The nation needs to take drastic steps to control an epidemic of teenage drinking that is costing $53 billion a year, the National Academy of Sciences said yesterday, calling for curbs on glamorous references to alcohol in hip-hop music and movies, harsh penalties on stores that sell alcohol to teenagers, and steep increases in taxes on beer.

The broadside by the academy's Institute of Medicine was unusual in its breadth and intensity, and the alcohol industry quickly denounced it as a return to failed Prohibition-era policies.

Rather than merely telling teenagers not to drink, the report said, adults must take action to deglamorize alcohol, and society must punish companies that profit from underage drinking.

The report marks an important shift in strategy that echoes recent antismoking efforts. If implemented, the recommendations would be the most dramatic crackdown in decades on alcohol makers, retailers and the entertainment media -- and would put the campaign against underage drinking on the same footing as the war against teenage smoking.

"The social cost for underage drinking is $53 billion a year, including $19 billion for traffic crashes alone," said Richard J. Bonnie, chairman of the panel and director of the Institute of Law, Psychiatry, and Public Policy at the University of Virginia at Charlottesville. Yet, he added, "the federal government spends 25 times more on preventing illicit drugs than on preventing illicit drinking by young people."

While it is illegal to sell alcohol to anyone younger than 21, as many as 90 percent of 12th graders say it is easy to get their hands on a drink, the report said. In 2002, nearly half of all 12th graders reported drinking at least once in the previous month, and more than a quarter of all high school seniors reported having five or more drinks in the past two weeks.

Robert Hornik, a University of Pennsylvania researcher on the institute's panel, said many parents of heavy drinkers knew nothing about their children's drinking.

The alcohol industry dismissed the findings as old wine in old bottles -- and said the recommendations exceeded the congressional mandate for the study.

"It is warmed-over, tired solutions," said David Rehr, president of the National Beer Wholesalers Association. "If you look at what the report says, most of the stuff -- raising alcohol taxes, having a national media campaign, urging law enforcement to be more involved -- we've already known, and some of them haven't worked."

The institute's report said its recommendations were aimed not only at Congress and the alcohol industry, but at state and local governments, parents and communities.

Lobbyists have already begun lining up support for and against the recommendations. In an e-mail statement, Rep. Lucille Roybal-Allard (D-Calif.) said, "Now it is up to lawmakers to step forward and implement this strategy."

Unlike the direct impact of teenage smoking on health, most of the social costs of underage drinking result from activities promoted by alcohol use -- reckless driving, crime and unsafe sex. Increasing excise taxes could partly offset these "social costs" and lower alcohol consumption by teenagers, whose buying decisions tend to be sensitive to price fluctuations, the report said. While the size of any tax increase is a political decision, the scientists said, they predicted that a 10 percent increase would result in a 3 percent decrease in alcohol sales overall, with a greater decline among adolescents.

Rehr dismissed the idea, saying underage drinking has been declining. He called the $53 billion figure inflated -- with much of the cost of traffic accidents going to fees collected by trial lawyers.

"Look at states with high excise taxes," he said. "There is no evidence of lower illegal underage consumption."

The report also called for a crackdown on entertainment, especially on the recording industry. References to liquor brands and glamorous portrayals of drinking are especially common in hip-hop music and music videos, the report said. Lyrics frequently link drinking with wealth, violence and sexual activity. The report called for a more stringent rating system to help parents control what music their children listen to.

The Recording Industry Association of America rejected the recommendation, saying that "75 percent of parents find the current parental advisory label program adequate."

In a separate development, the alcohol industry made a commitment to the Federal Trade Commission yesterday to place its advertisements only in media with audiences for which at least 70 percent of the group is older than 21. The academy report called for raising that figure to 85 percent.

Jeff Becker, president of the Beer Institute, said there is no evidence that industry advertisements lead to underage drinking.

The report urged the creation of a nonprofit organization, funded by the alcohol industry, to monitor the effectiveness of intervention programs and settle debates over which ones work best. The report also called on states to strengthen statutes that hold retailers responsible if they sell alcohol to minors who get into traffic accidents or commit crimes.

The report also said that government surveys of teenage drinking should ask for the brand names of alcohol. The scientists said the government should deliver an annual report to Congress on the progress made against underage drinking.

"It's time this country finally shines a light on this problem that causes so much pain and suffering for families," said Wendy Hamilton, president of Mothers Against Drunk Driving, a national advocacy group that welcomed the report. "Alcohol-related deaths are completely preventable."