American alcohol education and prevention efforts for youth emphasize abstinence. In support of this approach, epidemiologists conclude that early drinking by adolescents increases the lifetime likelihood of alcohol dependence and that overall drinking levels in a society are directly linked to drinking problems. At the same time, cultural, ethnic, and social differences in drinking indicate that drinking styles are socialized and that those groups that encourage regular but controlled drinking yield lower rates of binge drinking and alcohol-related problems. Recent international epidemiologic research has found that societies in which men and women consume their alcohol in bursts have more drinking problems. The same cultures with high binge drinking rates for adults have high rates of adolescent drunkenness. It has, however, proven difficult to impose a moderate-drinking template on cultures, including notably American adolescent and college cultures. Nonetheless, approaches that focus on preventing problems rather than on abstinence per se--called harm reduction--may have value in reversing problems created by youthful drinking. The question is whether the socialization of moderate drinking can be incorporated as a harm reduction technique for young people, at least for college students. (Contains 3 tables.)