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Objectives. We systematically reviewed the effects of alcohol taxes and prices on alcohol-related morbidity and mortality to assess their public health impact. Methods. We searched 12 databases, along with articles' reference lists, for studies providing estimates of the relationship between alcohol taxes and prices and measures of risky behavior or morbidity and mortality, then coded for effect sizes and numerous population and study characteristics. We combined independent estimates in random-effects models to obtain aggregate effect estimates. Results. We identified 50 articles, containing 340 estimates. Meta-estimates were r=-0.347 for alcohol-related disease and injury outcomes, -0.022 for violence, -0.048 for suicide, -0.112 for traffic crash outcomes, -0.055 for sexually transmitted diseases, -0.022 for other drug use, and -0.014 for crime and other misbehavior measures. All except suicide were statistically significant. Conclusions. Public policies affecting the price of alcoholic beverages have significant effects on alcohol-related disease and injury rates. Our results suggest that doubling the alcohol tax would reduce alcohol-related mortality by an average of 35%, traffic crash deaths by 11%, sexually transmitted disease by 6%, violence by 2%, and crime by 1.4%. [ABSTRACT FROM AUTHOR]

Context: Public health law has received considerable attention in recent years and has become an essential field in public health. Public health law research, however, has received less attention. Methods: Expert commentary. Findings: This article explores public health law research, defined as the scientific study of the relation of law and legal practices to population health. The article offers a logic model of public health law research and a typology of approaches to studying the effects of law on public health. Research on the content and prevalence of public health laws, processes of adopting and implementing laws, and the extent to which and mechanisms through which law affects health outcomes can use methods drawn from epidemiology, economics, sociology, and other disciplines. The maturation of public health law research as a field depends on methodological rigor, adequate research funding, access to appropriate data sources, and policymakers’ use of research findings. Conclusions: Public health law research is a young field but holds great promise for supporting evidence-based policymaking that will improve population health. [ABSTRACT FROM AUTHOR]

Evaluations that combine social science and law have tremendous potential to illuminate the effects of governmental policies and yield insights into how effectively policy makers' efforts achieve their aims. This potential is infrequently achieved, however, because such interdisciplinary research contains often overlooked substantive and methodological challenges. This article offers detailed guidance for conducting successful multidisciplinary evaluations that use legal data. It addresses major issues that commonly arise and offers practical solutions based both on the authors' extensive experience and recommended best practices developed in concert with the Robert Wood Johnson Foundation's Public Health Law Research Program. [ABSTRACT FROM AUTHOR]

Background: Many population studies find that alcohol prices are inversely related to alcohol consumption and alcohol-related problems, including among college students and young adults. Yet, little is known about the “micro-level” effects of alcohol price on the behavior of individual consumers in natural drinking settings such as college bars. Therefore, we assessed patron’s cost per gram of ethanol consumed at on-premise drinking establishments and its association with intoxication upon leaving an establishment. Methods: On 4 consecutive nights during April 2008, data were collected from 804 patrons exiting 7 on-premise establishments in a bar district located adjacent to a large university campus in the southeastern United States. Anonymous interview and survey data were collected as well as breath alcohol concentration (BrAC) readings. We calculated each patron’s expenditures per unit of ethanol consumed based on self-reported information regarding the type, size, number, and cost of consumed drinks. Results: A multivariable model revealed that a 10-cent increase in cost per gram of ethanol at on-premise establishments was associated with a 30% reduction in the risk of exiting an establishment intoxicated (i.e., BrAC ≥ 0.08 g/210 l). Conclusions: The results are consistent with economic theory and population-level research regarding the price elasticity of alcoholic beverages, which show that increases in alcohol prices are accompanied by less alcohol consumption. These findings suggest that stricter regulation of the drink discounting practices of on-premise drinking establishments would be an effective strategy for reducing the intoxication levels of exiting patrons. [ABSTRACT FROM AUTHOR]

Introduction: Drinking by youth remains prevalent. The Reducing Underage Drinking through coalitions (RUD) project funded ten states for 8 years to form coalitions designed to change the policy and normative environment regarding youth access to alcohol. An independent national outcome evaluation of this $21-million effort was conducted. Methods: Using a longitudinal quasi-experimental design, the ten intervention states were compared with the other 40 states, with repeated annual measures of outcomes from 1995 to 2004. Measures included print news media coverage, legislative bills enacted, youth drinking behavior, and youth alcohol-related driving behaviors and traffic crash mortality. Analyses using latent growth curve modeling methods were conducted in 2005. Results: Significant differences in slopes between treatment and comparison states were found for several outcome measures, particularly in the more-proximal outcome domains. Across all outcome domains, the pattern of effects was in the direction of positive effects of the RUD coalitions, although for most individual measures the differences were not statistically significant. The magnitude of observed differences associated with the RUD coalitions were sizable, with an estimated effect size of 1.10 on media coverage, 0.46 on state policies enacted, −0.44 on youth drinking behaviors, and −0.16 on alcohol-related driving and fatal car-crash mortality. Conclusions: The pattern of results and the magnitude of estimated effects provides evidence of effect of the RUD coalitions. The lack of statistically significant differences for most individual outcome measures indicates the difficulty of unambiguously demonstrating the full effects of an effort designed to change behaviors and health outcomes of the entire youth population of multiple states. [Copyright &y& Elsevier]

Objectives. The primary goals of this study were to assess the propensity for alcohol sales to underage customers and obviously intoxicated customers at community festivals, and to assess the prevalence of alcohol control policies at these events. A secondary goal was to identify server and festival characteristics and festival policies related to the likelihood of illegal alcohol sales. Methods. We conducted pseudo-underage purchase attempts at 43 festivals and pseudo-intoxicated purchase attempts at 50 festivals to assess the likelihood of illegal sales. Research staff made observations at festivals and contacted festival planners by telephone following each event to assess which alcohol policies were implemented. We conducted backwards stepwise multivariate analyses for each purchase attempt outcome to identify policies and characteristics related to likelihood of illegal alcohol sales. Results. Pseudo-intoxicated buyers purchased beer in 89% of 95 attempts (standard deviation [SD]=0.31) and pseudo-underage buyers were able to purchase beer in 50% of 82 attempts (SD=0.50). All festival planners reported having at least two of the 10 alcohol policies we assessed, but no festival had implemented all 10 policies. Server characteristics were not related to either purchase attempt outcome. In the multivariate analyses, having more alcohol control policies was related to a greater likelihood of illegal sales to intoxicated customers; however, having more alcohol control policies was associated with a lesser likelihood of alcohol sales to underage customers. Restricting the number of servings per person was also associated with a lesser likelihood of alcohol sales to underage customers. Conclusions. Propensity for illegal alcohol sales at festivals is very high. Research is needed to identify interventions to prevent illegal alcohol sales at these events. [ABSTRACT FROM AUTHOR]

This article discusses the first study to assess public opinion of alcohol policies in Puerto Rico. In 2001, a telephone survey of 514 adults on the island assessed levels of support for 20 alcohol control policies covering five domains: (a) raising alcohol taxes, (b) restricting alcohol consumption in public places, (c) punishing adult providers of alcohol, (d) restricting youth access to alcohol, and (e) restricting marketing of alcohol. Results show high-level support for all alcohol policies, especially for restrictions on alcohol consumption in public places (93% to 95% support) and increases in alcohol taxes earmarked for alcohol treatment, prevention, and education (92% support). Multiple regression analyses reveal older respondents, compared to younger respondents, and respondents reporting lower levels of alcohol consumption were more supportive of alcohol control policies. Results demonstrate a willingness in Puerto Rico to consider public policy solutions to social and health problems associated with drinking. [ABSTRACT FROM AUTHOR]

The major objective of this study was to compare trends in three types of fatal injuries associated with alcohol use among youth under the legal drinking age and among adults of legal drinking age from 1990-1998. The fatal injuries investigated included homicide, suicide, and motor vehicle-traffic deaths. Results were: ( 1 ) motor vehicle-traffic deaths and homicide were higher among youth under the legal drinking age than among adults of legal drinking age; whereas, suicide was more common among adults of legal drinking age than among youth under the legal drinking age; and, (2) African American. Hispanic. and American Indian male youth under the legal drinking age were at substantial risk of being victims of homicide and motor vehicle-traffic deaths. [ABSTRACT FROM AUTHOR]

Compares data collected with paper forms to data collected with handheld computer-based forms in a field observation study of alcohol purchase attempts at community festivals in a large metropolitan area. Ease of use of handheld computers; Implementation costs of using personal digital assistants versus paper for data collection.

We examined organizational characteristics and types of political actions of neighborhood associations, and factors influencing the amount of political activity among the associations. We hypothesized that four neighborhood characteristics (population size, income, educational level, and percentage of owner-occupied households) and six organizational characteristics (budget, number of staff, size of board, newsletter publication, coalition involvement, and resident involvement) would influence the amount of political activity of the associations. We obtained data from the 1990 U.S. Census and a survey of neighborhood associations (n = 84) in Minneapolis and St. Paul, Minnesota. We found that neighborhood associations engaged in numerous and diverse political activities. Results from multiple regression analyses revealed that median household income was negatively associated with amount of political activity. Population size of the neighborhood and intensity of involvement in multi-organization coalitions were both positively associated with political activity (all significant at p < .05). We conclude that neighborhood associations, particularly those in larger and poorer neighborhoods, can be key allies in health and social policy efforts. © 2002 John Wiley & Sons, Inc. [ABSTRACT FROM AUTHOR]

We conducted a qualitative analysis of 23 state Responsible Beverage Service (RBS) laws to determine how effective the laws are in mandating or encouraging high-quality RBS programs. As of January, 2001, 12 states at least partially mandate RBS training for alcohol establishments and 11 states offer incentives to encourage participation in RBS training. We collected information regarding state RBS laws from two sources: (I) RBS statutes and associated regulatory provisions, and (2) telephone surveys of Alcoholic Beverage Control agency staff. We identified and evaluated five components of RBS laws: program requirements, administrative requirements, enforcement provisions, penalties for lack of compliance with law, and benefits for participation in training programs. Comprehensiveness of RBS laws varied by state; however, RBS legislation was weak across all states overall. While some states were strong in one or two of the RBS components, almost all states were weak in at least one component. [ABSTRACT FROM AUTHOR]

Legal standards for liability of commercial sellers and social providers of alcoholic beverages are affected by social norms concerning accountability and responsibility. Using a nationwide probability sample telephone survey of 7,021 U.S. residents, we conducted a randomized experiment in which each subject was asked to respond to multiple vignettes. The vignettes told stories of drinking situations, systematically varying dimensions concerning age of drinker, commercial versus social settings, amount of alcohol consumed, history of previous behavior, and seriousness of damage or injury following drinking. Analyses involved linear mixed (i.e., random effects) model regressions, using responses to vignettes as the outcome variable, controlling for a series of sociodemographic, behavioral, and attitudinal measures. Results showed that age of drinker (young), setting (bar), and previous behavior (history of irresponsibility) were most strongly associated with harsher judgments of civil liability. Citizens' multiple standards for assigning legal liability and implications for public policy are discussed. [ABSTRACT FROM AUTHOR]

Clear policies and expectations are key to increasing responsible service of alcohol in licensed establishments. Few training programs focus exclusively on owners and managers of alcohol establishments to reduce the risk of alcohol service. Project ARM: Alcohol Risk Management is a one-on-one consultation program for owners and managers. Participants received information on risk level, policies to prevent illegal sales, legal issues, and staff communication. This nonrandomized demonstration project was implemented in five diverse bars. Two waves of underage and pseudo-intoxicated purchase attempts were conducted pre- and postintervention in the five intervention bars and nine matched control bars. Underage sales decreased by 11.5%, and sales to pseudo-intoxicated buyers decreased by 46%. Results were in the hypothesized direction but not statistically significant. A one-on-one, outlet-specific training program for owners and managers is a promising way to reduce illegal alcohol sales, particularly to obviously intoxicated individuals. [ABSTRACT FROM AUTHOR]

We surveyed the U.S. non-institutionalized population age 18 + on opinions regarding 23 alcohol control policies (N = 7,021). The cooperation rate among contacted households was 70% and the overall response rate was 54%. Results showed high levels of public support for most alcohol control policies. Over 80% support restrictions on alcohol use in public places, such as parks, beaches, concert venues, and on college campuses. Eighty-two percent support increased alcohol taxes, provided the funds are used for treatment or prevention programs. Over 60% support alcohol advertising and promotion restrictions, such as banning billboard advertising, banning promotion at sporting events, or banning liquor and beer advertising on television. [ABSTRACT FROM AUTHOR]

Presents information on a study which determined whether servers of alcoholic beverages in the United States recognize obvious signs of intoxication and also assessed the tactics servers use when dealing with intoxicated patrons. Methods; Results; Conclusions.

Reducing the availability of alcohol through alcohol control policies such as excise taxes and the minimum legal drinking age has been effective in reducing a wide range of alcohol-related problems, including traffic crashes, liver cirrhosis, and violence. Alcohol control policies may be classified into two overlapping categories--public and institutional policies. Some policies such as alcohol server training may be either mandated by governmental jurisdictions or voluntarily adopted by individual institutions, which include alcohol retail establishments, other businesses, worksites, schools, colleges/universities, law enforcement agencies, religious institutions, insurance agencies, and alcohol producers. Public policies may be mandated by national, state/provincial, or local governments to regulate where, when, and how alcohol is sold and consumed. This paper describes the wide array of public and institutional policies available to reduce alcohol-related problems. Summaries of research evaluating specific alcohol control policies are provided when available. [ABSTRACT FROM AUTHOR]

Researchers in recent years have suggested that control of the aggregate level of alcohol consumption is an important component of a comprehensive programme for the prevention of alcohol-related problems. The present study focused on the relationship between alcohol consumption and perhaps the most significant acute alcohol-related problem, motor vehicle crashes. Data analyzed included monthly frequencies of alcohol-related property damage and injury producing motor vehicle crashes and monthly distribution of beer, wine, and distilled spirits in the State of Michigan. To increase confidence that observed correlations represented causal relationships between aggregate consumption and crash involvement, variance in each time series explainable on the basis of its own past history was filtered out first using ARIMA models, with the remaining variance used in analyses of the consumption/crash relationship. Using cross-lagged correlation methods, significant relationships were found between wholesale beer and wine distribution in a given month, and the number of alcohol-related motor vehicle crashes one month later. [ABSTRACT FROM AUTHOR]

After receiving little attention from 1940 to 1970, minimum-age laws were a focus of debate and policy change in the United States from 1970 to 1985. In the 1970s, 29 states lowered the legal age, and in the late 1970s and early 1980s, all states with an age below 21 raised the legal age to 21 for all types of alcoholic beverages. Research on the effects of such policy changes were a central component in the political debates on minimum-age laws. The process by which research results influenced public policy deliberations is discussed. Characteristics that facilitated research results being taken into account in the policy debates included: (1) of high interval validity that withstood challenge, (2) dissemination of the research results beyond networks of scientists, and (3) participation of bridging individuals who learned of the research results, and condensed and communicated key findings to policy-makers. [ABSTRACT FROM AUTHOR]

Surveys law enforcement personnel's views on the enforcement of the minimum drinking age in the United States. Conducting of interviews; Enforcement as measured by arrest rates; Role of political factors in determining enforcement.

Analyzes patterns of criminal and administrative enforcement of the legal minimum drinking age in four states in the United States from 1988 to 1990. Analytic methods used as including Spearman rank-order correlation and regression modeling; Low rates of enforcement to sellers.

Studies patterns of acquisition of alcoholic beverages by underage youth. Finding that in this study the alcohol initially used by those in their early teens is usually obtained from parents' stocks or from older siblings and friends; Percentage of 10- and 11-year-olds who use alcohol; Statistics on alcohol use at other ages; Early alcohol use and possible risk of addiction; More. INSET: Sample questions used to stimulate focus group discussions..

Describes the incorrect use of safety restraint devices in automobiles observed in a sample of child passengers. Percentage of children using seat belts and child restraint devices; Discussion of the categories in the incorrect usage of child restraining devices; Consequences of incorrect use of child restraint devices.

ABSTRACT. Effects of Michigan's law requiring all young children to be restrained when traveling in automobiles were assessed. Data on all reported residents of the state who were involved in crashes from 1978 through 1983 were examined using times-series analysis methods. Reported restraint use among injured children younger than 4 years of age involved in crashes increased from 12% before to 51% after the law was implemented. More importantly, a 25% decrease in the number of children younger than 4 years injured in crashes was associated with the law. A reduction of this magnitude was repeatedly found, whether analyzing the raw frequency of children injured, the rate of injured children per crashed vehicle, the rate of in]tired children per vehicle mile traveled, or the proportion of all injured occupants accounted for by young children. The substantial increase in restraint use and decrease in number of children injured appear to be direct results of the law, because similar changes did not occur among any of the comparison age groups. The 25% reduction in the number of young children injured means that an estimated 522 children per year are protected from injury because of Michigan's compulsory child restraint law. [ABSTRACT FROM AUTHOR]

Evaluates training programs for alcohol servers and establishment managers. Methodology used; Identification of 10 categories in which to rate server training programs; What studies of the effects of server training have indicated.