The prestigious National Academy of Sciences (NAS) is expected to soon release a Congressionally mandated report on underage drinking, despite the fact that the alcoholic-beverage industry has been working from the project's inception to influence the report, discredit the panel members, and attack the committee's findings before they are released.

Members of the panel preparing the report insist the attacks will not affect the report's recommendations. And the industry tactics could backfire if they end up prompting more press and public attention to the NAS findings, such as a recent cover story in the Wall Street Journal (subsequently picked up by other newspapers nationally) and an article in the Washington Post by Robert Wood Johnson Foundation fellow Jim Gogek.

The controversy centers on the different approaches that the industry and some leading prevention experts want to take in preventing underage drinking. The alcohol industry, citing youth surveys, contends that the best way to prevent underage alcohol use is to encourage parents to talk to their children about drinking. But recent research in the area of environmental prevention has shown that exposure to alcohol advertising is related to increased consumption, and that raising the cost of alcohol via increased taxation can reduce youth alcohol use.

The alcohol industry -- notably the National Beer Wholesalers Association (NBWA) -- initially expressed support for the study. But the industry quickly soured on the report once details about the committee began emerging.

"While focusing on issues strongly advocated by anti-alcohol groups -- such as taxation, advertising and restricted access -- NAS has given insufficient consideration to successful licensed-beverage industry responsibility programs," said the NBWA in a June 12, 2002 press release. "The panel has also paid little attention to developing real solutions such as increasing involvement by parents, peers, teachers and community leaders, enforcing existing laws, and personal choice of minors."

But panel members say they based their recommendations -- as yet unreleased -- on a wide range of sources, including researchers, advocates, government officials, youth, and the alcohol industry. NBWA President David Rehr and Beer Institute President Jeff Becker, for example, both provided testimony to the panel.

"The committee heard from some of the best researchers in the country," one panel member said. "Obviously, the committee looked at strategies that had research and evaluation along with them ... It's too bad the industry tried to manipulate the process and discredit the report."

"I find it curious that the alcohol lobby is complaining about the NAS panelists and their findings even before the recommendations are released, particularly given the fact that the alcohol lobby agreed to this study," said Rep. Lucille Roybal-Allard (D-Calif.), who sponsored the legislation initiating the NAS study. "Our ultimate goal should be to stop illegal underage drinking and protect our children from its potentially devastating consequences. If the NAS's scientific evidence finds that stricter marketing guidelines or increased alcohol excise taxes will help address our nation's crisis of underage drinking, then we need to heed their recommendations and take appropriate action."

Industry Involved from Outset

The industry's interest in the NAS report is nothing new. In late 2001, Congress was considering a funding request from the Bush Administration to spend half a billion dollars on a national media campaign to fight illicit drug use by youth. Advocacy groups like Mothers Against Drunk Driving and the Center for Science in the Public Interest (CSPI) urged lawmakers to launch a similar campaign against underage alcohol use -- by far, the larger public-health problem.

Faced with opposition from the alcohol industry -- which said the proposal called for "attack ads" against alcohol use -- Congress failed to approve legislation establishing the National Media Campaign to Prevent Underage Drinking, sponsored by Roybal-Allard. However, Congress did provide funding for NAS to issue a report that reviews current underage-drinking programs and proposes a national strategy to reduce and prevent underage drinking.

NAS established its underage-drinking committee last summer, charging the panel with reviewing existing federal, state, and nongovernmental programs, including media programs, designed to change the attitudes and health behaviors of youth. "The review will include programs that focus directly on behavior change as well as those designed to change underage drinking behavior through reduction of adolescent access to alcohol, such as through increased excise taxation, aggressive enforcement of age and identification checks, and restrictions of alcohol on college campuses," according to NAS.

The reaction of the alcohol industry was immediate, and negative. In August 2002, a letter issued jointly by the NBWA, the Beer Institute, and the Wine and Spirits Wholesalers of America to NAS study director Mary Ellen O'Connell charged that the committee was biased and unbalanced -- "dominated by individuals who have taken positions publicly on most every aspect regarding underage drinking, and who share a single view toward the licensed-beverage industry."

The letter singled out for criticism committee members Marilyn Aguirre-Molina, Ed.D., former senior program officer at the Robert Wood Johnson Foundation and currently professor of population and family health at Columbia University's Mailman School of Public Health; Philip J. Cook, Ph.D., distinguished professor of public-policy study at Duke University; Joel W. Grube, Ph.D., director of the Prevention Research Center at the Pacific Institute for Research and Evaluation; Mark Moore, Ph.D., Guggenheim Professor of Criminal Justice Policy and Management at the Kennedy School of Government; and Denise Herd, Ph.D., associate professor of behavioral sciences in the Division of Health and Social Behavior at UCal Berkeley's School of Public Health.

The alcohol industry also complained that the NAS was exceeding its mandate from Congress by looking at alcohol-tax issues and, in other correspondence, called for alcohol-industry representatives or their nominees to be given a seat on the panel.

This spring, as the panel wrapped up its last hearing in preparation for issuing its findings, the alcohol industry went on the offensive again, rounding up 131 allies in Congress to send a letter to Bruce Alberts, president of the NAS, stating that the underage-drinking report should not recommend "changes intended to adversely affect the beverage industry" or use the report "to buttress new and untested theories to reduce illegal consumption."

SAMHSA's Stunner

Then, in a move that stunned addiction-field advocates and researchers, Stephen G. Wing, the acting assistant administrator for alcohol policy at the Substance Abuse and Mental Health Services Administration (SAMHSA) sent a letter to NAS recommending that alcoholic-beverage industry representatives be allowed to peer-review the NAS report. "That was absolutely shocking," said one panel member. "I don't even understand SAMHSA's weighing in on it."

Wing stressed in an interview with Join Together that the letter called for peer review by a "wide range" of groups, including traditional advocacy organizations and the alcohol industry. But only the industry had sought such additional influence over the NAS report, as George Hacker, director of the alcohol-policies project at CSPI, pointed out in a June 23 letter to SAMHSA Administrator Charles Curie.

"We can't imagine that SAMHSA would have recommended pre-release peer review by the tobacco industry, had the subject report concerned smoking," wrote Hacker. "SAMHSA's attempted interference in the NAS report process both puzzles and troubles us," he said, calling for SAMHSA to retract the letter.

The SAMHSA letter also prompted a sharp rebuke from the Senate Appropriations Committee on Labor, HHS, and Education. "The committee provided funding to the NAS for this report in fiscal year 2002 because it values the NAS' reputation for objectivity, independence, and competence, and it has confidence that the NAS will offer the most appropriate science-based findings and recommendations," the Senate committee stated in its FY2004 SAMHSA budget report. "SAMHSA should not recommend the involvement of groups with potential conflicts of interest in the peer-review process."

Wing defended the letter, however, saying that "a thorough review" of the NAS report would allow it to achieve "more buy-in and greater legs."

"I'm disappointed that the Senate didn't see it the same way we did," he added.

Vanee Vines, a spokesperson for the NAS, said that the members of the peer-review panel, chosen in April, would not be revealed until the report is released. "The policy is not to include people with an obvious conflict of interest," added the NAS' O'Connell.

Congress had called for a report to be issued by June 2003, and the delay in issuing the underage-drinking findings has prompted suspicion that the report is being rewritten or buried. But Richard Bonnie, the underage-drinking panel chairman and a veteran of numerous past NAS committees, said that the delays are nothing unusual.

Despite pressure from Congress, SAMHSA, and the industry, the original membership of the NAS panel is unchanged, and panel members say that as of this writing their recommendations remain intact.

"This is a well-tested (NAS) process that we've used to obtain public input," said Bonnie. "We're aware of the industry's interest, but I'm absolutely confident that it has not compromised the integrity of the committee's work."

Bonnie says he is hopeful that the report will be released by mid-August.