The Alcohol Policy Environment and Policy Subgroups as Predictors of Binge Drinking Measures Among US Adults

Xuan, Ziming; Blanchette, Jason G.; Nelson, Toben F.; Heeren, Timothy; Oussayef, Nadia L; Naimi, Timothy S.

doi:10.2105/ajph.2014.302112

Cited by 75 publications

(66 citation statements)

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“…When investigating the associations between the alcohol policy environment and the prevalence of binge drinking in US states, a recent publication found that the most promising policies to reduce binge drinking, in addition to increasing the price of alcoholic beverages, were those which targeted the general population (as opposed to policies focusing on underage drinkers), focused on alcohol consumption (e.g. policies focusing on the production, sale or use of alcohol rather on impaired driving), and reduced the availability of alcohol (Xuan et al, 2015). In sum, an effective political strategy to reduce binge drinking at the population level should contain both price increases and efforts to reduce alcohol availability.…”

Section: Structural Interventions: Policy and Environmental Factorsmentioning

confidence: 99%

Binge drinking: Health impact, prevalence, correlates and interventions

Kuntsche

Thrul

et al. 2017

Psychology & Health

308

211

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Section: Structural Interventions: Policy and Environmental Factorsmentioning

confidence: 99%

Binge drinking: Health impact, prevalence, correlates and interventions

Kuntsche

Thrul

et al. 2017

Psychology & Health

308

211

View full text Add to dashboard Cite

“…5 The effect magnitude of the APS for reducing the odds of youth binge drinking was similar to that for reducing the odds of adult binge drinking. 29 For youth drinking measures, however, APS score calculation methods that incorporated policy efficacy ratings (in addition to implementation ratings) did not improve goodness of fit, whereas incorporating both efficacy and implementation ratings improved goodness of fit to predict adult binge drinking. 31 One possible explanation is that panelists' policy efficacy ratings for adults had greater construct validity than their efficacy ratings for youth.…”

Section: Adult Consumption As Mediator Of Population-oriented Policiementioning

confidence: 94%

“…Alcohol Policy Scale (APS) scores, with higher scores representing stronger mixes of alcohol policies, demonstrate good construct validity to predict lower odds of binge drinking and alcoholimpaired driving among adults. 29,31,32 To date, no study has assessed the relationship between the alcohol policy environment and youth drinking in the United States, nor the independent relationships between population-oriented versus youthoriented policies and youth drinking. As shown in Fig 1, the objectives of this study were to assess the relationship of the alcohol policy environments with youth drinking and youth binge drinking, determine the independent relationships between population-oriented policies and youth-oriented policies and youth drinking behaviors, and examine whether adult drinking mediates the relationship between population-oriented policies and youth drinking.…”

Section: Articlementioning

confidence: 99%

“…13 Most policy studies have examined the effects of discrete alcohol policies. [24][25][26][27][28] However, all states use multiple alcohol policies, which may result in combined or interactive effects, 29,30 and this overall alcohol policy environment varies widely in US states. 24 Our research team recently developed a scale to measure the policy environment in US states and Washington, DC.…”

Section: What This Study Addsmentioning

confidence: 99%

“…29 Population-oriented policies were defined as policies that are not designed primarily for people under the legal drinking age, whereas youthoriented policies were those that are designed specifically for people #20 years of age.…”

Section: Youth-versus Population-oriented Policy Subgroupsmentioning

confidence: 99%

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Youth Drinking in the United States: Relationships With Alcohol Policies and Adult Drinking

2015

PEDIATRICS

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BACKGROUND: The relationship between the alcohol policy environment (ie, the combined effectiveness and implementation of multiple existing alcohol policies) and youth drinking in the United States has not been assessed. We hypothesized that stronger alcohol policy environments are inversely associated with youth drinking, and this relationship is partly explained by adult drinking.METHODS: Alcohol Policy Scale (APS) scores that characterized the strength of the state-level alcohol policy environments were assessed with repeated cross-sectional Youth Risk Behavior Survey data of representative samples of high school students in grades 9 to 12, from biennial years between 1999 and 2011. RESULTS:In fully adjusted models, a 10 percentage point increase in APS scores (representing stronger policy environments) was associated with an 8% reduction in the odds of youth drinking and a 7% reduction in the odds of youth binge drinking. After we accounted for youth-oriented alcohol policies, the subgroup of population-oriented policies was independently associated with lower odds of youth drinking (adjusted odds ratio 0.94; 95% confidence interval 0.92-0.97) and youth binge drinking (adjusted odds ratio 0.96; 95% confidence interval 0.94-0.99). State-level per capita consumption mediated the relationship between population-oriented alcohol policies and binge drinking among youth.CONCLUSIONS: Stronger alcohol policies, including those that do not target youth specifically, are related to a reduced likelihood of youth alcohol consumption. These findings suggest that efforts to reduce youth drinking should incorporate population-based policies to reduce excessive drinking among adults as part of a comprehensive approach to preventing alcohol-related harms. Future research should examine influence of alcohol policy subgroups and discrete policies. WHAT'S KNOWN ON THIS SUBJECT:Youth drinking is associated with adult drinking. Alcohol policies can influence youth and adult drinking. However, it is unknown whether alcohol policies influence youth drinking patterns directly or through their effect on adult drinking. WHAT THIS STUDY ADDS:Alcohol policies, including population-oriented policies, are protective for youth drinking. The effect of population-oriented policies may be mediated though effects on adults. These findings suggest that efforts to reduce youth drinking should rely on policies that address all age groups. Dr Xuan helped design the study, supervised statistical analysis, interpreted data and results, and drafted and revised the manuscript; Mr Blanchette coordinated data collection on alcohol policies, contributed to the development of the Alcohol Policy Scale, conducted statistical analyses, interpreted data and results, and made critical revisions of the manuscript for important intellectual content; Dr Nelson contributed to conception and design of the study, contributed to interpretation of data results, and made critical revisions of the manuscript for important intellectual content; Ms Nguyen collect...

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Association of State Alcohol Policies With Alcohol-Related Motor Vehicle Crash Fatalities Among US Adults

et al. 2018

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IMPORTANCEMotor vehicle crashes are a leading cause of mortality. However, the association between the restrictiveness of the alcohol policy environment (ie, based on multiple existing policies) and alcohol-related crash fatalities has not been characterized previously to date.OBJECTIVE To examine the association between the restrictiveness of state alcohol policy environments and the likelihood of alcohol involvement among those dying in motor vehicle crashes in the United States.DESIGN, SETTING, AND PARTICIPANTS This investigation was a repeated cross-sectional study in which state alcohol policies (operationalized by the Alcohol Policy Scale [APS]) from 1999 to 2014 were related to motor vehicle crash fatalities from 2000 to 2015 using data from the Fatality Analysis Reporting System (1-year lag). Alternating logistic regression models and generalized estimating equations were used to account for clustering of multiple deaths within a crash and of multiple crashes occurring within states. The study also examined independent associations of mutually exclusive subgroups of policies, including consumption-oriented policies vs driving-oriented policies. The study setting was the 50 US states. Participants were 505 614 decedents aged at least 21 years from motor vehicle crashes from 2000 to 2015.MAIN OUTCOMES AND MEASURES Odds that a crash fatality was alcohol related (fatality stemmed from a crash in which Ն1 driver had a blood alcohol concentration [BAC] Ն0.08%). RESULTSFrom 2000 to 2015, there were 505 614 adult motor vehicle crash fatalities in the United States, of which 178 795 (35.4%) were alcohol related. Each 10-percentage point increase in the APS score (corresponding to more restrictive state policies) was associated with reduced individual-level odds of alcohol involvement in a crash fatality (adjusted odds ratio [aOR], 0.90; 95% CI, 0.89-0.91); results were consistent among most demographic and crash-type strata. More restrictive policies also had protective associations with alcohol involvement among crash fatalities associated with BACs from greater than 0.00% to less than 0.08%. After accounting for driving-oriented policies, consumption-oriented policies were independently protective for alcohol-related crash fatalities (aOR, 0.97; 95% CI, 0.96-0.98 based on a 10-percentage point increased APS score).CONCLUSIONS AND RELEVANCE Strengthening alcohol policies, including those that do not specifically target impaired driving, could reduce alcohol-related crash fatalities. Policies may also protect against crash fatalities involving BAC levels below the current legal limit for driving in the United States.

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The Alcohol Policy Environment and Policy Subgroups as Predictors of Binge Drinking Measures Among US Adults

Abstract: A small number of policies that raised alcohol prices and reduced its availability appeared to affect binge drinking.

Cited by 75 publications

References 27 publications

Binge drinking: Health impact, prevalence, correlates and interventions

Binge drinking: Health impact, prevalence, correlates and interventions

Youth Drinking in the United States: Relationships With Alcohol Policies and Adult Drinking

Association of State Alcohol Policies With Alcohol-Related Motor Vehicle Crash Fatalities Among US Adults

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