Social Host Policies and Underage Drinking Parties

Social host policies focused on underage drinking parties are implemented to reduce social availability of alcohol and high-risk drinking by adolescents in private locations. We examined the policies’ relationship with drinking location, peer-group drinking size, heavy episodic drinking, and nonviolent consequences. Cross-sectional data from 11,205, 14–20-year olds, were analyzed using multilevel modeling. Policies were not associated with drinking location, decreased heavy episodic drinking, or nonviolent consequences. However, adolescents from communities with a preexisting policy had lower odds of drinking in large peer groups compared to those from communities without a policy at baseline. Additional research is needed to examine their effectiveness. The study's limitations are noted.     

Assessing the Validity of On-Premise Alcohol License Data in Six Communities in California: Operating Characteristics and Outlet Densities

This study evaluated State of California alcohol license records as a measure of businesses selling alcohol for consumption on premise. In 2008, researchers attempted to visit all 799 licensed restaurants, bars, and pubs in six medium-sized cities near San Francisco. Surveys collected detailed business characteristics for a subsample of 151 bars or restaurants that included a separate bar area. Results suggest inaccuracies of official records regarding license locations and types (bar/pub vs. restaurant). Analyses also indicate that establishment characteristics are related to local alcohol outlet densities. Study implications and limitations are discussed.     

Outlets,drinking and driving: a multilevel analysis of availability

OBJECTIVE: This study examines the degree to which the physical availability of alcohol as measured by outlet densities is related to self-reported individual drinking patterns, preferred drinking location, as well as both driving after drinking (DAD) and driving while intoxicated (DWI). METHOD: Data from 7,826 drinkers were obtained from a general-population telephone survey of 1,353 zip code areas in California. Measures of individual alcohol consumption included drinking frequency, drinks per occasion and variance in quantities consumed per occasion. Preferred drinking locations included bars, restaurants and the homes of drinkers and of their friends. DAD was defined as driving a motor vehicle within 4 hours of having one or more alcoholic drinks, and DWI was defined as driving after having too much to drink and drive safely. Geographic measures of outlet densities were obtained for bars, restaurants and off-premises establishments, using zip codes as geographic units of analysis. Hierarchical linear modeling was used to relate outlet densities within and surrounding respondents' area of residence to respondents' drinking and to respondents' drinking and driving. RESULTS: Whereas restaurant densities were directly related to greater drinking frequencies and DAD, bar densities were inversely related to DAD. There were no direct effects of drinking patterns on drinking and driving. Drinking and driving was strongly related to drinking location preference (e.g., bars and restaurants) only when considered simultaneously with individual drinking patterns, particularly drinking frequency. CONCLUSIONS: Increased restaurant density is strongly related to higher rates of both self-reported driving after drinking and drinking frequency. The strongest influence on both driving after drinking and driving while intoxicated is preferred drinking location considered together with individual drinking patterns. Outlet density and preferred drinking location when considered together with individual drinking patterns support driving after drinking and thereby increase the potential for alcohol-related accidents.     

Permission to cross the border: effective policy reduces high-risk drinking by Marines

OBJECTIVE: At a Marine Corps base near the Mexican border, off-base alcohol- related incidents increased when serving alcohol to personnel under age 21 on the base was no longer permitted. The bars across the Mexican border, where the legal drinking age is 18, are an important source of alcohol for the Marine enlisted men. To reduce cross-border drinking, the base command instituted a "chit" system requiring enlisted men to receive written permission to cross the border. This study evaluates the effectiveness of that policy. METHOD: Breath test surveys of American youths returning from Tijuana to San Diego County provided counts and blood alcohol concentration (BAC) of marines returning from a night of drinking in Mexico before and after the "chit" policy. Comparison counts and breath tests for Navy personnel from a San Diego base not affected by the "chit" policy were available for the same time periods. RESULTS: The number of underage marines returning from Mexican bars was reduced by 78%, and of those the number with illegal (> or = .08%) BACs was reduced by 84%. There was no significant change for the comparison group of sailors. CONCLUSIONS: It appears that the "chit" policy was highly effective at least for the 6-month post-period covered by this study. This apparent success influenced the implementation of the "chit" policy on all naval facilities in the San Diego area.     

Local Support for Alcohol Control Policies and Perceptions of Neighborhood Issues in Two College Communities

Background: Although valuable, national opinion surveys on alcohol policy may be less informative for policy development at the local level. Using samples of adult residents in 2 college communities, the present study: (1) measured public support for local alcohol control policies to stem underage drinking and alcohol overservice in on-premise outlets, (2) assessed residents’ opinions regarding neighborhood problems, and (3) identified factors associated with strong policy support. Methods: We administered random-sample telephone surveys to residents aged 21 years and older in college communities located in Community 1 (N = 501; mean age = 57.4 years, SD = 14.7) and Community 2 (N = 505; mean age = 56.0 years, SD = 15.2). The response rates were typical of telephone surveys (Community 1: 33.5%; Community 2: 29.9%). We assessed support for 16 alcohol control policies and the occurrence of specific types of neighborhood incidents (e.g., witnessing intoxicated people). We used multiple regression analyses to determine factors associated with policy support. Results: Residents in Community 1 reported significantly higher weekly alcohol use, a greater number of witnessed neighborhood incidents, and a higher level of perceived neighborhood problems than did residents in Community 2. Residents in Community 1 perceived local alcohol control policies and their enforcement to be significantly stricter. Overall, policy support was high and did not differ between the communities. In both communities, higher policy support was significantly associated with being female, being older, less weekly alcohol use, and lower perceived strictness of alcohol control policies and enforcement. Conclusions: It is important for campus officials and community leaders to be aware of and publicize favorable public opinion when advocating for policy change, especially at the local level. Information on residents’ perceptions of the neighborhood issues they face can also inform local policy and enforcement efforts.     

Drinking practices,alcohol policy and prevention programmes in Japan

The purpose of this article is to outline alcohol consumption patterns and related problems, alcohol control policy and prevention programmes in Japan, which are not well-known in other countries. In Japan, per capita alcohol consumption is no longer increasing and has even started to decrease. At the same time, diversification of drinking populations has made a rapid progress. For the last several decades, alcohol consumption in non-traditional drinking populations, such as women and young people, has been on a steep rise. Consequently, in addition to traditional drinking problems observed among adult males, the magnitude of problems among these non-traditional populations has expanded. Alcohol policy and prevention programmes, however, have not developed to adequately control these problems. Availability of alcoholic beverages, including to underage populations, remains very high. Legislation related to alcohol control has not been well enforced, with the exception of the Road Traffic Law. Tax systems on alcoholic beverages are not relevant to the suppression of alcohol consumption. Moreover, there are virtually no restrictions on advertising or sponsorship and no provisions concerning an alcohol-free environment. Prevention programmes and activities to reduce harm from drinking have been carried out, especially for underage drinking, but they are insufficient to tackle the existing problems. Comprehensive discussions on alcohol policy and implementation of effective prevention programmes with participation of all sectors concerned are necessary, in parallel with actions taken by the WHO and other organisations.     

Public opinion and community-based prevention of alcohol-related harms

Aim: This article looks at alcohol policy opinions from the point of view of the possibilities and frames for creating local alcohol control policy. Local action against harms related to drinking is a compromise between different points of view, and the question of public support is important for community-based prevention. Data and analyses: The respondents of a postal questionnaire were asked if they supported different alcohol policy measures, and logistic regression analyses were carried out to examine the impact of the demographic characteristics, drinking measures and observations of alcohol-related harms in the community. Results: The wide majority of the population supported such measures suitable for community-based prevention as enforcement of the minimum legal age to purchase alcohol, surveillance of restaurants and shops, and the ban to sell alcohol to a drunken person. Decreasing numbers of outlets of restaurants or their opening hours were least popular. There was a relationship between drinking habits and alcohol policy opinions. Abstainers and moderate drinkers were most likely to support all alcohol policy measures examined, whilst heavier drinkers were least likely to support them. There was a connection between awareness of alcohol problems in one's locality, and favourable opinions on alcohol control measures. The result is similar with the ones found earlier in other countries. Conclusion: Potential members of local alcohol policy coalitions seem to have some similarities in different countries.     

A partial ban on sales to reduce high-risk drinking South of the border: seven years later

OBJECTIVE: On weekend evenings, thousands of youths (ages 20 and younger) and young adults (ages 21-25) residing in communities along the U.S. border cross into Mexico to patronize all-night bars where the drinking age is 18, rather than 21, and where the price of alcohol is considerably less than in the United States. On January 1, 1999, Juárez, Mexico, implemented a 2 AM (instead of 5 AM) bar-closing policy. The number of crossers and their blood alcohol concentration levels on return were reduced in the year following this policy change. The present study's objective was to determine the long-term (7-year) effect of the earlier-closing bar policy on cross-border drinking in Mexico. METHOD: Analyzed data (1998 to August 2005) were from quarterly breath-test surveys at the El Paso (Texas)/Juárez (Mexico) border, bar observations in Juárez, and trauma data in El Paso. RESULTS: Bar surveys in Juárez show that the 2 AM closing policy, initiated 7 years ago, continues to be enforced, as has the reduction (89%) in youthful crossers returning after 3 AM. The number of underage youths returning earlier in the evening (before 3 AM), however, unchanged for 2 years after the policy change, has doubled recently. CONCLUSIONS: The early closing of bars in Juárez has a continuing positive impact on the reduction of the number of those returning after 3 AM. Although initially there appeared to be no displacement of the late returnees into the early hours (before 3 AM), the number of bar visitors crossing and returning earlier has been steadily increasing. Suggestions for reducing cross-border heavy episodic drinking are described.     

Geographic clustering of underage drinking and the influence of community characteristics

The aim of this paper was to examine the extent to which underage drinking clusters geographically in a sample of communities, and to investigate the manner in which community-level contexts are related to this process. We used data from a randomized community trial of underage drinking to provide the first quantitative estimates of the magnitude of the geographic clustering of underage drinking based upon pairwise odds ratios (PWORs). The Enforcing Underage Drinking Laws Randomized Community Trial provided data from repeated cross-sectional samples of youth aged 14–20 from 68 communities surveyed in 2004, 2006, and 2007 (n = 18,730). Past 30-day drinking, binge drinking, getting drunk, experiencing non-violent consequences as a result of drinking and making a purchase attempt all significantly clustered within-communities with PWORs ranging from 1.05 to 1.21. After adjustment for individual-level characteristics, results remained relatively unchanged. However, there was evidence that the magnitude of the clustering varied as a function of neighborhood disadvantage, neighborhood disorder, and family structure. Clustering of drunkenness and experiencing non-violent consequences as a result of drinking was greatest in the least economically disadvantaged and least disordered communities with the greatest percentage of married-couple families. The clustering of making a purchase attempt, however, was greatest in more disordered communities, specifically the largest communities with the highest degree of residential mobility and housing density. These findings that clustering of underage drinking behaviors varies by community context has the potential for identifying the types of communities to target for underage drinking behavior-specific preventive interventions.     

Evaluating self-checkout lanes as a potential source of alcoholic beverages for minors

ABSTRACT. Objective: This exploratory study examined the ability of young adults to purchase alcoholic beverages through self-checkout lanes without being asked for age verification. Although the minimum drinking age in all 50 U. S. states is 21 years of age, drinking among underage persons (ages 12-20) remains a serious public health concern. Self-checkout options in off-sale alcoholic beverage outlets (e.g., grocery store chains, liquor stores) may represent a potential source of illicit access to alcohol compared with traditional checkout purchases. Method: A total of 216 stores with self-checkout lanes were randomly selected in five Southern California counties. Pseudo-patrons independently judged to be 23 years of age or younger purchased alcohol in each store. Results: Overall, 8.8% of all purchase observations resulted in a failure to ask for identification to purchase alcohol. Conclusions: The growing number of self-checkout options at supermarkets can be a potential source of alcohol for minors; however, the risk they pose is similar to that of traditional checkout purchases. Policies relating to the purchase of alcohol at any store, regardless of checkout type, should be modified so that every purchase of alcohol requires an identification card to be swiped regardless of age. (J. Stud. Alcohol Drugs, 73, 713-717, 2012).     

Harry Potter and the Underage Drinkers: Can We Use This to Talk to Teens About Alcohol?

ABSTRACT

Underage drinking continues to be a major problem in America. Approximately 20% of all alcohol consumed in the United States is consumed by minors with 44% of 8th graders and 77% of 12th graders reporting that they have tried alcohol at least once. The National Highway Traffic Safety Administration reported that, in 2003, as many as 3,657 drivers, 15 to 20 years old, were killed in motor vehicle crashes in the United States. The most recent book in the Harry Potter series, Harry Potter and the Half-Blood Prince, has several references to underage drinking and the provision of alcohol to minors by adults. Given the popularity of the book, clinicians can use this to talk to adolescents about alcohol use.     

Measuring public opinion on alcohol policy: a factor analytic study of a US probability sample

Public opinion has been one factor affecting change in policies designed to reduce underage alcohol use. Extant research, however, has been criticized for using single survey items of unknown reliability to define adult attitudes on alcohol policy issues. The present investigation addresses a critical gap in the literature by deriving scales on public attitudes, knowledge, and concerns pertinent to alcohol policies designed to reduce underage drinking using a US probability sample survey of 7021 adults. Five attitudinal scales were derived from exploratory and confirmatory factor analyses addressing policies to: (1) regulate alcohol marketing, (2) regulate alcohol consumption in public places, (3) regulate alcohol distribution, (4) increase alcohol taxes, and (5) regulate youth access. The scales exhibited acceptable psychometric properties and were largely consistent with a rational framework which guided the survey construction.     

Communities mobilizing for change on alcohol: outcomes from a randomized community trial

OBJECTIVE: Communities Mobilizing for Change on Alcohol (CMCA) was a randomized 15-community trial of a community organizing intervention designed to reduce the accessibility of alcoholic beverages to youths under the legal drinking age. METHOD: Data were collected at baseline before random assignment of communities to intervention or control condition, and again at follow-up after a 2.5-year intervention. Data collection included in-school surveys of twelfth graders, telephone surveys of 18- to 20-year-olds and alcohol merchants, and direct testing of the propensity of alcohol outlets to sell to young buyers. Analyses were based on mixed-model regression, used the community as the unit of assignment, took into account the nesting of individual respondents or alcohol outlets within each community, and controlled for relevant covariates. RESULTS: Results show that the CMCA intervention significantly and favorably affected both the behavior of 18- to 20-year-olds (effect size = 0.76, p<.01) and the practices of on-sale alcohol establishments (effect size = 1.18, p<.05), may have favorably affected the practices of off-sale alcohol establishments (effect size = 0.32, p = .08), but had little effect on younger adolescents. Alcohol merchants appear to have increased age-identification checking and reduced propensity to sell to minors. Eighteen- to 20-year-olds reduced their propensity to provide alcohol to other teens and were less likely to try to buy alcohol, drink in a bar or consume alcohol. CONCLUSIONS: Community organizing is a useful intervention approach for mobilizing communities for institutional and policy change to improve the health of the population.     

An evaluated community action project on alcohol

This article reports outcomes of an evaluated community action program directed toward alcohol problem prevention. In a quasi-experimental design, change was monitored in six cities--two cities with an alcohol-focused community organizer and media campaign, two cities with the media campaign only and two reference cities. The community organizers worked with a local alcohol coordinating committee and other local organizations. They focused on alcohol availability (including the promotion of nonalcoholic beverages), advertising and, to a lesser extent, pricing policies. The media campaign focused on reducing the large-quantity drinking of young men, and generated considerable controversy. Before and after surveys of the general population were carried out to evaluate the outcome of the project. Support for control policies on advertising, availability and price held steady in the treatment communities but dropped in the reference communities. The perception of alcohol being essential to entertaining and as being relatively innocuous decreased significantly in the community-action cities. The project thus appears to have met its objectives in these areas, although primarily by stemming the national trend toward greater support for liberalization.     

Factors Associated with Parents' Belief in the Appropriateness of Providing Alcohol to their Child

Background: Parental provision of alcohol to their underage child has been associated with risky adolescent drinking. While parents' belief in the appropriateness of providing their child with alcohol may influence their provision behaviors, research into the factors associated with this belief is lacking. Objectives: This study sought to identify the factors associated with parents' belief in the appropriateness of providing alcohol to their underage child. Methods: Western Australian parents of 12–17 year olds (n = 443) completed an online survey assessing their drinking habits, alcohol provision behaviors, alcohol-related beliefs and attitudes, their child's alcohol consumption, and demographics. Results: Nearly half (44%) the parents surveyed reported providing their underage child with alcohol. Parents of older children and parents who (i) did not believe in the harms and recommendations associated with alcohol use in youth, (ii) agreed with youth-related drinking myths, and (iii) reported more occasions of alcohol consumption by their child were more likely to believe that it was appropriate to provide alcohol to their underage child. Those who believed providing alcohol to their underage child was appropriate were in turn more likely to provide alcohol. Conclusions: Interventions aiming to reduce parental provision of alcohol to children should focus on changing parents' beliefs that this is an appropriate harm minimization behavior. Belief change may be facilitated by the implementation of public education campaigns that increase parents' belief in the alcohol-related harms associated with youth drinking and debunk youth-related drinking myths.     

Reducing high-risk drinking by young Americans south of the border: the impact of a partial ban on sales of alcohol

OBJECTIVE: Determine the effect of a partial sales ban on cross border drinking in Mexico. METHOD: On weekend evenings, thousands of youths (younger than 21 years) and young adults (21 to 25 years) residing in communities along the U.S. border cross over into Mexico to patronize all-night bars where the drinking age is 18 rather than 21 years and where the price of alcohol is considerably less than in the United States. On January 1, 1999, Juárez, Mexico, across the border from El Paso, Texas, implemented a 2 AM bar closing policy replacing the previous 5 AM closing time. Breath alcohol tests of pedestrians at the Juárez/El Paso border before and after the policy change were compared with a similar sample of pedestrians at the Tijuana, Mexico/San Diego, California border. RESULTS: At the Juárez/El Paso border, the total number of youths with positive BACs returning from Juárez after 3 AM when the bars were closed was reduced 89%, whereas the number returning between midnight and 3 AM remained unchanged. There was no change in either period at the Tijuana/San Diego comparison site. CONCLUSIONS: Early closing of the bars in Juárez reduced the number of youths returning after 3 AM to the United States with positive BACs.     

Leisure activity participation in relation to alcohol purchasing and consumption in adolescence

BackgroundBuilding upon the socioecological perspective, this study examines prospective associations linking leisure activity participation with alcohol purchasing and consumption in early adolescence.MethodsA total of 1763 seventh graders (age 12–13 years) were recruited from middle schools in urban Taiwan via multi-stage sampling and followed-up 1.5 years later during ninth grade. Information about leisure activities, covariates (i.e., gender, puberty development, family structure, parental educational attainment, monthly allowance, peer drinking, and childhood alcohol experience), and two outcome variables (i.e., alcohol purchasing and drinking behaviors) was gathered via web-based self-administered questionnaires. Data concerning alcohol outlets and recreational resource for each community district were retrieved from official statistics and commercial sources. Two-level hierarchical generalized linear models were used to evaluate association estimates.FindingsFive percent of ninth graders ever purchased alcohol and nearly one in seven drank alcohol on three or more occasions (i.e., occasional drinking) in the past year. Sports, unstructured, and organized leisure activities were not linked with illegal alcohol purchasing when community contexts were statistically adjusted; a higher community on-premised alcohol outlet density increased alcohol purchasing by 94% (95% CI = 1.24–3.06). In contrast, unstructured leisure activity participation at 7th grade predicted occasional drinking (adjusted Odds Ratio [aOR] = 5.52; 95% CI = 3.13–9.74). Sports participation was associated with reduced risk of occasional drinking in the communities with high unregulated alcohol outlets (aOR for interaction = 0.58; P < .001).ConclusionOur research provides insights to differential roles of leisure activity participation in shaping adolescents' commercial alcohol access and occasional drinking. Macro-social contexts should be considered in the efforts to reduce underage drinking problems through leisure activities.     

Alcohol advertising in the New Zealand university student press

University students drink more heavily than their non-student peers in New Zealand. The promotion of alcohol via advertising is a known contributor to heavy drinking. The aim of this paper was to determine the nature and extent of alcohol-related advertising and related policies at New Zealand universities. We sought to obtain all issues for 2005, of student newspapers at five New Zealand universities that had participated in an ongoing research project examining alcohol-related harm. The number of alcohol-related advertisements was determined and counts were weighted by the proportion of the page they took up. We surveyed senior university administrators to determine whether policies existed to regulate alcohol advertising on campus. The number of alcohol-related advertisements in student publications ranged from 1 to 129 across the academic year (median: 74 advertisements, 34 full-page equivalents). At three universities, most advertisements promoted bars, pubs and restaurants, while at the other two universities, most alcohol-related advertising was for events sponsored by a brewery, alcohol company or local pub. At one university with almost no advertising, a brewery sponsorship agreement with the student association forbade other parties from advertising alcohol and related events. Alcohol-related advertising is pervasive in the New Zealand university student press. Student associations should consider the ethics of alcohol industry sponsorship in light of the high prevalence of heavy drinking in this population group.     

Associations of Early Age of First Intoxication with Past Year Drinking Contexts and Problems

Background: Mechanisms underlying associations between early drinking and problems are largely unknown. Objectives: We investigated (a) associations between early age of first intoxication (≤15?years) and past year drinking in different contexts and (b) whether early age of first intoxication is differentially associated with problems in these contexts. Methods: We used survey data collected in 2013–2014 from 405 past-year adolescent drinkers in 24 midsized California cities. Data included demographics; drinking behaviors; age of first intoxication; frequency of being at and drinking at restaurants, bars/nightclubs, outdoor places, and home; and problems. We used multilevel logistic and negative binomial models to account for the clustering of adolescents within cities. Probabilities were corrected to maintain family-wise error rates. Results: Early age of first intoxication was associated with a 120% increase in the odds of drinking at outdoor settings (OR = 2.20, p_c < .05). Early age of first intoxication was associated with increased numbers of problems related to drinking in restaurants (IRR = 5.72, p_c < .001), outdoor settings (IRR = 3.40, p_c < .001), and homes (IRR = 2.84, p_c < .001). Later intoxication (≥16?years) was not significantly associated with increased drinking or problems in any of these contexts. Conclusions: Results suggest that underage drinkers who report early intoxication are more likely to drink at outdoor settings, but not other contexts. However, they may differentially experience drinking problems across contexts. To target youths who have experienced intoxication at an early age and to reduce problems, prevention interventions should focus on outdoor settings.     

A study on effectiveness of local alcohol policy: Challenges and solutions in the PAKKA project

To an increasing degree, alcohol policy and prevention in the Nordic countries is expected to be carried out on the local level as the free-trade agreements and international harmonization of alcohol taxes and regulations are limiting the scope of traditional national alcohol policies. In recent reviews on the effectiveness of alcohol political interventions the recommended strategy for local communities is to combine community mobilization with various types of environmental strategies focused on the supply of alcoholic beverages. The PAKKA project continues the international tradition of research on community-based prevention of alcohol-related harms. In this paper we discuss the challenges and solutions of evaluating community-based prevention projects, using the recently started ‘PAKKA’ (Local Alcohol Policy) project as a concrete example. The PAKKA project relies on a mixed-intervention strategy attempting to change the local social, economic and physical environment related to risky and under-age drinking. In measuring the project's effectiveness a quasi-experimental research design is used. In our research design we have had to tackle three interconnected problems: the problems of causality in a multi-component population level study, the problem of generalizability and the complex role of the researcher.