Estimate of the commercial value of underage drinking and adult abusive and dependent drinking to the alcohol industry.

Objectives: To document quantity and cash value of underage and adult Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV)-defined abusive and dependent drinking as well as underage drinking and adult DSM-IV-defined abusive and dependent drinking combined to the alcohol industry.

Design: Analysis of multiple cross-sectional national data sets.

Setting: The 2001 National Household Survey on Drug Abuse, the 2001 Youth Risk Behavior Survey, the 2001 Behavioral Risk Factor Surveillance Survey, the 2000 US Census, the 2000 to 2001 National Epidemiological Survey on Alcohol and Related Conditions, and the 2001 Adams Business Research.

Participants: A total of 260,580 persons aged 12 years and older across 4 data sources.

Main Exposure: Underage drinking or pathological drinking defined as meeting the DSM-IV criteria for abusive or dependent drinking.

Main Outcome Measures: Total amount of alcohol consumed and the cash value for alcohol consumed among underage and adult drinkers with DSM-IV-defined alcohol abuse and dependence as well as all underage drinkers combined with adult drinkers with DSM-IV-defined alcohol abuse and dependence.

Results: The short-term cash value of underage drinking to the alcohol industry was 22.5 billion dollars in 2001-17.5% of total consumer expenditures for alcohol. The long-term commercial value of underage drinking is the contribution of underage drinking to maintaining consumption among adult drinkers with alcohol abuse and dependence, which was equal to at least 25.8 billion dollars in 2001.

Conclusions: The combined value of illegal underage drinking and adult pathological drinking to the industry was at least 48.3 billion dollars, or 37.5% of consumer expenditures for alcohol, in 2001. Alternative estimates suggest that these costs may be closer to 62.9 billion dollars, or 48.8% of consumer expenditures for alcohol.