The scope of the problem.

Alcohol is the drug of choice among youth, often with devastating consequences. Alcohol is a leading contributor to injury death, the main cause of death for people under age 21. Drinking early in life also is associated with an increased risk of developing an alcohol use disorder at some time during the life span. Data consistently indicate that rates of drinking and alcohol-related problems are highest among White and American Indian or Alaska Native youth, followed by Hispanic youth, African Americans, and Asians. Prevalence rates of drinking for boys and girls are similar in the younger age groups; among older adolescents, however, more boys than girls engage in frequent and heavy drinking, and boys show higher rates of drinking problems. This article summarizes research on the epidemiology of youth drinking, including the consequences of youthful drinking, risk and protective factors and drinking trajectories, and information on special populations at particular risk for drinking-related problems.