Responsible Retailing Forum Santa Fe, New Mexico March 31, 2005 Stephen Wing Associate Administrator for Alcohol Policy Substance Abuse and Mental Health Services Administration

The Problem Underage drinking is a serious and persistent problem in the United States. Although some progress has been made since the late 1970’s, prevalence rates have remained relatively stable for over 10 years. In 2003, a higher percentage of youth use alcohol (29), than tobacco (23.3 ), or illicit drugs (14.9) (SAMHSA 2004). In 2002, about 2.3 million youth ages 12 through 20 drank 5 or more drinks on an occasion, 5 or more times a month; (SAMHSA, 2004).

The Problem (cont..) Alcohol use by persons under age 21 poses both acute and long-term risks. In 2002, 1.5 million youth ages 12 through 17 met criteria for admission to alcohol treatment (optional addition – of these, only 120,000 received treatment) (SAMHSA, 2003). Alcohol is the leading contributor to the leading cause of death for people under age 21. Annually, 7000 youth under 21 die from alcohol- related injuries, homicides (1500) and suicides (300) (NHTSA, 2003,; CDC, 2004; Smith et al, 1999; Levy, Miller, Cox, 1999; Hingson and Kenkel, 2004).

The Problem (cont..) 40% of those who start drinking before the age of 15 meet criteria for alcohol dependence at some point in their lives. Research indicates that the human brain continues to develop into a person’s early 20’s and that exposure of the developing brain to alcohol may have long-lasting effects on intellectual capabilities and may increase the likelihood of alcohol addiction (Brown, Tapert, Granholm and DeBellis, 2000).

The Problem (cont..) Underage alcohol consumption results in serious second-hand effects. Half of all persons who die in traffic crashes involving drinking drivers under age 21 are persons other than the drinking driver (Hingson & Winter, 2003). Among college students under age 21 alone, 50,000 experience alcohol-related date rape, and 430,000 are injured by another student who has been drinking (NIAAA, 2002).

The Costs Alcohol use by youth imposes an estimated $53 billion in social costs annually, including $19 billion from traffic crashes and $29 billion from violent crime.

National Academy of Sciences/ Institute of Medicine Report (NAS/IOM) To help develop a cost-effective strategy for reducing and preventing underage drinking, the Congress mandated a study of the issue by NAS/IOM in the Labor, Health and Human Services and Education Appropriations Act of NAS/IOM established an Ad Hoc committee to analyze the problem and develop a strategy designed to prevent and reduce underage alcohol drinking. Reducing Underage Drinking: A Collective Responsibility, was released in the fall of 2003.

The Strategy Create a national shared commitment with multiple players Engage adults, including parents Encourage State and local action Implement multiple components

The Strategy Goal The overarching goal of the proposed strategy is to “create and sustain a broad societal commitment to reduce underage drinking,” and to“pursue opportunities to reduce the availability of alcohol to underage drinkers, the occasions for underage drinking, and the demand for alcohol among young people.”

Strategy Components Adult-Oriented Media Campaign National Partnership Advertising Restraint Entertainment Responsibility Compliance with Access Limits Youth-Oriented Interventions Community Interventions Government Assistance and Coordination Alcohol Excise Tax Research and Evaluation

The Need for Coordination As part of its strategy, the report made a series of recommendations for increased Federal involvement, including the following recommendation: “A federal interagency coordinating committee on prevention of underage drinking … be established, chaired by the Secretary of the U. S. Department of Health and Human Services (HHS).” The conference report accompanying H. R. 2673, the Consolidated Appropriations Act of 2004, expressed the conferees’ concern about underage drinking and the need to take immediate steps to better coordinate Federal efforts to address this problem.

Interagency Coordinating Committee on Prevention of Underage Drinking (ICCPUD) The report directed the Secretary of Health and Human Services to establish an Interagency Coordinating Committee on the Prevention of Underage Drinking (ICCPUD) and to issue an annual report summarizing all Federal agency activities concerning the issue. The report also directed the Secretary to prepare a plan for combating underage drinking, including the projected costs and next steps to be taken, and to report progress on such a plan within 90 days of the enactment of the Act.

ICCPUD (cont..) The then Secretary Thompson asked SAMHSA to assume a leadership role in addressing this important public health issue. Accordingly, the SAMHSA Administrator created and convened the ICCPUD which consists of representatives from the numerous Federal agencies committed to this issue:

Coordinating Committee National Institute on Alcohol Abuse and Alcoholism (NIH/NIAAA) National Highway Traffic Safety Administration (DOT/NHTSA) Centers for Disease Control and Prevention (DHHS/CDC) Office of Juvenile Justice and Delinquency Prevention (DOJ/OJJDP) Office of National Drug Control Policy (ONDCP) Administration for Children and Families (DHHS/ACF) Office of Safe and Drug Free Schools (DoEd) Office of the Surgeon General (DHHS/OSG) Office of the Assistant Secretary for Planning and Evaluation (DHHS/ASPE) Department of Defense Federal Trade Commission, Ex Officio Alcohol and Tobacco, Tax and Trade Bureau (TTB)

Purpose of the Committee The Committee: Serves as a mechanism for coordinating Federal efforts and as a resource for development of a plan for combating underage drinking mandated by Congress. Is supported by a group of agency representatives with expertise and responsibilities in the area of alcohol prevention that meets weekly.

Committee Activities To date, the Committee has: Completed a survey of major Federal programs addressing underage drinking. Developed interagency activities addressing the issue. Developed a draft framework of a plan for combating this problem.

The goals of the plan are to: Strengthen a national commitment to addressing the problem of underage drinking. Exercising Federal leadership will be critical to this effort. Prevent underage drinking and its negative consequences. Improve research, evaluation, and surveillance. Goals of the Plan

The draft plan, together with the inventory of federal programs, has been submitted to the Congress as an Interim Report. We have sought comments on the plan from the Hill, advocacy groups, and the industry. The plan is being revised, and will be included in a report that will serve as the Department’s first annual report on underage drinking. Reports on Underage Drinking

Current Activities We are planning a national meeting on underage drinking that will take place in Fall 2005 and will be followed, in Spring 2006, by a web-based meeting of communities across the country. The Ad Council is working on a public service campaign, targeted towards 11–15-year-olds, that addresses the problem of underage drinking. We are working on the development of a searchable website that any interested party could visit to identify Federal programs addressing this issue. This will make it much easier for the field to know where to look for materials, as well as potential sources of funding.

A thorough analysis of all Federal data sources regarding underage drinking is already underway. The purpose of which is to identify ways to strengthen our surveillance of underage drinking itself, and its negative consequences. We have developed common message points for use by Government officials to use when talking about this issue. Since programs have been identified that have demonstrated effectiveness in preventing underage drinking, we are considering a federal registry of effective programs for use by States and communities. Several agencies are considering using SAMHSA’s National Registry of Effective Programs (NREPP). Current Activities (cont..)

As a result of the ICCPUD process, the Office of Safe and Drug Free Schools and SAMHSA are considering national web- base training for schools on the prevention of underage drinking. Reach Out Now For the fourth year, the Substance Abuse and Mental Health Services Administration (SAMHSA) will join with Scholastic Inc. to produce and distribute a special issue of Scholastic magazine focused specifically on underage drinking. In the spring of 2005, every 5 th and 6 th grade class in the United States will receive a four page set of lessons and in- class activities for teachers to use as part of their classroom instruction. Also included is a "take-home" packet for students that provides their parents helpful information and activities families can do together to help prevent underage drinking. Current Activities (cont..)

As part of the Reach Out Now project, SAMHSA has joined with the Leadership to Keep Children Alcohol Free, and other leaders across the country to conduct Teach Ins based on the Reach Out Now materials. Experience has shown that such “teach-ins” can draw media attention to the important issue of underage drinking, and simultaneously encourage the use of the materials in other classrooms. Current Activities (cont..)

Last year, we had Teach Ins in all 50 State and the District of Columbia. Further information on this year’s Teach Ins is available at We encourage you to join this annual effort to inform 5 th and 6 th graders, their parents and their communities about the risks of underage drinking. Current Activities (cont…)

Conclusion SAMHSA and the Committee believe that Federal leadership is a critical, but not by itself sufficient, element in addressing this significant public health problem. national Without a national commitment to addressing this issue, we are not likely to make much progress. Therefore not only how we exert federal leadership is important, but how we encourage communities, parents, other adults, and youth themselves to become part of a broad, nation-wide commitment, is vital to any of our efforts.