"A study of this kind hasn't been done in some 20 years, and it shows that the alcohol industry is making billions of dollars from the sale of alcohol to minors," said study author Pamela Trangenstein, an assistant professor at the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill.
The study, published Thursday in the Journal of Studies on Alcohol and Drugs
, used national data on self-reported adult and underage drinking from the US Centers for Disease Control and Prevention and other sources. Researchers compared those numbers to industry sales in 2016, which they said was the latest data available, and adjusted for underreporting.
"It's really shocking that underage drinkers generated $17 billion in alcohol sales as late as 2016," said nutrition researcher Marion Nestle, a visiting professor of nutritional sciences at Cornell University who has authored numerous books on the politics of the food and beverage industry.
"If we ever needed a reason to toughen up on alcohol policies, this study provides it," said Nestle, who was not involved in the study.
"It is not in the industry's interest to moderate underage use in any way; that is where their future profits lay," said Paul Gruenewald, scientific director of the Prevention Research Center of the Pacific Institute for Research and Evaluation, who also was not involved in the study.
"Demand is insured by getting youth to start drinking as early in their lives as possible, providing constant demand throughout the life course," said Gruenewald, who has researched the availability of alcohol since the late 1980s.
Underage access to alcohol still a problem
The study, which was sponsored by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), also examined underage drinking habits in 2011. The analysis showed a decline from 2011 to 2016 -- minors consumed 11.7% of the standard alcoholic drinks sold in 2011 versus 8.6% in 2016. In the US, a standard drink is about 0.6 fluid ounces or 14 grams of pure alcohol, which differs depending on the type of adult beverage consumed.
The study found sales revenue from alcoholic drinks consumed by minors also dropped, from 10% of total sales ($208 billion) in 2011 to 7.4% of total sales ($237 billion) in 2016 -- or a drop from $20.9 billion to $17.5 billion.
Regardless of the decline, "underage drinking is still a significant public health issue," said Mona Shah, senior program officer in the Research-Evaluation-Learning unit of the Robert Wood Johnson Foundation, which has invested nearly $700 million
over 20 years in alcohol and substance abuse prevention efforts in the US.
"Drinking and binge drinking remain common among high school students and underage college students," said Shah, who was not involved in the study.
Trangenstein pointed to 2019 numbers
from the NIAAA that show 7 million 12- to 20-year-olds said they drank alcohol in the past month, while 4.2 million reported binge drinking.
"Both of those numbers should be zero," she said.
Despite decades of trying to combat teen access to alcohol, way too many young people slip through enforcement cracks, experts say.
"It is broadly known and acknowledged throughout the alcohol research community that underage youth can directly or indirectly, through others, purchase alcohol through retail outlets," Gruenewald said.
"One usual quoted figure
, for instance, is that underage youth can successfully purchase alcohol through off-premise outlets, such as grocery and convenience stores, about 30% of the time," he added.
The consequences are significant, experts say. Each year, drinking is linked to more than 3,500 deaths and 210,000 years of potential life lost among people under age 21, according to the US Centers for Disease Control and Prevention.
Alcohol poisoning, physical and sexual violence, and an increased risk of suicide and homicide among youth is also tied to alcohol abuse, and teens can suffer changes in brain development that may have life-long effects, the CDC says.
"Youth who began drinking before the age of 15 have four times higher risk
of developing an alcohol use disorder, with all the health risks and impacts that entails," Trangenstein said.
Majority of underage sales
AB InBev, or Anheuser-Busch InBev, is by far the largest in the industry, selling over 500 brands and "countless" beer varieties
, according to its website. The study found over 21% of drinks consumed by underage youth in 2016 were made by AB InBev, for an estimated $2.2 billion in sales revenue.
Molson Coors - which was called MillerCoors until 2019 and is cited as MillerCoors in the study -- makes 113 beers and hard ciders
and gathered 12.3% of the 2016 underage market share. That's roughly $1.1 billion in sales revenue, the study said.
Diageo sells over 200 brands
of liquor and the Irish beer Guinness. The study found Diageo accounted for 11.1% of the alcohol market share for minors in 2016, taking in an estimated $2 billion in sales revenue.
Combined, products from the