This study estimated the magnitude & costs of problems, including suicide, resulting from underage drinking & compared those costs with associated alcohol sales. Fatal & nonfatal cases attibutable to underage alcohol use were estimated. Underage drinking accounted for at least 16% of alcohol sales in 2001 in the United States & led to 3,170 deaths & 2.6 million other harmful events. In 2001, 157 youths died in alcohol-attributable suicides. These deaths & other injuries & events cost $1,039,000,000 (medical care, lost work & other monetary costs, & quality-of-life costs) & resulted in 7,580 quality-adjusted life years lost. (91 refs.)