communities to our
political leaders at the national and State levels--to end the
complacent attitude about underage drinking and to take action to end
this public health epidemic. There is an urgent need to expand
prevention, treatment and community programs and improve enforcement of
existing laws to prevent underage drinking. More youth drink alcohol
than smoke tobacco or use other illegal drugs, yet Federal investments
in preventing underage drinking pale in comparison with resources
targeted at preventing illicit drug use.
The media constantly reports on the countless numbers of alcohol-
related deaths and injuries of today's youth, but our nation accepts
and even enables these preventable tragedies. The future of our
nation's youth continues to hang in the balance. Underage drinking is
illegal, and yet millions of kids continue to engage in this high-risk
behavior every month, every weekend, and even every day.
The NAS has reviewed the research and has recommended strategies
that will significantly reduce and prevent underage drinking: a
national media campaign to prevent underage drinking, tougher standards
for alcohol advertising, improved teen drinking prevention laws, better
enforcement and awareness of these laws, expanded youth and community
interventions, and increased Federal and State excise taxes on
alcohol--all areas that MADD's members view as critical to solving this
problem.
MADD will continue to work with Members of Congress and with
partners in the public health community to pursue introduction of a
comprehensive, science-based legislative package designed to reduce and
prevent underage drinking. I urge this committee to use the NAS
recommendations as a roadmap to create a healthier future for America's
youth.
The devastating effects of underage drinking are completely
preventable. The NAS recommendations give us a new beginning and a
fresh approach to attack this problem. We must, as a nation, ramp up
our efforts, and today is a new beginning in that endeavor. Thank you.
Prepared Statement of David DeAngelis
Good morning. My name is David DeAngelis, and I am a senior at
North Haven High School in North Haven, Connecticut. I would like to
thank Senator Dodd, Senator DeWine, and the sub-committee for inviting
me to be here this morning. I am honored to have the opportunity to
speak on this issue.
Three summers ago, three classmates and I attended the Connecticut
MADD Power Camp. One speaker left a lasting impression on us. Her
teenage daughter had been killed by a drunk driver and she began
speaking to young people about the perils of drinking and driving. The
task grew increasingly difficult and on the way to our group, she
prayed to her daughter for a sign to help her continue. A car passed.
The license plate read ``SAVE 1''.
The four of us left the camp determined to address the problems of
underage drinking in our community and started a newspaper column
titled ``SAVE 1''. We decided to target adults, hoping to enlighten
parents and encourage them to help their children make the right
choices. After the other three students graduated, I continued to write
it on my own.
Although I receive positive feedback about the column, I sometimes
get frustrated. Last spring, I gave a presentation to parents at my
town's middle school and only thirty people showed up. Trying to remain
motivated became a challenge.
That changed this summer when I volunteered as a staffer at Power
Camp and worked with students to develop a project for their town. I
left the camp optimistic after watching them rally behind their idea to
focus on passing a local ordinance against serving alcohol to minors at
house parties.
Today I speak before you on the heels of the release of the NAS
report on underage drinking. When I read the report, especially the
committee's proposal for a national adult-oriented media campaign, the
words Adult-oriented jumped out at me. Targeting adults is necessary to
effectively address underage drinking. Parents often take on a ``kids
will be kids'' attitude and think that drinking is part of growing up.
Actually, young people try to emulate adults whose social lives revolve
around alcohol. Many parents not only condone the use of alcohol but
also provide liquor to their children and their children's friends.
Last May, a classmate of mine had an after-prom party where alcohol
was included. To make sure the guests would be ``safe'', his parents
confiscated their car keys. This summer, what started as a few kids
hanging out in a basement turned into a full-fledged party as more and
more kids showed up with beer. The parents spent the entire evening
upstairs never checking on the group.
Then, there are the times when parents are not home. Kids party,
drink, and do stupid and dangerous things. One girl, hosting a party,
jumped into her pool fully clothed after getting drunk. Three times.
Another classmate celebrated his birthday by drinking at a friend's
house and falling down the stairs.
Underage drinking is not a problem confined to the town of North
Haven. It happens everywhere. This past July, I was here in Washington
for Boys Nation. Standing in the airport, I met some of the other
delegates and casually asked what they liked to do for fun. One
promptly replied, ``Drink'' and began recounting stories that involved
getting drunk with his friends.
A large number of high school students are affected by underage
drinking, including those who have made the decision not to drink.
These kids are often ostracized by students in the more popular
drinking circles and fight daily pressures to join.
This initiative is extremely important. It will take a national
movement to change the apathetic attitudes of parents. Blatant
disregard for the drinking age simply cannot be tolerated. The youth of
America are receiving the message that underage drinking is acceptable,
not to mention the messages they receive from the media.
The alcohol industry spends over one billion dollars each year on
advertising, portraying drinking as a ticket to good times. Most
disturbing is the fact that alcohol companies advertise during TV
programs viewed predominantly by teenagers. On the radio, more beer
commercials are heard by children than by adults. These ads are clever,
entertaining, and humorous. I can recite a radio commercial for Beck's
Beer that I heard almost every day this summer.
When children are not getting bombarded with commercials, they are
seeing images promoting drinking in the shows they watch. Who else is
watching MTV at 4:00 in the afternoon? Or at 1:00 on a Saturday when
shows like ``Spring Break'' and ``Fraternity'' are aired?
Connecticut has the highest rate of underage drinking. The average
age that children begin drinking is 11 for boys and 13 for girls. The
Connecticut Coalition to Stop Underage Drinking has been at work for
the past seven years addressing these issues, focusing much of its
energy on the role of adults. It has also begun work on each of the
local recommendations in the NAS report.
But they only scratch the surface of the problem. We--the entire
nation--need the federal government's guidance, direction, and
resources. Underage drinking is a national crisis which is only getting
worse. The NAS recommendations are too valuable to ignore.
Prepared Statement of Catherine Bath, Program Director, Security On
Campus, Inc.
Dear Senator DeWine and Committee Members: We at Security On
Campus, Inc., a national nonprofit organization concerned with the
safety of college students, want to thank the Senate for supporting
stronger Federal action on the serious problem of drinking among our
youth. The recommendations of the NAS report need to be implemented to
save the needless waste of young lives. I know. I lost my only son to
an alcohol-related incident at Duke University in November 1999. There
is no greater heartbreak. There is no loss more tragic or unnecessary!
Should we be surprised at the high percentages of college and high
school students experimenting with alcohol and engaging in high-risk
drinking? Our children have been exposed to the alcohol industry's
public service announcements (AKA beer commercials) all of their young
lives. Other than the alcohol industry's advertisements to party with
beer, bond with beer, be fun, popular and successful with beer, our
children have had virtually no other education about alcohol. My son
(now deceased) and his whole generation, now in college, grew up
mesmerized by Spuds McKenzie and the Budweiser Frogs!
Why are alcohol advertisers not required to issue a long list of
warnings (the truth--like the drug companies are required to do) on TV?
Why are they allowed to advertise such a dangerous drug to our children
at all?
The National Campaign to Prevent Underage Drinking Act of 2001
never got passed into law. Why? Because the alcohol industry lobby is
more powerful than the voice of this country's parents. All of the
efforts to effect some change in this culture are subverted at every
juncture by the alcohol industry, a very powerful and cash rich
presence and force at every level, including governmental. They are
lobbying to lower beer tax to its 1951 level.
That is a slap in the face of every parent in this country. And it
is a knife in the heart of parents such as myself who have lost their
children to alcohol and there are SO MANY OF US!
Prepared Statement of Brandon Busteed, Founder and CEO, Outside The
Classroom
I am so utterly frustrated and disappointed. I'm frustrated with
the fact that this country has an underage drinking problem of epidemic
proportions, yet the resources dedicated to solving it have been
miniscule by any measure. I'm frustrated by the lack of leaders willing
to address the problem. I'm especially frustrated that so many people
don't care, and that some even want to keep things status quo. I'm
disappointed that it has taken Congress so long to even consider doing
something about it. I'm disappointed in myself in believing that very
little will come of this hearing. I'm disappointed most of all that
those leaders needed most to solve this problem--the college and high
school students themselves--are completely missing from this dialogue.
You'll see and hear today from alcohol industry lobbyists seeking
to protect their market and profits, researchers who are decades
removed from college and high school, and activists who have lost
family members and close friends to alcohol-related deaths. All these
perspectives are critical and deserve to be heard. Indeed, they are
typically the only ones heard. But unfortunately, you're not going to
hear from some of the sources that most need to be heard. You're not
going to hear from people like me, save if you take the time to read
this--one of the many written testimonies submitted to this hearing.
I'm 26-years-old--about 4 years removed from my undergraduate
experience at Duke University where I was a student activist advocating
responsible drinking and nonalcoholic lifestyles. Different from most
who get involved in this effort, I was not spurred into action by the
death of a friend or an alcoholic relative. I was an NCAA Division I
standout in track and cross-country. I was a public policy major. I am
a white male athlete raised in an upper-middle class home. Based on
those demographics, I'm in about the highest-risk category for high-
risk drinking that there is. About the only thing missing is that I was
not a member of a Greek organization in college. But my father is an
active elder in his Greek organization, and there was every reason to
believe I should have/could have/would have followed his footsteps.
What makes me unusual is that I fit all the standard stereotypes
for being the opposite of who I am today. I should be a ``binge''
drinker. Instead, I'm the founder and CEO of an organization, Outside
The Classroom, that has educated over 100,000 college students about
alcohol through an online course called AlcoholEdu. I am a young person
who has chosen to make a career out of tackling this social epidemic of
high-risk drinking. And I'm extremely impatient.
The study by the National Academy of Sciences clearly articulated
the problem and made some useful recommendations about a solution. But
unfortunately its assessment of effective prevention programs simply
regurgitated already outdated studies such as the now 3-year-old NIAAA
study on college drinking. It did nothing to advance the knowledge of
and evaluation of successful new programs that are up and running
today. For example, AlcoholEdu did not yet exist when the NIAAA
conducted their assessment of effective college prevention programs. In
just 3 short years later, we've demonstrated success on hundreds of
campuses.
The fact of the matter is that there are many programs already up
and running that are working to reduce dangerous drinking on college
campuses and in high schools today. These programs need better
financial support along with more formal evaluation. AlcoholEdu, our
online prevention program, is only one. Others include environmental
management campaigns, stricter enforcement of alcohol policies, and
more encouragement and funding of alcohol-free social alternatives. Our
partner in delivering AlcoholEdu for High School, Mothers Against Drunk
Driving, has a suite of prevention programs that are getting dramatic
results in high schools and communities.
In fact, the new concept we have pioneered of ``Population-Level
Prevention,'' where an entire social group goes through a prevention
program simultaneously, is one of the most important steps forward in
prevention that we've seen in years. With AlcoholEdu, our research has
shown that when all the first-year students in a college go through the
online prevention experience together, overall consumption of alcohol
declines from rates before the program, rates of abstention increase
rather than decrease, and, most important, rates of dangerous, high-
risk binge drinking--cause of the most harmful negative consequence of
alcohol on campus--decline dramatically.
Such successful programs may be working today, but they need more
economic support during the worst fiscal crisis colleges and high
schools have faced in a generation.
Therefore the policy implications are clear. Congress should pay
heed to the advice in the NAS report to raise taxes on alcohol. The
money is needed to fund important prevention programs that are already
available, and that will work when applied on a population basis. The
real scandal is that this country is doing virtually nothing to fund
and support prevention efforts. The statistics speak for themselves. We
spend 25 times more money on anti-drug campaigns (other than alcohol)
than we do on anti-drug campaigns related to alcohol. Yet, alcohol is
by far the most widely used drug with the most death and destruction
associated with it--far more than all other drugs combined. And it's
clear the alcohol industry bears much of the responsibility simply by
virtue of selling and marketing alcohol.
Therefore it's only right that the Federal Government should tax
the industry to support public efforts to protect our young people from
this danger. However, the taxes shouldn't go toward funding programs
run or in any other way supported by the alcohol industry. Instead,
Congress should use the money to authorize funding for proven programs
delivered by nonprofit and for profit providers without any alcohol-
industry affiliations, mimicking the same successful public policy we
have learned from tobacco industry settlements.
Specifically, Congress should allocate funds to implement
recommendations 10-1, 10-2, 10-3 and 10-4 in the NAS report focusing on
Youth-Oriented Interventions. This funding would support planning for a
youth-focused media campaign, implementation of evidence-based
population-level education programs, and support for evaluations of
evidence-based comprehensive prevention programs in colleges. Congress
should also allocate funds to implement recommendations 11-1 and 11-2
in the section of the report focusing on Community Interventions,
helping community leaders conduct comprehensive prevention programs
utilizing evidence-based strategies and programs.
The NAS proposal that a grand public-private partnership be formed
also is the right idea. With the right public funding to prime the
pump, we will see an inflow of private capital from across the rest of
the private-sector spectrum to address the problem. At Outside The
Classroom, which is a private, for-profit company, we have forged an
alliance with one of the world's best-known nonprofit organizations,
Mothers Against Drunk Driving, and are calling on the private sector to
do their share as well. We are issuing a challenge to the nation's CEOs
to fund prevention programs for every high school student in the
country by contributing to a new Youth Alcohol Prevention Partnership
Fund. The cost of this program--less than $5 per student per school for
a school-wide Population-Level Prevention Program--gives real meaning
to the old saying, ``an ounce of prevention is worth a pound of cure.''
It is an innovative partnership between a for-profit and a nonprofit
that is actively engaging the private sector to meet the demand for a
solution to a problem that, by effectively disabling America's youth,
is undermining our nation's future productivity and competitiveness.
The CEOs we've spoken with like the philosophy of our prevention
partnership, because it attacks the problem at the source--by drawing
the first line in the battle against underage drinking with the
individual young people themselves. By educating young people about the
problems of high-risk drinking, and by engaging them in leadership
activities to attack the problem, we are inculcating the value of
personal accountability and responsibility in our citizens and leaders
of tomorrow which will be absolutely essential to any long-term effort
to solve the problem. And, because beneficial results from a program
like AlcoholEdu are so easily measured, it provides the kind of ROI
measurement that the private sector needs. Finally, it is actually
solving a problem that will directly affect the private sector's
competitiveness and profitability in the future.
The Federal Government should assist with these prevention efforts
not only by providing direct funding for them, but also by providing
funding for the evaluation of programs necessary to rapidly discover
which programs work best, and how, so that they might be propagated
across the country all the more rapidly.
As a recent member of the underage population, I understand what
will motivate young people to change their behavior. I had my first
alcoholic drink on February 10, 1999, one month before my 22nd
birthday, and three months before my graduation from college. The fact
that I didn't drink never hurt my social life in college one bit. I was
elected a class officer every year, and served as class president my
junior year. My senior year--because of my efforts to provide an
alternative lifestyle for campus--I was elected by my peers to serve as
Duke's Young Trustee--a 3-year position on Duke's Board of Trustees. I
wouldn't say that my actions were ``popular'' though. At one point
during my undergraduate career, students were so upset by a non-
alcoholic party I planned following a basketball victory that I had the
door of my car kicked in along with death threats on my answering
machine. Most people would have thrown in the towel. I only became more
convinced that I was on the right track towards social change.
During my senior year, I founded a national nonprofit organization
with two of my undergraduate colleagues. Its purpose was to work
jointly with student leaders and administrators to find creative
alternatives to social life on campus--that either did not involve
alcohol or involved it in safe, responsible, legal, and ``de-
emphasized'' ways. We had plenty of successes and plenty of failures.
One of the biggest failures was in our capabilities as a nonprofit
organization. We applied for and were denied 16 grants from 16
different foundations and government entities.
Although we were able to attract some private donations for our
efforts, we had zero success at convincing grantors to fund our
efforts. We were trying to do something innovative and ground-breaking,
but unfortunately our nation's foundations and government agencies are
not designed to support such initiative. We didn't have Ph.D.'s, we
didn't have CVs and successful track records, and we didn't have
operating history. What we did have was an idea that eventually found
its way, but only through sheer willpower, true innovation, and an
appeal to the private sector.
Since I couldn't find a way to do what I wanted as a nonprofit, I
decided that I might have a compelling case to start a for-profit
company. So, I took my innovative idea and went to the only place that
rewards innovation: private industry and venture capital. I've since
raised nearly $7 million for Outside The Classroom, Inc. and our
program AlcoholEdu--a science-based, non-opinionated online course
about alcohol. In only 3 years, AlcoholEdu is now the single most
widely used course on the Internet. And because we built-in the
evaluation and assessment of the course, we now have the world's
largest evaluative database on college students and alcohol with nearly
15 million data points from tens of thousands of students from hundreds
of colleges and universities.
After 3 years, I am confident that we are on to something extremely
important. We have been pioneering the concept of ``population-level
prevention'' whereby AlcoholEdu is mandated or required of all students
in a population--namely all first-year students. When a college or
university requires the course of all students, we can demonstrate
dramatic reductions in high-risk drinking and related behaviors, and
increases in abstention and the use of protective factors. Highlights
include:
Abstainers rose from 39.4 percent to 43.4 percent, a 10
percent increase.
Heavy episodic drinkers dropped from 38.1 percent to 35.0
percent, an 8 percent decrease Problematic drinkers (who had 10-plus
drinks at least once during the past two weeks) dropped from 12.1
percent to 9.9 percent, an 18 percent decrease.
The average number of drinks consumed per week, for
drinkers, dropped from 9.9 before the course to 8.6 a month after
AlcoholEdu.
Population-level prevention is based on the theory that high-risk
drinking is not an individual or addiction problem; rather it is a
social epidemic that finds its home within social networks. And just as
these social networks among young people can drive negative norms
related to alcohol, they can also be used to drive positive, safe norms
related to alcohol. In our research, we have found that when
AlcoholEdu--an interactive, personal education related to alcohol--is
given to entire population of students, it creates a viral and
interactive reaction which results in more students talking to one
another about the experience. Because all students are required to take
AlcoholEdu and because AlcoholEdu evokes a very personal educational
experience from each student, the school creates a common bond or
shared experience among this population. That common bond is exactly
what drives the dialogue among students, and when students are creating
their own dialogue about what they've learned, they are essentially
engineering a new cultural norm around alcohol. A norm that is less
tolerant of high-risk drinking and negative consequences, and more
supportive of abstention.
I don't need to espouse the validity and power of what AlcoholEdu
is doing. Its results are speaking loud and clear, and at the end of
the day results will drive what our approach to solving this problem
will be. I'm confident I'll be a part of the solution and so will
Outside The Classroom--despite the fact that I'm not a Ph.D., and my
organization is for-profit. And I also know that finding a solution
will require many leaders and many organizations collaborating on a
truly comprehensive approach to addressing the problem.
Let me be clear: I'm not a prohibitionist. I never have been and
never will be. But let me also be clear about another point: I think
alcohol, specifically the abuse of it, is the number one cause
undermining the future success of America and our competitiveness in
the world. It is keeping college students from realizing their true
potential, and it has essentially diminished the value of higher
education as a process to train the leaders of tomorrow. A vast number
of college students are literally ``pissing away'' their education.
And, increasingly, a vast number of our high school and middle school
students are on the way to squandering their promising futures too.
I'm willing to help. I'm here to solve the problem. And I'm looking
for support. All of us in the prevention field are looking for support.
And we're waiting to see how you're going to respond. Please don't do
what's expected and disappoint us. The answers to solving this epidemic
are clear and present. The leadership from government is not. But it
can be. And I urge you to take action now.
Prepared Statement of Peter H. Cressy, Ed.D., President/CEO, The
Distilled Spirits Council of the United States
Mr. Chairman and Members of the Subcommittee, on behalf of the
Distilled Spirits Council of the United States (DISCUS), a national
trade association representing U.S. producers, marketers, and exporters
of distilled spirits products, I commend you for initiating the hearing
on national strategies to reduce underage drinking. As a former
university president, parent and now CEO of a major beverage alcohol
trade association, I appreciate the opportunity to discuss this serious
and complex problem.
Code of Responsible Practices for Beverage Alcohol Advertising and
Marketing
For decades, DISCUS and its members have been deeply committed to
social responsibility and have worked aggressively to fight underage
drinking. Since the 1930's, DISCUS members have adhered to a voluntary
code of advertising and marketing practices. The overriding principle
of the Code is to market our products to adults in a responsible and
appropriate manner.
A major component of the Code is the Code Review Board (Board). The
Board serves as an enforcer by quickly responding to complaints from
both the public and competitors alike. DISCUS is proud to note that
member companies have fully and readily complied with the decisions
rendered by the Board. Moreover, non-DISCUS members have been largely
responsive as well.
During the hearing, some discussion focused on examples of
inappropriate alcohol advertising content. Senator Dodd referenced a
print advertisement by Bacardi tagged ``Vegetarian By Day. Bacardi By
Night'' that provides an excellent example of the effectiveness of the
DISCUS Code review process. In 2001, following publication of the ad, a
competitor within the industry filed a complaint with the Code Review
Board. The Board subsequently determined the content inconsistent with
provisions of the Code. Shortly thereafter, Bacardi withdrew the
advertisement from circulation.
In 2003, DISCUS adopted major revisions to the Code to underscore a
commitment to the most responsible advertising and marketing practices
in the industry, including:
All drinks Code covering over 2,800 brands of spirits,
beer and wine
70 percent adult demographic for all ad placements and
promotional events
Transparency through public reports of complaint decisions
Participation by external advisors
Continuation of ban on advertising in college newspapers
Age verification mechanisms for websites
Explicit restraints regarding sexual content
Minimum of 25 years old for all models/actors in
advertising
Virtually all of the available research makes it clear that parents
and peers have the greatest influence on a minor's decision to drink.
Similar studies also prove that advertising affects brand choice rather
than the decision to drink illegally or to abuse beverage alcohol.
Nonetheless, DISCUS and its members have taken the steps outlined above
in response to changing technologies and societal concerns. A leading
public health professional--Dr. Robert Reynolds, Director of Policy
Analysis and Training at the Pacific Institute for Research and
Evaluation reinforces this point:
``There can be no public confidence in alcohol industry self-
regulation until the results of the complaint process are open to
public review. DISCUS, by adopting new standards for transparency and
public reports about complaints, promises sunshine to previously secret
decisions. As a public health professional, I must applaud the new
commitment by DISCUS to provide the American people with the
information necessary to judge their actions, not just their words.''
DISCUS and its member companies are proud of the Code review
process and the expeditious and just manner that complaints are
handled. The Federal Trade Commission, offering a similar assessment in
a report to Congress last month, found the Code review process
``rigorous and effective.''
The Century Council
Since 1990, The Century Council, an independent organization funded
by America's leading distillers, has spent $130 million on programs
developed with multiple academic, government and community partners.
Many of these programs and strategies are similar to those recently
advocated in the 2003 National Academy of Sciences report.
American Campus and Alcohol Conferences
In October 2000, DISCUS initiated an effort among universities to
reduce drinking on college campuses throughout the country. Together
with Eastern Connecticut State University, The George Washington
University, University of Massachusetts Dartmouth, University of
Massachusetts Amherst, and University of Louisville, DISCUS convened a
3-day working conference where campus and community teams developed
realistic plans to combat campus drinking. Representatives from 34
universities, including Connecticut College and Bowling Green State
University, attended the conference with teams comprised of students,
faculty, community leaders, local law enforcement, and beverage alcohol
retailers. At the conclusion of the conference, each team was
encouraged to apply for grants to implement their plans. As a result,
roughly $300,000 was distributed in program grants to seventeen
universities who submitted requests.
This model program has resulted in a nationwide series of regional
conferences. We have now completed four and have worked with nearly 200
colleges and universities. Additional conferences are scheduled at
Eastern Connecticut State University in November and DePauw University
in Indiana next February.
Again, Mr. Chairman, allow me to commend you, your staff and the
Subcommittee for addressing underage drinking. DISCUS and its members
are determined and dedicated to ensuring that our products are consumed
responsibly and in moderation by those of legal drinking age who choose
to drink. I look forward to further collaborative partnerships that
make a real impact on this complex and serious issue.
Prepared Statement of George A. Hacker, Director, Center for Science in
the Public Interest, CSPI and Kimberly Miller, Manager of Federal
Relations Alcohol Policies Project Center for Science in the Public
Interest
INTRODUCTION
Thank you for the opportunity to submit testimony regarding one of
the most damaging and neglected public health and safety threats facing
our society. Underage drinking is by far the nation's costliest and
most neglected youth drug problem, and CSPI commends the Committee for
focusing much needed attention on this important public health issue.
Underage The hearing is especially timely given this month's release of
two major reports to Congress on underage drinking and related issues,
from the National Academy of Sciences and the Federal Trade Commission,
respectively.
For more than 20 years, CSPI's Alcohol Policies Project has worked
to prevent and reduce alcohol problems at the national, State and local
levels, collaborating with thousands of organizations and individuals
to promote a comprehensive, prevention-oriented policy strategy to
improve public health and safety and help save young lives. During that
time we have developed the strong conviction that Federal efforts to
prevent and reduce underage drinking have been sorely underfunded,
woefully fragmented, fundamentally invisible and largely ineffective.
Numerous obstacles have thwarted the creation of a comprehensive,
highly focused, clearly identified, and hard-hitting Federal effort to
address underage drinking. We hope that the work of this Committee will
begin to help overcome some of those long-standing barriers.
First, we would like to review the legislative and policy context
which gave rise to the National Academy of Sciences' ground breaking
report, recommending a comprehensive national strategy to reduce
underage drinking. Second, we will address the longstanding absence of,
and glaring need for, a stronger, more visible, consistent, and
effective Federal leadership role in reducing underage drinking and its
widespread public health and safety harms. Third, we will outline why a
media and communications campaign to prevent underage drinking needs to
be the centerpiece of a comprehensive, aggressive national prevention-
oriented public health and safety strategy. Finally, we will highlight
two other priority areas for Federal action to reduce underage drinking
in the areas of taxation and advertising.
legislative and policy context of underage drinking prevention efforts
CSPI was part of a broad coalition of national and local public
health and safety organizations that for 2 years supported
Congressional efforts to include underage drinking prevention messages
in the Office of National Drug Control Policy's billion-dollar Youth
Anti Drug Media Campaign (see attached list of organizations). Although
ultimately unsuccessful, efforts by Representatives Wolf and Roybal-
Allard in the House and by Senator Frank Lautenberg in the Senate
generated substantial support and hotly contested debate on the issue.
Despite votes that excluded alcohol from ONDCP's media campaign,
Congressional debate on the issue strongly affirmed the clear and
compelling need for a parallel, but comparable national media campaign
to prevent underage drinking. Numerous members of Congress recognized
the incongruity of spending hundreds of millions of dollars to prevent
illicit drug use, while ignoring underage alcohol use, widely
recognized as the far more devastating, severe, and widespread drug
problem for young Americans. Congressional debate reflected strong
support \1\--and recognition of the need--for an underage drinking
prevention campaign to raise awareness of the problems associated with
underage drinking and deliver prevention messages to young people,
parents, community leaders, and public health and safety officials.
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\1\ Congressional Record, Volume 145, July 1, 1999 (Senate)] [Page
S7987-S8010], Floor debate on Lautenberg Amendment No. 1214 to S. 1282
fiscal year 2000 Treasury Postal Appropriations bill).
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In this context, on April 4, 2001, Representatives Lucille Roybal-
Allard (D-CA) and Frank Wolf (R-VA) introduced legislation to establish
a ``National Media Campaign to Prevent Underage Drinking'' (H.R. 1509).
Shortly thereafter, Senators Harry Reid (D-NV) and John Warner (R-VA),
and others, introduced companion legislation in the Senate (S. 866).
The proposed legislation would create a discrete underage-drinking
media campaign focused on alcohol and housed in the Department of
Health and Human Services. These bills are backed by a broad array of
public health and safety groups, including CSPI, the American Medical
Association (AMA), Mothers Against Drunk Driving (MADD), Consumer
Federation of America, Latino Council on Alcohol & Tobacco, the Trauma
Foundation, and the American Academy of Pediatrics, as well as by the
Advertising Council and the National Partnership for a Drug-Free
America. Countless local and statewide groups also support the measure.
The bipartisan bills have garnered 82 co-sponsors in the House and 18
in the Senate.
While the legislation was not enacted in the 107th Congress, report
language in the fiscal year 2002 Labor, Health and Human Services and
Education appropriations bill represented an important first step in
moving the media-campaign issue forward. With support from the National
Beer Wholesalers Association and the Distilled Spirits Council of the
United States, appropriations language provided $500,000 for the
National Academy of Sciences and Institute of Medicine to develop a
strategy to reduce and prevent underage drinking. Congress charged the
Academy to produce a comprehensive policy and prevention strategy to
combat underage drinking and its consequences, with emphasis on the
role a media campaign could play in such a strategy.
THE NAS REPORT'S MEDIA CAMPAIGN RECOMMENDATIONS
Based on a review of available research, the NAS report strongly
recommends that the Federal Government fund and actively support the
development of a national media effort targeted at adults, as a major
component of a campaign to reduce underage drinking. It states that the
goals of the national media campaign would be to instill a broad
societal commitment to reduce underage drinking, to increase specific
actions by adults that are meant to discourage or inhibit underage
drinking, and to decrease adult conduct that tends to facilitate
underage drinking.
The report also calls for intensive research and development for a
youth-focused national media campaign relating to underage drinking. It
stipulates that if this work yields promising results, the inclusion of
a youth-focused campaign in the strategy should be considered.
These recommendations provide strong backing for a renewed push to
pass Federal legislation creating a national media campaign to prevent
underage drinking. This goal has been a top alcohol-policy priority for
public health, consumer, religious, and substance abuse prevention
groups for several years, and a media campaign should be a top priority
for legislative action flowing from the NAS report.
THE GLARING ABSENCE OF A VISIBLE, COHESIVE FEDERAL VOICE ON UNDERAGE
DRINKING
For too long, the Federal Government has been far too silent on
underage drinking and the promise of many policy interventions and
communications strategies to reduce problems that have devastating
economic and public health and safety consequences. We believe that the
longstanding absence of a visible, effective, coordinated Federal voice
and role in addressing underage drinking and its harms contributes to a
social norm of acceptance, tolerance, and even accommodation of
underage drinking.
Worse yet, this abdication of Federal responsibility on underage
drinking has left alcohol producers primarily in charge of educating
young people and the public, both about alcohol use and about how to
combat underage drinking. Despite wildly self-serving industry
propaganda, those efforts to address underage drinking have been
unevaluated and generally ineffective. Although more visible than
Federal media programs to prevent underage drinking, industry's
investment in those messages--both financial and creative--pales in
comparison with what it spends promoting drinking. For example,
Anheuser-Busch, the world's largest brewer, claims to have spent some
$350 million since 1982 on public awareness and social responsibility
messages. That's about what the company spends in just 1 year on
advertising.
One way to measure the government's lack of commitment to this
issue is to look at the resources devoted to preventing alcohol
problems among young people. A May, 2001 report released by the U.S.
General Accounting Office (GAO), Underage Drinking: Information on
Federal Funds Targeted at Prevention, concludes that only $71 million
of the Federal Government's fiscal year 2000 budget was allocated
specifically to the prevention of underage drinking. This pitiful
allocation is dwarfed by the $18 billion our government spends on the
drug war, the $52 billion in estimated costs of underage drinking, and
the $2 billion alcohol producers spend per year on alcohol advertising
and promotion. To make matters worse, these woefully inadequate
resources are scattered among disparate Federal agencies, and many
programs have been developed with little coordination among the
agencies and no unifying vision or strategy.
Unlike with tobacco, for which the Department of Health and Human
Services has been designated as the lead agency for the government's
efforts in the area of smoking and health and chairs a statutorily
established Inter-Agency Committee on Smoking and Health, there's no
lead agency for the development or implementation of a strategy on
underage drinking or combating societal alcohol problems.
The Surgeon General has issued several widely publicized reports on
the public health hazards of tobacco, and regularly issues reports on
the marketing of tobacco products to young people. Despite numerous
appeals over the years from an array of public health and safety
groups, the Surgeon General has never held a single workshop or issued
any report on underage drinking. In fact, the 1988 Surgeon General's
Workshop on Drunk Driving stands out as the Department's sole high-
visibility forum on alcohol, period.
Similarly, the Federal Government's efforts to combat the
devastation of illicit drugs are backed by a well-funded, cohesive,
publicly articulated, national drug-control strategy. That strategy is
coordinated by ONDCP, an executive-department agency that reports
directly to the President. Since the mid-1990s, Congress has
appropriated billions to that agency, including hundreds of millions of
dollars for a national youth anti-drug media campaign.
Nothing remotely resembling such a concerted effort has ever
existed to address underage drinking, or alcohol abuse. Yet, according
to DHHS, alcohol is the most costly of all drug problems, imposing
economic costs of more than $185 billion on the nation each year and
causing more than 100,000 deaths. According to the Centers for Disease
Control, alcohol is a key factor in the three leading causes of death
among young people in America: accidents, homicides, and suicides.
Unlike tobacco, which kills its users in middle age and later, alcohol
is a drug that actually kills thousands of young people each year, many
more than die from the use of all other drugs combined.
THE NEED FOR A MEDIA CAMPAIGN AS THE CENTERPIECE OF FEDERAL EFFORTS TO
PREVENT UNDERAGE DRINKING
According to the Department of Health and Human Services,
prevention efforts are beginning to pay off in declining rates of teen
smoking. However, in part due to the absence of comparable efforts to
combat underage drinking, alcohol use and binge drinking among teens
continue at alarmingly high rates. The latest National Household Survey
data suggest that alcohol use among American youth has even increased.
Ten million 12- to 20-year-olds reported drinking alcohol in the year
prior to the survey. Of those, nearly 6.8 million (19 percent) reported
binge drinking and 2.1 million (6 percent) were heavy drinkers. Among
the 12- to 17-year-olds, 10.6 percent binge drink and 2.5 percent say
they're heavy drinkers. In fact, previous month alcohol use among 12-
to 17-year-olds increased more than 5 percent since 2000; 17.3 percent
reported alcohol use in the past month.
As a society, we have invested heavily in massive public awareness
campaigns designed to deter young people from taking up smoking and
experimenting with illicit drugs. Those campaigns have provided an
effective backdrop for a myriad of revolutionary public and private
reforms that range from the imposition of advertising restrictions on
cigarettes to the prohibition--even in bars--of indoor tobacco use.
There is little doubt that they have helped to change the social and
political conversation about smoking and drugs, and have empowered
citizens and communities to take effective action on behalf of young
people and society.
Recently, it has become increasingly apparent that comprehensive
communications programs have actually played an important role in
steering young people away from tobacco use. Evidence from Florida,
California, and Massachusetts demonstrates that reaching young people
with the right messages can make a difference. Although perhaps more
complicated to implement, a similarly effective media campaign to
prevent and reduce underage drinking is both imperative and achievable.
Of course, not even the best media campaign would magically
eradicate underage drinking, any more than ONDCP's campaign has
eliminated youth drug use. Nor is it realistic to imagine that
sufficient resources would be available for a media campaign that,
independently, could compete with more than $2 billion dollars a year
in aggressive alcohol advertising and promotion, much of which appeals
directly to underage youth. However, a highly visible media campaign
that reaches mass--and target--audiences with consistent, powerful,
credible, and persuasive messages on underage drinking can help in many
ways. As the centerpiece of an integrated prevention strategy, it
would:
Provide a clear, consistent Federal voice and message on
underage drinking that would highlight government interest in,
leadership for, and commitment to reducing the widespread harms of
underage drinking.
Focus public attention on underage drinking as a
significant public health and safety issue and elevate it on the
public's and policy makers' radar screens. A well-financed, focused,
appropriately targeted, creative, and provocative media campaign can
generate discussion and debate, challenge complacency, and prompt State
and community action for needed policy and practice reforms. Media
involvement will help motivate and bolster community members working to
change those community norms that contribute to youth alcohol use.
Communicate highly visible, culturally imbedded media
messages that (when effectively crafted and delivered) can help shift
attitudes, shape perceptions, and change the national conversation
about underage drinking, both among youth and adults. Administered
effectively, a national media campaign would put to good use the
enormous creativity and talent of willing participants in the media and
advertising industries. Those professionals pride themselves on their
prowess in influencing youths' attitudes and behaviors.
For too long, the absence of cohesive, well-researched,
coordinated, and highly promoted prevention messages has allowed
alcohol producers free reign to poison the airwaves, both with
seductive product appeals and with ineffective, vague, and self-serving
``socially responsible'' public relations pitches. Those generally
untested and unevaluated messages serve more to inoculate alcohol
marketers from potential legal liability and Congressional and
regulatory scrutiny than they do as real prevention.
Despite our reservations about industry's public awareness
campaigns, we would not expect a national, government-sponsored media
campaign on underage drinking to supplant those messages. Industry
efforts would and should continue, given the alcoholic-beverage
industry's undeniable responsibility to discourage the misuse of its
products. However, just as we would never delegate the responsibility
for youth smoking prevention efforts primarily to cigarette companies,
we should not continue to allow vested interests in the alcoholic-
beverage industry to have the principal voice when it comes to
communicating with young people and adults about preventing underage
drinking.
If the alcoholic-beverage industry is sincere in its commitment to
prevent underage drinking, it should embrace public efforts to educate
adults and young people about alcohol. A media campaign on underage
drinking will not be about prohibition. It would not be about
stigmatizing drinkers or alcohol producers. It would not, we would
hope, be about communicating simplistic and self-defeating messages
that heighten youth rebellion and interest in alcohol. It should be
about ending our national denial of underage drinking as a major public
health and safety issue and instilling a broad societal commitment to
reducing underage drinking. A national media campaign would help
increase public awareness and understanding of the destructive role of
alcohol in young people's lives, and it would strengthen community
resolve and capacity to take effective action to reduce and prevent
underage drinking and its myriad harms.
OTHER KEY PRIORITIES FOR FEDERAL ACTION ON UNDERAGE DRINKING: TAXES AND
ADVERTISING
Among the NAS report's many worthy recommendations, those
concerning taxation and advertising deserve brief mention.
1. Alcohol Taxes: One of the report's more controversial outcomes
was a recommendation that Congress and State legislatures raise excise
taxes to reduce underage consumption and to raise additional revenues
for prevention programs. The report cites three arguments for higher
taxes to combat underage drinking. ``First, underage drinking imposes
particularly high average social costs. . . . Second, raising excise
tax rates . . . is a strategy that has strong and well-documented
prevention effects on underage drinking. Third, a designated portion of
the funds generated by the taxes can be earmarked for preventing and
reducing underage drinking.''
At the Federal level, this recommendation sends a clear message to
lawmakers that--at the very least--lowering Federal excise taxes on
alcoholic-beverages (in particular, beer--the primary alcoholic drink
of choice for young people) is a bad idea. Supporters of legislation to
reduce the Federal excise tax on beer and other alcoholic beverages now
have a clear choice between protecting young people's health and safety
or padding the bottom line of a politically-connected industry.
At the State level, the NAS report's tax recommendations firmly
support and provide fresh impetus for State's initiatives to raise
excise taxes on alcoholic-beverages to reduce underage drinking and
raise revenues for prevention and treatment.
2. Alcohol Advertising: The NAS report urged the alcohol industry
to strengthen its current voluntary advertising codes, refrain from
marketing practices that have substantial appeal to youth, and be more
careful to place ads to reduce youthful exposure. Even though the NAS
report acknowledged the lack of direct evidence for a causal link
between advertising and alcohol consumption, it supported better
industry self-regulation and recommended that Congress appropriate
necessary funding for the U.S. Department of Health and Human Services
(DHHS) to monitor underage exposure to alcohol advertising on a
continuing basis and to report periodically to Congress and the public.
It also urged that the DHHS's principle annual survey on youth
substance use be amended to include the collection of data on underage
drinkers' product and brand choices.
Some industry representatives have alleged that the Federal Trade
Commission's (FTC's) recent report to Congress, ``makes the NAS report
moot'' on alcohol advertising. Nothing could be further from the truth.
Although the FTC's report is quick to congratulate the alcoholic-
beverage industry's promised voluntary adoption of a ``70 percent adult
audience'' placement standard (up from 50 percent), the practical
effects of this change will be minimal. The revised standard
essentially mirrors what the industry is already doing. In fact,
several years ago, when NBC considered running liquor ads using an even
higher 85 percent adult-audience placement standard, advertising trade
professionals pointed out that an 85 percent benchmark would be
virtually meaningless, because nearly every NBC show would qualify
(given that 72 percent of the U.S. population is 21 or older). In
short, the shift to a 70 percent threshold is cosmetic, and will afford
no real reduction in the extent of youth exposure to alcohol
advertising.
The FTC's report also conspicuously punts on the critical issue of
``spillover''--that is the impossibility of designing ads that appeal
to 21-year-olds without also appealing to younger persons as well. The
FTC's failure on this point (other than its almost offhand
acknowledgements that ads reach significant numbers of underage persons
and appeal to them) reflects an underlying legal conclusion that
industry's right (given the paucity of evidence that advertising and
consumption and harm are causally linked) to target legal-age consumers
trumps society's responsibility to protect children and adolescents.
We think industry can do better, by eliminating youthful themes,
concepts, and characters, by imposing stricter placement standards, and
by more prominently promoting only the moderate use of its products.
It's worth noting that some stores that sell alcohol exercise extra
caution, for example, by carding everyone up to the age of thirty.
Advertisers could do likewise by designing ads that skew ``age-
upwards'' in appeal, rather than ``age-downwards.'' Advertising content
issues present challenging legal and business questions, but need to be
addressed more seriously by producers than they have been.
The FTC's report also fails to respond to Congress' specific
request to examine the impact of expanded broadcast advertising of the
new generation of liquor-branded ``alcopops'' (such as Smirnoff Ice,
Bacardi Silver, and Skyy Blue) on underage persons. The report instead
fatalistically states that ``there is no information to show the extent
to which teens drink these beverages,'' and proceeds to base its
conclusions solely on a review of industry-supplied marketing
materials. That is simply not good enough.
``Alcopop'' producers openly acknowledge that their products are
specifically aimed at ``entry level'' drinkers, and that the use of
liquor brand names on these products is aimed at drawing young drinkers
to the parent brands of hard liquor. The FTC's failure to seriously
examine the appeal of such products to underage consumers underscores
the need to implement the NAS recommendation that the DHHS's principle
annual survey on youth substance use be amended to include the
collection of data on underage drinkers' product and brand choices. The
availability of such data is essential to understanding the actual
youth impact of new products and the advertising campaigns that promote
them.
In sum, on the advertising front, we urge Congress to:
Act on the NAS recommendations to encourage better
voluntary placement standards;
Require regular Federal monitoring of and reporting on the
impact of alcohol advertising on underage consumers;
Require the DHHS to amend its annual national survey on
youth substance use (known as the ``Monitoring the Future'' Survey) to
include the collection of data on underage drinkers' product and brand
choices.
Establish a national media campaign on the risks and harms
of underage drinking to balance the messages parents and young people
receive from alcohol advertising.
We thank the Committee for its consideration of our views, and
would be pleased to assist its efforts in any way we can.
Prepared Statement of General Arthur T. Dean, Major General, U.S. Army,
Retired Chairman and CEO Community Anti-Drug Coalitions of America
Underage drinking is a national epidemic affecting our nation's
children. Community Anti-Drug Coalitions of America (CADCA) strongly
supports a major Federal role in the funding and implementation of
policies, strategies and programs aimed at preventing underage
drinking. It is essential for every community in the nation to have the
necessary tools and resources to protect their children from the
harmful effects of underage drinking. Community coalition efforts that
involve multiple sectors of a community working together to implement
comprehensive strategies have proven effective in changing norms and
reducing underage drinking.
Underage drinking is a serious, pervasive public health issue that
must be seriously addressed at the Federal, State and local levels.
Federal policies and programs need to include an increased focus on the
importance of collaborative, comprehensive community responses to
underage drinking. Multiple strategies, that include regulation,
enforcement, training, community education and media campaigns need to
be implemented in every State and community in the nation.
Many of CADCA's coalition members have had major successes
implementing community-wide strategies that have markedly reduced
underage drinking. For example in Ohio, the Coalition for a Drug-Free
Greater Cincinnati has established comprehensive policies, strategies
and programs to help lower alcohol consumption by youth. Due to those
efforts alcohol use among 7th to 12th graders decreased by 23 percent
between 1993 and 2000. In the same region where a coalition did not
exist, alcohol use remained constant. Community coalitions can and do
provide the community-wide synergy to decrease the consumption of
alcohol among youth.
In Troy, Michigan, the Troy Community Coalition documented the
impact adult alcohol consumption had on youth behavior. The Coalition
worked with local businesses to encourage them and their employees to
be positive role models for their children. They also established a
campaign, ``Do Your Part to Prevent Alcohol Tragedy'' in which the
Coalition convinced insurance companies to reduce insurance premiums
for bars and bar owners that consistently checked ID's, refused to
provide alcohol to adults who have had too much to drink, and whose
employees received server training through coalition sponsored
workshops. Due to these strategies, binge drinking among Troy's high
school students was reduced by 10 percent between 1999 and 2000. In the
12 years since the Troy Community Coalition has been in operation the
percentage of 8th grade students reporting they had consumed an
alcoholic beverage in their lifetime was reduced by 22.5 percent.
In Vallejo, California, the Vallejo Fighting Back Coalition is
working with the local police department to train teens to attempt to
purchase alcohol at local outlets. These ``teen decoys'' also conduct
assessments of outlets and encourage operators to create youth ``safe''
zones within the stores. The Vallejo Alcohol Policy Coalition has
implemented environmental strategies to reduce the harm caused by
alcohol in the community. These strategies include: a teen party
ordinance, a conditional use permit ordinance, server/seller training
and review of all new applications to sell alcohol in Vallejo. Finally,
each family with a middle or high school student is provided with a
copy of the teen party ordinance and drug and alcohol information,
along with a request to sign a parent pledge that their children will
not be permitted to attend or give parties where alcohol is served. Due
to these in-depth community strategies, Vallejo reduced past month
alcohol use by 11th graders by 9 percent from 37 percent in 1999 to 28
percent in 2001; Vallejo's 2001 rate for past month alcohol use by 11th
graders is 13 percent lower than the comparable statewide rate.
CADCA knows first hand that the most effective way to achieve
reductions in underage drinking is through the consistent application
of comprehensive community-wide strategies that focus on policy and
environmental changes. CADCA therefore recommends that the Federal
Government focus more attention and financial resources on effective
strategies to combat underage drinking such as those outlined in the
recently released report by the National Academy of Sciences entitled
Reducing Underage Drinking: A Collective Responsibility.
Prepared Statement of Juanita D. Duggan, CEO and Executive Vice
President, Wine and Spirits Wholesalers of America, Inc.
Mr. Chairman: Thank you for the opportunity to submit testimony to
your subcommittee for this important hearing. I represent the Wine and
Spirits Wholesalers of America, Inc. (WSWA), a national trade
organization and the voice of the wholesale branch of the wine and
spirits industry. Founded in 1943, WSWA represents more than 400
privately held, family owned and operated companies in 44 States, the
District of Columbia and Puerto Rico that hold State licenses to act as
wine and/or spirits wholesalers.
The purpose of the National Academies of Sciences report and
today's hearing is to look at how we can increase safeguards to prevent
underage access to alcohol so that, for example, a 14-year-old girl or
boy can't easily get beer, wine or liquor. As industry, government,
parents and others work to strengthen these measures, there are those
who want to weaken and ultimately dismantle the very heart of these
longstanding safeguards.
These counterproductive forces include direct shipments of alcohol
to homes from retailers and producers, as well as a series of court
cases specifically intended to undermine local control of alcohol. If
they succeed, the system of checks and balances we now have in place to
guard against underage access--like a basic face-to-face transaction--
will go away. Left in the wake of this vital system will be a
freewheeling alcohol trade that will thrive in anonymous, faceless
alcohol purchases which cannot be tracked or otherwise monitored.
When it comes to alcohol, our society recognizes its unique nature
and need for a unique system to control its distribution. After all,
the selling of beer, wine and liquor is not the same as selling cars,
books or CDs.
Now, I would like to turn to the NAS report itself. David Rehr,
President of the National Beer Wholesalers Association, Inc. may have
said it best in an opinion column printed in the September 26, 2003
Washington Times:
``Illegal underage drinking deserves the nation's serious
attention. It doesn't deserve a non-scientific study focusing on
unproven methods that fail to identify real solutions. Congress took
the first step in asking for a credible, scientific, unbiased study to
attack underage drinking. They stepped up to the plate. Unfortunately,
the NAS struck out.''
There is a nugget of gold, however, that can be mined from the NAS
report. In section two of the report entitled ``The Strategy,'' the NAS
focuses on the issue of underage access, in particular, Internet Sales
and Home Delivery. The report states that underage purchase of alcohol
over the Internet or through home delivery is a method of illegal
access to alcohol used by 10 percent of underage drinkers. That figure,
however, is based on data reported in the 2000 Journal of Studies on
Alcohol, and the report correctly concludes that increasing utilization
of the Internet may have increased that percentage greatly over the
last 3 years. Finally, the NAS report goes so far as to suggest that
the significance of these illegal underage sales is so great that:
``. . .an argument can be made for banning Internet and home
delivery sales altogether in light of the likelihood that these methods
will be used underage purchasers. . .'' (Page 176)
The NAS, in an otherwise flawed report, has struck gold in
highlighting a point of access of alcohol for underage drinkers that is
statistically significant and growing. Moreover, this point of access
is one that public policy makers have the power to control. Recently,
the wholesale tier has taken upon itself the role of safeguarding the
three-tier system against those who seek to undermine it through direct
shipment sales of alcohol, such as the ones cited by the NAS. To truly
understand the dangers presented by an unregulated alcohol distribution
system, it is helpful to illustrate how underage access to alcohol is
different in these circumstances.
First and foremost, sales made via the phone or through the
Internet, since they are not face-to-face, cannot positively establish
the age of the purchaser. There is no guarantee that the person
ordering the alcohol is of age. Most young people between the ages of
18 and 21 years of age (and many who are even younger) possess credit
cards allowing them to order online-still others have the use of their
parents' cards; there is no way for the online supplier to accurately
verify the age of the person ordering.
Moreover, there is no way to ensure that a minor does not
ultimately receive a shipment of alcohol. The suppliers wash their
hands of the alcohol once it leaves their premises, and there is no
guarantee that the delivery service will require an I.D. upon
delivery--or that they will not simply drop the box off at the door
unattended.
That is exactly what happened when scores of media outlets
conducted stings over the past several years to determine the safety of
direct sales. Those stings showed how easy it was for minors to order
alcohol online-and how sloppy the carriers were who delivered the
alcohol, often without checking I.D. or often just leaving the alcohol
on the front doorstep. Perhaps more telling, a sting by the Michigan
Attorney General's office ensnared 79 different companies who illegally
shipped 1,020 bottles of wine, 318 bottles of beer and 20 bottles of
spirits, many of those sales going to underage buyers.
At a 2002 forum on the issue of online commerce hosted by the
Federal Trade Commission, Michigan Assistant Attorney General Irene
Mead testified that not only were minors caught purchasing beer and
wine online during stings to bust retailers breaking the law, but they
also had made the startling discovery that minors were able to purchase
high-proof grain alcohol as well. She told the frightening story of a
teen in a rehabilitation facility that actually succeeded in having a
case of bourbon delivered to the facility--straight to him via the
Internet. When he finished that case he contacted the Internet site and
said all the bottles were broken on delivery. A free case was promptly
shipped to him, again without detection.
Separately, the owner of the 877 Spirits catalog told an audience
at a legal conference on alcohol beverage law that minors were
constantly trying to buy alcohol online through his company. He said
they were often able to detect minors through their buying methods.
Meaning, 877 Spirits bills itself as on online gift catalog. Therefore,
when orders are placed for delivery within the same zip code as the
purchaser, it indicates a potential concern, since his products would
be available locally. The catalog often asks the potential purchaser to
send a fax copy of their I.D. and credit card and though the person
says it is on the way--the proof never arrives.
Proponents of direct shipping alcohol beverages discount the
implications of these enforcement actions and reports, claiming they
are somehow tainted and the product of wholesaler orchestration. While
we would like to claim credit for these illuminating stings,
wholesalers do not control news reporters and certainly do not control
the Michigan Attorney General's office. But that really isn't the
point; the fact is that companies do exist that do business with remote
consumers, and either do not have adequate controls in place, or simply
do not care if they sell to minors.
The three-tier, wholesaler supported system for controlled
distribution of alcohol provides for the quick identification and
apprehension of a retailer who sells to minors, a safeguard that is
impossible to implement with respect to direct-shipped sales.
Keep in mind, the genesis of the wine and spirits wholesaler, a key
component in the modern system of controlled beverage alcohol
distribution, can be traced back to the decision by State lawmakers at
the end of Prohibition to establish the three-tiered system for the
distribution of beverage alcohol--a decision that was theirs to make as
a result of the ratification of the 20 Amendment in 1933.
The 21st Amendment is unambiguous in its enumeration of power to
the States to regulate the importation and controlled distribution of
alcohol within its borders. And no Supreme Court decision interpreting
that amendment over the past 70 years has ever diminished that
authority. The simple fact is, as noted by respected jurist Frank
Easterbrook in a compelling 7th Circuit opinion upholding Indiana's
right to determine and control the channels of distribution, alcohol is
not cheese and its sale and distribution should be treated specially.
Principal among the reasons that the three-tiered system was
established was consumer protection; it was determined that there
should be an intermediary separating the supply and retail tiers to
ensure that large suppliers with market power did not dominate
individual retailers by establishing ``tied-houses.'' These pre-
prohibition tied-house retailers made their profits not by-the-glass,
or by-the-bottle, but rather through winning incentives for moving
large quantities of alcohol. In other words, the imposition of a
mandatory wholesale tier served to end many unhealthy and unsafe
practices that prevailed prior to Prohibition.
The wholesale tier functions as a partner with State regulatory
systems that are designed to promote the core 21st Amendment concerns--
ensuring orderly market conditions, promoting temperance, including
keeping alcohol out of the hands of minors and collecting tax revenue.
By requiring that every drop of alcohol passes through the three-tiered
system, States are assured that every bottle of alcohol is properly
labeled, taxed and sold only to adults.
In order to understand how the three-tiered system operates as a
partner with the State and Federal regulatory communities and serves
the interests of consumer protection, I would ask you to follow a
bottle as it flows through the three-tiered system.
A supplier must obtain approval for the label from the Alcohol and
Tobacco Tax and Trade Bureau (TTB) to ensure that it contains truthful
and non-misleading information and that it contains mandatory health
warnings. That bottle must then be sold to a State and federally
licensed wholesaler who is responsible for maintaining and filing
detailed records of each bottle brought into the State, pays the excise
taxes due on the alcohol, and delivers the alcohol to a State licensed
retail establishment. The retailer is responsible for paying over to
the State the sales taxes generated by each sale, and is directly
responsible for ensuring that alcohol does not fall into the hands of
minors or other prohibited individuals. Since both the wholesaler and
the retailer must be licensed by the State, they are fully accountable
for any dereliction of their duties. They are subject to on-site
inspections, auditing and compliance checks, and any violation can
result in a loss of license, fines and other potentially more severe
penalties.
Wholesalers believe that the three-tier system is our nation's
premier safeguard against underage access to alcohol. As an industry,
we are not only committed to this system, but also to its philosophy.
We work diligently to uphold the letter and spirit of the stringent
laws of each State in which we do business.
Congress has recently recognized the need for legislative action to
support the safeguards and accountability mechanisms of the three-tier
system. Mr. Chairman, you, along with Senators Hatch and Kohl authored
the landmark Federal legislation that made it more feasible to
prosecute an illegal direct shipper. ``The 21st Amendment Enforcement
Act,'' passed by the 106th Congress and signed into law in 2000,
provides State Attorneys General with a powerful means by which to
protect their citizens and prosecute illegal direct shippers.
However, the contributions of the wholesalers to the communities in
which they live and work go far beyond protecting the three-tier system
of alcohol distribution. Our commitment as good corporate citizens is
also unwavering.
Last year, WSWA conducted the first-ever survey of our members'
broader contributions to their communities. We found that our members
donate more than $55 million a year to charitable causes throughout
this country. They include:
United Way, Boys and Girls Clubs of America, YMCA/YWCA, The Sober
Ride Project, D.A.R.E. (Drug Abuse Resistance Education), Ronald
McDonald House, MADD, Make a Wish Foundation, Project Graduation,
Center for Women and Families, Crusade for Children, Sky Ranch, Big
Brother Project, Camp Braveheart and many others.
Our members not only contribute to organizations that confront the
problems some people face with alcohol abuse and other risky behaviors,
but to other organizations that contribute to the greater good of us
all--artistic endeavors, environment enrichments and developmental
teachings that exemplify responsible behavior. These efforts promote
social connectedness and help dissuade inappropriate behavior such as
alcohol abuse and underage consumption. For example, the youth groups I
listed help disadvantaged kids make the right choices about drugs,
alcohol and risky behavior in general. You cannot overlook our
commitment to these organizations.
Instead, the proponents of direct shipping are posing a growing
threat to preventing underage alcohol access. Led by a handful of
powerful retailers and elite wineries, these direct shipping advocates
want to dismantle the three tier-system of safeguards and instead ship
directly to consumers--with little or no controls in place. These
groups are suing in several States and the Supreme Court will likely
take up the case. The bottom line issue that must be addressed is
simply this: Should leaders in local communities control how alcohol is
marketed and sold within their State, or will wineries and large
international alcohol conglomerates make that decision? We think local
communities should have more control, not less--and we think most
Americans would agree.
In conclusion, Mr. Chairman, we as wholesalers of wine and spirits
recognize--as did Judge Easterbrook--that our product is not cheese and
must be treated specially. We recognize alcohol's unique consideration
in our society and support--even defend--the regulation and control of
its distribution. We also believe that we are good partners to the
communities in which we live and work. As such, we are appreciative of
the opportunity to provide testimony at this hearing and would hope
that the Chairman will continue to consider Wine and Spirits
Wholesalers of America a resource as you work to prevent underage
consumption and access to alcohol.
Thank you again for this opportunity to provide testimony today for
this important hearing.
Prepared Statement of the Governors Highway Safety Association (GHSA)
The Governors Highway Safety Association (GHSA) is a nonprofit
association whose members administer Federal highway safety grant
programs, including those that are aimed at reducing underage drinking
and driving. Although underage drinking and driving is only one facet
of the complex underage drinking issue, it is a serious and costly
problem for the country and a priority for the organization. GHSA has
received Federal grants from both the National Highway Traffic Safety
Administration (NHTSA) and the Office of Juvenile Justice and
Delinquency Prevention (OJJDP) to develop materials and training on
underage drinking.
Significant progress has been made in underage drinking and driving
over the last 20 years, largely due to the 1984 enactment of the
National Minimum Drinking Age law. Nonetheless, young drivers are still
being killed in motor vehicle crashes at an unacceptable rate.
According to NHTSA, 17 percent of all underage drivers in fatal crashes
were intoxicated and 24 percent of young drivers killed in fatal
crashes in 2002 were intoxicated. Further, 69 percent of young drinking
drivers involved in fatal crashes were unrestrained, and 77 percent of
those drinking and killed in crashes were unrestrained. Clearly there
is much work to be done to prevent this unnecessary loss of young life.
GHSA firmly believes that the problem of underage drinking and
driving must be addressed as part of a comprehensive approach to
underage drinking. The National Academy of Sciences recently released
report, ``Preventing and Reducing Underage Drinking,'' advocates such
an approach, and GHSA strongly supports it. We believe that the NAS
report is a landmark study that lays out the blueprint for future
action on underage drinking. Implementation of the report will take a
concerted, coordinated effort by all levels of government as well as
considerably more resources from the Federal and State governments and
the alcohol industry.
GHSA also supports a number of specific recommendations in the NAS
report.
We laud the recommendation that Federal agencies form an
interagency committee to coordinate their efforts on underage drinking.
Different Federal agencies approach the problem of underage drinking
differently, and there is little coordination between them. These
agencies have working relationships with different State agencies, but
there is no attempt to develop a comprehensive approach at the State
level. For example, State highway safety agencies are eligible to use
their NHTSA impaired driving grants for underage drinking programs.
OJJDP funds State programs aimed at enforcing underage drinking laws.
Some State highway safety offices are grant recipients, but so are
State criminal justice and health agencies. The Center for Substance
Abuse Prevention (CSAP) of the U.S. Department of Health and Human
Services (HHS) directs funds to State substance abuse agencies for
underage drinking prevention. The National Institute of Alcohol Abuse
and Alcoholism conducts research on underage drinking but disseminates
the results largely to the prevention and health communities. The
Center for Injury Prevention and Research of the Centers for Disease
Control conducts research on impaired driving and disseminates the
results to the public health and highway safety communities but not
necessarily to the law enforcement community. If the Federal Government
took a leadership role on this issue and developed a coordinated
approach, then it is more likely that the States would respond in a
similar manner.
Further, the NAS report recommends that a national training and
research center should be established in HHS, presumably to serve the
constituent Federal and State agencies with a responsibility for
reducing underage drinking. If there were a single center, then the
kind of duplicate Federal research and training programs that currently
exist could be eliminated. Two years ago, GHSA recommended to NHTSA,
CSAP, OJJDP and the HHS program on Drug Free Schools that they fund a
joint underage community-based training program and a research effort
to evaluate the effectiveness of the training. Without direction and
resources from Congress, however, the suggestion was not followed. A
national center is needed since training and research are integral
parts of any underage drinking solution.
Another recommendation that GHSA strongly supports is the one
calling for community interventions. The NAS report recommends that
community leaders assess the underage drinking program in their
communities and consider effective approaches to reducing underage
drinking. GHSA was fortunate to receive a grant from NHTSA to develop a
pilot project on underage drinking prevention. GHSA identified six
communities and worked with their existing coalitions to assess their
underage drinking problems and develop strategic plans for addressing
the problems. Out of the pilot project, eight underage drinking
guidebooks (on topics similar to those recommended by NAS) and one
resource book was produced, and a training program was developed. (The
guidebooks may be accessed on NHTSA's website, www.nhtsa.dot.gov/
injury/alcohol. Click on youth and then on ``Community How to Guides on
Underage Drinking Prevention.'') The guidebooks have been so popular
with community organizations that NHTSA is on its third printing of
them. Unfortunately, however, NHTSA did not have the resources to
continue the community intervention effort and the pilot project has
languished.
We believe that a community-level approach to underage drinking is
critical and have proven successful in the prevention and criminal
justice fields. (The Center for Substance Abuse Prevention, for
example, has developed a Model Communities program which has been
thoroughly evaluated and found successful.) Once a community has
recognized the need to address the issue and put the resources and
institutional infrastructure in place to address it, then there is a
higher likelihood that underage drinking will be reduced and will
remain reduced after Federal funding has disappeared. GHSA strongly
urges this Committee to consider funding community intervention efforts
such as the one developed by GHSA.
Restricting access to alcohol is an area with which GHSA members
are very familiar since they provide the leadership on underage
drinking legislation and enforcement and on education programs about
the legislation and enforcement. Therefore, the NAS recommendations on
access are ones which the Association strongly supports. State highway
safety offices use Federal highway safety grants to fund sobriety
checkpoints and saturation patrols (for those States constitutionally
prohibited from conducting checkpoints), enforcement of zero tolerance
laws, compliance checks, server training, programs to discourage adults
from providing minors with alcohol, and educational programs to
discourage underage purchase of alcohol.
GHSA members have also been very supportive of graduated licensing
laws: 38 States now have these very effective laws. The Association has
encouraged its members to review existing graduated licensing laws and
strengthen them by restricting the number of underage passengers and by
enacting nighttime driving curfews. Our proposal for reauthorization of
the Transportation Equity Act for the 21st Century (TEA-21) would
provide incentives to States that enhance their graduated licensing
laws, among other actions.
GHSA also supports keg registration and dram shop laws, and many
State highway safety agencies have provided information that has helped
legislatures enact these laws. In addition, GHSA members have been
supportive of State efforts to modify existing laws to allow passive
alcohol testing since research has shown that these low-cost devices
are very effective in providing a preliminary indication of a drunk
driver.
There is one access issue in the NAS report that has not gotten
much attention: the issue of Internet alcohol sales and home delivery.
According to the report, surveys show that 10 percent of young people
report obtaining alcohol through the Internet or home delivery and that
this percentage is likely to grow. This direct shipment effectively
puts the delivery person in the role of having to screen for underage
access, thereby eliminating the State alcohol beverage control systems
and reducing accountability. The panel indicated that a case can be
made to ban this type of sale and GHSA believes that this should be
explored further. We are concerned that, as the Federal Government and
others work to curtail underage access through current channels,
another door not be opened through the Internet and home deliveries.
The issue deserves increased attention by the committee.
GHSA also supports the NAS recommendations on youth-oriented
interventions. The Association concurs that only evidence-based youth-
focused education programs should be funded. As noted previously,
however, not enough is being done at the Federal level to ensure that
the research results are being disseminated to all agencies--including
State highway safety agencies--with a responsibility for underage
drinking prevention.
GHSA is pleased that NAS has recommended a comprehensive approach
to college-based interventions--an idea that fits nicely with its
community-level intervention recommendation and with the GHSA underage
drinking prevention pilots. The Association concurs that college
interventions should also be carefully evaluated and a list of
evidence-based programs published. At the same time, it is important
not to discard potentially effective programs based on limited research
findings. College age ``social norming'' is a case in point. Under this
approach, colleges seek to create a new campus social norm around the
positive behavior of students who drink moderately or not at all. A
recent report by the Harvard School of Public Health cast doubt on the
effectiveness of this approach and urges colleges and universities to
cease funding such programs. GHSA feels, however, that social norming
has many potential benefits and that further demonstration programs and
evaluative research must be conducted.
One of the most controversial recommendations in the NAS report is
the one to increase Federal alcohol excise taxes. While GHSA does not
have explicit policy supporting such an increase, the Association
strongly opposes any effort to reduce alcohol excise taxes, as has been
proposed in S. 809 and H.R. 1305. Under these legislative initiatives,
Federal beer taxes would be rolled back to their 1951 level,
effectively reducing the taxes by 50 percent. Economic studies have
shown that the price of alcoholic beverages, particularly beer, is very
elastic: the lower the price, the higher the demand for the product.
Conversely, the higher the price, the lower the demand. These studies
estimate that the 1991 increase in beer taxes saved more than 600 young
lives in alcohol-related crashes each year. Hence, if beer is the
alcoholic drink of choice of young persons, and if the price is
reduced, it is predictable that young persons will drink more beer.
From GHSA's perspective, this will lead to more underage drinking and
driving and more needless loss of young lives. GHSA therefore strongly
believes that lowering the price of alcoholic beverages is very poor
public policy and should be avoided at all costs.
Another controversial recommendation focuses on alcohol advertising
and urges that alcohol companies refrain from marketing practices that
have a substantial underage appeal. The report also recommends that
alcohol trade associations strengthen their voluntary advertising codes
so that commercial messages are not placed in venues that have a
substantial underage appeal. GHSA strongly concurs with both
recommendations.
The Association was very disappointed with the recent Federal Trade
Commission's (FTC) report which concluded that the alcohol industry is
complying with a previous FTC order that limited advertising to media
with at least a 50 percent adult audience. While we applaud the actions
of
the Beer Institute and the Distilled Spirits Council of the United
States to immediately raise the voluntary standard to 70 percent, GHSA
believes that even that standard is too low. GHSA was particularly
disappointed that the FTC did not use the Congressional-mandated review
of industry advertising practices as an opportunity to convene the
alcohol industry, safety groups, and prevention organizations to hammer
out revised advertising standards that could be acceptable to all
parties. We believe that the solution to the alcohol advertising
problem must be a joint effort between the industry as well as agencies
and organizations that are responsible for halting underage drinking.
This concludes the statement of the Governors Highway Safety
Association. Thank you for the opportunity to submit our views on such
an important issue and one that is of high priority to the Association
and Congress.
Prepared Statement of Ralph Hingson, Sc.D., Professor, Associate Dean
for Research, Boston University School of Public Health
My name is Dr. Ralph Hingson. Last year I was asked by the
Committee on Developing a Strategy to Reduce and Prevent Underage
Drinking of the National Academy of Sciences to write a background
paper ``Social and Health Consequences of Underage Drinking'' for their
report released September 10, 2003 Reducing Underage Drinking: A
Collective Responsibility. They also asked me to present at their
committee hearings the Report of the National Institute on Alcohol
Abuse and Alcoholism (NIAAA) ``A Call to Action: Changing the Culture
of Drinking at U.S. Colleges''. This report to which I contributed
(Hingson et al. 2002; Hingson and Howland 2002) was prepared by a task
force of college presidents, researchers, and students convened by
NIAAA to:
1) review the magnitude and dimensions of college student drinking
problems in the United States; and
2) explore what prevention and treatment strategies have been
tested and found in scientific research to reduce those problems.
I would like to review findings on 1) the magnitude and
consequences of underage drinking, and 2) strategies established
through scientific research to reduce those problems.
MAGNITUDE AND CONSEQUENCES OF UNDERAGE DRINKING
To assess the magnitude and consequences of underage drinking in
the United States, we examined data from:
The Fatality Analysis Reporting System (FARS) for the year
2002 of the National Highway Traffic Safety Administration (NHTSA).
Injury mortality statistics from the U.S. Centers for
Disease Control and Prevention (2003).
U.S. Census population statistics.
Smith, et al. Fatal non-traffic injuries involving
alcohol: A meta-analysis. Annals of Emergency Medicine, 1999, a review
of 331 published medical examiner studies from 1975 to 1995 in the
United States.
The 2002 National Household Survey on Drug Use and Health
conducted in person with over 68,000 randomly selected persons age 12
and older by the Substance Abuse and Mental Health Services
Administration (2003).
The 2001 Youth Risk Behavior Survey, a self-administered
in school study of a random sample of 13,600 U.S. high school students
with an 83 percent response rate conducted by the U.S. Centers for
Disease Control and Prevention (Grunbaum et al. 2002).
The 1999 National Survey of Drinking and Driving conducted
for NHTSA in 1999, with 5,733 respondents of age 16 and older (Royal
2000).
The 1992 National Longitudinal alcohol Epidemiologic
Survey conducted with over 40,000 adults 18 and older in 1992 by the
U.S. Census Bureau for the National Institute of Alcohol Abuse and
Alcoholism.
KEY FINDINGS
1) The average age that American youth begin drinking has declined
from 17.6 in 1965 to 15.9 in 1999. Among persons 12-20 years old in
1990, 2.2 million or 11 percent started drinking before the age 18. By
2000 that number nearly doubled to 4.1 million, 17 percent of the 12-20
age group (2002 National Household Survey on Drug Use and Health, U.S.
Census Bureau).
2) Among U.S. high school students, 29 percent (over 4.3 million)
started drinking alcoholic beverages before age 13 (2001 Youth Risk
Behavior Survey).
3) Among high school students nationwide, those who begin drinking
at younger ages are much more likely than those who wait until they are
older to drink heavily and drink heavily more frequently. Those who
start to drink at age 10 or younger are 11 times more likely than those
who wait until they are 17 or older to have consumed 5 or more drinks
on at least 6 occasions in the past month, 22 percent vs. 2 percent
(2001 Youth Risk Behavior Survey).
4) Those high school students who drink 5+ drinks at least 6 times
per month, nearly one million students, compared to those who don't
drink are much more likely in a given month to engage in behavior that
places them and others at risk for injury, death, or illness. Those
frequent heavy drinkers are:
--more likely to drive after drinking, 41 percent vs. 0 percent.
--5 times more likely to ride with a drinking driver, 80 percent
vs. 14 percent.
--5 times more likely to never wear a seatbelt, 15 percent vs. 3
percent. (Thus they are more likely to be in traffic crashes and if in
a crash, seriously injured or killed).
--4 times more likely to carry a weapon, 44 percent vs. 10 percent.
--7 times more likely to carry a gun, 22 percent vs. 3 percent.
--6 times more likely to be injured in a fight, 13 percent vs. 2
percent.
--9 times more likely to be injured in a suicide attempt, 9 percent
vs. 1 percent.
--27 times more likely to have used marijuana, 27 percent vs. 1
percent. much more likely to use cocaine 26 percent vs. 0 percent.
--13 times more likely to have injected drugs, 13 percent vs. <1
percent.
--8 times more likely to have had sex with 6 or more partners, 31
percent vs. 4 percent.
--less likely to use condoms during their last sexual intercourse,
54 percent vs. 63 percent. In the U.S. 138,000 persons ages 13-29 have
been diagnosed with HIV/AIDS (U.S. Department of Health and Human
Service 2000).
--nearly 4 times more likely to have been or gotten someone else
pregnant, 19 percent vs. 5 percent. Annually there are over 900,000
unplanned teenage pregnancies (Henshaw 1998).
5) High school students who drink 5+ drinks on at least six
occasions per month, were 3 times more likely to report that their
grades at school in the past year were mostly D's and F's, 15 percent
vs. 5 percent. While their risky violent behaviors, illicit drug use
and sexual behavior may also contribute to their poor academic
performance, new research indicates that the teenage brain is
developing throughout adolescence and is disproportionately vulnerable
during adolescence to adverse effects of alcohol on memory, planning,
and spatial relations. Magnetic resonance imaging studies have shown
decrements in frontal lobe activity associated with heavy adolescent
alcohol consumption (Brown, Tapert, Granholm, and Delis 2000; Tapert,
Brown, Meloy et al. 2001).
6) These newly identified effects of alcohol on the brain may help
explain why alcohol impairs the driving ability of people under 21 more
than it does for adults. A review of over 100 experimental scientific
articles on alcohol and driving skills published from 1981-1997
(Moskowitz and Fiorentino 2000) revealed that alcohol impairs some
driving skills beginning with any significant departure from zero blood
alcohol content (BAC). The majority of experimental studies examined
reported significant impairment at BACs of 0.05 percent and all drivers
can be expected to experience impairment in some critical driving
skills by a BAC 0.08 percent or less.
Research comparing drivers in single vehicle fatal crashes to those
stopped in national roadside surveys on similar roadways at the same
time of day and day of the week who were not in crashes reveal each
0.02 percent increase in blood alcohol level nearly doubles the single
vehicle fatal crash risk (Zador et al. 1991). The most recent national
crash and survey analysis reveals that at BACs of 0.08 percent-0.099
percent compared to zero BAC in all age and gender groups, there is at
least an 11-fold increase in single vehicle fatal crash risk, but for
males 16-20 there is a 52-fold increased risk relative to same age
sober drivers.Compounding their heightened single vehicle fatal crash
risk at each blood alcohol level relative to older drivers, when they
drive after drinking, drivers under 21 have higher blood alcohol
levels, on average BAC of 0.10 percent, 3 times the average level
consumed by adults who drive after drinking. Young drinking drivers are
also more likely to have passengers in the vehicle than adult drunk
drivers (Royal 2000).
In 2002 nationwide over 2,200 people died in crashes involving
drinking drivers under the age of 21. Half of the people who died in
those crashes were persons other than the underage drinking driver.
Over half were under the age of 21 while nearly 500 were over age 21
(Fatality Analysis Reporting System 2002).
7) Based on medical examiner studies of alcohol involvement in non-
traffic injury deaths among persons under 21, there may be another 2000
non-traffic alcohol-related injury deaths annually caused by falls,
drownings, burns, overdoses, as well as, nearly 2000 alcohol-related
intentional injury deaths, homicides and suicides (CDC 2003; Smith
1999; Levy, Miller, Lox 1999).
IMPLICATIONS
There is a strong need to increase education and enforcement of
laws that exist in every State making it illegal to sell alcohol to
persons under 21 and for persons under 21 to drive after any drinking.
There is also a clear need to improve our measurement of underage
drinking and related problems.
We need to collect information in our national surveys on
harms underage drinkers cause to others just as we have collected
information on harms drinking college students cause other college
students (600,000 assaults caused by drinking college students annually
and 70,000-80,000 sexual assaults/date rapes perpetrated by drinking
college students) (Hingson et al. 2002).
We need to conduct national surveys about alcohol
consumption and related health risks with respondents at younger ages
starting at early as 9 or 10 to more accurately understand when
drinking begins, what contributes to early alcohol use and to
prospectively examine associated immediate and long-term consequences.
Every unintentional death should be tested for alcohol
just as most fatally injured drivers in fatal crashes are tested for
alcohol. The alcohol testing of fatally injured drivers has provided a
valuable yardstick against which to measure the impact of laws to
reduce drinking and driving. States passing laws can be compared to
States that do not pass these laws to see if there are post-law
reductions in alcohol-related deaths. Knowledge gained from studies
like this have productively guided our efforts to address this problem.
We need a similar yardstick to better assess the impact of
interventions to reduce alcohol-related falls, drownings, burns,
overdoses, homicides and suicides.
STRATEGIES TO PREVENT UNDERAGE DRINKING
Fortunately there are strategies scientifically tested and
demonstrated through rigorous studies to reduce underage drinking and
related problems. These include:
Individually-oriented strategies
Environmental strategies
Comprehensive community intervention
Individually-Oriented Strategies
Strategies to change knowledge, attitudes, beliefs and behaviors of
person whose drinking places themselves and others at risk have been
shown to reduce drinking and related problems. Particularly effective
have been brief counseling behavior modification strategies in Trauma
Centers and Emergency Departments. Gentilello et al. (1999) screened
all patients treated at the Harborview Trauma Center in Seattle,
Washington. Forty-six percent had been injured under the influence of
alcohol. Similar proportions have been found at other Trauma Centers
(Rivara 2000).
Half of those injured under the influence were randomly allocated
to receive a 30-minute brief intervention during which time they were
advised: 1) how their drinking compared to people of the same age and
gender nationwide; 2) what their increased risk of subsequent injury or
illness was if they continued to drink at levels recorded at intake
into the study; 3) where they could obtain counseling and other
assistance in reducing their drinking. One year later, those in the
intervention group were averaging 3 drinks less per day and over a 3
year follow-up period those in the intervention group relative to the
control group experienced 23 percent fewer drunk driving arrests, a 47
percent reduction in emergency department admissions for injury and a
48 percent reduction in hospital in-patient injury admissions. Most of
the reductions occurred among patients who did not meet diagnostic
criteria for alcohol dependence.
A similar experimental study was completed in a Pediatric Emergency
Department by Monti et al. (1999) at Providence Hospital. In both, the
brief counseling intervention and standard care group drinking declined
6 months after intake into the study, but the brief intervention group
reported one-quarter the number of drinking driving incidents, one-
seventh the number of traffic violations, and one-quarter the number of
alcohol-related injuries. A key to the remarkable success of both
studies was that the patients were queried and counseled about their
drinking at a teachable moment when they had just been so severely
injured under the influence of alcohol that they needed to be treated
in an emergency department or given life support in a trauma center.
Larimer (2002) has recently reviewed a similar series of
experimental studies that screened college students for drinking
problems and reported significant reductions in drinking and alcohol-
related problems among those offered brief interventions. Fleming
(1999) similarly reviewed over 30 experimental studies of brief
interventions in primary care and hospital settings that also indicated
brief interventions were followed by reductions in drinking and
alcohol-related problems.
Thus, while there are clearly numerous, rigorous experimental
evaluations that indicate brief interventions and counseling can help
persons with risky drinking behaviors, a limitation is that most
adolescents do not believe they have drinking problems, do not attend
screening programs, are not queried about their drinking by their
physicians and health care providers and are not receiving the sort of
brief intervention counseling demonstrated to reduce alcohol problems.
There is an urgent need to expand screening and brief intervention
counseling of adolescents with drinking problems.
However, before this can be accomplished a major policy impediment
must be addressed. In over 35 States, there are laws that permit
insurance companies to withhold medical reimbursement for the treatment
of patients injured under the influence of alcohol (Rivara 2000). These
laws create a disincentive for physicians and health care providers to
screen for the underlying factor ``alcohol'' that may be contributing
to many of the injuries that bring patients to emergency departments
and trauma centers.
Environmental Intervention
In addition to individually-oriented intervention, efforts to
reduce alcohol availability in the environment can reduce underage
drinking. The most important such intervention has been raising the
legal drinking age to 21. Over the past two decades alcohol-related
traffic deaths have declined 56 percent in 16-20 year olds. During the
same time period, traffic deaths in that age group where alcohol is not
a factor have increased 42 percent as the numbers of drivers under 21
has increased as has the distance they travel (Figure 1). In 1984
Congress passed and President Reagan signed legislation that would
withhold Federal highway construction funds from States that did not
raise the legal drinking age to 21. At that time 25 States had a legal
drinking age of 21. By 1988 all States adopted that law.
A review by the U.S. Centers for Disease Control and Prevention of
49 studies published in the scientific literature found that in States
where drinking ages were lowered in the 1970s on average experienced a
10 percent increase in alcohol-related crashes in the targeted age
group of drivers. Conversely, in States where drinking ages were raised
there was a 16 percent decrease in alcohol-related crashes in the
target age groups of drivers. The National Highway Traffic Safety
Administration (NHTSA) estimates that annually 700-1000 traffic deaths
are prevented by the adoption of the minimum legal drinking age of 21,
bringing the total number of lives saved by that law to more than
21,000 by 2002.
I believe the NHTSA estimate is conservative for two reasons.
First, it does not take into account other causes of death associated
with alcohol misuse among young persons--unintentional injuries, falls,
drownings, burns, overdoses, homicides, suicides, HIV/AIDS infection,
etc. Second, it does not take into account a new body of scientific
studies that indicate the younger people are when they start to drink
the greater their likelihood not only as adolescents but as adults of
experiencing a myriad of life-threatening alcohol-related problems.
Analyses of the National Longitudinal Alcohol Epidemiologic Study
reveals that persons who begin drinking at age 14 or younger are 4-5
times more likely in their life to experience alcohol dependence (Grant
1998); 7 times more likely to as adults to drink to intoxication on a
weekly basis (Hingson et al. 2000); 12 times more likely to be
unintentionally injured under the influence of alcohol (Hingson et al.
2000); 7 times more likely to be in motor vehicle crashes because of
drinking (Hingson et al. 2002); and, 11 times more likely to be in
physical fights while or after drinking (Hingson et al. 2001) [Figures
2-6]. The statistically significant relationships between starting to
drink at a younger age and unintentional injury, motor vehicle crash,
and involvement in physical fights after drinking persist even after
analytically controlling for personal history of alcohol dependence,
frequency of heavy drinking, illicit drug use, smoking, family history
of alcoholism, race and ethnicity and other respondent characteristics
associated with early onset of alcohol use (Hingson et al. 2000, 2001,
2002).
These findings raise the possibility that delaying drinking onset
or preventing alcohol use during adolescence may have benefits in
reducing alcohol-related unintentional and intentional injuries and
deaths not only during adolescent but also adult years. This
possibility is of great importance because unintentional injuries are
the leading cause of death in the United States from ages 1-34 and
intentional injuries are the second leading cause of death from ages
10-34 (CDC 2003). In 2000, there were 97,900 unintentional injury
deaths in the United States (CDC 2003) of which 41,944 were traffic
crash deaths. In 2000, 17,380 traffic deaths (40 percent) were alcohol-
related (involving a driver or pedestrian who had been drinking). The
meta-analysis of medical examiner studies conducted by Gordon Smith
(1999) revealed that 39 percent of non-traffic unintentional injury
deaths tested positive for alcohol at the time of death. Thirty-one
percent of traffic crash deaths and 31 percent of other unintentional
injury deaths involved persons with blood alcohol levels above 0.10
percent meaning they would have been legally intoxicated. These data on
blood alcohol concentrations of non-traffic unintentional injury deaths
indicate there are over 20,000 alcohol-related non-traffic
unintentional injury deaths annually in the U.S.
The meta-analysis of medical examiner studies of Smith (1999)
indicated that 47 percent of homicide victims and 29 percent of suicide
victims had positive blood alcohol levels. In 2000 there were 16,765
homicide deaths and 39,350 suicide deaths indicating that at least
7,800 homicide deaths and 8,500 suicide deaths were alcohol related.
Thus, all total each year over 50,000 people die in the United States
from alcohol-related unintentional or intentional injuries. Alcohol is
a major if not the leading contributor to the top 2 leading causes of
death among young people in the United States, unintentional and
intentional injuries.
Price of Alcohol
The National Academy of Sciences in its Report to Congress in 2003
reviewed the literature on price of alcohol and alcohol-related
problems and recommended that Congress and State legislators should
raise excise taxes to reduce underage alcohol consumption and to raise
additional revenues for this purpose.
The research literature on the effects of price on alcohol
consumption indicates that as price increases, consumption decreases
(Toomey and Wagenaar 2002). Among moderate drinkers, it has been
estimated that a 1 percent price increase results in a 1.19 percent
decrease in consumption (Manning 1995). Younger, heavier drinkers tend
to be more affected than older, heavier drinkers (Kenkel 1993; Godfrey
1997; Chaloupka and Wechsler 1996; Sutton and Godfrey 1995). Younger
drinkers have less discretionary income and that may contribute to
their heightened sensitivity to alcohol prices.
Higher alcohol prices have also been found to reduce alcohol-
related problems such as motor vehicle fatalities (Kenkel 1993),
robberies, rapes, and liver cirrhosis deaths (Cook and Moore 1993; Cook
and Tauchen 1982; Ruhm 1996).
If, as recommended by the National Academy Report (2003) revenues
generated by alcohol tax increases to raise beverage prices are in turn
earmarked for programs and enforcement of policies known to reduce
underage drinking that could be further reduce underage drinking
problems.
Legislation to Reduce Alcohol-Related Traffic Deaths
A variety of laws have also been found to reduce alcohol-related
traffic deaths (Voas et al. 2000; Hingson, Heeren, Winter 1994, 1996,
2000; Hingson and Winter 2003 in press; Shults 2001; Wells-Parker 1995;
Wagenaar 2001; Zador et al. 1989). These include criminal per se laws,
enacted in all States, that stipulate that having a blood alcohol level
above the legal limit is evidence by itself that a person was driving
while legally intoxicated, a criminal offense; administrative license
revocation, the law in 40 States that permit police to immediately
confiscate the license of any driver operating a motor vehicle with a
blood alcohol level above the legal limit in that State; mandatory
assessment and alcohol treatment if warranted for persons convicted of
driving while intoxicated, the law in 32 States; 0.08 percent legal
blood alcohol limits for drivers age 21 and older, the law in 44
States; zero tolerance laws making it illegal for driver under age 21
to drive with any measurement amount of alcohol, the law in all States;
and primary enforcement safety belt laws, the law in 20 States that
allow police to stop and give a citation to drivers of vehicles
containing unbelted or unrestrained motorists. Sobriety checkpoints are
a particularly effective enforcement strategy to assist in the life-
saving implementation of these laws (Castle et al. 1995; Lacey et al.
1999; Shults et al. 2001). We need each of these laws in every State
and they should be coupled with active education and enforcement
efforts.
Comprehensive Community Interventions
Implementation of environmental strategies has to occur at the
community level. The just released National Academy of Sciences report
(2003) emphasized the importance of community based efforts to reduce
underage drinking and related problems. The report indicates
comprehensive initiatives are the most effective and recommends
community organizing, coalition building and use of mass media. They
also recommend communities and States undertake regular and
comprehensive compliance check programs including notification of
retailers concerning the program and follow-up communication to them
about the outcome (sale/no sale) for their outlet.
Research supports these recommendations. Several carefully
conducted school based and community based initiatives have been found
in rigorous research evaluations, most sponsored by the National
Institute on Alcohol Abuse and Alcoholism, to have had particular
success in reducing drinking and/or related alcohol problems among
young people (Hingson and Howland 2002). These programs typically
coordinate efforts of city officials from multiple departments of city
government, school, health, police, alcohol beverage control, etc.
which include concerned private citizens and their organizations, as
well as, parents, students and merchants who sell alcohol. Often,
multiple intervention strategies are incorporated into the programs
including school based programs involving students, peer leaders and
parents, media advocacy, community organizing and mobilization,
environmental policy change to reduce alcohol availability to youth and
heightened enforcement of laws regulating sales and distribution of
alcohol and laws to reduce alcohol-related traffic injuries and deaths.
The Mid Western Prevention Project attempted to prevent abuse of
alcohol, tobacco, and illicit drugs, such as cocaine, among adolescents
age 10-14 in Kansas City, Missouri and later in Indianapolis, Indiana.
A quasi-experimental design in Kansas City and a randomized
experimental design in Indianapolis were used to evaluate the program
(Pentz 1989). In Kansas City, a 10-session youth training program on
skills for resisting substance use included homework sessions involving
active interviews and role plays with parents and family members about
family rules regarding the use of these substances, and successful
techniques to avoid their use, and counteract media and community
influences to use these substances. Approximately 80 percent of
students completed the exercises with parents or adult family members.
Mass media coverage was also initiated as part of the intervention.
Topic areas included psycho social consequences of the use of alcohol,
tobacco, and other drugs, correction of perceptions about the
prevalence of peer drug use, recognition of adult media and community
influences on substance use, peer and environmental pressure
resistance, assertiveness in practicing pressure resistance, problem
solving for difficult situations that involve potential substance use,
and statements of public commitments to avoid alcohol, tobacco and
other drug use. Modeling and role playing of resistance skills,
feedback with peer reinforcement, peer leader facilitation and
discussion of homework results were part of the program.
Forty-two schools participated in the study. When students in the
24 intervention schools were compared at 1 year follow up to students
in 18 delayed intervention schools, prevalence of use of alcohol,
cigarettes and marijuana was lower in the intervention schools 11
percent vs. 16 percent for alcohol use, 17 percent vs. 24 percent for
cigarette use and 7 percent vs. 16 percent for marijuana use.
Project investigators (Chou et al. 1998) also tracked 1904 students
exposed to the program in Indianapolis. They were compared with a
sample of 1508 in the control group. Schools were randomly assigned to
groups, and students were followed at 6 months, 1.5 years, 2.5 years
and 3.5 years after baseline. After analytically controlling for
ethnicity, gender, socioeconomic status, father's occupation, school
type and grade, the researchers found that among subjects using
alcohol, tobacco or other drugs at baseline, secondary prevention
effects reducing alcohol use were found at the 6 month and 1.5 year
follow up, and for tobacco at 6 month follow up. The authors concluded
the social influence based primary prevention program produced benefits
not only among students who are non-users at baseline but also among
those using substances at baseline.
Project Northland in Minnesota (Perry et al. 1996) was designed to
reduce alcohol use among young adolescents. Sixth, seventh and eighth
graders were exposed to 3 years of a behavior curriculum, that educated
them to communicate with their parents about alcohol, deal with peer
influence and normative expectations about alcohol, and understand
methods that bring about community level of change in alcohol-related
programs and policies. Students learned skills to resist alcohol use
and skills for bringing about social, political and institutional
change. A ``Town Meeting'' was conducted by students making
recommendations for community action for alcohol use prevention.
Community task forces included a cross section of community
government officials, law enforcement personnel, school
representatives, health professionals, youth workers, parents,
concerned citizens, and adolescents. Community task forces stimulated
passage of several local alcohol-related ordinances to prevent sales to
minors and intoxicated patrons. Businesses provided discounts to
students who pledged to be alcohol and drug free. A theater production
was also undertaken.
A higher percentage of students in the intervention group were
alcohol users at baseline prompting stratified follow up analyses of
users and non-users at baseline. At follow up, the percentages that
used alcohol in the past week and past month were significantly lower
in the intervention group. No significant follow up differences between
groups were found on measures of cigarette smoking or marijuana use.
DARE and DARE Plus. DARE Plus took the traditional DARE program
involving police education with 7th and 8th grade students about
alcohol and drugs and enhanced it with a peer-led parental involvement
classroom program, youth-led extracurricular activities, community
adult action teams and postcard mailings to parents. Evaluation of this
program randomly allocated 24 middle and junior high schools to receive
DARE Plus, DARE or a control intervention. Over 6,200 students were
enrolled and 84 percent were followed for 2 years.
In schools receiving DARE Plus relative to control schools, boys
showed less increase in alcohol use, other drug use and tobacco use.
Girls showed less increase in drunkenness when DARE Plus and DARE
schools were compared. No significant differences between students'
behavior in DARE schools and controls schools were observed over time
(Perry C., Komro K., Veblen-Mortenson S., et al. 2003).
In Communities Mobilizing for Change (Wagenaar 2000), 15
communities were randomly allocated to intervention or comparison
groups. The intervention used a community organizing approach to reduce
the accessibility of alcoholic beverages to youth under the legal
drinking age.
The intervention communities sought to reduce the number of alcohol
outlets selling to young people, availability of alcohol to youth from
non-commercial sources such as parents, siblings, older peers, and
community tolerance of adults providing alcohol to underage youth.
Action was encouraged through city councils, school and enforcement
agencies, as well as private institutions such as alcohol merchants,
business associations, and the media.
Relative to the comparison communities the intervention communities
achieved a 17 percent increase in outlets checking the age
identification of youthful appearing alcohol purchases, a 24 percent
decline in sales by bars and restaurants to potential underage
purchasers, a 25 percent decrease in the proportion of 18-20 year olds
seeking to buy alcohol, a 17 percent decline in the proportion of older
teens who provided alcohol to younger teens and a 7 percent decrease in
the percentage of respondents under age 21 who drank in the last 30
days.
The Community Trials Program (Holder et al. 2000) was a 5-year
initiative designed to reduce alcohol involved injuries and death in 3
experimental communities. The program had 5 mutually reinforcing
components.
The first component tried to mobilize the community support for
public policy interventions by increasing general awareness, knowledge,
and concern about alcohol-related trauma. Initiatives jointly planned
by project organizers and local residents were implemented by the
residents.
Second, a Responsible Beverage Server component sought to reduce
sales to intoxicated patrons and increase enforcement of local alcohol
laws by working with restaurants, bar and hotel associations, beverage
wholesalers, the Alcohol Beverage Control Commission and local law
enforcement.
Third, a DWI component sought to increase the number of DWI arrests
by a combination of special officer training, deployment of passive
alcohol sensors, and the use of DUI checkpoints. News coverage
publicized these activities.
Fourth, the media brought attention to underage drinking. Sales
clerks, owners, managers were trained to prevent sales of alcohol to
minors and enforcement of underage drinking laws increased. Compliance
check surveys detected sales of alcohol to underage purchasers and
police gave citations to violators. Fifth, local zoning powers
regarding alcohol outlet density were used to reduce availability of
alcohol.
The percentage of alcohol outlets that sold to underage drinkers
declined in each intervention community (Grube 1997). Alcohol related
crash involvement as measured by single vehicle night crashes declined
10 percent-11 percent more in program than comparison communities.
Alcohol related trauma visits to Emergency Departments declined 43
percent (Holder et al., 2000).
The Massachusetts Saving Lives Program (Hingson et al. 1996) was a
5-year (1988-1993) comprehensive community intervention designed to
reduce alcohol impaired driving and related traffic deaths. Six program
communities were selected to receive financial support for their
initiatives based on a competitive proposal process (Haverhill, Lowell,
Marlborough, Medford, Plymouth, and North Hampton). These were compared
with five matched communities whose applications also satisfied
selection criteria but were not funded. The rest of the State of
Massachusetts also served as a comparison. Outcome data was collected
for the period 5 years before and 5 years after the intervention.
In each program community, a full time coordinator from the Mayor
or City Manager's office organized a task force of concerned private
citizens and organizations and officials representing various city
departments (e.g. School, health, police, and recreation). Each
community received approximately $ 1 per inhabitant per year in program
funds. Half the funds were spent to hire the coordinator and the
balance for increased police enforcement and other program activities
and educational materials. Voluntary activity was also encouraged.
Active task force membership ranged from 20 to more than 100 persons in
each community. An average of 50 organizations participated in each
city.
Most of the initiatives were developed by the communities. The
program sought to reduce drunk driving as well as behaviors
disproportionately exhibited by drunk drivers, related risks, such as
speeding, running red lights, failure to yield to pedestrians in
crosswalks, and failure to wear safety belts. To reduce drunk driving
and speeding, communities introduced media campaigns, checkpoints,
business information programs, speeding and drunk driving awareness
days, speed watch telephone hotlines, police training, high school per
led education, Students Against Drunk Driving Chapters, College
Prevention programs, alcohol free prom nights, beer keg registration,
and increased liquor outlet surveillance by police to reduce underage
alcohol purchase. To increase pedestrian safety and safety belt use,
program communities conducted media campaigns and police check points,
posted crosswalk signs warning motorist of fines for failure to yield
to pedestrians, added crosswalk guards, and offered preschool education
programs and training for hospital and prenatal staff. Coordinators
engaged in numerous media advocacy activities to explain trends in
local traffic safety problems and strategies the communities were
implementing to reduce traffic injury and death. The proportion of
drivers under age 20 who reported driving after drinking in random
digit dial telephone surveys, declined from 19 percent during the final
year of the program to 9 percent in subsequent years. There was little
change in comparison areas. The proportion of vehicles observed
speeding through use of radar was cut in half, whereas there was also
little change in comparison cities. There was a seven percent increase
in safety belt use, a significantly greater increase than shown in
comparison area.
Fatal crashes declined from 178 during the 5 preprogram years to
120 during the 5-program years. This was a 25 percent greater reduction
than in the rest of Massachusetts. Fatal crashes involving alcohol
declined 42 percent and the number of fatally injured drivers with
positive blood alcohol levels declined 47 percent relative to the rest
of Massachusetts (90 percent of fatally injured drivers in
Massachusetts are tested annually for alcohol). Visible injuries per
100 crashes declined 5 percent more in Saving Lives Cities than the
rest of the State during the program period. The fatal crash declines
were greater in program cities particularly among younger drivers age
15-25. All six-program cities had greater declines in fatal and
alcohol-related fatal crashes than comparison cities or the rest of the
State.
CONCLUSIONS
Alcohol is a leading contributor to the leading causes of death for
persons under 21 and up to age 34 unintentional and intentional injury.
Each year over 50,000 people nationwide die from alcohol-related
injuries. The average age that young people begin to drink in the U.S.
is declining with 29 percent of high school students, 4.3 million
starting to drink before age 13. Alcohol has a disproportionately
deleterious effect on the developing brain during adolescence producing
decrements in memory, planning, and spatial relations. The younger the
age people begin to drink the greater their likelihood of developing
alcohol dependence and frequent heavy drinking patterns, and
experiencing unintentional injuries under the influence of alcohol,
motor vehicle crashes because of drinking, and physical fights while or
after drinking. These relationships are found not only during
adolescence, but carry over into adult life.
Underage drinking is associated with a variety of health risks not
only to adolescent drinkers but other adolescents and adults as well.
Half the people who died in motor vehicle crashes involving drinking
drivers under 21 are persons other than that underage drinking driver.
Our government at all levels, Federal, State and local, has an
obligation to protect its citizens from harms posed to them by underage
drinking drivers. There is a clear need to expand screening,
counseling, environmental and comprehensive community efforts to reduce
underage drinking and onset of drinking at very young ages.
Fortunately, there is a sizeable research literature that has
identified individually oriented counseling strategies that can reduce
problematic drinking as well as environmental approaches such as
greater enforcement of the age 21 drinking age law, zero tolerance laws
making it illegal for persons younger than 21 drive after any drinking,
increased price of alcohol with tax revenues earmarked for prevention
and treatment programs with proven effectiveness, and heightened
enforcement of other alcohol service and anti-drinking driving laws.
The enforcement of these laws is best accomplished at the community
level and several rigorously evaluated comprehensive community
intervention studies have demonstrated these efforts can markedly
reduce drinking and associated alcohol-related injuries and deaths
among young persons.
There is an urgent need to adopt interventions along these lines
proposed in the National Academy of Sciences 2003 report, Reducing
Underage Drinking: A Collective Responsibility.
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a note on the effects of lower legal drinking ages in europe
The National Academy of Sciences report (2003) noted the belief
held by some people that in Europe, where drinking ages are lower than
in the U.S., young people learn to drink in a more responsible manner
and that lowering the legal drinking age would reduce underage
drinking.
The National Academy report provided clear evidence that this
notion has no basis in fact. In 1999 random surveys 15-year-olds in 29
European nations were asked the same questions about drinking as used
in the Monitoring the Future national surveys of U.S. 10th grade
students. In 28 of 29 European nations, a greater percentage of the
adolescents surveyed drank in the past 30 days than in the U.S. In 21
of the European nations, a greater proportion of youth surveyed drank
to intoxication in the past year. Since 1995, the proportions of U.S.
youth under 21 who report drinking to intoxication has remained
constant whereas in half the European countries, studies have shown the
proportion has increased. Lower legal drinking ages do not reduce the
proportion of underage drinkers; rather they reduce the age of
initiation of alcohol use.
We as a Nation should examine why most European nations have lower
legal blood alcohol limits that the U.S., a higher age of driving
licensure, and the effects on youth drinking and driving of their often
more widespread public transportation. The European nations might
benefit from an examination of our history of raising the legal
drinking age to 21 and the benefits of those changes in reducing
alcohol-related traffic and other injury fatalities.
Independent State Store Union, ISSU,
Harrisburg, PA 17108,
September 29, 2003.
Hon. Mike DeWine,
U.S. Senate,
Washington, DC 20510.
Dear Mr. Chairman: I have worked in the alcohol beverage industry
for 32\1/2\ years as a State store manager of the Pennsylvania Liquor
Control Board.
We see daily the hands of old people and young people from every
economic and social class shake as they scrounge their dollars and
cents to buy their half pints of whiskey or pints of vodka.
We see billboards in poor neighborhoods extolling $30.00 bottles of
cognac where children fight to go to bed early to get a mattress.
We see heavily advertised quarts of beer sold in hoagie shops
cheaper than a quart of water.
We have watched 25 years of alcohol advertising on Super Bowl
Sunday validate to every 8-21 year old male that drinking beer is the
American male right of passage.
I have read that 63 percent of all adults favor a law that would
ban all advertisements of alcoholic beverages on billboards in the
country. Let's do it.
As an American citizen, a liquor store manager, a president of a
union representing State liquor store managers in Pennsylvania and a
member of the Global Alcohol Policy Alliance, I encourage your
committee to ban all alcohol advertising in the USA.
Alcohol is a factor in the four leading causes of death for people
under 21--car fatalities, homicide, suicide and other accidental
deaths.
A child is six times more likely to die from alcohol than all the
other drugs combined.
The only argument against the ban of alcohol advertising is that
too many dollars pass through too many hands and that allows the six-
fold youth alcohol death ratio to live on and on.
Sincerely,
Ed Cloonan,
President, Independent State Store Union (ISSU).
______
Prepared Statement of Hon. Susan M. Molinari, Chairman, The Century
Council
Mr. Chairman and Members of the Subcommittee: The Century Council
is an independent, national not-for-profit organization dedicated to
fighting drunk driving and underage drinking. Headquartered in
Washington, DC, and funded by America's leading distillers, the
Council's mission is to promote responsible decision-making regarding
drinking, or not drinking, of beverage alcohol and to discourage all
forms of irresponsible consumption through education, communications,
law enforcement and other programs. Since 1991, The Council's funding
companies (Allied Domecq Spirits & Wine North America, Bacardi USA.,
Inc., Brown-Forman, DIAGEO, Future Brands LLC, Pernod Ricard USA) have
invested $130 million to support the Council's efforts to develop and
implement alcohol education and prevention programs.
The Century Council is chaired by the Honorable Susan Molinari. An
independent Advisory Board comprised of distinguished leaders in
business, government, education, medicine and other relevant
disciplines assists the Council in its' development of programs and
policies. Additionally, the Council maintains advisory panels in the
areas of education and traffic safety that provide related guidance in
those areas.
The recently released National Academy of Sciences (NAS) report on
underage drinking clearly accomplishes an extremely important goal and
one that is central to The Century Council's mission. The report shines
a spotlight on this critically important issue and hopefully as a
result, decreases the awareness gap that exists in our country
regarding underage drinking and the important relationship that parents
have in solving this problem.
Since 1991, the Council has been on the front lines of developing
programs, strategies and tactics that both highlight the issues and
develop promising practices that result in long-term positive impact
and many of the points covered in the NAS report are in concert with
the philosophies, and actions, of The Century Council. As an
independent organization, dedicated to fighting drunk driving and
underage drinking, staffed with professionals in these areas, the
Council is now, and has been in the past, providing many of the
programs and services that the report recommends.
The Century Council, operating on the philosophy that collective
action can have a greater impact than individual efforts, involves all
sectors of the community including beverage alcohol wholesalers and
retailers, law enforcement, public officials, educators, insurers,
health care professionals and private citizen organizations in the
fight against drunk driving and underage drinking.
In pursuit of these goals, The Century Council identifies areas of
concern in the fight against drunk driving and underage drinking,
coordinates the development of initiatives to address such areas, and
implements education and public awareness campaigns and promotes
legislation through strategic partnerships.
Hand-in-hand with all sectors of the community, The Century Council
develops innovative, award-winning programs focused on the following
core activities:
Promoting alcohol educational programs for middle school-
through college aged students and for their parents, teachers, and
adult supervisors;
Creating law enforcement and retailer programs with
materials and promotions designed to deter minors from purchasing
beverage alcohol;
Researching and identifying solutions for drunk driving
and underage drinking and advocating for effective laws and policies at
the state and Federal levels;
Developing programs that target drunk drivers, with a
special emphasis on the hardcore drunk driver, and creating promising
strategies and legislation to eliminate the problem;
Delivering blood alcohol education to inform the public
about State laws for blood alcohol concentration (BAC) and how and
individual's BAC level is affected based on gender, weight, and number
and type of beverage;
Clearly the issue of underage drinking is an important one. Many
organizations highlight high-profile incidents involving underage
drinking and call for action. Unfortunately, many of those same
organizations do little to actually develop and implement programs to
effectively combat and correct the problem. The Century Council focuses
much of its efforts on programs, strategies and tactics to combat
underage drinking. As always, our efforts are guided by noted
professionals working in the field of alcohol education and prevention
who ensure that our activities hold promise in effecting a long-term
positive shift in the behavior of our youth.
These programs in both the education and traffic safety arenas
include:
Ready or Not Talking With Kids About Alcohol is a community
program created in partnership with Boys & Girls Clubs of America,
Ready or Not helps parents and other adults prevent underage drinking
problems among middle-school age children (ages 10 to 14). The program
includes a 30-minute video illustrating five concrete steps adults can
take to prevent illegal underage drinking and a facilitator kit for use
in workshops or at home. Spanish-language Sin Rodeos: Hablando con los
ninos sobre el alcohol and Native American adaptations are also
available free-of-charge.
Brandon Tells His Story is a high school program that features
Brandon Silveria, a permanently disabled young man who crashed his car
after having a few drinks at age 17. Brandon and his father, Tony, tour
America's high schools to educate students--over one million to date--
about the dangers and consequences of underage drinking. In addition to
the lecture program, The Century Council reaches thousands more
students with a half-hour video and accompanying classroom activity
guide that brings Brandon's story to high schools across the country.
Three video messages focusing on back-to-school, spring break, and
prom/graduation are available to keep Brandon's story alive throughout
the school year. The video has won the education field's prestigious
Chris award and a FREDDIE first-place in the American Medical
Association's International Health & Medical Film Competition.
Alcohol 101 for High School Seniors is an interactive CD-ROM
program with a companion Educator's Guide designed to aid educators in
preparing students to make informed choices about alcohol. By
demonstrating the negative outcomes of bad decisions and providing safe
and healthy alternatives, Alcohol 101 for High School Seniors
encourages students to maintain safety and control in situations
involving alcohol. Alcohol 101 for High School Seniors was developed
through a partnership between the American School Counselor Association
(ASCA). Additional information can be found at
www.Alc101forHSseniors.org.
``Parents, You're Not Done Yet'' is a brochure designed to
encourage parents of incoming college freshmen to discuss college
drinking with their kids before they leave home and during the first
weeks of the school year. With input from educators, alcohol policy
administrators and other higher education professionals, The Council
created and has distributed more than 3 million free brochures to over
1,300 colleges. A downloadable version of the brochure, in both English
and Spanish, is available online at www.centurycouncil.org.
Alcohol 101 PlusTM is an innovative, interactive CD-ROM program
aimed at helping students make safe and responsible decisions about
alcohol on college campuses. Set on a ``virtual campus,'' Alcohol 101
Plus combines the core elements of the award-winning Alcohol 101
program, including the ``Virtual Bar,'' with new content targeted to
at-risk populations--first year students, Greeks, student-athletes, and
judicial policy offenders. The realistic scenarios highlight the
specific issues, challenges, and decisions these groups face when it
comes to alcohol in a college setting and provides students and
educators with the opportunity forreflection and discussion. The
program also includes an interactive alcohol education game developed
in partnership with SONY, which provides the user with an opportunity
to learn about how alcohol affects an individual's health, performance,
and decision-making. A website, www.alcohol101plus. org, complements
the Alcohol 101 Plus CD by providing a wealth of additional information
for students, facilitators, and the media.
Promising Practices identifies constructive ways to fight alcohol
abuse on university and college campuses. Developed through a grant
from The Century Council, David Anderson, Ph.D. and Gail Gleason
Milgram, Ed.D. developed a sourcebook of promising practices. This
sourcebook, the only kind in the country, included two updates and
companion materials such as task force and action planners. This
resource includes nearly 300 proven alcohol abuse prevention programs
at both public and private schools throughout the country and policies
and programs included in the Sourcebook are in use on campuses
nationally.
``Speak Up'' is a joint project between The Century Council and the
National Collegiate Athletic association (NCAA) that focuses on
delivering alcohol education and prevention to student athletes.
Through NCAA's Champs Life Skills coordinators, facilitated discussions
dealing with alcohol issues are conducted with Division I, II and III
student athletes.
Cops in Shops--a cooperative effort, involving local retailers and
law enforcement, designed to deter minors from attempting to illegally
purchase alcohol and adults who purchase alcohol for minors. Undercover
officers are assigned to participating retail locations; often one
works inside the store while a second is positioned outside to
apprehend adults who procure alcohol for youth.
Point of Sale Materials--more than ten million posters, decals,
buttons and employee information brochures have been distributed free
of charge to over 100,000 retailers in all 50 states. Based on recent
survey data stating that 65 percent of youth who drink obtain alcohol
from their family and friends, The Century Council, working with the
American Beverage Licensees (ABL), created a new campaign that
highlights the point of access to alcohol by underage youth and
encourages parents to play a more active role in keeping alcohol out of
the hands of our nation's youth. The key component to the campaign is a
30 second Public Service Announcement, buttons and informational cards,
distributed at the point of purchase, that provide tips for parents on
how to talk with their kids about alcohol. To raise awareness of the
industry's efforts, The Council continues to host local events brining
together retailers, wholesalers, and community leaders to deter
underage purchasing.
The Blood Alcohol Educator CD-ROM is an interactive CD-ROM for
adults that provides the blood alcohol concentration (BAC) limit for
driving in a user's particular state and educates the user on how their
personal BAC level changes based on their gender, weight and number and
type of drink. Once in the program's ``Virtual Bar,'' the user can
select from a variety of drinks to determine their BAC level and a
clock calculates how long it will take for the user's BAC level to
return to zero. The BAE CDROM is the centerpiece of a national campaign
that includes a BAE Van tow that has distributed over 100,000 BAE CD-
ROMs to the public free-of-charge. The BAE Van is outfitted with the
colorful BAE logo and builds out into a cyber-cafe with three computer
terminals to allow visitors to use the program. The BAE CD-ROM is
available in both English and Spanish and, in addition to the CD-ROM
and Van tour, can be used on the web at www.b4udrink.org.
The Century Council believes that in educating parents, youth and
educators in alcohol prevention and education, outreach to the Hispanic
community is of utmost importance. As a result, the Council has a
variety of Hispanic programs including;
The Century Council's award-winning Hispanic program--``Si
Toma, No Maneje'' was the first comprehensive program in the nation to
provide the large, growing Hispanic population with Spanish-language
anti-alcohol-abuse information. The Century Council's commitment is to
provide the Hispanic community with culturally sensitive messages about
the dangers of drunk driving and underage drinking. As a result of this
approach, The Council has designed a complete array of educational
programs that are easy to use and adaptable to the individual needs of
the community.
Hice La Promesa! (I Made the Promise)--This program, a pledge to
not drive drunk, to serve as designated drivers and to encourage
families and friends to do the same, was created in partnership with
the Catholic Archdiocese of Los Angeles. Over 2,000 parishes have
conducted Hice La Promesa! events reaching more than 1 million
Catholics.
Sin Rodeos: hablando con los nifios sobre el alcohol--A Spanish
language version of The Council's Ready or Not: Talking With Kids About
Alcohol program was produced in partnership with the Los Angeles
Unified School District (LAUSD). Sin Rodeos presents the key messages
of Ready or Not through culturally sensitive situations. The program is
also supported by the ASPIRA Association, the Cuban American National
Council, League of United Latin American Citizens (LULAC), National
Association of Latino Elected and Appointed Officials Education Fund
(NALEO), National Council of La Raza (NCLR), and the National Puerto
Rican Coalition.
Public Service Announcements (PSA's)--In 1994, The Century
Council's public service announcement ``El Nino'' received an award
from Hispanic Business Magazine as Best Public Service Announcement.
Vive, por nuestro futuro! Si tomas, no manejes! is the title of our
most recent campaign developed in partnership with Recording Artists,
Actors and Athletes Against Drunk Driving (RADD) and the National
Association of Broadcasters (NAB). More than a dozen radio and
television PSAs were produced featuring Hispanic celebrities such as:
Edward James Olmos, Chayanne, India, Shakira and Tito Puente. The NAB
distributed the TV and radio PSAs nationwide in mid-September 2000, in
conjunction with Hispanic Heritage Month.
Other Programs Available in Spanish--The Century Council also
offers the Blood Alcohol Educator (BAE) program, the ``Parents, You're
Not Done Yet'' brochure and some Point of Sale materials in Spanish.
The Century Council also has an ongoing PSA program featuring well-
known public figures and celebrities discussing the dangers of drunk
driving and the need for alcohol education; many are produced in both
English and Spanish.
It is important to note that The Century Council also focuses on
combating drunk driving and has similar programs, strategies and
tactics to attack this important problem. As the focus of this
statement surrounds the issue of underage drinking, an overview of
those programs will not be included in this packet.
The Century Council constantly conducts research and focus groups
to assist us in developing new programs and to gauge the effectiveness
of our efforts. Attachments are included at the end of this statement
that are relevant to any discussion on underage drinking.
Simply highlighting the problem and promoting action plans that are
not data-driven are not in the best interest of solving this important
issue. Since 1991, The Century Council, and America's leading
distillers who fund us, have had a long-standing commitment in the
fight to stop underage drinking. Our belief is that science-based,
programs developed by professionals and widely distributed to parents,
educators and youth is the best action towards the goal of stopping
underage drinking. We will continue our efforts and as always, stand
ready to work with any strategic partners and members of the Committee
to accomplish this task. Thank you.
Attachments:
Prepared Statement of Stacia Murphy, President, National Council on
Alcoholism and Drug Dependence, NCADD
Thank you for providing this opportunity to present written
comments to the Senate Subcommittee on Substance Abuse and Mental
Health Services, and we hope this statement will be made part of the
hearing record.
As indicated in the recent report from the Institute of Medicine
titled ``Reducing Underage Drinking--A Collective Responsibility,''
underage drinking is a critical public health issue. Through this
testimony, we hope to give support to the conclusions of the report.
Furthermore, we urge implementation of the report's key findings and
agree that there should be:
Greater allocation of government resources to address
underage drinking;
Stronger constraints on alcohol advertising aimed at youth
audiences;
Stricter enforcement for regulations banning the sale of
liquor to underage drinkers;
An increase in the excise taxes on alcohol to promote a
campaign to reduce underage drinking, much as has been done to reduce
smoking.
To achieve these important goals, NCADD would support a strong
Federal voice on underage drinking. As individuals and as a nation, we
can't afford to look the other way any longer. America's youth are our
future and we need to insure that they are no longer drowned in a
whirlpool of negative consequences.
Founded in 1944, the National Council on Alcoholism and Drug
Dependence is the oldest advocacy organization in the country
addressing America's most widely used drug, alcohol. With over 95
Affiliates in 28 States, we work at the national level on policy issues
related to barriers in education, prevention and treatment for
alcoholics, other drug dependent persons and their families.
Prepared Statement of The National Association for Children of
Alcoholics
The National Association for Children of Alcoholics supports the
NAS report recommendations. The reduction of underage drinking is a
critical public health imperative. In addition, it can halt the family
cycle of addiction, since those who do not drink until age 21 are much
less likely to become alcoholics themselves. This is especially
relevant to children of alcoholics since they are at great risk of
having a genetic vulnerability and being exposed to environmental
influences that may make them more susceptible to becoming alcoholics
themselves.
One in four children lives in a family with alcohol abuse or
alcoholism. This is a critical mass of the nation's children who are at
increased risk for alcohol, other drug and mental health problems
because of the environment in which they live, and prevention of
underage drinking is crucial to their potential for healthy and
productive lives.
Prepared Statement of James A. O'Hara III, Executive Director, Center
on Alcohol Marketing and Youth
Mr. Chairman, Senator Dodd, distinguished Members of the
Subcommittee, your hearing today marks an important recognition of the
scope and devastating consequences of underage drinking for our youth
and our families. The numbers you are hearing today do indeed tell a
story of abuse and risk.
Let me underline a few more of the telling statistics of the abuse
and devastating consequences from the recently released National
Research Council/Institute of Medicine report, Reducing Underage
Drinking: A Collective Responsibility.
``[A]lmost one-half of the 12-year-olds who reported
alcohol use reported having drunk heavily [five or more drinks on same
occasion] in the past 30 days.'' \1\
---------------------------------------------------------------------------
\1\ National Research Council and Institute of Medicine, Reducing
Underage Drinking: A Collective Responsibility, Committee on Developing
a Strategy to Reduce and Prevent Underage Drinking, Eds. Richard J.
Bonnie and Mary Ellen O'Connell, Board on Children, Youth, and
Families, Division of Behavioral and Social Sciences and Education
(Washington, DC: The National Academies Press, 2003), 41.
---------------------------------------------------------------------------
``The rate of heavy drinking doubles from age 14 (about 6
percent) to age 15 (about 12 percent) and continues to increase
steadily.'' \2\
---------------------------------------------------------------------------
\2\ Ibid., 41.
---------------------------------------------------------------------------
``While only 7 percent of licensed drivers in 2000 were
aged 15 to 20, they represented approximately 13 percent of drivers
involved in fatal crashes who had been drinking.'' \3\
---------------------------------------------------------------------------
\3\ Ibid., 61.
---------------------------------------------------------------------------
``. . . 29 percent of 15- to 17-year-olds and 37 percent
of 18- to 24-year-olds said that alcohol or drugs influenced their
decision to do something sexual.\4\
---------------------------------------------------------------------------
\4\ Ibid., 63.
---------------------------------------------------------------------------
Behind all the numbers and statistics are the shattered lives of
our children and families. Let me remind you how a year ago this month
we read with shock and disbelief of the 200 or so high school students
who arrived drunk to their homecoming dance in Scarsdale, New York.\5\
Five of these young people were hospitalized for acute alcohol
poisoning. The incident occasioned much debate and concern about
parents' responsibilities. It also raises the question of why so many
of our teens think the only way to have a good time is with alcohol. In
short, it reflects the complicated but devastating reality of underage
drinking as described by the NRC/IOM's historic report: ``Understanding
why adolescents drink is more likely to be found in the confluence of
factors.'' \6\
---------------------------------------------------------------------------
\5\ See, e.g., Jane Gross, ``Teenagers' Binge Leads Scarsdale to
Painful Self-Reflection,'' New York Times, Tuesday, 8 October 2002,
sec. B, p. 1; ``200 students arrive at school dance drunk,'' The Times
Union, Friday, 27 September 2002, sec. B, p. 2.
\6\ National Research Council and Institute of Medicine, 87.
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The Center on Alcohol Marketing and Youth (GAMY) focuses its work
on one of those factors--alcohol advertising. In fact, alcohol
advertising and its role in underage drinking have been of concern to
public health officials and policy makers for many years. Then Surgeon
General Antonia Novello requested the Inspector General of the U.S.
Department of Health and Human Services to report on alcohol
advertising's appeal to underage youth and how effectively the Federal
and State Governments, as well as the alcohol industry, were monitoring
it. The Inspector General's report, issued in 1991, found that the
Federal and State agencies were fragmented in their approaches to
alcohol advertising and that the alcohol industry's self-regulatory
codes were largely ineffective.\7\ At the request of Congress, the
Federal Trade Commission has now released two reports on alcohol
advertising and underage youth, the first in September 1999 and the
second earlier this month. In the 1999 report, the FTC called on the
industry to make several reforms in its self-regulation,\8\ and in the
second report the FTC found that the industry had made significant
improvements.\9\
---------------------------------------------------------------------------
\7\ Office of Inspector General, Department of Health and Human
Services, Youth and Alcohol: Controlling Alcohol Advertising That
Appeals to Youth (Washington, DC: Department of Health and Human
Services, 1991), 6, 10-12.
\8\ Federal Trade Commission, Self-Regulation in the Alcohol
Industry: A Review of Industry Efforts to Avoid Promoting Alcohol to
Underage Consumers (Washington, DC: Federal Trade Commission, 1999),
ii-iii.
\9\ Federal Trade Commission, Alcohol Advertising and Marketing: A
Report to Congress (Washington, DC: Federal Trade Commission, 2003), i.
---------------------------------------------------------------------------
A key point made by each of these reports is that responsibility
for alcohol advertising rests with the industry. The industry regulates
itself through the codes of the trade associations and of individual
companies. In general, these codes address two main topics: content and
placement.\10\ Over the years, the content of alcohol advertising has
generated some of the sharpest controversy in terms of questions of its
appeal to underage youth. The Budweiser frogs and Spuds McKenzie may be
two of the most well-known and controversial. A 1996 study of children
ages nine to 11 found that children were more familiar with Budweiser's
television frogs than Kellogg's Tony the Tiger, the Mighty Morphin'
Power Rangers, or Smokey the Bear. \11\ Even the most recent FTC report
that commended the industry for ``added . . . attention to the issue of
ad content'' also remarked, ``Still, a visible minority of beer ads
feature concepts that risk appealing to those under 21.'' \12\
---------------------------------------------------------------------------
\10\ See, e.g., Beer Institute, ``Advertising and Marketing Code,''
(Accessed 25 Sept 2003);
Distilled Spirits Council of the United States, ``Code of Responsible
Practices for Beverage Alcohol Advertising and Marketing,'' (Accessed 25 Sept 2003); Wine
Institute, ``Code of Advertising Standards,'' (Accessed 25 Sept 2003).
\11\ L. Leiber, Commercial and Character Recall by Children Aged 9
to 11 Years: Budweiser Frogs Vs. Bugs Bunny (Berkeley: Center on
Alcohol Advertising, 1996).
\12\ Federal Trade Commission, Alcohol Advertising and Marketing,
ii.
---------------------------------------------------------------------------
While the FTC did not specify which ads were in this ``visible
minority,'' here are examples of ads that have, in fact, generated
significant controversy over their content in the past year:
``Because We Can,'' a television ad for Coors Light
``Laundromat,'' a television ad for Smirnoff Ice
``Cat Fight,'' a television ad for Miller Lite
These ads have raised questions in the minds of many in the public
health community about the adequacy of alcohol industry self-
regulation. On the other hand, the alcohol industry may well point to
them as examples of responsiveness. Coors announced on June 2, 2003
that it pulled ``Because We Can'' as the result of its participation in
the Better Business Bureau's Advertising Pledge Program and a ruling by
the BBB APP that the ad violated Coors's own advertising code; \13\
Diageo, the parent company for Smirnoff Ice announced last spring that
it was pulling its ad because of complaints. According to the data
available to GAMY from TNS Media Intelligence/CMR, both of these ads
were last broadcast several months before either company announced
their decisions. \14\
---------------------------------------------------------------------------
\13\ ``Advertiser's Statement, Submitted: 2 June, 2003,'' in
``Final Decision, Better Business Bureau Advertising Pledge Program,''
Case No. 02-02a, Decided May 16, 2003, (Accessed 25 Sept. 2003).
\14\ TNS Media Intelligence/CMR.
---------------------------------------------------------------------------
The Center's primary focus, however, has been on the placement of
alcohol advertising--where the industry chooses to place its ads, and
who is exposed to the advertising and how frequently. We are a public
health project based at Georgetown University's Health Policy Institute
and funded by grants from The Pew Charitable Trusts and the Robert Wood
Johnson Foundation. Since September 2002 we have released a series of
reports on the exposure of underage youth--ages 12 to 20--to alcohol
advertising in the measured media of magazines, television and radio.
Our research has, in effect, been an attempt to conduct public health
surveillance of alcohol advertising, using the databases routinely used
by advertising agencies and consumer product companies in the planning
of advertising campaigns. To assist us in this effort, we have employed
the services of Virtual Media Resources, a media research and planning
firm based in Natick, Massachusetts.
We have found widespread and pervasive overexposure of underage
youth to alcohol advertising in all three media.
For magazines:
Youth saw more beer and distilled spirits advertising than adults
in magazines in 2001--45 percent more for beer brands and 27 percent
more for distilled spirits brands.\15\
---------------------------------------------------------------------------
\15\ ``More likely to be seen by'' (as well as percentage measures
of youth overexposure and other comparisons of adult and youth exposure
to alcohol advertising in this testimony) is based on ``gross rating
points,'' which measure how much an audience segment is exposed to
advertising per capita. Another way of measuring advertising exposure
is ``gross impressions'' (the total number of times all the members of
a given audience are exposed to advertising). The adult population will
almost always receive far more ``gross impressions'' than youth because
there are far more adults in the population than youth. Center on
Alcohol Marketing and Youth, Overexposed: Youth a Target of Alcohol
Advertising in Magazines (Washington, DC: Center on Alcohol Marketing
and Youth, 2002), 1.
---------------------------------------------------------------------------
Marketers of low-alcohol refreshers, the so-called
``malternatives'' such as Smirnoff Ice, delivered 60 percent more
magazine advertising to youth than adults in 2001.\16\
---------------------------------------------------------------------------
\16\ Ibid., 1.
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These ads have been placed in magazines like Vibe and Spin that,
respectively, had underage audiences of 41 percent and 39 percent in
2001, as well as in magazines like Allure with a 34 percent underage
audience and In Style with 25 percent underage readership.\17\
---------------------------------------------------------------------------
\17\ The beer and distilled spirits industries have now revised
their codes to prohibit placement where underage youth are 30 percent
or more of the audience. Ibid., 11.
---------------------------------------------------------------------------
For television:
Almost a quarter of the television alcohol advertising in 2001--
51,084 ads--was more likely to be seen by youth than by adults.\18\
---------------------------------------------------------------------------
\18\ Center on Alcohol Marketing and Youth, Television: Alcohol's
Vast Adland (Washington, DC: Center on Alcohol Marketing and Youth,
2002), 2.
---------------------------------------------------------------------------
In 2001, alcohol advertising on television reached 89 percent of
young people 12-20, who saw an average of 246 alcohol ads each. The 30
percent of young people ages 12--20 who were most likely to see alcohol
advertising on television saw at least 780 alcohol TV ads in 2001.\19\
---------------------------------------------------------------------------
\19\ Ibid., 2.
---------------------------------------------------------------------------
The alcohol industry's television advertising has been placed on
shows like That `70s Show, The Parkers, and MADtv.\20\
---------------------------------------------------------------------------
\20\ The beer and distilled spirits industries have now revised
their codes to prohibit placement where underage youth are 30 percent
or more of the audience. Ibid., 2-3, 7.
---------------------------------------------------------------------------
For radio:
Youth heard more radio advertising for beer, ``malternatives'' and
distilled spirits in 2001 and 2002 than adults 21 and over. Underage
youth, ages 12--20, heard 8 percent more beer and ale advertising and
12 percent more malternative advertising. The exposure was even greater
for the distilled spirits category, where youth heard 14 percent more
advertising.\21\
---------------------------------------------------------------------------
\21\ Center on Alcohol Marketing and Youth, Radio Daze: Alcohol Ads
Tune in Underage Youth (Washington, DC: Center on Alcohol Marketing and
Youth, 2003), 5.
---------------------------------------------------------------------------
The vast majority of radio advertising reaching underage youth was
placed on radio stations with four formats: Rhythmic Contemporary Hit,
Pop Contemporary Hit, Urban Contemporary and Alternative. The artists
featured on these formats are, for example, 50 Cent, Jennifer Lopez, LL
Cool J, Nelly, Justin Timberlake, Eminem, Ja Rule, Dru Hill, Snoop
Dogg, Red Hot Chili Peppers, Audioslave and Foo Fighters.\22\
---------------------------------------------------------------------------
\22\ Ibid., 9, fn 27.
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Let me explain what we did and what these numbers mean. Standard
industry databases provide information on where ads are placed. TNS
Media Intelligence/CMR provides information on where ads are placed in
magazines and on television programs, and Media Monitors, Inc. (MMI)
provides information on which radio stations broadcast ads and at what
time of the day. Other industry-standard databases--such as MRI,
Arbitron and Nielsen Media Research--provide information on the
audience composition for magazines, for radio stations and for
television programming. Each of these audience composition databases
obviously has certain limitations on how that data is collected, but
these are the databases on which the advertising and consumer product
industries rely, and are the databases on which the alcohol industry
trade associations indicate they will rely to ensure that member
companies place their ads appropriately.\23\ The ad placement data and
audience composition data were analyzed by VMR to calculate the reach
(what proportion of a given age group had the opportunity to see an ad)
and the frequency (on average, how many times someone in a given age
group would be exposed to an ad). We expressed the reach and frequency
of alcohol advertising to underage youth--ages 12 to 20--and to legal-
age adults--those over age 21--in terms of gross rating points (GRPs),
a measure used by media planners to compare the weight of advertising
delivered per capita to different age groups or to other demographic
segments. By comparing GRPs, which account for the size of the
population of a particular age group, we are able to see which age
group is more likely to be exposed to, or to see, alcohol advertising.
As I mentioned, this is the kind of public health surveillance we
already should have in our fight to reduce and prevent underage
drinking, but it has been lacking.
---------------------------------------------------------------------------
\23\ Federal Trade Commission, Appendix D and Appendix E, Alcohol
Marketing and Advertising, D-6-7, E8-10.
---------------------------------------------------------------------------
The alcohol industry frequently cites gross impressions as a more
appropriate way to measure alcohol advertising. For example, the
following statement was made by the Distilled Spirits Council of the
United States (DISCUS) on June 20, 2003:
``CAMY wants the public to believe more youth hear and see alcohol
ads than adults. They are just plain wrong and their own data confirm
this fact. If you dig beneath their rhetoric and look at their own
data, it shows spirits advertising is clearly directed to adults,''
said Distilled Spirits Council President Peter Cressy. . . .
The table below--derived from CAMY's own data--shows distilled
spirits advertising is directed to adults.
Percentage of Impressions Derived from 21+ Audience
Media--Percent
Print--81 percent
Radio--83 percent
TV--76 percent
Source: Derived from CAMY Reports'' \24\
---------------------------------------------------------------------------
\24\ Distilled Spirits Council of the United States, ``CAMY
Releases Another Misleading Report on Underage Drinking,'' 20 June 2003
(Accessed 25 Sept 2003).
---------------------------------------------------------------------------
Well, there are a lot more adults than there are children. By
omitting the fact that 84.2 percent of the age 12+ population are
adults (age 21 and over), and 15.8 percent are underage youth (ages 12
to 20), DISCUS tells only part of the story in stating the percentages
of gross impressions. Because of the disparity in population size,
there are more impressions per person for youth and fewer per person
for adults.
To examine this criticism from an advertising perspective, take the
case of magazines. In 2001, 19.1 percent of all magazine gross
impressions for distilled spirits were for youth ages 12-20, and 80.9
percent were for adults, age 21+. This equates to more GRPs for youth
than for adults; that is, more impressions per person for youth than
adults. While ``only'' 19.1 percent of gross impressions were delivered
to youth, an even smaller percentage (15.8 percent) of the total
population (age 12 and older) is composed of youth. Therefore the
number of GRPs for youth is disproportionately large: 12,550 for youth,
versus 9,916 for adults. In fact, youth received 26.5 percent more GRPs
than adults--or 26.5 percent more impressions per person. (See Table 1)
Put in terms of reach and frequency, the GRP analysis shows clearly
what is hidden by relying on gross impressions: for distilled spirits
advertising in magazines in 2001, 92 percent of youth ages 12-20
(reach) saw on average 136 ads (frequency), while 95 percent of adults
age 21+ (reach) saw on average 104 ads (frequency). Simply stated,
youth were greatly overexposed to the distilled spirits advertising in
magazines in 2001.
Our research has utilized the most current data available to
provide a reliable and verifiable analysis of underage youth exposure
to alcohol advertising. The key public policy question going forward is
how we protect underage youth from excessive exposure to alcohol
advertising. It should be kept in mind that the alcohol industry has
already agreed that there should be some limits to their advertising by
the very fact that for years they have had voluntary codes restricting
the placement of their own advertising.\25\ The IOM report also lays
out what we believe is a convincing public policy rationale for limits
on the alcohol advertising that reaches underage youth:
---------------------------------------------------------------------------
\25\ Beer Institute, ``Advertising and Marketing Code;'' Distilled
Spirits Council of the United States, ``Code of Responsible Practices
for Beverage Alcohol Advertising and Marketing;'' Wine Institute,
``Code of Advertising Standards.''
---------------------------------------------------------------------------
``It is sometimes assumed that, in the absence of compelling
evidence of causation, there is no legitimate basis for limiting the
exposure of young people to alcohol advertising. This assumption is
wrong for three reasons. First, the absence of definitive proof may be
caused by the methodological complexity of the inquiry rather than the
absence of a contributing effect. . . . Second, there is a sound common
sense basis for believing, even in the absence of definitive proof,
that making alcohol use attractive to young people increases the
likelihood that they will become alcohol consumers as young people
rather than waiting until they are adults. . . . Third, persistent
exposure of young people to messages encouraging drinking by young
people (even if they appear to be 21) contradicts and interferes with
the implementation of the nation's goal of discouraging underage
drinking.'' \26\
---------------------------------------------------------------------------
\26\ National Research Council and Institute of Medicine, 136-7.
---------------------------------------------------------------------------
The last point made by IOM deserves underlining: the alcohol
industry's advertising of the good times to be had by the consumption
of alcohol undercuts and drowns out the messages of responsibility and
caution given by parents and other adults. And parents know this and
want something done. We commissioned public opinion research by Peter
D. Hart Associates and American Viewpoint and found that parents
overwhelmingly (81 percent) believe that, due to the potentially
harmful effects of its products, the alcohol industry has a special
responsibility to avoid exposing young people to messages encouraging
alcohol consumption. \27\
---------------------------------------------------------------------------
\27\ Memorandum, ``Results of a National Survey of Parents,'' from
Peter D. Hart Research Associates, Inc./American Viewpoint to All
Interested Parties, Washington, DC, June 24, 2003, (Accessed 25 Sept 2003).
---------------------------------------------------------------------------
The beer and distilled spirits industries, as of this month
according to the recent FTC report and their own trade associations,
have now committed not to place alcohol advertising where the underage
audience is 30 percent or more. \28\ This is a significant reduction
from the previous industry threshold of 50 percent and is to be
welcomed. Whether it is sufficiently protective of our children remains
the question, however.
---------------------------------------------------------------------------
\28\ See, e.g., Federal Trade Commission, Alcohol Advertising and
Marketing, ii; Beer Institute, ``Advertising and Marketing Code;''
Distilled Spirits Council of the United States, ``Code of Responsible
Practices for Beverage Alcohol Advertising and Marketing.''
---------------------------------------------------------------------------
The IOM has recommended that industry move toward a 15 percent
threshold, and CAMY's own research suggests a 15 percent threshold is
the most protective and likely to prevent routine overexposure of
underage youth, ages 12 to 20. The reasoning is straightforward.
Underage youth represent 15.8 percent of the U.S. population, age 12
and over. Advertising placed in venues where the audience composition
is 15 percent or less simply follows the distribution of the
population. As I said, the IOM has called for the industry to move
toward this threshold. In addition, when a distilled spirits company
sought to break the decades-old voluntary ban on distilled spirits
advertising on broadcast television, it proposed to limit its
advertising to late-night television, and in other dayparts to limit
its advertising to programs where the underage audience was 15 percent
or less.\29\ Also, the company promised to air one of its
responsibility ads for every four product ads.\30\ Finally, a
representative for the leading beer company in the United States--
AnheuserBusch--was recently quoted as saying the ``vast majority'' of
their advertising in the last 10 years has been placed on programs
``which traditionally attract audiences that are approximately 80
percent adult.'' \31\ Clearly, what needs to happen is a balancing of
the public health goal of limiting underage youth exposure to alcohol
advertising and of the rightful economic self-interest of alcohol
companies to advertise to their legal audience. With a distilled
spirits company indicating that a 15 percent threshold is economically
viable and with the country's largest beer company saying that a ``vast
majority'' of its advertising has met a 20 percent threshold for the
last 10 years, it would appear that some reduction from the newly
announced 30 percent threshold, which allows for placement of alcohol
ads where underage youth are twice their number in the general
population, is still achievable and would further the public health
goal. Let me be clear that there are many devils in the details: Is the
threshold computed on a population base of age 2 and over or age 12 and
over? Is the threshold applied to each brand of a company since
advertising plans are normally developed for a specific brand, or is it
company-wide?
---------------------------------------------------------------------------
\29\ Stuart Elliot, ``NBC, with Conditions, to Accept Ads for
Liquor,'' New York Times, Friday, 14 December 2001, sec. C, p. 1.
\30\ Ibid.
\31\ Theresa Howard, ``Alcohol advertisers agree to raise standards
to help keep their messages away from kids,'' USA Today, Wednesday, 10
Sept 2003, sec. B, p. 5.
---------------------------------------------------------------------------
But even as we have this policy debate on a reasonable standard
that would protect the health and well-being of our children and
recognize the economic self-interest of the industry, the IOM pointed
to several steps that our Public Health Service and other Federal
agencies can take today:
A national media campaign that educates adults about the
real dangers and risks of underage drinking and their important
responsibilities in reducing and preventing it.\32\
---------------------------------------------------------------------------
\32\ Recommendation 6-1. National Research Council and Institute of
Medicine, 110.
---------------------------------------------------------------------------
A coordinated effort with increased funding commensurate
with the problem by the Federal agencies now responsible for underage
drinking prevention programs so that they are more effective, better-
leveraged and complement one other, and achieve real results so that 10
years from now we aren't seeing the same stalled progress identified by
the IOM.\33\
---------------------------------------------------------------------------
\33\ Recommendation 12-1. Ibid., 237.
---------------------------------------------------------------------------
An annual report with key indicators of underage drinking.
This is basic public health surveillance that should already be done so
that we can assess what is working and what isn't.\34\
---------------------------------------------------------------------------
\34\ Recommendation 12-3. Ibid., 238.
---------------------------------------------------------------------------
The filling of key gaps in our public health
surveillance--the monitoring of underage youth exposure to alcohol
advertising and the collection of data on our public health surveys on
brand use by underage persons just like the data we already annually
collect for underage use of cigarette brands.\35\
---------------------------------------------------------------------------
\35\ Recommendations 7-4, 12-5, 12-6. Ibid., 145, 240, 241.
---------------------------------------------------------------------------
In closing, let me quote the IOM report: ``The problem of underage
drinking in the United States is endemic and, in the committee's
judgment, is not likely to improve in the absence of a significant new
intervention.'' \36\ Let me put the IOM's conclusion another way:
Unless we act now, we will have failed to have learned the lessons from
Scarsdale, New York and hundreds of other communities around this
country where our children and families have suffered the tragic
consequences of underage drinking.
---------------------------------------------------------------------------
\36\ Ibid., 103.
Prepared Statement of David K. Rehr, Ph.D., President, National Beer
Wholesalers Association
I. INTRODUCTION
Chairman DeWine, Mr. Kennedy, and Members of the Substance Abuse
and Mental Health Services Subcommittee, the members of the National
Beer Wholesalers Association (NBWA) appreciate the opportunity to
submit this testimony in connection with the subcommittee's hearing on
underage drinking and the recently released report by the National
Academy of Sciences (National Academies). We also thank the Chairman
for convening this forum, and providing the opportunity to share the
industry's thoughts on this important topic, draw attention to the many
valuable responsibility programs being implemented by the beer industry
and express our concern for the underlying National Academies process
that preceded the study released on September 10, 2003.
II. BACKGROUND ON NATIONAL ACADEMIES STUDY
During the debate on the 2002 Labor, Health and Human Services, and
Education Appropriations Bill, NBWA, in conjunction with industry
allies, advocated for and supported the House and Senate appropriators'
decision to study existing Federal, State, and non-governmental
programs designed to reduce and prevent underage drinking. NBWA also
supported the decision to appropriate $500,000 to the National
Academies to review such programs. Conference Report attached as
Appendix A.
Both decisions were supported because NBWA and its members do not
condone or support abuse of our products, and we are committed to
reducing and combating underage alcohol-related issues. Additionally,
the wholesaler industry has many successful, effective underage
responsibility programs that it was anxious to share with the National
Academies, and NBWA was enthusiastic about participating in a process
that was initially perceived to be fair and even-handed.
The study of programs designed to reduce underage drinking was
determined as necessary, in part, due to a report that was released in
May of 2001 by the Government Accounting Office (GAO) titled ``Underage
Drinking--Information on Federal Funds Targeted at Prevention,''
wherein it was concluded that:
Twenty-three Federal agencies have program efforts that
address underage alcohol prevention, and for fiscal year 2000 an
estimated $71 million was specifically allocated to efforts designed to
reduce underage drinking.
SAMHSA and approximately 16 other Federal agencies
identified about $1 billion of fiscal year 2000 combined funding that
addressed alcohol prevention and illegal drug use. A breakdown of how
that funding is allocated could not be determined.
An additional estimated $769 million out of $2.2 billion
of block, formula and incentive grant funds may have been used by
States to address prevention of drug and alcohol use by youth.
The Federal Government spends substantial resources on
underage prevention, with no real means of accounting for these
resources or the effectiveness of these efforts, questioning the way in
which Federal agencies are spending taxpayer dollars. Appendix B.
As a first step, the National Academies posted the project scope on
July 11, 2002, revealing for the first time publicly its decision to
expand the scope of the study to include areas that were not mandated
by Congress. Appendix C.
The Labor-HHS report language requested a study of an array of
programs designed to prevent and reduce underage drinking and
established a very specific list of inquires to which Congress was
seeking a reply. The National Academies went beyond the scope of this
charge and chose to delve into areas of legislative authority, thereby
overreaching and contradicting Congressional intent. To be specific,
the conference report language does not seek input from the National
Academies or its advisory committee with regard to tax-related issues.
However, the project scope suggests, with some emphasis, the need for
an excise tax increase, a decision that is outside the authority and
jurisdiction of the National Academies, and should not have been
singled out in the study's stated scope as an area of emphasis or
extraordinary review by the selected committee.
Simply stated, the scope decided upon by the National Academies and
its specific instructions to the committee are material alterations of
the Congressional report language. By taking this liberty, the National
Academy guided the committee to a predetermined approach and blatantly
disregarding Congressional intent.
With regard to the committee selection process, it is important for
the subcommittee to know that prior to the National Academies posting
the names of the twelve panelists who were ultimately chosen to conduct
the study, several members of Congress and the licensed beverage
industry wrote the National Academies with recommendations of qualified
experts to participate in the study. Congressional letters are on file
with the National Academies. Industry letter attached as Appendix D.
However, none of those who were recommended were chosen, in spite
of the fact that their professional backgrounds and relative expertise
more than adequately qualified them for inclusion on the study
committee.
The process underway at the National Academies was beginning to
show repeated signs of exclusion of outside stakeholder recommendations
and efforts for equal participation and inclusion. After the National
Academies posted the twelve proposed panelist's names and brief
biographies, concerns for a fair and meaningful approach grew stronger.
Not only had the project's scope been expanded, revealing the National
Academies' interest in overemphasizing tax increases, the proposed
committee panel did not represent an overall balance of professional
views and backgrounds. It remains uncertain whether the committee knew
that eight of 12 of panelists chosen to serve had conflict of interest
issues surrounding their acceptance of funding from one of the nation's
largest Neo-Prohibitionist foundations.
Therefore, on August 12, 2002, the licensed beverage industry made
a written inquiry regarding general information on the nominees and
seeking verification that Federal law was being followed with regard to
the selection process. Appendix E.
Additionally, during the brief time that was allowed for comment on
the proposed study panelists, follow-up letters making recommendations
of alternate experts were again sent by two Members of Congress. Again,
those names were rejected by the National Academies.
They provide the subcommittee with an idea of how the National
Academies conducted the study, the following is intended to highlight
just some of the areas of concern previously expressed to the National
Academies.
Federal Advisory Committee Act
Membership in Federal advisory committees, including committees
created by the National Academies, is regulated by the Federal Advisory
Committee Act (FACA). Pursuant to section 15(a)(2) of FACA, the
National Academies is obligated to ensure that individuals appointed to
an advisory committee have no conflicts of interest, that the overall
membership of the committee is ``fairly balanced'' and that the final
report will reflect the Academy's independent judgment. The FACA
requirements, including especially the fair balance requirement, are
intended to ensure that advisory committees do not become vehicles by
which narrow special interest groups may capture a governmental process
to advance their own agendas.
National Academies Secretive Process
In response to NBWA's written request for pertinent information
regarding the nominees, their professional backgrounds, potential
conflicts of interests and the individual or organization who submitted
or sponsored each of the 12, the National Academies, citing internal
policies, refused to produce any information, stating that it
considered such information to be ``privileged'' and ``not available
for public release,'' revealing that their committee selection process
is shrouded in secrecy, protected by its own established policies and
insulated from public review, scrutiny and comment.
Without access to relevant information and documentation on those
chosen and the process surrounding their selection, which has been
restricted from access by the National Academies, the public is unable
to demonstrate that reasonable steps were taken to ensure that the
committee is fairly balanced.
In a letter to Congress, National Academies President Bruce Alberts
provides a typically bureaucratic response to offer assurances that
conflicts of interest were reviewed and those panelists who voluntarily
took or received financial support would either request to be removed
or be passed over. Neither of which was done, casting doubt on the
legitimate scientific approach taken by the National Academies.
National Academies Failure to Balance
The National Academies is obligated by a general duty, internal
guidelines and Federal law to protect the overall process of the study
at issue, with the goal of ensuring its objectivity, fairness and lack
of bias. A process that is unfair will render a study that is as well.
Without the former, the National Academies cannot ensure--to Congress
or the public--the latter. With regard to the study at issue, the
advisory committee is not fairly balanced. At least five individuals
who strongly support tax increases or restrictive alcohol access laws
as effective were chosen.
Mark Moore published an article entitled ``Actually,
Prohibition was a Success, `` wherein he contends the restrictive
alcohol access laws of the Prohibition era effectively lowered the
prevalence of drinking.
Marilyn Aguirre-Molina has made claims that the alcohol
industry is ``killing'' young people and ``stealing'' society's heroes,
holidays, and values. She has asserted in writing that restrictive
alcohol access laws most effectively prevent problem drinking.
Philip Cook's academic articles endorse increased alcohol
taxation: ``Current [alcohol] excise taxes are too low, both nationally
and in every State. The rates are far less than the average social cost
of each drink consumed. Raising the excise tax would be in the public
interest.''
Judy Cushing supports restrictive alcohol access laws and
is currently involved in a lobbying effort aimed at increasing Oregon's
beer excise tax.
Joel W. Grube's academic writings conclude that price and
tax increases are among the most effective policies for limiting youth
drinking.
In light of the well-established positions of these panelists on
restrictive access and tax increases, the other panelists do not fairly
balance or provide for an overall balance of views on the committee as
a whole. Additionally, Richard Bonnie, Robert Hornik, Bonnie Halpern-
Felsher and Janis Jacobs do not appear to have any significant
expertise as regards underage drinking.
Other worthy candidates were recommended for inclusion to render a
more fairly balanced advisory committee. NBWA, joined by the Beer
Institute and the Wine and Spirits Wholesalers of America, Inc.,
nominated three distinguished academics--Richard Jessor, Robert Pandina
and David Anderson. Members of Congress also made independent
recommendations.
When considered as a whole, the panel was not and could not
reasonably have been regarded by the National Academies as ``fairly
balanced.'' The panel was calculated to ensure a final consensus report
that would endorse the National Academies' apparently preconceived
conclusion that underage drinking is most effectively combated by
increased excise taxes and restrictive alcohol access laws.
National Academies Ignored Industry Responsibility Programs
The National Academies and the advisory committee that was selected
have both exhibited conduct that suggests a failure to follow
Congress's mandate to ``review existing Federal, State, and non-
governmental programs, including media-based programs, designed to
change the attitudes and health behaviors of youth.'' Many
organizations, including the NBWA, submitted documents, articles,
videotapes and other materials on a broad range of established
responsibility programs designed to address underage issues; however,
evidence strongly suggests that National Academies and the committee
ignored outright the industry programs submitted.
Through national, State and local efforts, beer wholesalers and the
beer industry in general actively participate in a broad array of
highly successful prevention programs that effectively address illegal
underage concerns. As a result, the beer industry has gained a wealth
of knowledge and information on underage issues, including information
relevant to many of the areas addressed in the fiscal year 2002 Labor,
Health and Human Services, Education and related agencies conference
report that called for the study that will be addressed during today's
subcommittee hearing.
Additionally, the beer industry has been successful in reducing
illegal underage purchase and consumption through a variety of efforts.
These efforts are outlined in documentation previously provided to the
National Academies committee, and include information on countless
programs, such as point-of-sale ID programs, retailer education and
server training efforts, public service announcements, supplier
partnerships on paid advertising and efforts at the State level for
stricter penalties on retailers and consumers engaged in illegal
underage purchase and consumption. In fact, illegal drinking among high
school seniors has dropped 30 percent over the last two decades,
according to a study sponsored by the National Institute on Drug Abuse.
Thanks to the industry's prevention programs, and the efforts of
parents, teachers and others, 82 percent of the nation's youth are now
making the right decision to not drink alcohol illegally according to
research from the U.S. Department of Health and Human Services.
Materials were submitted on approximately 125 beer industry
programs being conducted nationwide. These programs were provided in
November of 2002 to the National Academies for review. Regrettably, the
committee never reviewed these materials and as late as July of 2003,
they remained unopened in cellophane shrink-wrapped packaging.
National Academies Workshop Activities
At a workshop conducted on October 10-11, 2002, limited time or
attention was paid to the topic of programs or their review. During the
2 days of workshop discussions, minimal time was given to the
discussion of existing programs, in particular private-sector programs.
However, significant time and discussion was allowed to address discuss
vilification of the licensed beverage industry--a legal industry.
The following are examples of comments made:
``. . . if the government is willing to demonize a large
industry, it can really impress teenagers.'' Robin Room, Stockholm
University
``So in conclusion, I think, again, governments can use a
variety of policies to raise price. Taxation is clearly the easiest . .
.'' Frank Chaloupka, University of Illinois at Chicago
The workshop participants that were invited by the National
Academies further reveals the intent to push the study efforts in a
predetermined direction as opposed to an objective and balanced review
by those representing an array of opinions and attitudes toward
effectively addressing underage drinking. For example, James O'Hara,
with the Center on Alcohol Marketing and Youth (CAMY), was invited to
participate.
The work of CAMY and Mr. O'Hara has been described by Robert
Lichter, the head of the Statistical Assessment Service, as ``tainted
by advocacy,'' ``done to influence government action'' with findings
that ``were tilted to require FTC action.'' The CAMY study at issue
looked at alcohol advertising in national magazines in 2001 and
concluded that various brands advertised heavily in ``youth-oriented''
magazines. Magazines such as Sports Illustrated, People and
Cosmopolitan were included in the study in spite of the fact that the
overwhelming majority of the readership of these publications is
beyond--considerably beyond--21-years-old.
Because industry concerns were going unaddressed by the National
Academies, on June 2, 2003, approximately 136 members of the United
States House of Representatives joined in writing to National Academies
President Bruce Alberts asking that he ensure that the study remain on
track and within the perimeters of Congressional intent.
On June 18, 2003, I also wrote to Mr. Alberts to reiterate prior
concerns over the way the study was being conducted, the secretive
nature of the National Academies staff and the fact that information
was being unnecessarily guarded. Specifically, an inquiry was made as
to why the National Academy file contained a copy of a previous letter
from industry, wherein the National Academy had redacted from public
viewing, non-controversial text regarding the National Academy's
obligations under Federal law. Appendix F.
I have enclosed Mr. Albert's response for the subcommittee's review
as well as a copy of the original letter and the redacted version of
the letter that was placed in the National Academies public file.
Appendix G.
I urge the subcommittee to review Mr. Albert's explanation in his
letter dated August 13, 2003, and compare the two letters submitted--
both the complete version and the redacted version--and make your own
determination as to whether or not the contents that were redacted fit
within the category described in paragraph two of Mr. Albert's letter.
Possibly you will be enlightened as to the ways of the National
Academy.
Additionally, in Mr. Albert's letter, he states that the
``extensive programmatic and research information'' provided by
organizations have been ``carefully considered'' by the committee. I
would ask that the subcommittee inquire as to the degree of
consideration the National Academies' committee was able to give to
programs that were never removed from shrink-wrapped packaging.
III. CONCLUSION
While the process underlying the National Academies study is
replete with efforts to exclude the industry, silence its voice and
disregard its successful efforts on the important issue of reducing and
eliminating underage drinking, a more important fact remains--a
significant opportunity to offer Congress with a meaningful review has
been missed. What was needed, and what Congress requested, was a
thorough review of which government and private-sector programs work
and which do not. Some of the most effective programs are being
conducted in our communities, not necessarily by government agencies.
Private sector groups, foundations, non-profit organizations and faith-
based groups are avoiding bureaucratic red tape and taking their
message directly to homes and schools. Congress needs to know what
works.
The National Academies report failed Congress and
America's kids. Rather than serving as a blueprint for all parties--
government, community groups, law enforcement and the beer industry--
the report lacks scientific back-up to combat illegal underage
drinking.
The report is a result of biased academics, the majority
of whom should have been dismissed from the panel for obvious conflicts
of interest.
It is beyond irresponsible that the National Academies
chose to disregard Congress's instructions and squandered half-a-
million dollars to produce an unreliable study that fails to adequately
identify real solutions to successfully combat illegal underage
drinking.
Unfortunately, Congress is no closer today to identifying
successful programs to address illegal underage drinking, than it was a
year and a half ago, and $500,000 taxpayer dollars ago.
Notwithstanding these misguided efforts, the beer industry remains
committed to the fight against illegal underage drinking. Let's focus
on real solutions, such as the programs that are working in our
communities, and not tax hikes and untested programs. Working together,
we can keep alcohol out of the hands of our children, and available for
adults of legal drinking age to enjoy safely and responsibly.
APPENDIX D
Beer Institute,
Wine and Spirits Wholesalers of America, Inc.,
WSWA,
National Beer Wholesalers Association, NBWA,
Alexandria, VA 22314,
May 20, 2002.
Mary Ellen O'Connell,
Study Director,
Board on Children, Youth and Family,
National Research Council/Institute of Medicine,
2001 Wisconsin Avenue, NW,
Harris-156 Washington, DC 20007.
Dear Ms. O'Connell: In response to the National Academy of Sciences
(NAS) notice for public comment, we are writing to recommend several
experts for consideration as participants in the NAS study addressing
underage purchase and consumption of licensed beverages.
As representatives of various national associations that represent
those in the licensed beverage industry, we believe that the below-
mentioned experts, who are widely respected in their fields, possess
the scientific and clinical background necessary to contribute to the
task of analyzing existing underage prevention programs and aiding in
the development of a cost-effective strategy to reduce underage abuses.
Pursuant to the Labor, Health and Human Services and Education
Appropriations conference report for fiscal year 2002, Congress has
requested that NAS and Institute of Medicine (IOM) ``develop a cost-
effective strategy for reducing and preventing underage drinking.'' As
part of the study, Congress has called for a review of existing
Federal, State and non-governmental programs.
In response to this congressional mandate, we believe that these
experts can provide valuable assistance in the NAS effort to evaluate
those programs sponsored and implemented by Federal and State
governments as well as the vast range of privately implemented programs
that have so successfully addressed the underage issue through a
variety of approaches, including youth behavioral changes and
modifications.
While we do not agree with all of their professional conclusions,
given their established backgrounds, we believe each would make an
excellent choice for the NAS/IOM study panel. These individuals have
previously participated in a broad range of studies sponsored by
Federal agencies, have significant experience with youth culture, and
possess a vast array of knowledge and information that would be of
great benefit and value to the goal that Congress has targeted.
Curriculum vitae information has been included for your review on each
of the following recommendations:
Richard Jessor, Ph.D., Director of Institute of Behavioral Sciences,
Department of Psychology, University of Colorado:
Dr. Jessor has devoted his professional career to the study and
research of adolescent and youth development, including the social
psychology of risk behavior and socializing problem behavior among
youth. He has served for the past 10 years as the director of the
MacArthur Foundation Research Network on Successful Adolescent
Development Among Youth in High-Risk Settings. He has served on
multiple advisory boards and prominent committees empanelled to
research and review alcohol-related issues, including serving on
numerous boards for the National Institute on Alcohol Abuse and
Alcoholism (NIAAA) as well as for the NAS. Additionally, he has
received grant support from NIAAA, the National Institute of Drug Abuse
(NIDA), National Institute of Mental Health and Robert Wood Johnson
Foundation.
Robert J. Pandina, Ph.D., Director and Professor of Psychology, Center
for Alcohol Studies, Rutgers University:
Dr. Pandina serves on the review and editorial board of the
American Journal of Drug and Alcohol Abuse and the Journal of Studies
on Alcohol. He serves as the Director of the Center's Health and Human
Development Laboratory, which is conducting a longitudinal study of
alcohol- and drug-using behavior, its etiology, and its consequences.
He has received grants from NIAAA, NIDA, and the New Jersey State
Department of Health. His research interests include psychopharmacology
and neuropsychology; alcohol and drug dependence longitudinal studies;
forensic psychology; and sports psychology. Dr. Pandina serves on
several advisory and editorial boards and serves as a Scholar in
Residence at the National Institute on Drug Abuse.
David Anderson, Ph.D., Associate Professor of Education, George Mason
University:
Dr. Anderson is an associate professor and Director of the Center
for the Advancement of Public Health at George Mason University. He
serves as a project director and researcher on numerous national,
State, and local projects and also teaches graduate and undergraduate
courses on drug and alcohol issues. He has been involved in developing
and implementing drug and alcohol prevention programs, with a targeted
emphasis on schools and local communities. Anderson also co-authored
two national surveys on college drug and alcohol prevention efforts and
is co-director of the Promising Practices: Campus Alcohol Strategies
project, which identifies exemplary alcohol abuse prevention
strategies. With a shared interest in the success of the pending NAS
study, we believe each of these experts to be worthy of serious
consideration for inclusion on the study panel. Additionally, we look
forward to a conclusion that reveals meaningful ways to further build
upon the success of all existing programs, including those implemented
within the licensed beverage industry, designed to prevent and reduce
underage purchase and consumption. Thank you for your consideration.
Sincerely,
Jeff Becker,
President, The Beer Institute.
David K. Rehr,
President, National Beer Wholesalers of America.
Juanita Duggan,
Executive Vice President/CEO,
Wine and Spirits Wholesalers of America.
______
APPENDIX E
Beer Institute,
Wine and Spirits Wholesalers of America, Inc.,
(WSWA),
National Beer Wholesalers Association, NBWA,
Alexandria, VA 22314,
August 12, 2002.
Mary Ellen O'Connell,
Study Director,
Board on Children, Youth, and Families,
National Research Council/Institute of Medicine,
500 5th Street, NW,
11th Floor, Washington, DC 20001.
Re: Project #BCYF-I-02-01-A, Developing a Strategy to Reduce and
Prevent Underage Drinking
Dear Ms. O'Connell: In response to the National Academy of Sciences
(NAS) July 23, 2002, posting of provisional committee nominees for the
above-referenced study, we are writing to provide formal comments on
the proposed committee as well as the process by which the nominees
have been reviewed and selected by NAS.
As representatives of various national associations that represent
those in the licensed beverage industry, we advocated for and support
the House and Senate appropriators' decision to study existing Federal,
State, and non-governmental programs designed to reduce and prevent
underage drinking. We also support the decision to involve NAS in the
process to review such programs, having previously recommended several
experts for inclusion on the NAS advisory committee.
Through national, State and local efforts, our various.
associations and their respective members actively participate in
hundreds, if not thousands, of highly successful programs that
effectively address underage concerns. As a result, the licensed
beverage industry has gained a wealth of knowledge and information on
underage issues, including many of the areas detailed in the relevant
section of the fiscal year 2002 Labor, Health and Human Services,
Education and related agencies conference report.
To assist the committee in this important endeavor and to help
establish an environment that will contribute to the return of a study
that is viewed as fair and credible, NAS is obligated by a general
duty, National Research Council (NRC) guidelines, and Federal law to
protect the overall process and ensure its objectivity, fairness and
lack of bias.
A process that is contaminated or unfairly slanted will yield a
study that is as well. Alternatively, a fair process that ensures a
balanced committee, void of biases and conflicts of interest, and one
that adheres to proper procedure will assist in producing meaningful
results. Without the former, NAS cannot ensure--to Congress or the
public--the later. Of equal importance is the fact that a great deal of
congressional and public attention will undoubtedly be paid to the
results of this study, in turn, making strict adherence to and
compliance with a process that assures fairness and balance all the
more critical.
With a shared interest in the outcome of the study, we are writing
to express several concerns that we believe could potentially interfere
with the study's goals, as they were carefully contemplated and
determined by Congress, and which could ultimately weaken and undermine
the credibility and value of the study at issue.
A. The overall composition of the proposed committee lacks fairness
and balance as required by Section 15 of the Federal Advisory Committee
Act.
NAS has not met the requirements of the 1997 Amendments to the
Federal Advisory Committee Act (FACA), which State that those with
conflicts of interest are to be excluded and that committee panels must
be fairly balanced in terms of the points of view represented and the
functions to be performed.
Section 15 of FACA states:
The Academy shall make its best efforts to ensure that (A) no
individual appointed to serve on the committee has a conflict of
interest that is relevant to the functions to. be performed, unless
such conflict is promptly and publicly disclosed and the Academy
determines that the conflict is unavoidable, (B) the committee
membership is fairly balanced as determined by the Academy to be
appropriate for the functions to be performed, and (C) the final report
of the Academy will be the result of the Academy's independent
judgment. The Academy shall require that individuals that the Academy
appoints or intends to appoint to serve on the committee inform the
Academy of the individual's conflicts of interest that are relevant to
the functions to be performed.
When Congress clarified FACA's application to NAS, NAS readily
agreed to a standard intended by all to protect the integrity of NAS
research and study efforts, while at the same time ensuring fairness in
the process, public access to information, review by a balanced and
unbiased advisory committee, and avoidance of conflicts of interests.
The need for balance and avoidance of biases has been further
reiterated in the NRC's ``Conflicts of Interest Policy'' and its
``Updated Checklist for Responsible Staff Officers for Compliance with
Section 15 of the Federal Advisory Committee Act,'' wherein NRC
internal policy calls for an unbiased committee or, alternatively, the
identification of a ``balance of potentially biasing backgrounds or
professional or organizational perspectives,'' when an unbiased panel
is not selected. NRC procedures also state that ``bias'' can be
determined by a candidate's expression of a particular point of
view.\1\
Taken as a whole, the proposed committee does not represent a
balance and is comprised of individuals who are biased on the issues.
It is unfairly weighted and reflects an unequal distribution of
professional backgrounds, points of view and professional affiliations.
More importantly, it is dominated by individuals who have taken
positions publicly on most every aspect regarding underage drinking,
and who share a single view toward the licensed beverage industry,
making it difficult for NAS to renounce the claim that the majority of
the committee has already taken sides and is predisposed in its joint
opinion of the issues that it will be reviewing.
With this in mind, we do not believe that the committee under
consideration can or will maintain an objective view on the issues at
hand. With the majority of the panelists of a predisposed opinion, the
integrity and credibility of the pending study is already called into
question.
Having expressed concerns with the proposed committee and the
ultimate reliability of the conclusions to be rendered, we would ask
the NAS to release the names of the alternate candidates it has slated
pursuant to NRC procedure and--practice. A public release of the
alternative list would allow for a meaningful review of all names being
considered and would provide the public with an opportunity to assist
in assuring that a fair and balanced committee is selected.
B. Panel recommendations include those with stated biases and
predetermined positions on the issues to be addressed by the study.
The 20-calendar day timeframe for interested parties to provide
comment does not allow for a meaningful and fair review of the proposed
committee. In the very short time we have had to review, research and
comment on the panelists' backgrounds, we have already determined that
at least five or more have made public statements or taken positions
publicly on the issues they are to address. The positions of those
proposed should be viewed as a strong indication of their prospective
biases.
Specifically, positions have been taken by Marilyn Aguirre-Molina,
Dr. Philip Cook, Dr. Joel Grube, Dr. Mark Moore, Dr. Denise Herd and
others indicating their lack of objectivity on many of the issues
surrounding the study and their biases favoring a predisposed and
single position.
C. Conflicts of interest are to be avoided.
The Section 15 FAA requirements state that the NAS shall require
individuals to inform the Academies of any potential conflicts of
interest. NRC policy on ``Disclosure of Personal Involvements and Other
Matters Potentially Affecting Committee Service'' defines ``conflict of
interest'' as ``. . . any financial or other interest or affiliation
which conflicts with the service of an individual because it could
impair the individual's objectivity or could create an unfair
competitive advantage for any person or organization. . . .''
With the brief amount of biographical information that has been
posted, it is virtually impossible for an interested party to determine
if there is a potential or actual conflict of interest on the proposed
committee. In order to raise a conflicts concern, sufficient details
must be given. The public is handicapped in its desire to ensure that
the committee is free of a conflict.
Additionally, while the actual NRC ``Potential Sources of Bias and
Conflicts of Interest'' forms may be confidential, the fact that a
proposed panelist has completed and returned the form should not be. To
date, we have been unable to confirm or verify that the NAS has
followed this process and that in fact, among those recommended to
conduct the study, no conflicts of interest exist. Merely declaring
that a policy exists is of little use without a means of determining
and guaranteeing its implementation.
D. Inadequate biographical information has been posted with regard
to the provisional committee nominees.
Section 15 of FACA requires the Academies to provide biographies of
those slated to serve on the committee. The NRC has stated that the
biographical postings shall include specific information about the
backgrounds, qualifications; affiliations, and prior committee service
of each proposed committee member. The NRC has also emphasized that
responsible staff officers will review with the executive directors the
potential sources of conflicts and biases that have been accumulated
from various sources, including public feedback.
Again we would argue that without a more complete and meaningful
release of information, the public is restricted in its desire to
participate in the process and its right to access of information. The
information posted and provided by the NRC is overly brief and
insufficient. As has been revealed by our independent efforts alone,
there is substantially more background information on the suggested
panelists that is relevant to the study and should be posted and
disclosed.
The clear intent of both Congress and the NRC with regard to the
above-referenced requirement was to ensure that interested parties were
provided with enough information to allow for a meaningful review of
the nominees. Without adequate and detailed information, a review is
essentially meaningless.
Interestingly, NRC allows for each nominee to ``approve'' the text
of his biographical information before being posted. While we
understand the nominee has a right to protect certain pieces of
information and that the NAS has a legal obligation to assist in
protecting the nominees' privacy concerns, the fact that a nominee may
``approve'' the information being released allows for mischief.
We ask that you post additional information on these individuals'
backgrounds and their research in order that the public may participate
in identifying potential sources of bias and possible conflicts of
interest. Congress and Federal agencies cannot conceal information of
this nature; therefore, the conclusions of a committee on which
Congress is to rely should not be derived from a process that lacks
fair and adequate disclosure of information.
Specifically, we are requesting that additional biographical
information be posted that discloses all relevant conflicts or bias
information, including the number of NAS committees each nominee has
served on in the past, any previously stated positions or opinions on
the issues and programs to be addressed by the study, any past or
current relations the nominees have with NAS, the United States
Department of Health and Human Services, or any interested party. We
would also like clarification by NRC that either no conflicts of
interest or biases exist or that the existence of such has been
properly disclosed.
To disclose this information after the close of the 20-day formal
comment period is of little or no use.
E. The scope of the project as stated by NAS does not comply with
the intent of Congress and exceeds the authority NAS has been granted.
The intended scope of the study as stated by NAS differs from the
conference report language of the fiscal year 2002 Labor/Health and
Human Services appropriations bill. The study's determinations are
important to Congress and those engaged in the effort to prevent and
reduce underage drinking; therefore, it is important to ensure that the
committee refrains from deviating from the scope of Congress's intent.
The conference report language requests a study of an array of
programs designed to prevent and reduce underage drinking, and
enumerates a very specific list of inquires to which Congress is
seeking a reply. NRC policy states that the ``project scope description
should be . . . consistent with the terms of reference in a contract,
grant, or cooperative agreement.''
For NAS to go beyond the scope of the request set out in the
conference report and delve into areas of legislative authority defies
its own procedures and is overreaching and contradictory to
congressional intent. Nowhere in the report language does Congress seek
input from NAS or its advisory committee with regard to tax-related
issues. Yet, the scope as stated by NAS suggests, with some emphasis,
that the study will be reviewing excise tax measures.
NAS holds itself out as a ``private, non-profit, self-perpetuating
society of distinguished scholars engaged in scientific and engineering
research, dedicated to the furtherance of science and technology and to
their use for the general welfare.'' According to the NAS original
charter, Congress signed NAS into being to ``. . . report upon any
subject of science or art.''
This mandate does not extend to NAS legislative authority in any
area, and certainly not in the area of recommending tax increases on
the public, an area of sensitivity and one that is specifically
reserved for Congress and its congressional committees. Any decision to
implement or increase excise taxes, or any other tax, is totally
outside the authority and jurisdiction of NAS, and we strongly object
to the inclusion of any tax-related matters in this study.
We are also concerned that the stated scope does not provide much
detail or information regarding the types of programs that will be
studied. The conference report references non-governmental programs for
review. We believe private sector programs can contribute a great deal
to the value of the project. There are many highly successful and well-
received programs that have been implemented by various local and
community organizations, parent and civic associations, businesses,
schools, non-profits, and the licensed beverage industry. We would urge
that these programs also be reviewed and receive equal weight and
consideration.
Sincerely,
Jeff Becker,
President, Beer Institute.
Juanita Duggan,
Executive Vice President/CEO,
Wine and Spirits Wholesales of America.
David K. Rehr,
President, National Beer Wholesalers Association.
ENDNOTES
1. All references to the National Research Council's (NRC) Updated
Checklist for Responsible Staff Officers for Compliance with Section 15
of the Federal Advisory Committee Act (FACA) are derived or extracted
from the August 10, 1998, update of the policy original drafted and
released on December 17, 1997. References to its Conflicts of Interest
Policy are from NRC's 1992 publication. A request to the National
Academy of Sciences (NAS) for the most recent publications has been
made but not yet received.
______
REDACTED VERSION OF APPENDIX E
Beer Institute,
Wine and Spirits Wholesalers of America, Inc.,
WSWA,
National Beer Wholesalers Association, NBWA,
Alexandria, VA 22314,
August 12, 2002.
Mary Ellen O'Connell,
Study Director,
Board on Children, Youth and Families,
National Research Council/Institute of Medicine,
500 5th Street, NW, 11th Floor,
Washington, DC 20001.
Re: Project# BCYF-1-02-O1-A, Developing a Strategy to Reduce and
Prevent Underage Drinking
Dear Ms. O' Connell:
REDACTED
REDACTED
REDACTED
REDACTED
REDACTED
REDACTED
REDACTED
E. The scope of the project as stated by NAS does not comply with
the intent of Congress and exceeds the authority NAS has been granted.
The intended scope of the study as stated by NAS differs from the
conference report language of the fiscal year 2002 Labor/Health and
Human Services appropriations bill. The study's determinations are
important to Congress and those engaged in the effort to prevent and
reduce underage drinking; therefore, it is important to ensure that the
committee refrains from deviating from the scope of Congress's intent.
The conference report language requests a study of an array of
programs designed to prevent and reduce underage drinking, and
enumerates a very specific list of inquires to which Congress is
seeking a reply. NRC policy states that the ``project scope description
should be . . . consistent with the terms of reference in a contract,
grant, or cooperative agreement.''
For NAS to go beyond the scope of the request set out in the
conference report and delve into areas of legislative authority defies
its own procedures and is overreaching and contradictory to
congressional intent. Nowhere in the report language does Congress seek
input from NAS or its advisory committee with regard to tax-related
issues. Yet, the scope as stated by NAS suggests, with some emphasis,
that the study will be reviewing excise tax measures.
NAS holds itself out as a ``private, non-profit, self-perpetuating
society of distinguished scholars engaged in scientific and engineering
research, dedicated to the furtherance of science and technology and to
their use for the general welfare.'' According to the NAS original
charter, Congress signed NAS into being to ``. . . report upon any
subject of science or art.''
This mandate does not extend to NAS legislative authority in any
area, and certainly not in the area of recommending tax increases on
the public, an area of sensitivity and one that is specifically
reserved for Congress and its congressional committees. Any decisionto
implement or increase excise taxes, or any other tax, is totally
outside the authority and jurisdiction of NAS, and we strongly object
to the inclusion of any tax-related matters in this study.
We are also concerned that the stated scope does not provide much
detail or information regarding the types of programs that will be
studied. The conference report references. non-governmental programs
for review. We believe private sector programs can contribute a great
deal to the value of the project. There are many highly successful and
well-received programs that have been implemented by various local and
community organizations, parent and civic associations, businesses,
schools, non-profits, and the licensed beverage industry. We would urge
that these programs also be reviewed and receive equal weight and
consideration.
Sincerely,
Jeff Becker,
President, Beer Institute.
Juanita Duggan,
Executive Vice President/CEO,
Wine and Spirits Wholesalers of America.
David K. Rehr,
President, National Beer Wholesalers Association.
REDACTED
______
APPENDIX F
National Beer Wholesalers Association, NBWA,
Alexandria, VA 22314-2044,
June 18, 2003.
Dr. Bruce Alberts,
President,
National Academy of Sciences,
500 Fifth Street, NW,
Washington, DC 20001.
Dear Dr. Alberts: As you know, the National Beer Wholesalers
Association (NBWA) strongly advocated that Congress include language in
the 2002 Labor-HHS Appropriations Conference Report calling for a
comprehensive study of existing underage drinking programs. As a result
of that legislation, the National Academy of Sciences (NAS) received
$500,000 to conduct a thorough review of existing Federal, State and
non-governmental programs to combat underage drinking.
As taxpayers and vigorous opponents of the illegal underage
purchase and consumption of licensed beverages, NBWA members are
concerned by the steps taken by the panel to date that focus on issues
beyond Congress's original intent, and which reflect the anti-industry
bias of panelists, agendas and witnesses. This is not the first time we
have raised these concerns.
In a letter addressed to Study Director Mary Ellen O'Connell dated
August 12, 2002, NBWA expressed concerns that NAS did not meet the
requirements of the 1997 Amendments to the Federal Advisory Committee
Act (FACA). Those requirements state that individuals with conflicts of
interest are to be excluded from committee panels, and that those
panels be fairly balanced in terms of the points of view represented
and the functions to be performed.
Oddly enough, the contents of the copy of this letter that exists
in the NAS public file have been redacted, barring the public and media
from its review. We find this highly unusual and request an explanation
as to why it was done.
NBWA continues to be concerned about the lack of objectivity of the
panel as the study moves forward. As a whole, the committee is not
fairly balanced, being comprised of several individuals who must be
presumed to be biased based on public positions that have revealed
their preconceived opinions regarding many of the issues involved.
Several members of Congress, NBWA and industry allied groups made
independent recommendations of various, well-respected experts for
inclusion on the panel. However, NAS ignored those suggestions and
selected a panel of individuals who do not represent diverse views or
opinions on the issues they are tasked with reviewing.
As mentioned before, the scope of the study as stated by NAS
differs from the intent of Congress as stated in the conference report
language. Specifically, the conference report does not seek input from
NAS or its advisory committee with regard to tax-related issues. Excise
taxes are totally outside the authority and jurisdiction of NAS.
Additionally, the committee appears to have paid little attention
to developing real solutions, such as increasing involvement by
parents, peers, teachers and community leaders, enforcing existing
laws, influencing the personal choices of minors and weighing the value
of successful licensed beverage industry responsibility programs.
We are especially disappointed in the lack of consideration given
to already established industry responsibility programs during the
study process. The beer industry actively promotes responsible
consumption of its products and has made a significant contribution to
addressing underage issues. A sample of the vast array of programs
include point-of-sale ID programs, public service announcements,
retailer and server education and educational materials to help parents
talk to their children about illegal underage drinking. Information on
more than 125 beer industry programs was provided to the committee for
review during the study process.
The beer industry's responsibility efforts, along with those of
parents, teachers, community leaders and other organizations, have led
to real progress in the fight against underage drinking. Research
sponsored by the University of Michigan conducted over the past two
decades clearly demonstrates that drinking among our nation's youth has
significantly declined. The work of the industry should be recognized
by the committee and its multitude of programs should be thoroughly
reviewed.
The directive of Congress has thus far been ignored in the
committee process. In fact, nearly 140 members of Congress recently
wrote to NAS requesting that the study focus on the original intent--
existing Federal, State and non-governmental programs--and not on
untested theories and policy changes intended to adversely affect the
licensed beverage industry. NBWA supports comprehensive solutions to
the problems associated with the illegal underage purchase and
consumption of licensed beverages.
What was meant to be a thorough review of programs to fight
underage drinking has gone astray. The NAS study is apparently focused
largely on increasing beer excise taxes, developing a taxpayer-funded
anti-beer media campaign and imposing unnecessary advertising limits
and restrictions.
All in all, the committee is failing to provide an adequate effort
to yield a credible, reliable study that Congress may rely on for
unprejudiced results. Over the years, the beer industry has made an
enormous contribution to reducing illegal underage purchase and
consumption, and I again urge the committee to review private-sector
programs and give them equal weight and consideration.
Sincerely,
David K. Rehr, Ph.D.,
President.
______
APPENDIX G
National Academy of Sciences,
The National Academies,
Washington, DC 20418,
August 13, 2003.
David K. Rehr,
President, National Beer Wholesalers Association,
1101 King Street,
Suite 600,
Alexandria, VA 22314-2944.
Dear Dr. Rehr: I write in response to your June 18, 2003 letter
regarding the National Academies study on Developing a Strategy to
Reduce and Prevent Underage Drinking. Thank you for your continued
interest in this important project.
In accordance with Section 15 of the Federal Advisory Committee
Act, the National Academies, through our Public Access Records Office,
makes available to the public written information presented to the
study committee by individuals who are not officials, agents, or
employees of the Academies. The extensive programmatic and research
information that you and other organizations and individuals have
provided to the committee is included in the project's public access
file and has been carefully considered by the committee. The National
Academies' leadership carefully considers information provided by the
public related to the composition of the committee--including
particularly suggestions of individuals as prospective nominees to the
committee, or comments about the credentials of specific members who
have been provisionally appointed to the committee--but this
information is not included in the public access file. This type of
information is relevant to our institutional management of the study,
but is not germane to deliberations of the study committee. The
contents of your August 12, 2002 to Mary Ellen O'Connell that were
redacted fit into this latter--category as they were specific to
National Academies' procedures and specific committee members.
We of course will ensure that the report of the study addresses the
questions posed by Congress, and that it reflects the relevant
scientific literature. As is the case with all studies conducted at the
National Academies, we have tapped the expertise in several of our
boards such as the Board on Children, Youth and Families, and have
received input from members of the Institute of Medicine, the National
Academy of Sciences, and the National Research Council's Governing
Board among others. These extensive consultations enable us to provide
an objective and independent response to the Congressional request. The
statement of task for the committee directs it to equally consider the
full range of approaches to reducing underage drinking. During the
course of the study, the committee has taken into account, in the
context of its charge, the range of input received in the form of
commissioned papers, written and verbal testimony, correspondence, and
informational materials provided by multiple interested parties, such
as your organization.
As you know, the committee's draft report is subjected to a
rigorous external review. As a final check on the quality and
objectivity of the study, the Academies appoint additional independent
experts with a range of views and perspectives to review and comment on
the draft report prepared by the committee. The review process is
structured to ensure that the report addresses the approved study
charge and does not go beyond it; the findings are supported by the
evidence and arguments presented; the exposition and organization are
effective; and the report is impartial and objective. Once revisions in
response to review are made by the committee to satisfy our rigorous
review process, the report is transmitted to the sponsoring agency and
released to the public. Names and affiliations of reviewers are made
public when the report is released.
The review of the committee's draft report is underway, so it would
be inappropriate to respond to the views you share regarding the focus
of the report, or what is or is not included in it. I look forward to
providing you with the committee's report in the near future and to
receiving your comments.
Sincerely,
Bruce Alberts,
President.
______
Response to Questions of Senator Reed From Richard Bonnie
Question 1. Mr. Becker in his written testimony states that the NAS
report ``ignored the clear direction of Congress to evaluate existing
Federal, State and non-governmental programs'' focusing instead of
costly, experimental programs.
As Chair of the NAS Committee that crafted this report, how do you
respond to this claim?
Answer 1. The committee reviewed available evidence regarding the
effectiveness of a wide variety of government and private programs for
the purpose of developing a comprehensive national strategy to reduce
underage drinking. We relied on the available scientific literature,
commissioned papers, testimony and submissions from the public, and the
committee's expertise in areas such as public policy, public health,
youth development and substance abuse prevention. The committee's
charge was to provide science-based recommendations about how best to
reduce and prevent underage drinking, and we believe we fulfilled that
charge.
Question 2. I was particularly struck by the number of
recommendations in the NAS report geared toward limiting access to
alcohol at the State and local level.
What can we do at the Federal level to encourage States and
localities to adopt some of these thoughtful recommendations?
Answer 2. To help monitor and increase compliance with access
restrictions, the committee recommends that a provision similar to the
Synar Amendment's requirement for youth tobacco sales be established
for alcohol sales. As a condition of receiving block grant funds,
States could be required to achieve designated rates of retailer
compliance with youth access prohibitions. Relevant block grants
include the OJJDP block grant mentioned above as well as the prevention
set-aside of the substance abuse prevention and treatment block grant
in SAMHSA. Although not specifically discussed in the report, an
incentive for States to increase compliance could also be established
by providing bonus funding to States that achieve a particularly high
level of compliance.
Both the Federal Government and States should improve coordination
of the multiple agencies (e.g., substance abuse, education,
transportation, justice) involved in addressing underage drinking. As
part of establishing the recommended Federal interagency task force,
the Federal Government might direct States to identify a lead State
agency contact as a liaison to the Federal Government.
The committee also recommends that funding be provided directly to
communities to enable them to develop and implement initiatives
specifically aimed at reducing underage drinking. The committee
believes that such funding could be modeled after the Drug Free
Communities Act which provides funding to communities to develop drug
use prevention efforts generally. If such a funding stream is
established, communities should be required to implement evidence-based
approaches, including limiting access to alcohol.
The Department of Justice, through the Office of Juvenile Justice
and Delinquency Prevention (OJDDP), operates the largest Federal
program, the Enforcing the Underage Drinking Laws program, specifically
targeted at underage drinking. This program provides block grant
resources to States and discretionary grants to States and communities.
States and localities who receive these funds could be encouraged to
adopt the committee's recommendations. The technical assistance center
operated by this program is one potential source for such guidance.
Although not discussed in the report, a federally-funded multi-
State demonstration effort might serve as a useful first step to
mobilize State and local activity to reduce underage drinking.
Question 3. The report also references an initiative between the
National Institute on Alcohol Abuse and Alcoholism (NIAAA) and a
consortium of college Presidents that presented its findings on
strategies to reduce binge drinking on college campuses. The President
of the University of Rhode Island was one of the members of this task
force.
What role does the NIAAA (``N-I-triple A'') initiative play in
terms of the comprehensive strategy being advocated in the NAS report?
Answer 3. NIAAA is the Federal agency with lead responsibility for
research related to underage drinking. NIAAA should continue and expand
its portfolio of research to enable continuous refinement of the
national strategy proposed in the committee's report and to increase
our knowledge about the effectiveness of particular approaches. For
example, information about how the strategy might need to differ for
various age groups, and how to reach groups that have not traditionally
been reflected in research such as youth in the workplace, needs to be
developed. NIAAA could also facilitate State and local action by
funding research on State and local-level interventions focused on
underage drinking.
Many of the recommendations specific to college campuses made in A
Call to Action are similar to those recommended by the committee.
Undoubtedly this is because the NIAAA effort involved a similar
synthesis of scientific evidence. NIAAA's continued involvement in this
initiative, particularly if it is coupled with ongoing research to
allow further tailoring of approaches to specific types of campuses,
should advance the approach outlined in the committee's report.
Response to Questions of Senator Reed From Jeff Becker
Question 1. One of the recommendations of the NAS report is for the
alcohol industry to partner with public entities in the formation of an
independent non-profit foundation with the sole mission of designing,
implementing and evaluating evidence based programs for preventing
underage drinking. Are you and the individual companies willing to
discuss such a partnership with other potential partners?
Answer 1. The beer industry agrees with the NAS that partnerships
with independent, non-profit and public entities that are leaders in
the fight against underage drinking are an important component in the
fight against underage drinking. That is why for decades, brewers have
financially supported independent groups like BACCHUS/GAMMA, the TEAM
Coalition, the National Conference of State Liquor Administrators,
local chapters of Mothers Against Drunk Driving, several college and
university social norms and anti-alcohol abuse programs, and many
others who are experts in their respective fields. The Subcommittee has
a comprehensive package of materials on our existing efforts, and we
would be pleased to spend some time with members and/or staff to review
these initiatives in greater detail.
This packet of material was also supplied to the NAS to use in
fulfilling the Congressional request for an examination of existing
programs to fight underage drinking. One of the shortcomings in the
National Academies report was its failure to evaluate these programs.
We respectfully refer the Subcommittee to three recent Federal surveys
and reports that do include inventories of existing programs sponsored
by brewers, many of which have been independently evaluated. One of the
most comprehensive surveys was performed for the Department of Justice
Office of Juvenile Justice and Delinquency Prevention (OJJDP). A report
that focused on college drinking was released in 2003 by the National
Institute on Alcohol Abuse and Alcoholism and a third report and
evaluation was released earlier this year by the Substance Abuse and
Mental Health Services Administration. The same organization that
performed the survey for the OJJDP actually delivered a commissioned
paper to the National Academies panel and never mentioned the work that
his organization performed with Federal funds.
Brewers have long come to the realization that we are far more
effective in the fight against underage drinking when we are able to
team with people and organizations that are open to our involvement and
treat us as sincere partners in the process. Toward that end, Beer
Institute members are not prepared to commit to funding or
participating in a non-profit organization dedicated to the design,
evaluation, and implementation of underage drinking programs. At this
point in time, we do not even understand the expectations for such an
organization or its mission and structure. Members of the brewing
industry have ongoing and significant commitments to existing non-
profit organizations whose missions include programs or research
activities to address various aspects of underage drinking. Any
significant new commitment would take resources away from those
programs.
Please keep in mind that I represent the Beer Institute and its
members. I do not speak on behalf of the entire ``alcohol industry.''
In fact, the repeated characterizations of ``the alcohol industry'' as
one unit demonstrates a lack of understanding that the ``alcohol
industry'' is made up of independent businesses operating in a
regulated, three-tier system that was designed by Congress and adopted
by the States after the repeal of Prohibition to ensure accountability,
integrity, and efficient tax administration. As mandated in Federal and
State law, production, distribution, and retail sale of alcohol
beverages are conducted by over 600,000 separate licensed entities
operating throughout the United States. Within that universe, beer,
wine, and hard liquor are regulated separately in view of the distinct
differences among the products. We briefly referenced this point in our
testimony, and we attempted to communicate information about the
organization of the industry to the National Academies during the
deliberations of the underage drinking panel.
Congress has certainly recognized the need for multiple approaches
by authorizing several Federal agencies to address aspects of underage
drinking. Those agencies in turn fund hundreds of grantees including
research institutions and agencies of State and local government, non-
profit community organizations and others. Federal agencies have funded
or conducted basic behavioral and biomedical research, a variety of
prevention initiatives, grants to State and local law enforcement,
educational efforts designed for specific age groups, and drunk driving
prevention programs. The work to be done is far beyond the reach of one
non-profit group.
Question 2. Setting aside the issue of excise taxes, the NAS report
made many other recommendations embracing approaches that the industry
supports--such as focusing on parents and also increasing compliance
with the underage drinking laws. What parts of the strategy do you
agree with?
Answer 2. Without going through an exhaustive point by point review
of the National Academies document, brewers and beer wholesalers are
already heavily involved in nine of the ten strategy components in the
National Academies report. If you consider the fact that brewers
already pay billions of dollars in Federal and State excise taxes with
virtually no compliance costs to government agencies, beer industry
members are involved in all ten areas.
In the September 2003 Federal Trade Commission Report on Alcohol
Marketing and Advertising, the Commission found that a focus on two key
issues is needed to make further progress in the battle against illegal
underage drinking: Educating adults who directly or indirectly supply
youth with alcohol, and enforcing the laws against sales to underage
people.
In many respects, the FTC's and the National Academies' findings
were remarkably simple and poignant. Neither, however, surprised
brewers who have devoted tremendous resources to developing programs
for parents and educators to use in talking with kids about underage
drinking, and developing programs in multiple languages for retailers
on the front lines to help them spot fake identification and train them
on tactics used by underage people to purchase alcohol. We
wholeheartedly endorse and support efforts in these two areas.
Response to Questions of Senator Reed From Wendy Hamilton
Question 1. You point out in your written testimony that there have
been dramatic declines in the number of drunk driving fatalities
involving underage drinkers since the 1980's. However, over the past
decade, we have made little progress in further reducing the number of
these fatalities. Why has this stagnation occurred?
Answer 1. Our nation accepts underage drinking as a mere ``rite of
passage,'' so it is no surprise that underage drinking rates--and
associated consequences such as youth alcohol-related traffic crashes--
have not improved for the past decade. Progress to reduce youth alcohol
use was made in the 1980's in large part due to the increase of the
minimum drinking age (MDA) to 21. As the National Academy of Sciences
reports:
Limiting youth access to alcohol has been shown to be effective in
reducing underage drinking and drinking-related problems. Since 21
became the nationwide legal drinking age, there have been significant
decreases in drinking, fatal traffic crashes, alcohol-related crashes,
and arrests for ``driving under the influence'' (DUI) among young
people.
Increasing the minimum drinking age to 21 has been one of the most
effective public health policies in history, resulting in a significant
decrease in fatal traffic crashes, DWI arrests, and self-reported
drinking by young people. However, the law alone does not preclude
youth from gaining access to alcohol. The National Academy of Sciences
also reports:
Given the widespread availability and easy access by underage
drinkers, minimum drinking age laws must be enforced more effectively,
along with social sanctions. The effectiveness of underage drinking
laws could be enhanced through such approaches as compliance checks,
server training, zero tolerance laws, and graduated driver licensing
laws.
While the effectiveness of the 21 MDA law is undeniable, there is
much more that the nation must do to reduce and prevent underage
drinking. General deterrence through sanctions, improved enforcement,
and public awareness of enforcement is needed in order to effectively
implement restrictions on youth alcohol use. It is critical that
funding be made available to enforce existing laws and to implement
scientifically-proven community prevention programs.
Enforcement of State and local laws has proven to be a highly
effective tool in underage drinking prevention. Tougher enforcement of
laws aimed at reducing underage drinking is greatly needed, and
Congress can provide the impetus for action by enacting a law based on
NAS Recommendation 9-3:
9-3: The Federal Government should require States to achieve
designated rates of retailer compliance with youth access prohibitions
as a condition of receiving block grant funding, similar to the Synar
Amendment's requirements for youth tobacco sales.
The nation also needs to execute a coordinated effort at the
national, State and local level to combat this public health problem.
MADD urges Congress to implement NAS Recommendations 12-1 through 12-6,
which demonstrate a clear need for better ``Government Assistance and
Coordination'' at the national level in order to reduce underage
drinking:
12-1: A Federal interagency coordinating committee on prevention of
underage drinking should be established, chaired by the secretary of
the U.S. Department of Health and Human Services.
12-2: A National Training and Research Center on Underage Drinking
should be established in the U.S. Department of Health and Human
Services. This body would provide technical assistance, training, and
evaluation support and would monitor progress in implementing national
goals.
12-3: The secretary of the U.S. Department of Health and Human
Services should issue and annual report on underage drinking to
Congress summarizing all Federal agency activities, progress in
reducing underage drinking, and key surveillance data.
12-4: Each State should designate a lead agency to coordinate and
spearhead its activities and programs to reduce and prevent underage
drinking.
12-5: The annual report of the secretary of the U.S. Department of
Health and Human Services on underage drinking should include key
indicators of underage drinking.
12-6: The Monitoring the Future Survey and the National Survey on
Drug Use and Health should be revised to elicit more precise
information on the quantity if alcohol consumed and to ascertain brand
preferences of underage drinkers.
The decade-long plateau in underage drinking rates demands
attention. The NAS report provides a science-based roadmap to reduce
underage drinking, and MADD hopes to work with this Committee to
implement this strategy.
Question 2. A central focus of the NAS report is the importance of
an adult-oriented strategy to foster the development of a societal
commitment to reduce underage drinking. Why do you think parents are
accepting of underage drinking?
Answer. Unlike marijuana, ecstasy or cocaine, alcohol is a legal
product for people 21 and older. MADD does not take issue with the
responsible, legal use of alcohol. However, because alcohol is a legal
product for the adult population, and is widely accepted as a ``rite of
passage,'' youth prevention is especially difficult. One never hears,
``thank goodness my kid is just smoking weed'' or ``thank goodness my
kid is only doing ecstasy;'' but parents often do say ``thank goodness
my kid is only drinking alcohol.'' Adults and society at large
incorrectly view youth alcohol use as a harmless part of growing up,
even though alcohol kills 6.5 more youth than all other illicit drugs
combined. Clearly there is a gaping hole in messages that go out to
parents and communities (and in school curriculum) about the dangers of
youth alcohol use.
Adults often facilitate youth access to alcohol--from the store
clerk who doesn't check IDs, to the police officer who pours out the
beer and send teens home without punishment for breaking the law, to
adults who don't mind buying beer for a kid who slips him an extra $10.
In addition, the alcohol industry continues to be the sole
continuous source of messages to the nation on alcohol use, and through
its targeted advertising practices and slick marketing campaigns
portrays alcohol use as fun, sexy and cool. Ads often air during
programs that are overwhelmingly viewed by teens.
The need for a comprehensive public education campaign aimed at
underage drinking prevention is undeniable as most parents and youth
are unaware of the dangers associated with youth alcohol use. Many
parents do not recognize the prevalence of, or the risks associated
with, drinking for their own children. Parents have not been educated
about alcohol's effects on the development of the adolescent brain, and
often contribute (whether knowingly or not) to their underage
children's drinking by giving kids access to alcohol, by not responding
to children's drinking, and by not adequately monitoring their
children's behavior. Kids receive mixed messages on a daily basis from
their parents, other adults, the media and society at large.
MADD commends the NAS for calling for a national advertising
campaign to prevent underage drinking and strongly supports NAS
Recommendation 6-1:
6-1: The Federal Government should fund and actively support the
development of a national media effort, as a major component of an
adult-oriented campaign to reduce underage drinking.
The goals of the national media campaign, as presented by NAS,
would be to instill a broad societal commitment to reduce underage
drinking, to increase specific actions by adults that are meant to
discourage underage drinking, and to decrease adult conduct that
facilitates underage drinking.
Question 3. In your experience, how do parental attitudes towards
alcohol compare to their attitudes toward tobacco use?
Answer 3. Underage drinking and smoking is illegal, and yet
millions of kids continue to engage in these high-risk behaviors every
day. While not involved in tobacco policy, we surmise that the ``kids
will be kids'' attitude that parents take towards underage drinking is
similar with underage tobacco use.
Youth tobacco use prevention efforts, including media campaigns
designed to reduce youth smoking, have been shown to be effective. As
more and more parents and kids learn about the dangers associated with
smoking, societal attitudes have started to change. MADD will continue
to push for the implementation of scientifically-based youth alcohol
use prevention efforts, and the implementation of a nationally
coordinated strategy--based on the NAS report--to prevent use alcohol
use.
[Whereupon, at 11:55 a.m., the subcommittee was adjourned.]