In the original article 1 I addressed the beneficial functions of drinking alcohol for adolescents. Although I know that many researchers, prevention workers, and lay people may not want to hear about possible positive outcomes of drinking alcohol for adolescents, I believe it is important to discuss them, as well as to examine them adequately in empirical studies on adolescent samples for several reasons. The most important reason is, in my opinion, that the majority of young people do not start drinking alcohol because of the negative consequences it may have for them. In their work on drinking motives, Cooper and colleagues 2,3 showed that the most significant motives adolescents have for their drinking are social and enhancement motives. Thus, adolescents drink alcohol because they want to have fun and to have a good time with friends and/or a partner or to feel good, not to become involved in fights or automobile accidents. In the article, I addressed empirical findings of European, Australian, and North American studies, showing that drinking among adolescents is related to positive social consequences for adolescents, which was the main goal of this article.

This does not mean that drinking has no negative short-or long-term consequences for adolescents. In his reply to my article in Nutrition Today,4 Dowdall placed strong emphasis on the negative consequences of juvenile drinking. For instance, several studies have shown that adolescent alcohol use is related to drinking problems and alcohol abuse in adulthood. 5 Moreover, once youngsters start drinking they are not inclined to become abstainers at later ages 6 -quitting is not an issue for most adolescents. In addition, Temple and Fillmore, 7 Grant et al, 8 and Pape and Hammer 9 found some support for the consistency of the relative drinking position over time. In other words, those youngsters who drink heavily in the adolescent years are more likely to belong to the category of heavy drinkers in adulthood than those youngsters who drink moderately. According to Pulkkinen and Pitkanen, 10 social drinking in early and mid-adolescence was not correlated with problem drinking and negative alcohol-related consequences, whereas alcohol dependence was. These findings parallel findings of Beck et al, 11 who show that the reasons people have for drinking affect whether they become heavy or problem drinkers rather than the drinking levels. Youths who drink to reduce feelings of distress or poor psychosocial maladjustment might learn to perceive drinking as a coping mechanism and might be prone to higher drinking levels and problem drinking in late adolescence and young adulthood. These findings suggest that the functions drinking has for individual adolescents may affect what kind of drinking habits they develop later in life.

There is indeed much evidence for the negative consequences of binge drinking and alcohol misuse in adolescence. 4 Not only is drinking in adolescence, especially risky drinking patterns such as binge drinking or problem drinking, a predictor of alcohol misuse and problem drinking in adulthood, but drinking in adolescence is also related to automobile accidents, suicide, homicide, delinquency and aggression, sexual assaults. In addition, I agree with Dowdall that the costs for society of underage drinking are enormous, as well as the effects for individual adolescents and families, which are affected by these negative consequences. Nevertheless, I do not know to what extent a focus on the overwhelming number of studies on the short- and long-term negative consequences of drinking lead to more insight into the reasons young people have to take up drinking and to maintain their drinking habits throughout the adolescent years. In my opinion, in particular, more insight into the positive functions and consequences of drinking would provide a clearer picture on the etiology of adolescent drinking behavior than primarily focusing on its negative aspects. Furthermore, although it is essential to focus on alcohol misuse and its adverse consequences, it should be stressed that the majority of adolescent drinkers (moderate or not) do not become involved in sexual assaults, rapes, or automobile accidents. The majority of adolescents, at least in the Netherlands, drink on weekend days together with friends and relatives, particularly in pubs and night clubs and at parties, and do not suffer from any severe short-term consequences of their drinking. 11 Although many Dutch adolescents are indeed binge drinkers, their drinking patterns significantly change once they become involved in status roles, such as working, having a partner, and/or children. 12

Dowdall made some interesting comments on my article with which I agree in most cases. It should be stressed that my article was not meant to be an exclusive and extensive review of all available empirical evidence on the positive as well as negative functions and consequences of alcohol use and misuse among adolescents but was intended to focus on an issue that has not received much attention in the research literature, namely the positive functions of drinking, and the role these positive functions may play in the explanation of adolescent drinking.

I also agree with Dowdall that there is still not conclusive evidence on the beneficial functions of drinking for adolescents; in particular, longitudinal studies are required that focus on both the positive and negative consequences of drinking for adolescents. Only with empirical evidence can we move forward in formulating theories on adolescent alcohol use and using these theories for the effective prevention of alcohol misuse. In addition, I also believe that cross-national studies are needed that examine differences and similarities in predictors and consequences of drinking in different cultures and subcultures.

Furthermore, in new research, it is important to concentrate on the group of abstainers. Of course I agree with Dowdall that not all adolescents who remain sober fail to have friendships, intimate partners, or a social life in general. However, the studies I addressed in the article clearly show systematic differences in mean levels of indicators of social integration between drinkers and abstainers. To move forward in this line of research, studies should focus on disentangling the group of abstainers by looking at which subgroups exist among them and what reasons abstainers may have for not drinking alcohol.

It is essential to differentiate between alcohol use and misuse in discussions on the functions of drinking for adolescents, as Dowdall argued. This may be somewhat implicit in my original article. The empirical evidence on this issue is however not so straightforward as it appears. Some studies indeed show that extreme high levels of drinking are related to negative social outcomes, compared with moderate levels of drinking and abstaining, whereas other do find linear relationships between drinking levels and social outcomes. 1,5 Nevertheless, I agree that findings may differ when we look at binge drinking, drinking problems, or drinking in specific situations. For instance, I do not believe that future studies will demonstrate that, for instance, drinking more than 20 glasses per occasion would lead to positive social outcomes or that drinking alone would enrich adolescents' social lives.

Finally, I would like to thank Dowdall for his kind words about the ideas and research I presented in the article, as well as the critical comments he gave. I believe the debate on the positive and negative functions and consequences of drinking benefits is absolutely required to gain more insight into the predictors of adolescent alcohol use and misuse. In addition, there is a strong need for cross-cultural studies looking at adolescent drinking from various perspectives to examine whether, for example, drinking for US adolescents have different functions and consequences than for European adolescents.

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