Cheap and easy access to alcohol has negative social and health impacts. In Ireland, alcohol became 50% more affordable between 1996 and 2008 due to a 161% increase in off-licences selling alcohol while pub licences decreased by 19%. Underage drinking accounts for 11% of total alcohol consumed in the US, resulting in over 5,000 deaths and 190,000 emergency room visits annually for those under 21. Prevention efforts should encourage healthy activities instead of alcohol and limit its availability to youth.