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 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.

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.