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Center on Alcohol Marketing and Youth

The Toll of Underage Drinking

Drunk Driving, Alcohol Dependence, Risky Sexual Behavior, and Health Consequences.



Suicide and Self-Harm:


Brain Development:

Drinking Driving:


Alcohol Abuse or Dependence:

Risky Sexual Behavior:



Updated March 2016

The Toll of Underage Drinking (printer-friendly version)


1. Centers for Disease Control and Prevention (CDC). Alcohol and Public Health: Alcohol-Related Disease Impact (ARDI) Application, 2013. Accessed October 7, 2015 at:

2. Heron M. Deaths: Leading causes for 2010. National vital statistics reports; vol 62 no 6. Hyattsville, MD: National Center for Health Statistics. 2013. Accessed October 6, 2015 at

3. Hingson RW, Edwards EM, Heeren T, & Rosenbloom D. (2009).  Age of Drinking Onset and Injuries, Motor Vehicle Crashes, and Physical Fights After Drinking and When Not Drinking.  Alcoholism: Clinical & Experimental Research, 33(5): 783-790.  Accessed October 12, 2015 at:

4. Aziz, H., Siordia, J.A., Rhee, P., Pandit, V., O’Keeffe, T., Kulvatunyou, N., & Joseph, B. (2015). Analyzing the effects of alcohol on adolescent trauma using the National Trauma Data Bank. The Journal of Trauma and Acute Care Surgery, 79(3):463-467.

5. Albers, A. B., Siegel, M., Ramirez, R. L., Ross, C., DeJong, W. & Jernigan, D. H. (2015).  Flavored Alcoholic Beverage Use, Risky Drinking Behaviors, and Adverse Outcomes among Underage Drinkers: Results from the ABRAND Study. American Journal of Public Health, 105(4):810-815.  Accessed November 20, 2015 at:

6. Martiniuk AL, Chen HY, Glozier N, Patton G, Senserrick T, Williamson A, Woodward M, & Ivers R. (2015). High alcohol use a strong and significant risk factor for repetitive self-harm in female and male youth: a prospective cohort study. American Journal of Drug and Alcohol Abuse, 41(5):465-73.

7. Calculated from the Youth Risk Behavior Survey public use dataset available at:

8. Carpenter, C. (2004). Heavy Alcohol Use and Youth Suicide: Evidence from Tougher Drunk Driving Laws. Journal of Policy Analysis and Management, 23(4):831-842.

9. Squeglia LM, Rinker DA, Bartsch H, Castro N, Chung Y, Dale AM, Jernigan TL, & Tapert SF. (2014). Brain volume reductions in adolescent heavy drinkers. Developmental Cognitive Neuroscience, 9:117–125.  Accessed October 11, 2015 at:

10. Fjell AM, Walhovd KB, Brown TT, et al. (2012). Pediatric Imaging, Neurocognition, and Genetics Study. Multimodal imaging of the self-regulating developing brain. Proceedings of the National Academy of Sciences, 109(48):19620–19625.  Accessed October 11, 2015 at:

11. Wuethrich B. (2001). Getting Stupid. Discover, 22(3).  Available at:

12. Brown SA, Tapert SF, Granholm E, & Delis DC. (2000). “Neurocognitive Functioning of Adolescents: Effects of Protracted Alcohol Use.” Alcoholism: Clinical and Experimental Research, 24 (2): 164-171.

13. National Center for Injury Prevention and Control (2012). Teen Drinking and Driving: A Dangerous Mix.  Accessed October 6, 2015 at:

14. National Highway Traffic Safety Administration, (2014). Traffic Safety Facts 2013, Washington, DC: National Center for Statistics and Analysis, U.S. Department of Transportation. Available at

15. Ewing, B. A., Tucker, J. S., Miles, J. N., Shih, R. A., Kulesza, M.,  Pedersen, E. R., & D’Amico, E. J. (2015). Early Substance Use and Subsequent DUI in Adolescents. Pediatrics, 136(5):868-875.

16. Among persons with reported age, police-reported alcohol involvement, and classified injury severity.  Calculated from the National Highway Transportation Safety Administration public use dataset available at:

17. Substance Abuse and Mental Health Services Administration, Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-48, HHS Publication No. (SMA) 14-4863. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.  Accessed October 2, 2015 at

18. Kann L, Kinchen S, Shanklin SL et al. (2014). Youth Risk Behavior Surveillance — United States, 2013. Morbidity and Mortality Weekly Report, 63(No. SS-4).  Accessed October 2, 2015 at

19. U.S. Department of Health and Human Services. The Surgeon General’s Call to Action to Prevent and Reduce Underage Drinking: A Guide to Action for Educators. U.S. Department of Health and Human Services, Office of the Surgeon General, 2007. Accessed October 12, 2015 at:

20. Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health (HHS Publication No. SMA 15-4927, NSDUH Series H-50). Accessed October 19, 2015 at:

21. Li TK, Hewitt BG, & Grant BF. (2004). Alcohol Use Disorders and Mood Disorders: A National Institute on Alcohol Abuse and Alcoholism Perspective. Biological Psychiatry, 56(10): 718-720. Available at:

22. Team on Underage Drinking, National Institute on Alcohol Abuse and Alcoholism. (2004). Alcohol Consumption by Children and Adolescents: An Interdisciplinary Overview. Bethesda, MD: NIAAA.

23. Stueve A & O'Donnell LN (2005). Early Alcohol Initiation and Subsequent Sexual and Alcohol Risk Behaviors among Urban Youths. American Journal of Public Health, 95 (5):887-893.  Available at:

24. Substance Abuse and Mental Health Services Administration. (Mar. 20, 2007). The NSDUH Report: Sexually Transmitted Diseases and Substance Use. Rockville, MD: Office of Applied Studies.

25. Scaglione NM, Turrisi R, Mallett KA, Ray AE, Hultgren BA, & Cleveland MJ. (2014). How Much Does One More Drink Matter? Examining Effects of Event-Level Alcohol Use and Previous Sexual Victimization on Sex-Related Consequences.  Journal of Studies on Alcohol and Drugs, 75(2): 241–248. Accessed October 11, 2015 at:

26. Sacks JJ, Gonzales KR, Bouchery EE, Tomedi LE, & Brewer RD. (2015). 2010 National and state costs of excessive alcohol consumption.  American Journal of Preventive Medicine, 49(5):e73–e79.  Accessed October 17, 2015 at: