This report to the U.S. Congress, the fourth such report as required by the 2006 STOP (Sober Truth on Preventing) Underage Drinking Act, summarizes the latest research and prevention efforts aimed at dealing with the problem of adolescent alcohol abuse in the United States. Highlights of the report's findings include the following: while underage drinking has significantly declined since 2004 for adolescents aged 12 to 17, binge drinking continues to be a problem among 20-year olds, with 37 percent reporting binge drinking in the past 30 days; alcohol still continues to be the most widely used drug among American adolescents, with binge drinking being the most common underage pattern; and younger adolescent females now exhibit rates of drinking, binge drinking, and getting drunk similar to rates for adolescent males. The information in this report is presented in four chapters: Chapter 1 - Preventing and Reducing Underage Drinking: An Overview; Chapter 2 - Nature and Extent of Underage Drinking in America; Chapter 3 - A Coordinated Federal Approach to Preventing and Reducing Underage Drinking; and chapter 4 - Report on State Programs and Policies Addressing Underage Drinking. One major difference in this year's report is the addition of survey results from all 50 States and the District of Columbia to obtain information on State-supported underage prevention and enforcement activities, programs, and policies. Figures, tables, appendixes, and references