There is near universal agreement that childhood drinking is harmful to youth, but little attention has been focused on its harms or burdens to society as a whole. Is childhood drinking a threat to public health? What are the costs associated with childhood drinking to society in addition to the direct harm done to children?

To obtain answers to these questions, the Leadership to Keep Children Alcohol Free conducted a study among frontline individuals – including both those directly involved in developing and implementing childhood alcohol prevention strategies and opinion leaders who are well placed to understand the effect of childhood drinking on the public health of local communities.

In conducting this poll, the Leadership to Keep Children Alcohol Free sought to:

• Determine the standpoint of frontline persons and organizations on underage drinking as a threat to society, including the harm it causes at the local, community level.
• Probe to determine how opinion leaders conceptualize the costs associated with underage drinking.
• Establish how frontline organizations are attempting to solve this problem, and the availability of resources to do an effective job.
• Explore the impact of the environment as a factor in explaining the persistence of the problem of drinking by children – not just parents’ involvement – and that shaping and moving the environment is necessary to solve it.

This summary highlights the major findings of The Hidden Costs of Childhood Drinking, a comprehensive telephone study among 250 opinion leaders in five sectors related to alcohol prevention and childhood drinking: preventive organizations; public health organizations; law enforcement; government; and education.

PSB interviewed 50 opinion leaders in each of these five separate areas (for a total of 250 interviews):

• Preventive Organizations: National and local alcohol prevention organizations.

• Public Health Organizations: Non-governmental public health related organizations, schools of public health, and medical associations.

• Law Enforcement: State Attorneys Generals and law enforcement associations (including state police, local police and sheriffs).

• Government: Federal and state departments and agencies that deal with underage drinking and representatives of city council nationwide.

• Educators: Educators and education associations.

The study was conducted in June 2002 by Penn, Schoen & Berland Associates (PSB) of Washington, DC. The statistical significance of the results is +/- 6.2% at the 95^th confidence interval level.

1. Opinion leaders express alarm about childhood drinking in this country and consider it an extremely serious problem that affects children in urban, rural and suburban communities across the country. Most think the problem is getting worse, not better: children have easy access to alcohol and are drinking at an earlier age.

   Opinion leaders are very concerned about childhood drinking and identify it as a very serious problem in communities across the U.S.

• Almost all opinion leaders (99%) express concern about childhood drinking. Nearly 9 in 10 (87%) say they are "very" concerned.
• There is near universal agreement among opinion leaders (98%) that childhood drinking in this country is a serious problem. Nearly 8 in 10 (78%) say that it is a very serious problem.
• Opinion leaders from all parts of the country agree that childhood drinking is a problem that touches all communities. Nearly 8 in 10 (79%) say that childhood drinking is a large problem in urban, rural and suburban areas.

• Opinion leaders are eight times more likely to say that the problem of drinking by children has gotten worse (64%) rather than better (8%) over the past couple of years. An additional 16% say that the problem is the same.
• Nearly 3 in 4 opinion leaders (74%) say that more children are drinking at an earlier age compared to 10 years ago.
• Three in four opinion leaders (75%) say that it is easy for children ages 9 to 15 to get access to alcohol. Nearly 2 in 5 (38%) say that it is "very" easy.

2. The harm caused by underage drinking by children is significant and multi-dimensional, affecting all segments of society. Opinion leaders alert us to the hidden economic, social and cultural costs of underage drinking.

   Opinion leaders surveyed seem very concerned about the nature of harm that is caused by childhood drinking. They recognize both the direct negative impact it has on children themselves as well as the larger impact it has on society as a whole.

   Direct Harm to Children

   Opinion leaders cite the serious health and emotional problems as the most significant harm – 81% say it is a very significant harm – that is associated with childhood drinking.

Direct Harm to Society

Opinion leaders clearly recognize that the harms associated with childhood drinking have impact above and beyond the negative and more immediate effect it has on the children themselves.

• Nearly all opinion leaders (97%) agree – 83% strongly – that children who drink alcohol don’t fully understand the risks associated with drinking.
• More than 9 in 10 agree – over half (53%) strongly – that adults don’t fully understand the risks associated with children drinking alcohol.

• More than 7 in 10 opinion leaders (73%) say that ease of access to alcohol is a VERY important factor in contributing to children drinking.
• Six in 10 (60%) say that the positive portrayal of drinking on TV, in the movies and in music is a VERY important contributor.

• Nearly 2 in 3 opinion leaders (65%) say that the lack of supervised after-school activities is a very important factor in contributing to children drinking.
• Over half of opinion leaders (55%) surveyed cited societal beliefs that drinking is a "rite of passage" as a very important contributor.

• More than 7 in 10 opinion leaders (72%) agree – 41% strongly – that elected officials are not doing enough to curb drinking by children. In fact, nearly half (45%) do not think that elected officials take the prevention of childhood drinking seriously enough.
• More than 8 in 10 opinion leaders (82%) agree – 47% strongly – that law enforcement officials should do more to enforce underage drinking laws.
• Nearly 9 in 10 opinion leaders (88%) agree – 64% strongly – that the public should more strongly support law enforcement efforts to curb drinking by children.

Responses from opinion leaders indicate an overall conclusion that the issue of childhood drinking needs to have a higher priority on the national agenda. The findings indicate serious concerns with trends of alcohol use, as well as the influences and consequences of drinking by children. Opinion leaders also express support for action on prevention strategies. The following recaps the major findings of The Hidden Costs of Childhood Drinking:

1. Opinion leaders express alarm about childhood drinking in this country and consider it an extremely serious problem that affects children in urban, rural and suburban communities across the country. Most think the problem is getting worse, not better: children have easy access to alcohol and are drinking at an earlier age compared to 10 years ago.
2. The harm caused by underage drinking by children is significant and multi-dimensional, affecting all segments of society. Opinion leaders alert us to the hidden economic, social and cultural costs of underage drinking.
3. Opinion leaders believe that a wide range of environmental factors, chief among them ease of access, play a key role in influencing young children to drink alcohol in this country.
4. The message from opinion leaders is loud and clear: politicians, law enforcement and the public are not doing enough to prevent underage drinking by children. Opinion leaders support a broad range of measures to tackle the issue, chief among them increased funding for prevention and treatment activities.

For more information about preventing the problem of childhood drinking, visit the Leadership to Keep Children Alcohol Free’s Web site at www.alcoholfreechildren.org.

About the Leadership: The Leadership to Keep Children Alcohol Free is an initiative spearheaded by more than 30 Governors’ spouses to prevent the use of alcohol by children ages 9 to 15. The Leadership’s goal is to educate the American public about the dangers of early alcohol use and to mobilize action to prevent it. The initiative was founded in 1999 with support from the National Institute on Alcohol Abuse and Alcoholism and The Robert Wood Johnson Foundation and receives additional support from several other Federal agencies. It is advised by representatives from 28 public and private organizations with shared interests in children’s well-being and is the only national coalition that focuses on the prevention of alcohol use in this young age group.