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Leadership to Keep Children Alcohol FreeLeadership to Keep Children Alcohol Free, a unique coalition of Governors' spouses, Federal agencies, and public and private organizations, is an initiative to prevent the use of alcohol by children ages 9 to 15. It is the only national effort that focuses on this age group. Alcohol use begins at a very young age, and the proportion of young people who drink often or heavily is alarming. Serious, often lifelong consequences for health and well-being can result. The Leadership initiative is alerting the Nation to this critical public health problem and mobilizing action to prevent it. More information may be found at www.alcoholfreechildren.org. Table of Contents The strategies included in this guide were selected by a panel of scientists convened by the National Institute on Alcohol Abuse and Alcoholism, part of the National Institutes of Health in the U.S. Department of Health and Human Services. The scientists were chosen for their distinguished careers in research on alcohol abuse and dependence and related prevention programs. We are indebted to the following panel participants for their invaluable contributions:
A special note of appreciation goes to Michael Klitzner, Ph.D., Science Writer, Mary Wendehack and Patricia Green, Managing Editors, Diane Doyle, Research Librarian, and Rich Smith, Graphic Designer. lcohol is the most commonly used drug among our Nation’s young people, surpassing tobacco and illicit drugs.1 Alcohol is a powerful, mood-altering drug, and its use by children poses very serious health risks for bodies and minds that are still maturing. It can cloud judgment and interfere with developing social skills and academic achievement. For example, research demonstrates that adolescents who abuse alcohol may remember 10% less of what they have learned than those who don’t drink.2 Alcohol use may also lead to increased sexual activity, exposure to sexually transmitted disease, unplanned pregnancy, suicidal and violent behavior, criminal activity, injury, and death. BAR GRAPH Moreover, children are beginning to drink at very young ages, sometimes before they finish elementary school. Many drink specifically to get drunk. Although drinking is often considered a normal part of growing up, like starting to date and learning to drive, it is not. The Nation must recognize this overlooked group of drinkers—the 9- to 15-year-olds—and understand the extent of the problem and its dangers. The statistics tell the story.
The age at which a person first uses alcohol is a powerful predictor of lifetime alcohol abuse and dependence. More than 40 percent of individuals who begin drinking before age 15 will develop alcohol abuse or alcohol dependence at some time in their lives.4
The dangers of early alcohol use are clear. What may be less clear is how to begin to prevent it. This guide is a starting point for people like you—parents, teachers, health professionals, law enforcement personnel, alcohol retailers, policymakers, and others who are concerned with the well-being of children. It describes three basic prevention strategies and ways they can be applied in the home, the school, and the community, and offers effective, practical strategies for communities that have decided to take action to prevent underage drinking, especially among children and young adolescents. These strategies may lead to such changes as revised zoning laws, new policies or legislation, better enforcement of existing laws, and establishment of school policies on alcohol use.
To help you better understand how to put these strategies into action, the guide also includes real-life examples of efforts by people around the country to prevent drinking by 9- to 15-year-olds. Although the strategies may be adapted in different ways by different communities, their science base ensures that no matter what the location, from rural farming areas, to suburban school districts, to inner-city neighborhoods, these strategies work. Addresses for online "e-sources" point to further information. How to use the guide
Start by reading the brief descriptions of the three basic prevention strategies covered in the guide. Then learn how they are applied in the home, the school, and the community. Discover examples of how other communities have used the strategies. Take advantage of the A call to action While the idea of starting a prevention campaign in your community may seem a little daunting, experience indicates that an appeal based on the need to protect children, combined with some friendly persuasion, will get people involved. Studies showing high levels of underage drinking, easy accessibility to alcohol, and lack of compliance with existing laws can serve as triggers to action. Small, informed groups who actively address these types of problems are able to achieve remarkable outcomes. The following survey results show that the desire for change is there:
PIE CHARTS
Research and experience show that successful alcohol prevention programs should incorporate one or more of the following three science-based strategies:11 Reduce the availability of alcohol The most documented principle in alcohol use prevention is this: Make it harder for young people to get alcohol, and they will drink less. Communities can make alcohol less available by promoting responsible adult behavior and holding adults accountable when they provide alcohol to minors; by raising the price of beer, wine, and liquor; or by reducing the number of places where alcohol is sold or served. Improve the effectiveness of law enforcement Communities can better enforce policies designed to stop drinking among children and adolescents. Studies find that existing laws regulating underage drinking are often not enforced. When these laws are ignored, it not only enables young people to drink, but also communicates a general indifference. Change social norms Children draw conclusions about alcohol-related social norms from what they see and hear about alcohol in their families and communities. These norms strongly influence their own attitudes and behaviors regarding alcohol. When communities consistently prevent underage access to alcohol, publicize and enforce alcohol-related laws, and limit the promotion of alcohol, they reinforce the message that alcohol use by young people is unacceptable. Choosing an Initial Strategy As you plan your campaign, you should choose one or a combination of strategies from this guide that will work best for your community. The ideas listed below will help you decide. The strategy should be:
The sanctity of one’s home and family is a long-standing American value. Some may feel that regulating alcohol service in private homes and at parties violates this sanctity. However, when adults recognize the problems and dangers associated with underage drinking and their legal responsibilities to prevent it, they understand the need for these regulations. Change begins at home. For example, a recent study shows that children whose parents are involved in their lives—holding regular conversations, attending after-school events, listening to their problems—are less likely to drink or smoke.12 The National Institute on Alcohol Abuse and Alcoholism has prepared a pamphlet called Make A Difference: Talk to Your Child About Alcohol. This 24-page guide is geared to parents and guardians of young people ages 10 to 14. It contains a short description of the risks and problems associated with alcohol use among young people as well as actions parents can take to talk with children about these issues. It offers specific suggestions for teaching children how to say no to a drink, hosting alcohol-free parties for teens, and noticing the warning signs of drinking problems in children and adolescents.
Available online in English and Spanish: http://pubs.niaaa.nih.gov/publications/MakeADiff_HTML/MakeAdiff.pdf http://pubs.niaaa.nih.gov/publications/MakeADiff_SpanHTML/MakeDiffSpan.htm http://pubs.niaaa.nih.gov/publications/MakeADiff_SpanHTML/SpanDiff.pdf
Reduce Availability Prevent Availability to Minors in Homes — In some States, social host liability laws spell out the responsibilities of parents and other adults for providing alcohol to anyone under the age of 21 and the penalties for disobeying the laws. Public information campaigns can teach parents about these laws as well as their responsibility to keep alcohol where children and adolescents cannot get it.
Regulate Home Delivery — More than half the States in the United States allow home delivery For information on policies restricting home delivery, see http://www.epi.umn.edu/alcohol/policy/homdeliv.shtm
Improve Enforcement Break Up Parties — Large parties of underage drinkers pose a problem for police. On the one hand, police have a responsibility to get involved and make arrests or issue warnings. On the other hand, they know that young people may scatter to their cars when the police arrive, increasing the risk of crashes. Some jurisdictions have developed special police procedures that have been successful in breaking up large parties safely.
As school-based prevention programs have become more guided by research, they have broadened their focus from the individual to include environmental influences and social norms, in particular the effects of peers. For example, studies show that sixth graders who think that more of their peers are drinking than actually are drinking are more likely to drink when compared with those students who learn that their peers do not approve of drinking.16 Project Northland, developed by researchers at the University of Minnesota with a grant from the National Institute on Alcohol Abuse and Alcoholism, is a comprehensive alcohol use prevention program for students in grades six through eight. This program has successfully reduced alcohol use in this age group. The participants learn that fewer of their peers drink alcohol than they thought, how to resist pressure to drink, and to talk with their parents about what happens if they do drink.17
For more information about Project Northland and other school-based curricula, see
Change Social Norms Reinforce Acceptable Social Norms — Schools can establish alcohol policies that clearly state expectations and penalties regarding alcohol use by students. Such policies reinforce the norm that underage drinking will not be tolerated. School staff, students, parents, and the community must support and enforce such policies consistently in order to shape appropriate attitudes about alcohol among students.
A good school alcohol policy:
Offer Students Feedback About Use Rates — Schools can teach students actual alcohol use rates through education programs. Participants discuss how many students actually drink and whether drinking is a good idea. Students taught with this approach use alcohol less and have fewer related problems because they want to be in the majority.20
The Community Alcohol is a regular feature of leisure activities in most communities. Alcohol ads and billboards commonly display attractive, youthful models. Neighborhoods allow alcohol companies to sponsor local fairs, races, sports activities, and other family-focused events. And communities often turn a blind eye to underage drinking and sales to minors. In all these ways, society tells children that alcohol use is accepted, expected, and even essential to having a good time. Many communities are using a variety of strategies to control the visibility and availability of alcohol in their children’s environment. For example, in an experimental program funded by the National Institute on Alcohol Abuse and Alcoholism, seven participating communities made changes in local alcohol-related policies and practices when compared to eight nonparticipating communities. The changes involved local institutional policies as well as practices of law enforcement agencies, licensing departments, community and civic groups, houses of worship, schools, and the local media. The direct impact of this program, called Communities Mobilizing for Change on Alcohol (CMCA), required more checking of age IDs by alcohol retailers, resulting in fewer purchases of alcohol by 18- to 20-year-olds. CMCA shows that changing the alcohol-related social and policy environment in communities is essential to long-term prevention.22
For more information on the program, see
Reduce Availability Raise the Price of Alcoholic Beverages — Higher prices can reduce alcohol purchases, particularly those by minors.24, 25 Most studies have found that when the price of alcohol goes up, consumption by young people goes down.26, 27 In addition, research shows that an increase in the price of alcohol is linked to reductions in alcohol-related problems among adolescents.28 The most efficient means of increasing the price of alcohol is by increasing taxes.
Control the Number of Alcohol Outlets — Studies show that the more alcohol outlets there are in a community, the more citizens drink and the greater the probability of alcohol-related problems.29 Large numbers of alcohol outlets make it easier to buy alcohol and make it a more visible part of the community. Large numbers of outlets can also stretch the resources of enforcement agencies, making it harder to enforce minimum age laws. Communities can control the number of alcohol outlets through planning and zoning ordinances and conditional use permits.
Train and License Servers and Sellers — In many States and jurisdictions, alcohol licensees and their employees must be trained before they can do business. Training may cover the importance of checking IDs, how to identify false IDs, how to refuse politely to sell to underaged persons, and who is liable (sellers or employees) when sales are made to minors. This training is more effective when alcohol managers and owners are also trained in how to establish alcohol policies and practices for their businesses.31 Some States and jurisdictions are also setting a minimum age for servers and sellers of alcohol and requiring them to be licensed or certified.
Register Kegs — Large, unsupervised parties where alcohol is served, both in private homes and in other settings, have become a common part of the youth scene in many communities. Too often these parties take the form of "keggers"—parties where beer is available to everyone who attends. With keg registration, each keg is engraved with a unique identifier that is linked to the purchaser’s ID. If the keg turns up at a party where underaged people are drinking, the authorities can use the keg ID to trace the person responsible and impose appropriate penalties.
For a discussion of the issues surrounding keg registration policies, see
Improve Enforcement Enforce Establishment Policies — One way to reduce sales to minors is to check the age identification of all individuals who appear to be younger than 30. Establishments that regularly check IDs and closely supervise sales by employees have lower rates of underage sales.33 Communities can request owners and managers of alcohol establishments to require ID checks as a standard policy and to make sure their employees understand this policy. Communities that publicize and praise retailers who do not sell to anyone under 21 encourage retailers to become partners in the effort to prevent underage drinking.
For a discussion of age identification policies, see Conduct Compliance Checks — Compliance checks can show whether sellers and servers of alcohol are obeying minimum age laws. The buyer should preferably be age 18 to 19. Avoid the borderline age of 20 because the buyer may turn 21 between purchase and testimony. Using multiple buyers provides a more accurate check of the business and allows the business a greater opportunity to have at least partial success. If a sale is made, the police can take appropriate action. Police incident reports can also point to the merchants who made the underage sales. These enforcement strategies work better if they are widely publicized to outlet owners and their staff.34
Deter Third-Party Sales — Surveys suggest that many minors get alcohol from adults of legal age who buy it for them.37 Such "third-party sales" are illegal in most States. In those States, adults who buy alcohol for underage persons can be warned, cited, or arrested by the police. Merchants can also inform their customers about criminal and civil liabilities for providing alcohol to individuals under the age of 21.
For a discussion of this and other methods to deter third party sales, see
Change Social Norms Remove Alcohol Promotions That Appeal to Children — Children see and hear positive messages about alcohol every day. Billboard ads and store promotions for alcoholic beverages often display attractive young people and cute cartoon characters. Many products, from T-shirts to cookie jars, feature alcohol beverage logos. Communities can ask billboard companies and local merchants to stop alcohol promotions and remove tie-in products that target children.
BAR CHART
The suggestions below are good first steps to begin your campaign to prevent alcohol use by children in your community. They will help you find out what your community is already doing and where additional efforts might be needed. They will also help you to get in touch with other individuals and groups in your community who are already taking action or who might like to get involved. Just by talking to people about this issue, you will draw attention to it and put it on the public agenda.
Federal Agency Resources The funding partners in this initiative offer a wealth of materials that will be useful to those who are developing prevention campaigns in their communities.
National Institute on Alcohol Abuse and Alcoholism, NIH, DHHS How Does Alcohol Affect the World of a Child? This concise and easy-to-read brochure brings together a range of statistics on alcohol use by kids, its impact on their health and well-being, and the broader impact of alcohol use on society. http://www.alcoholfreechildren.org/en/pubs/html/Stat.htm http://www.alcoholfreechildren.org/en/pubs/pdf/statbooklet.pdf http://www.alcoholfreechildren.org/en/pubs/html/Stat_Spanish.htm http://www.alcoholfreechildren.org/en/pubs/pdf/Stat_Spanish.pdf Make a Difference: Talk to Your Child About Alcohol This guide describes the health risks and other problems associated with alcohol use by older children and young adolescents and offers tips to help parents and guardians establish open, trusting communication with their children. It also suggests ways for children to say no to alcohol, lists warning signs of a drinking problem, and outlines specific prevention strategies for parents and guardians. http://www.alcoholfreechildren.org/en/pubs/html/makeadifference.htm http://www.alcoholfreechildren.org/en/pubs/pdf/makeadifference.pdf http://www.alcoholfreechildren.org/en/pubs/html/hagaladiferencia.htm http://www.alcoholfreechildren.org/en/pubs/pdf/hagaladiferencia.pdf
National Center on Minority Health and Health Disparities, NIH, DHHS Alcoholism Studies This site describes multiple studies that NCMHD is sponsoring or co-sponsoring with other agencies, including studies on minority alcohol prevention. Office of Research on Women’s Health, NIH, DHHS Women Of Color Health Data Book This data book contains statistics about alcohol use by adolescent and adult females of color. http://orwh.od.nih.gov/pubs/wocEnglish2002.pdf National Institute of Child Health and Human Development This site contains publications, press releases and other media materials related to research on improving the health of children. National Highway Traffic Safety Administration, DOT Community How To Guides on Underage Drinking Prevention These guides advise local advocates on the following issues: coalition building, needs assessment and strategic planning, evaluation, prevention and education, underage drinking enforcement, public policy advocacy, media relations, and self-sufficiency. http://www.nhtsa.dot.gov/people/injury/alcohol/Community%20Guides%20HTML/Guides_index.html
Office of Juvenile Justice and Delinquency Prevention, OJP, DOJ Strategies to Reduce Underage Alcohol Use: Typology and Brief Overview This document provides a conceptual framework for understanding the array of strategies available to prevent underage alcohol use. It also provides a simple assessment of the level of effect that might be expected from each strategy, based on existing research and evaluation. http://www.udetc.org/documents/strategies.pdf Regulatory Strategies for Preventing Youth Access to Alcohol: Best Practices This document provides guidance on the best practices for shaping and implementing laws and regulations to restrict the commercial and social availability of alcohol to youth and to deter young people from attempting to purchase or consume alcohol. http://www.udetc.org/documents/accesslaws.pdf
Substance Abuse and Mental Health Services Administration, DHHS Prevention Enhancement Protocols System (PEPS) – Preventing Problems Related to Alcohol Availability: Environmental Approaches This Center for Substance Abuse Prevention (CSAP) document, presented in three formats for three different audiences, provides an extensive discussion of the many approaches that communities can take to prevent alcohol use by underage youth. Suggested for broad use, the guidelines offer practical, detailed interventions along with discussions of the advantages and disadvantages of these interventions. Each format is available online. Practitioners Guide http://www.health.org/govpubs/PHD822/aap.htm Reference Guide http://www.health.org/govpubs/PHD822/aar.htm Parent and Community Guide http://www.health.org/govpubs/PHD822/acc.htm Underage Drinking Prevention – Action Guide and Planner This CSAP guide and planner suggests strategies for implementing coordinated prevention activities. For planning purposes, it includes a calendar that identifies themes and issues around which to organize. It also includes relevant statistics, sample letters, press releases, speeches, and other materials to adapt for local campaigns. http://media.shs.net/prevline/pdfs/phd858.pdf
Prevention Platform SAMHSA'S Prevention Platform is an online resource for substance abuse prevention. It includes procedures for doing needs-assessments, building capacity, selecting best and promising interventions, implementing plans, and conducting evaluations.
The following pathways will take you to directories of individual State agencies or regional offices that will be able to provide you with local resources:
State Alcohol and Drug Abuse Agencies These agencies direct the alcohol and drug abuse programs in their States, overseeing treatment and prevention activities. National Association of State Alcohol and Drug Abuse Directors (NASADAD)
Office of Juvenile Justice and Delinquency Prevention – Underage Drinking Enforcement Training Center OJJDP has awarded grants to all 50 States and the District of Columbia under the Enforcing Underage Drinking Laws initiative. The following e-source takes you to the State contacts for the initiative: Enforcement of Underage Drinking Program http://www.udetc.org/StateContacts.asp
National Highway Traffic Safety Administration NHTSA has 10 regional offices, each of which offers a special focus on youth drinking and driving. Regional Offices: http://www.nhtsa.dot.gov/nhtsa/whatis/regions
State Alcohol Control Boards and Liquor Control Agencies These organizations are responsible for licensing the alcohol industries, for collecting and auditing taxes and fees paid by the licensees, and for enforcing the laws and regulations that pertain to the alcohol beverage industries. National Alcohol Control Beverage Association (not all States are members)
1. Johnston LD, O'Malley PM, Bachman JG, and Schulenberg JE. 2007. Data tables from the 2007 Monitoring the Future Survey. Ann Arbor, MI: University of Michigan News and Information Services. [On-line]. Available: www.monitoringthefuture.org; accessed 12/12/07. 2. Brown SA, Tapert SF, Granholm E, et al. 2000. Neurocognitive functioning of adolescents: Effects of protracted alcohol use. Alcoholism: Clinical and Experimental Research 24(2):164-171. 3. Johnston LD, O'Malley PM, Bachman JG, and Schulenberg JE. 2007. Data tables from the 2007 Monitoring the Future Survey. Ann Arbor, MI: University of Michigan News and Information Services. [On-line]. Available: www.monitoringthefuture.org; accessed 12/12/07. 4. Grant BF, Dawson DA. 1997. Age at onset of alcohol use and association with DSM-IV alcohol abuse and dependence: Results from the National Longitudinal Alcohol Epidemiologic Survey. Journal of Substance Abuse 9:103-110. 5. Weekly Reader National Survey on Drugs and Alcohol, 1995. Middletown, CT: Field Publications, Spring. 6. Johnston LD, O'Malley PM, Bachman JG, and Schulenberg JE. 2007. Data tables from the 2007 Monitoring the Future Survey. Ann Arbor, MI: University of Michigan News and Information Services. [On-line]. Available: www.monitoringthefuture.org; accessed 12/12/07. 7. Centers for Disease Control and Prevention. 2006. Youth Risk Behavior Surveillance United States, 2005. Morbidity and Mortality Weekly Report: CDC Surveillance Summaries 55(SS-5):1-108. 8. Johnston LD, O'Malley PM, Bachman JG, and Schulenberg JE. 2007. Data tables from the 2007 Monitoring the Future Survey. Ann Arbor, MI: University of Michigan News and Information Services. [On-line]. Available: www.monitoringthefuture.org; accessed 12/12/07. 9. Centers for Disease Control and Prevention. 2006. Youth Risk Behavior Surveillance United States, 2005. Morbidity and Mortality Weekly Report: CDC Surveillance Summaries 55(SS-5):1-108. 10. Wagenaar AC, Harwood E, Bernat D. 2002. The Robert Wood Johnson Foundation 2001 Youth Access to Alcohol Survey: Summary Report. Minneapolis: University of Minnesota, Alcohol Epidemiology Program. 11. Holder HD. 1999. Prevention aimed at the environment. In: McCrady BS, Epstein EE, eds. Addictions: A comprehensive guidebook. New York: Oxford University Press, pp. 573-594. 12. Simons-Morton B, Haynie DL, Crump AD, et al. 2001. Peer and parent influences on smoking and drinking among early adolescents. Health Education & Behavior 28(1):95-107. 13. For more information, contact Ohio Parents for Drug Free Youth, 6185 Huntley Road, Suite P, Columbus, OH 43229. 14. For more information, contact Safe Homes, National Family Partnership, Informed Families Education Center, 2490 Coral Way, Suite 301, Miami, FL 33145. 15. Join Together. 1998. Save lives: Recommendations to reduce underage access to alcohol and action steps for your community. Boston, MA. 16. Hansen WB. 1993. School-based alcohol prevention programs. Alcohol Health and Research World 17(1):54-60. 17. Williams CL, Perry CL, Farbakhsh K, et al. 1999. Project Northland: Comprehensive alcohol use prevention for young adolescents, their parents, schools, peers and communities. Journal of Studies on Alcohol (suppl 13):112-124. 18. Reno J, Holder EH, Marcus D, et al. 2000. Promising strategies to reduce substance abuse: An Office of Justice Programs (OJP) Issues and Practices Report. U.S. Department of Justice, Washington, DC. September 2000. 19. Eastern Kentucky University Training Resource Center. 2000. Combating underage drinking: A live national satellite broadcast. Office of Juvenile Justice and Delinquency Prevention, U.S. Department of Justice, http://www.trc.eku.edu/. 20. Hansen WB, Graham JW, Wolkenstein BH, et al. 1991. Program integrity as a moderator of prevention program effectiveness: Results for fifth-grade students in the adolescent alcohol prevention trial. Journal of Studies on Alcohol 52(6):568-579. 21. Join Together. 1998. Save lives: Recommendations to reduce underage access to alcohol and action steps for your community. Boston, MA. 22. Wagenaar AC, Murray DM, Gehan JP, et al. 2000. Communities mobilizing for change on alcohol: Outcomes from a randomized community trial. Journal of Studies on Alcohol 61:85-94. 23. Streicker J, ed. 1999. Case histories in alcohol policy. San Francisco, CA: Trauma Foundation. 24. Chaloupka FJ, Grossman M, Saffer H. 2002. Effects of price on alcohol consumption and alcohol-related problems. Alcohol Research and Health 26(1):22-34. 25. Grossman M, Chaloupka FJ, Saffer H, Laixuthai A. 1994. Effects of alcohol price policy on youth: A summary of economic research. Journal of Research on Adolescence 4:347-364. 26. Coate D, Grossman M. 1988. Effects of alcoholic beverage prices and legal drinking ages on youth alcohol use. Journal of Law and Economics 31(1):145-171. 27. Chaloupka FJ, Grossman M, Saffer H. 2002. Effects of price on alcohol consumption and alcohol-related problems. Alcohol Research and Health 26(1):22-34. 28. Grube JW, Nygaard P. 2001. Adolescent drinking and alcohol policy. Contemporary Drug Problems, 28(1):87-132. 29. Gruenewald P, Treno J. 2000. Local and global alcohol supply: Economic and geographic models of community systems. Addiction 95(Suppl 4):S537-S549. 30. Streicker J, ed. 1999. Case histories in alcohol policy. San Francisco, CA: Trauma Foundation. 31. Toomey TL, Wagenaar AC. 1996. Policy options for prevention: The case of alcohol. Journal of Public Health Policy 20(2):192-213. 32. For more information, contact Responsible Alcohol Sales & Service (RASS), PO Box 13374, Research Triangle Park, NC 27709. 33. Wolfson M, Toomey TL, Murray DM, et al. 1996. Alcohol outlet policies and practices concerning sales to underage people. Addiction 91:589-602. 34. Alcohol Epidemiology Program. 2000. Alcohol compliance checks: A procedures manual for enforcing alcohol age-of-sale laws. Minneapolis: University of Minnesota. 35. Streicker J, ed. 1999. Case histories in alcohol policy. San Francisco, CA: Trauma Foundation. 36. For more information, contact Pottsville Partnership for Youth Alcohol Prevention, 118 South Claude Aylord Blvd., Pottsville, PA 17901. 37. Wagenaar AC, Toomey TL, Murray DM, et al. 1996. Sources of alcohol for underage drinkers. Journal of Studies on Alcohol 57:325-333. 38. Wagenaar AC, Harwood E, Bernat D. 2002. The Robert Wood Johnson Foundation 2001 Youth Access to Alcohol Survey: Summary Report. Minneapolis: University of Minnesota, Alcohol Epidemiology Program.
Back Cover For more information about the Leadership initiative or any of the materials presented in this guide, contact:
The Leadership to Keep
7500 Old Georgetown Road, 9th Floor e-mail: leadership@alcoholfreechildren.org
Telephone: 301-654-6740 PDF Updated: January 2005 Because we are constantly updating our web pages to incorporate the most recent statistics, there may be some differences between the statistics in our published documents and those on the Web site. Please note that the Web site statistics are always our most current.
Initiative Founders:
The Robert Wood Funding Partners:
National Institute of
National Institute on
Office of Research on
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