This "Call to Action" serves as a reminder that underage drinking has serious social costs and tragic consequences, demonstrating the importance of prevention. Underage alcohol use is not inevitable, and schools, parents, and other adults are not powerless to stop it. The latest research demonstrates a compelling need to address alcohol use early, continuously, and in the context of human development using a systematic approach that spans childhood through adolescence into adulthood. Such an approach is described in this "Call to Action." This report describes alcohol as the most widely used substance of abuse by American youth. It describes the dangers of alcohol to adolescent development, the factors that lead to alcohol abuse by youth, and possibilities for prevention and intervention. The "Call to Action" identifies six goals that the Surgeon General has proposed for the Nation. Those goals are: (1) Foster changes in American society that facilitate healthy adolescent development and that help prevent and reduce underage drinking; (2) Engage parents and other caregivers, schools, communities, all levels of government, all social systems that interface with youth, and youth themselves in a coordinated national effort to prevent and reduce underage drinking and its consequences; (3) Promote an understanding of underage alcohol consumption in the context of human development and maturation that takes into account individual adolescent characteristics as well as environmental, ethnic, cultural, and gender differences; (4) Conduct additional research on adolescent alcohol use and its relationship to development; (5) Work to improve public health surveillance on underage drinking and on population-based risk factors for this behavior; and (6) Work to ensure that policies at all levels are consistent with the national goal of preventing and reducing underage alcohol consumption. Recommendations are made throughout this report on the roles schools and universities must play in education, prevention, and intervention. The following are appended: (1) Definition of a Standard Drink; and (2) DSM--IV--TR Diagnostic Criteria for Alcohol Abuse and Dependence. (Contains 20 footnotes.)