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Introduction: Driving under the influence (DUI) citations are still a serious concern among drivers aged 16-20 years and have been shown to be related to increased risk of fatal and nonfatal crashes. A battery of laws and policies has been enacted to address this concern. Though numerous studies have evaluated these policies, there is still a need for comprehensive policy evaluations that take into account a variety of contextual factors. Previous effort by this research team examined the impact of 20 minimum legal drinking age-21 laws in the state of California, as they impacted alcohol-related crash rates among drivers under 21 years of age while at the same time accounting for alcohol and gas taxes, unemployment rates, sex distribution among drivers, and sobriety checkpoints. The current research seeks to expand this evaluation to the county level (San Diego County). More specifically, we evaluate the impact of measures subject to county control such as retail beverage service (RBS) laws and social host (SH) laws, as well as media coverage, city employment, alcohol outlet density, number of sworn officers, alcohol consumption, and taxation policies, to determine the most effective point of intervention for communities seeking to reduce underage DUI citations.Methods: Annual DUI citation data (2000 to 2013), RBS and SH policies, and city-wide demographic, economic, and environmental information were collected and applied to each of the 20 cities in San Diego County, California. A structural equation model was fit to estimate the relative contribution of the variables of interest to DUI citation rates.Results: Alcohol consumption and alcohol outlet density both demonstrated a significant increase in DUI rates, whereas RBS laws, SH laws, alcohol tax rates, media clusters, gas tax rates, and unemployment rates demonstrated significant decreases in DUI rates.Conclusions: At the county level, although RBS laws, SH laws, and media efforts were found to contribute to a significant reduction in DUI rates, the largest significant contributors to reducing DUI rates were alcohol and gas taxation rates. Policy makers interested in reducing DUI rates among teenagers should examine these variables within their specific communities and consider conducting community-specific research to determine the best way to do so. Future efforts should be made to develop models that represent specific communities who are interested in reducing DUI rates among drivers aged 16-20 years. [ABSTRACT FROM AUTHOR]