Underage drinking was the focus of the National Council on Alcoholism and Drug Dependence’s (NCADD) 2014 Alcohol Awareness Month, held in April. During the event, various agencies worked together to promote public awareness and understanding, as well as launching efforts to reduce stigma, provide information about the risks of alcohol consumption, and promote treatment options for alcohol use disorders. Alcohol Awareness Month is supported by alcohol marketers. Members of the industry regularly introduce efforts and programs designed to reduce negative consequences associated with alcohol consumption, such as a recent program offering reduced cab fares for drinkers. A recent article in Medical News Today makes the point that the use of a government report by The Beer Institute to sell the public on trends showing underage drinking in decline may have accentuated only the positive and ignored the negative. The Beer Institute issued a release that showcased findings from the National Survey on Drug Use and Health (NSDUH), a function of the Substance Abuse and Mental Health Services Administration (SAMHSA). The release highlights “record low levels” of underage drinking, citing NSDUH findings that reflect a 27 percent decrease in adolescents’ past-month drinking, a 33 percent decline in binge drinking among adolescents and a 48 percent decline in heavy drinking. However, the findings lose some of their shine when it is noted by the article author that the survey has only been conducted since 2002. The Beer Institute also cites a study from the “Monitoring the Future” government survey that shows declines in drug and alcohol use among eighth-, 10th– and 12th-graders. Another study conducted at the University of California in Los Angeles shows record lows in the number of hours spent partying among college freshmen. The findings cited by The Beer Institute sound promising. But if underage drinking is really on a steep decline, why then was it chosen as the focus of Alcohol Awareness Month? Digging further into the findings from the NSDUH results, Medical News Today found the picture is not so bright. The 2012 NSDUH shows that adolescents use alcohol more often than all other illicit substances combined. In addition, the same survey showed that 9.3 million youth between the ages of 12 and 20 years old reported consuming alcohol in the past month, of which 5.9 million were binge drinkers. Among the 889,000 teens that reported needing help to overcome an alcohol use problem, only 76,000 received treatment. This leaves approximately 813,000 youth without treatment, and the end result can be fatal. A 2006 National Institute on Alcohol Abuse and Alcoholism (NIAAA) report indicated that 5,000 teens die annually from underage alcohol consumption. The total stems from a combination of motor vehicle crashes, homicides, suicide and various injuries. The average age of initiation to drinking also bears discouraging news. In 2003, the average age of initiation was 14, while in 1965 it was 17.5. The article notes that The Beer Institute may find it difficult to argue that teens are becoming more responsible in their choices, given this finding that reflects more long-term trends. The NIAAA research also shows that the younger kids are when they begin to drink, the more likely they are to engage in other dangerous behaviors, such as using drugs and engaging in risky sexual behaviors. While The Beer Institute may present findings that highlight positive trends in underage drinking rates, it is important that the findings are understood within the context of the report and broader trends.