Environmental-Level Strategies:

Environmental-level strategies aim to change the alcohol use environment in the campus, community, or both, and thus can affect the student body as a whole or in large subgroups such as those under age 21. Most of the environmental-level strategies on this site seek to reduce alcohol availability, one of the most effective ways to decrease alcohol use and related problems. A few strategies listed below try to reduce alcohol-related harm directly without restricting availability, and are included because colleges commonly use them. This guide isolated these strategies for assessment, and some may not be effective if used alone. Still, they may be useful parts of a multi-strategy effort.

a = New intervention (2019)

b = Intervention changed position in the matrix

Full Environmental Matrix

Environmental Strategies

Enforce

age-21 drinking age

(e.g., compliance checks)

Under this strategy, campuses and local and state government support and implement strong enforcement of the existing age-21 minimum legal drinking age. (Compliance checks are an approach regulated at the local or state level whereby undercover youth, supervised by law enforcement or licensing authorities, attempt to purchase alcohol. When a violation occurs, a penalty is applied to the server and/or the license holder, depending on local or state law.)


Effectiveness:star star star = Higher effectiveness

Cost:$$ = Mid-range

Barriers:## = Moderate

Primary Modality:

Public Health Outreach:B = Broad

Research Amount:**** = 5 or more longitudinal studies

Potential Resources:

Underage Drinking Enforcement Training Center, Conducting Compliance Check Operations (online training)

For more information about intervention designs and implementation, check the articles in the References tab.

References:

  • Barry R, Edwards E, Pelletier A, Brewer R, Naimi T, Redmond A, et al. Enhanced enforcement of laws to prevent alcohol sales to underage persons — New Hampshire, 1999–2004. Morbidity and Mortality Weekly Report, 53(21):452–4, 2004.

  • Flewelling RL, Grube JW, Paschall MJ, Biglan A, Kraft A, Black C, et al. Reducing youth access to alcohol: Findings from a community-based randomized trial. American Journal of Community Psychology, 51(1–2):264–77, 2013.

  • Grube JW. Preventing sales of alcohol to minors: Results from a community trial. Addiction, 92(Suppl. 2):S251–60, 1997.

  • Holmila M, Karlsson T, & Warpenius K. Controlling teenagers’ drinking: effects of a community-based prevention project. Journal of Substance Use, 15(3):201–14, 2010.

  • Preusser DF, Williams AF, & Weinstein HB. Policing underage alcohol sales. Journal of Safety Research, 25(3):127–33, 1994.

  • Scribner R & Cohen D. The effect of enforcement on merchant compliance with the minimum legal drinking age law. Journal of Drug Issues, 31(4):857–66, 2001.

  • Treno AJ, Gruenewald PJ, Lee JP, & Remer LG. The Sacramento Neighborhood Alcohol Prevention Project: Outcomes from a community prevention trial. Journal of Studies on Alcohol, 68(2):197–207, 2007.

  • Wagenaar AC, Toomey TL, & Erickson DJ. Preventing youth access to alcohol: Outcomes from a multi-community time-series trial. Addiction, 100(3):335–45, 2005.

  • Review:
    Elder R, Lawrence B, Janes G, Brewer R, Toomey T, Hingson R, et al. Enhanced enforcement of laws prohibiting sale of alcohol to minors: Systematic review of effectiveness for reducing sales and underage drinking. Transportation Research E-Circular, (E-C123):181–8, 2007.

References from 2019 update

  • Erickson, D.J.; Smolenski, D.J.; Toomey, T.L.; et al. Do alcohol compliance checks decrease underage sales at neighboring establishments? Journal of Studies on Alcohol and Drugs 74(6):852–858, 2013.

  • Moore, R.S.; Roberts, J.; McGaffigan, R.; et al. Implementing a reward and reminder underage drinking prevention program in convenience stores near southern California American Indian reservations. American Journal of Drug and Alcohol Abuse 38(5):456–460, 2012.

Notes:

Effectiveness ratings are based on estimated success in achieving targeted outcomes. Cost ratings are based on a consensus among research team members of the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number and design of studies.

Establish

minimum unit pricinga

Under this strategy, colleges or local/state/federal government sets the minimum price at which alcohol is allowed to be sold in alcohol establishments. The price may be set based on a variety of units or measures, such as per drink, per container size, or per volume of ethanol. This ensures that the price of alcohol is not discounted so much that customers are encouraged to purchase and consume more alcohol than they might otherwise.


Effectiveness:star star star = Higher effectiveness

Cost:$$ = Mid-range

Barriers:### = Higher

Primary Modality:

Public Health Outreach:B = Broad

Research Amount:**** = 5 or more longitudinal studies

Potential Resources:

For information about intervention designs and implementation, check the articles in the References tab.

References:

  • Brennan, A.; Meng, Y.; Holmes, J.; et al. Potential benefits of minimum unit pricing for alcohol versus a ban on below cost selling in England 2014: Modelling study. British Medical Journal 349:g5452, 2014.

  • Cousins, G.; Mongan, D.; Barry, J.; et al. Potential impact of minimum unit pricing for alcohol in Ireland: Evidence from the National Alcohol Diary Survey. Alcohol and Alcoholism 51(6):734–740, 2016.

  • Giesbrecht, N.; Wettlaufer, A.; Thomas, G.; et al. Pricing of alcohol in Canada: A comparison of provincial policies and harm-reduction opportunities. Drug and Alcohol Review 35(3):289–297, 2016.

  • Gill, J.; Black, H.; Rush, R.; et al. Heavy drinkers and the potential impact of minimum unit pricing—no single or simple effect? Alcohol and Alcoholism 52(6):722–729, 2017.

  • Herttua, K.; Makela, P.; and Martikainen, P. Minimum prices for alcohol and educational disparities in alcohol-related mortality. Epidemiology 26(3):337–343, 2015.

  • Holmes, J.; Meng, Y.; Meier, P.S.; et al. Effects of minimum unit pricing for alcohol on different income and socioeconomic groups: A modelling study. Lancet 383(9929):1655–1664, 2014.

  • Meier, P.S.; Holmes, J.; Angus, C.; et al. Estimated effects of different alcohol taxation and price policies on health inequalities: A mathematical modelling study. PLoS Medicine 13(2), 2016.

  • Seaman, P.; Edgar, F.; and Ikegwuonu, T. The role of alcohol price in young adult drinking cultures in Scotland. Drugs: Education, Prevention and Policy 20(4):278–285, 2013.

  • Sharma, A.; Vandenberg, B.; and Hollingsworth, B. Minimum pricing of alcohol versus volumetric taxation: Which policy will reduce heavy consumption without adversely affecting light and moderate consumers? PLoS ONE 9(1), 2014.

  • Sheron, N.; Chilcott, F.; Matthews, L.; et al. Impact of minimum price per unit of alcohol on patients with liver disease in the UK. Clinical Medicine 14(4):396–403, 2014.

  • Stockwell, T.; Auld, M.C.; Zhao, J.H.; and Martin, G. Does minimum pricing reduce alcohol consumption? The experience of a Canadian province. Addiction 107(5):912–920, 2012.

  • Stockwell, T.; Zhao, J.H.; Martin, G.; et al. Minimum alcohol prices and outlet densities in British Columbia, Canada: Estimated impacts on alcohol-attributable hospital admissions. American Journal of Public Health 103(11):2014–2020, 2013.

  • Stockwell, T.; Zhao, J.H.; Marzell, M.; et al. Relationships between minimum alcohol pricing and crime during the partial privatization of a Canadian government alcohol monopoly. Journal of Studies on Alcohol and Drugs 76(4):628–634, 2015.

  • Stockwell, T.; Zhao, J.H.; Sherk, A.; et al. Assessing the impacts of Saskatchewan's minimum alcohol pricing regulations on alcohol-related crime. Drug and Alcohol Review 36(4):492–501, 2017.

  • Vandenberg, B.; and Sharma, A. Are alcohol taxation and pricing policies regressive? Product-level effects of a specific tax and a minimum unit price for alcohol. Alcohol and Alcoholism 51(4):493–502, 2016.

  • Zhao, J.H.; Stockwell, T.; Martin, G.; et al. The relationship between minimum alcohol prices, outlet densities and alcohol-attributable deaths in British Columbia, 2002-2009. Addiction 108(6):1059–1069, 2013.

Notes:

a = New intervention (2019)

Effectiveness ratings are based on estimated success in achieving targeted outcomes. Cost ratings are based on a consensus among research team members of the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number and design of studies.

Increase

alcohol tax

Under this strategy, a state or local government increases the tax on the sale of alcohol, thereby raising the cost of alcohol consumption and decreasing the affordability of excessive drinking.


Effectiveness:star star star = Higher effectiveness

Cost:$$ = Mid-range

Barriers:### = Higher

Primary Modality:

Public Health Outreach:B = Broad

Research Amount:**** = 5 or more longitudinal studies

Potential Resources:

NIAAA, Alcohol Policy Information System:

For more information about intervention designs and implementation, check the articles in the References tab.

References:

References from 2019 update

Highlighted references:

  • Daley, J.I.; Stahre, M.A.; Chaloupka, F.J.; and Naimi, T.S. The impact of a 25-cent-per-drink alcohol tax increase. American Journal of Preventive Medicine 42(4):382–389, 2012.

  • Delcher, C.; Maldonado-Molina, M.M.; and Wagenaar, A.C. Effects of alcohol taxes on alcohol-related disease mortality in New York state from 1969 to 2006. Addictive Behaviors 37(7):783–789, 2012.

  • Staras, S.A.S.; Livingston, M.D.; and Wagenaar, A.C. Maryland alcohol sales tax and sexually transmitted infections: A natural experiment. American Journal of Preventive Medicine 50(3):e73–e80, 2016.

  • Wagenaar, A.C.; Livingston, M.D.; and Staras, S.A.S. Effects of a 2009 Illinois alcohol tax increase on fatal motor vehicle crashes. American Journal of Public Health 105(9):1880–1885, 2015.

Additional references:

  • Byrnes, J.; Shakeshaft, A.; Petrie, D.; and Doran, C. Can harms associated with high-intensity drinking be reduced by increasing the price of alcohol? Drug and Alcohol Review 32(1):27–30, 2013.

  • Casswell, S.; Huckle, T.; Wall, M.; and Yeh, L.C. International alcohol control study: Pricing data and hours of purchase predict heavier drinking. Alcoholism: Clinical and Experimental Research 38(5):1425–1431, 2014.

  • Chang, K.Y.; Wu, C.C.; and Ying, Y.H. The effectiveness of alcohol control policies on alcohol-related traffic fatalities in the United States. Accident Analysis and Prevention 45:406–415, 2012.

  • Crawford, M.J.; Parry, A.M.H.; Weston, A.R.W.; et al. Relationship between price paid for off-trade alcohol, alcohol consumption and income in England: A cross-sectional survey. Alcohol and Alcoholism 47(6):738–742, 2012.

  • Esser, M.B.; Waters, H.; Smart, M.; and Jernigan, D.H. Impact of Maryland's 2011 alcohol sales tax increase on alcoholic beverage sales. American Journal of Drug and Alcohol Abuse 42(4):404–411, 2016.

  • Gale, M.; Muscatello, D.J.; Dinh, M.; et al. Alcopops, taxation and harm: A segmented time series analysis of emergency department presentations. BMC Public Health 15:468, 2015.

  • Herttua, K.; Ostergren, O.; Lundberg, O.; and Martikainen, P. Influence of affordability of alcohol on educational disparities in alcohol-related mortality in Finland and Sweden: A time series analysis. Journal of Epidemiology and Community Health 71(12):1168–1176, 2017.

  • Holm, A.; Veerman, L.; Cobiac, L.; et al. Cost-effectiveness of changes in alcohol taxation in Denmark: A modelling study. Cost Effectiveness and Resource Allocation 12(1):1, 2014.

  • Jiang, H.; and Livingston, M. The dynamic effects of changes in prices and affordability on alcohol consumption: An impulse response analysis. Alcohol and Alcoholism 50(6):631–638, 2015.

  • Lhachimi, S.K.; Cole, K.J.; Nusselder, W.J.; et al. Health impacts of increasing alcohol prices in the European Union: A dynamic projection. Preventive Medicine 55(3):237–243, 2012.

  • Lin, C.M.; and Liao, C.M. Alcohol tax policy in relation to hospitalization from alcohol-attributed diseases in Taiwan: A nationwide population analysis of data from 1996 to 2010. Alcoholism: Clinical and Experimental Research 37(9):1544–1551, 2013.

  • Markowitz, S.; Poe-Yamagata, E.; Andrews, T.; et al. Estimating the relationship between alcohol policies and criminal violence and victimization. German Economic Review 13(4):416–435, 2012.

  • Nelson, J.P. Estimating the price elasticity of beer: Meta-analysis of data with heterogeneity, dependence, and publication bias. Journal of Health Economics 33:180–187, 2014.

  • Nelson, J.P.; and McNall, A.D. Alcohol prices, taxes, and alcohol-related harms: A critical review of natural experiments in alcohol policy for nine countries. Health Policy 120(3):264–272, 2016.

  • Page, N.; Sivarajasingam, V.; Matthews, K.; et al. Preventing violence-related injuries in England and Wales: A panel study examining the impact of on-trade and off-trade alcohol prices. Injury Prevention 23(1):33–39, 2017.

  • Razvodovsky, Y.E. Affordability of alcohol and alcohol-related mortality in Belarus. Adicciones 25(2):156–162, 2013.

  • Scherer, M.; Romano, E.; Caldwell, S.; and Taylor, E. The impact of retail beverage service training and social host laws on adolescents' DUI rates in San Diego County, California. Traffic Injury Prevention 19(2):111–117, 2017.

  • Subramanian, A.; and Kumar, P. The impact of price policy on demand for alcohol in rural India. Social Science and Medicine 191:176–185, 2017.

  • Wall, M.; and Casswell, S. Affordability of alcohol as a key driver of alcohol demand in New Zealand: A co-integration analysis. Addiction 108(1):72–79, 2018.

  • Xuan, Z.M.; Nelson, T.F.; Heeren, T.; et al. Tax policy, adult binge drinking, and youth alcohol consumption in the United States. Alcoholism: Clinical and Experimental Research 37(10):1713–1719, 2013.

Notes:

Effectiveness ratings are based on estimated success in achieving targeted outcomes. Cost ratings are based on a consensus among research team members of the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number and design of studies.

Restrict

happy hours/price promotions

Under this strategy, a campus or local or state government prohibits or restricts drink specials, such as the sale of two alcoholic beverages for the price of one, that encourage customers to drink more than they might otherwise.


Effectiveness:star star star = Higher effectiveness

Cost:$ = Lower

Barriers:### = Higher

Primary Modality:

Public Health Outreach:B = Broad

Research Amount:*** = 5 or more cross-sectional studies or 1 to 4 longitudinal studies

Potential Resources:

For more information about intervention designs and implementation, check the articles in the References tab.

References:

References from 2019 update

  • Baldwin, J.M.; Stogner, J.M.; and Miller, B.L. It's five o'clock somewhere: An examination of the association between happy hour drinking and negative consequences. Substance Abuse Treatment, Prevention, and Policy 9:17, 2014.

  • Kingsland, M.; Wolfenden, L.; Rowland, B.C.; et al. Alcohol consumption and sport: A cross-sectional study of alcohol management practices associated with at-risk alcohol consumption at community football clubs. BMC Public Health 13:762, 2013.

  • McClatchley, K.; Shorter, G.W.; and Chalmers, J. Deconstructing alcohol use on a night out in England: Promotions, preloading and consumption. Drug and Alcohol Review 33(4):367–375, 2014.

  • Paek, H.J.; and Hove, T. Determinants of underage college student drinking: Implications for four major alcohol reduction strategies. Journal of Health Communication 17(6):659–676, 2012.

Notes:

Effectiveness ratings are based on estimated success in achieving targeted outcomes. Cost ratings are based on a consensus among research team members of the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number and design of studies.

Retain

age-21 drinking age

All 50 U.S. states, the District of Columbia, and Guam currently prohibit anyone under age 21 from possessing alcoholic beverages; most states also prohibit those under age 21 from purchasing and consuming alcoholic beverages. Under this strategy, campuses and local and state governments support continuation of the age-21 minimum legal drinking age due to its effectiveness in reducing underage drinking consequences.


Effectiveness:star star star = Higher effectiveness

Cost:$ = Lower

Barriers:## = Moderate

Primary Modality:

Public Health Outreach:B = Broad

Research Amount:**** = 5 or more longitudinal studies

Potential Resources:

See related studies in References, which summarize reductions in alcohol use consequences due to the age 21 minimum legal drinking age.

References:

References from 2019 update

Highlighted References:

  • Callaghan, R.C.; Sanches, M.; Gatley, J.M.; and Stockwell, T. Impacts of drinking-age laws on mortality in Canada, 1980–2009. Drug and Alcohol Dependence 138:137–145, 2014.
  • Carpenter, C.; and Dobkin, C. The minimum legal drinking age and morbidity in the United States. Review of Economics and Statistics 99(1):95–104, 2017.
  • Gatley, J.M.; Sanches, M.; Benny, C.; et al. The impact of drinking age laws on perpetration of sexual assault crimes in Canada, 2009-2013. Journal of Adolescent Health 61(1):24–31, 2017.
  • Gruenewald, P.J.; Treno, A.J.; Ponicki, W.R.; et al. Impacts of New Zealand's lowered minimum purchase age on context-specific drinking and related risks. Addiction 110(11):1757–1766, 2015.
  • Huckle, T.; and Parker, K. Long-term impact on alcohol-involved crashes of lowering the minimum purchase age in New Zealand. American Journal of Public Health 104(6):1087–1091, 2014.
  • Keyes, K.; Brady, J.; and Li, G. Effects of minimum legal drinking age on alcohol and marijuana use: Evidence from toxicological testing data for fatally injured drivers aged 16 to 25 years. Injury Epidemiology 2(1):1, 2015.
  • Plunk, A.D.; Agrawal, A.; Tate, W.F.; et al. Did the 18 drinking age promote high school dropout? Implications for current policy. Journal of Studies on Alcohol and Drugs 76(5):680–689, 2015.
  • Yoruk, C.E. The effect of alcohol consumption on labor market outcomes of young adults: Evidence from minimum legal drinking age laws. B E Journal of Economic Analysis & Policy 15(3):1297–1324, 2015.
  • Yoruk, C.E.; and Yoruk, B.K. Alcohol consumption and risky sexual behavior among young adults: Evidence from minimum legal drinking age laws. Journal of Population Economics 28(1):133–157, 2015.

Additional References:

  • Baccini, M.; and Carreras, G. Analyzing and comparing the association between control policy measures and alcohol consumption in Europe. Substance Use and Misuse 49(12):1684–1691, 2014.
  • Callaghan, R.C.; Gatley, J.M.; Sanches, M.; and Asbridge, M. Impacts of the minimum legal drinking age on motor vehicle collisions in Quebec, 2000-2012. American Journal of Preventive Medicine 47(6):788–795, 2014.
  • Callaghan, R.C.; Sanches, M.; and Gatley, J.M. Impacts of the minimum legal drinking age legislation on in-patient morbidity in Canada, 1997-2007: A regression-discontinuity approach. Addiction 108(9):1590–1600, 2013.
  • Callaghan, R.C.; Sanches, M.; Gatley, J.M.; and Cunningham, J.K. Effects of the minimum legal drinking age on alcohol-related health service use in hospital settings in Ontario: A regression-discontinuity approach. American Journal of Public Health 103(12):2284–2291, 2013.
  • Carpenter, C.S.; Dobkin, C.; and Warman, C. The mechanisms of alcohol control. Journal of Human Resources 51(2):328–356, 2016.
  • Conover, E.; and Scrimgeour, D. Health consequences of easier access to alcohol: New Zealand evidence. Journal of Health Economics 32(3):570–585, 2013.
  • Disney, L.D.; LaVallee, R.A.; and Yi, H.Y. The effect of internal possession laws on underage drinking among high school students: A 12-state analysis. American Journal of Public Health 103(6):1090–1095, 2013.
  • Fell, J.C.; Scherer, M.; and Voas, R. The utility of including the strengths of underage drinking laws in determining their effect on outcomes. Alcoholism: Clinical and Experimental Research 39(8):1528–1537, 2015.
  • Fell, J.C.; Scherer, M.; Thomas, S.; and Voas, R.B. Assessing the impact of twenty underage drinking laws. Journal of Studies on Alcohol and Drugs 77(2):249–260, 2016.
  • Fitzpatrick, B.G.; Scribner, R.; Ackleh, A.S.; et al. Forecasting the effect of the Amethyst Initiative on college drinking. Alcoholism: Clinical and Experimental Research 36(9):1608–1613, 2012.
  • Jager, J.; Keyes, K.M.; and Schulenberg, J.E. Historical variation in young adult binge drinking trajectories and its link to historical variation in social roles and minimum legal drinking age. Developmental Psychology 51(7):962–974, 2015.
  • Jiang, H.; Livingston, M.; and Manton, E. The effects of random breath testing and lowering the minimum legal drinking age on traffic fatalities in Australian states. Injury Prevention 21(2):77–83, 2015.
  • Krauss, M.J.; Cavazos-Rehg, P.A.; Agrawal, A.; et al. Long-term effects of minimum legal drinking age laws on marijuana and other illicit drug use in adulthood. Drug and Alcohol Dependence 149:173–179, 2015.
  • Kypri, K.; Davie, G.; McElduff, P.; et al. Effects of lowering the minimum alcohol purchasing age on weekend assaults resulting in hospitalization in New Zealand. American Journal of Public Health 104(8):1396–1401, 2014.
  • Kypri, K.; Davie, G.; McElduff, P.; et al. Effects of lowering the alcohol minimum purchasing age on weekend hospitalised assaults of young Maori in New Zealand. Drug and Alcohol Review 34(3):299–303, 2015.
  • Kypri, K.; Davie, G.; McElduff, P.; et al. Long-term effects of lowering the alcohol minimum purchasing age on traffic crash injury rates in New Zealand. Drug and Alcohol Review 36(2):178–185, 2017.
  • Lindo, J.M.; Siminski, P.; and Yerokhin, O. Breaking the link between legal access to alcohol and motor vehicle accidents: Evidence from New South Wales. Health Economics 25(7):908–928, 2016.
  • Plunk, A.D.; Krauss, M.J.; Syed-Mohammed, H.; et al. The impact of the minimum legal drinking age on alcohol-related chronic disease mortality. Alcoholism: Clinical and Experimental Research 40(8):1761–1768, 2016.
  • Schelleman-Offermans, K.; Roodbeen, R.T.J.; and Lemmens, P. Increased minimum legal age for the sale of alcohol in the Netherlands as of 2014: The effect on alcohol sellers' compliance after one and two years. International Journal of Drug Policy 49:8–14, 2017.

Notes:

Effectiveness ratings are based on estimated success in achieving targeted outcomes. Cost ratings are based on a consensus among research team members of the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number and design of studies.

Restrict

alcohol sponsorship and advertisingb

Under this strategy, a campus or local or state government establishes policies that restrict or prohibit alcohol sponsorship and/or advertising of alcoholic beverages, particularly where such sponsorship or advertising exposes young people to alcohol messages, such as on college campuses, at rock concerts, or at athletic events.


Effectiveness:star star = Moderate effectiveness

Cost:$$$ = Higher

Barriers:## = Moderate

Primary Modality:

Public Health Outreach:B = Broad

Research Amount:**** = 5 or more longitudinal studies

Potential Resources:

For information about intervention designs and implementation, check the articles in the References tab.

References:

  • Review
    Saffer H. Alcohol advertising and youth. Journal of Studies on Alcohol and Drugs (Suppl. 14):173–81, 2002.

References from 2019 update
None

Notes:

b = Intervention changed position in the matrix

Effectiveness ratings are based on estimated success in achieving targeted outcomes. Cost ratings are based on a consensus among research team members of the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number and design of studies.

Enact

responsible beverage service training laws

Responsible beverage service training laws, enacted at the local or state level, mandate that all or some servers, managers, and/or license holders at alcohol establishments receive formal training on how to responsibly serve alcohol. Training includes ways to recognize signs of intoxication, methods for checking age identification, and intervention techniques. Note: Rating based on research on the effect of a statewide law.


Effectiveness:star star = Moderate effectiveness

Cost:$$$ = Higher

Barriers:## = Moderate

Primary Modality:

Public Health Outreach:B = Broad

Research Amount:*** = 5 or more cross-sectional studies or 1 to 4 longitudinal studies

Potential Resources:

For more information about intervention designs and implementation, check the articles in the References tab.

References:

References from 2019 update:

  • Fell, J.C.; Scherer, M.; Thomas, S.; and Voas, R.B. Assessing the impact of twenty underage drinking laws. Journal of Studies on Alcohol and Drugs 77(2):249–260, 2016.

  • Holder, H.D.; and Wagenaar, A.C. Mandated server training and reduced alcohol-involved traffic crashes: A time series analysis of the Oregon experience. Accident Analysis and Prevention 26(1):89–97, 1994.

  • Linde, A.C.; Toomey, T.L.; Wolfson, J.; et al. Associations between responsible beverage service laws and binge drinking and alcohol-impaired driving. Journal of Alcohol & Drug Education 60(2):35–54, 2016.

  • Scherer, M.; Fell, J.C.; Thomas, S.; and Voas, R.B. Effects of dram shop, responsible beverage service training, and state alcohol control laws on underage drinking driver fatal crash ratios. Traffic Injury Prevention 16:S59–S65, 2016.

  • Scherer, M.; Romano, E.; Caldwell, S.; and Taylor, E. The impact of retail beverage service training and social host laws on adolescents' DUI rates in San Diego County, California. Traffic Injury Prevention 19(2):111–117, 2018.

Notes:

Effectiveness ratings are based on estimated success in achieving targeted outcomes. Cost ratings are based on a consensus among research team members of the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number and design of studies.

Prohibit

alcohol use/sales at campus sporting events

Under this strategy, a campus bans the sale and consumption of alcohol at sporting events.


Effectiveness:star star = Moderate effectiveness

Cost:$$ = Mid-range

Barriers:## = Moderate

Primary Modality:

Public Health Outreach:F = Focused

Research Amount:**** = 5 or more longitudinal studies

Potential Resources:

For information about intervention designs and implementation, check the articles in the References tab.

References:

  • Bormann CA & Stone MH. The effects of eliminating alcohol in a college stadium: The Folsom Field beer ban. Journal of American College Health, 50(2):81–8, 2001.

  • Boyes WJ & Faith RL. Temporal regulation and intertemporal substitution—The effect of banning alcohol at college football games. Public Choice, 77(3):595–609, 1993.

  • Johannessen K, Glider P, Collins C, Hueston H, & DeJong W. Preventing alcohol-related problems at the University of Arizona’s homecoming: An environmental management case study. American Journal of Drug and Alcohol Abuse, 27(3):587—97, 2001.

  • Nelson TF, Lenk KM, Xuan ZM, & Wechsler H. Student drinking at us college sports events. Substance Use and Misuse, 45(12):1861–73, 2010.

  • Oster-Aaland LK & Neighbors C. The impact of a tailgating policy on students’ drinking behavior and perceptions. Journal of American College Health, 56(3):281–4, 2007.

  • Spaite DW, Meislin HW, Valenzuela T, Criss EA, Smith R, & Nelson A. Banning alcohol in a major college stadium:  Impact on the incidence and patterns of injury and illness. Journal of American College Health, 39(3):125–8, 1990.

References from 2019 update

  • Shook, J.; and Hiestand, B.C. Alcohol-related emergency department visits associated with collegiate football games. Journal of American College Health 59(5):388–392, 2011.

Notes:

Effectiveness ratings are based on estimated success in achieving targeted outcomes. Cost ratings are based on a consensus among research team members of the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number and design of studies.

Conduct

“reward & reminder” or “mystery shopping visit”a

Under this strategy, patrons who appear underage or intoxicated attempt to purchase alcohol. Servers/sellers are rewarded and/or congratulated for checking IDs and/or refusing alcohol service. Servers/sellers who sell alcohol receive education about the laws and training to improve compliance rather than punishment. The system can be implemented by an individual establishment or a campus, local, or state organization or enforcement agency.


Effectiveness:star star = Moderate effectiveness

Cost:$$ = Mid-range

Barriers:(At college and local level) # = Lower; (At state level) ## = Moderate

Primary Modality:

Public Health Outreach:B = Broad

Research Amount:*** = 5 or more cross-sectional studies or 1 to 4 longitudinal studies

Potential Resources:

For information about intervention designs and implementation, check the articles in the References tab.

References:

  • Moore, R.S.; Roberts, J.; McGaffigan, R.; et al. Implementing a reward and reminder underage drinking prevention program in convenience stores near southern California American Indian reservations. American Journal of Drug and Alcohol Abuse 38(5):456–460, 2012.

Notes:

a = New intervention (2019)

Effectiveness ratings are based on estimated success in achieving targeted outcomes. Cost ratings are based on a consensus among research team members of the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number and design of studies.

Enact

dram shop liability laws: Sales to intoxicated

This type of dram shop liability law is enacted at the state level to hold the owner or server(s) at a bar, restaurant, or other location responsible for damages caused by an intoxicated person who was overserved alcohol at that location. Liability can be established by case law or statute.


Effectiveness:star star = Moderate effectiveness

Cost:$$ = Mid-range

Barriers:## = Moderate

Primary Modality:

Public Health Outreach:B = Broad

Research Amount:**** = 5 or more longitudinal studies

Potential Resources:

National Conference of State Legislatures (examples of legislation, by state), Dram Shop Civil Liability and Criminal Penalty State Statutes

For more information about intervention designs and implementation, check the articles in the References tab.

References:

References from 2019 update
None

Notes:

Effectiveness ratings are based on estimated success in achieving targeted outcomes. Cost ratings are based on a consensus among research team members of the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number and design of studies.

Enact

dram shop liability laws: Sales to underage

This type of dram shop liability law is enacted at the state level to hold the owner or server(s) at a bar, restaurant, or other location responsible for damages caused by an underage drinker who was sold alcohol at that location.


Effectiveness:star star = Moderate effectiveness

Cost:$$ = Mid-range

Barriers:## = Moderate

Primary Modality:

Public Health Outreach:B = Broad

Research Amount:*** = 5 or more cross-sectional studies or 1 to 4 longitudinal studies

Potential Resources:

National Conference of State Legislatures (examples of legislation, by state, Dram Shop Civil Liability and Criminal Penalty State Statutes

For more information about intervention designs and implementation, check the articles in the References tab.

References:

References from 2019 update

  • Fell, J.C.; Scherer, M.; Thomas, S.; and Voas, R.B. Assessing the impact of twenty underage drinking laws. Journal of Studies on Alcohol and Drugs 77(2):249–260, 2016.

  • Romano, E.; Scherer, M.; Fell, J.; and Taylor, E. A comprehensive examination of U.S. laws enacted to reduce alcohol-related crashes among underage drivers. Journal of Safety Research 55:213–221, 2015.

  • Scherer, M.; Fell, J.C.; Thomas, S.; and Voas, R.B. Effects of dram shop, responsible beverage service training, and state alcohol control laws on underage drinking driver fatal crash ratios. Traffic Injury Prevention 16:S59–S65, 2016.

Notes:

Effectiveness ratings are based on estimated success in achieving targeted outcomes. Cost ratings are based on a consensus among research team members of the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number and design of studies.

Limit

number/density of alcohol establishments

Under this strategy, local or state governments enact regulations that reduce the number of alcohol establishments or limit the number that may be established in a community or area, often through licensing or zoning laws.


Effectiveness:star star = Moderate effectiveness

Cost:$$ = Mid-range

Barriers:### = Higher

Primary Modality:

Public Health Outreach:B = Broad

Research Amount:**** = 5 or more longitudinal studies

Potential Resources:

For more information about intervention designs and implementation, check the articles in the References tab.

References:

  • Review:
    Campbell CA, Hahn RA, Elder R, Brewer R, Chattopadhyay S, Fielding P, et al. The effectiveness of limiting alcohol outlet density as a means of reducing excessive alcohol consumption and alcohol-related harms. American Journal of Preventive Medicine, 37(6):556–69, 2009.

  • Recent studies:
    Mair C, Gruenewald PJ, Ponicki WR, & Remer L. Varying impacts of alcohol outlet densities on violent assaults: Explaining differences across neighborhoods. Journal of Studies on Alcohol and Drugs, 74(1):50–8, 2013.

  • Pridemore WA & Grubesic TH. Alcohol outlets and community levels of interpersonal violence: spatial density, outlet type, and seriousness of assault. Journal of Research in Crime and Delinquency, 50(1):132–59, 2013.

  • Scribner RA, Mason KE, Simonsen NR, Theall K, Chotalia J, Johnson S, et al. An ecological analysis of alcohol-outlet density and campus-reported violence at 32 US colleges. Journal of Studies on Alcohol and Drugs, 71(2):184–91, 2010.

References from 2019 update

Featured References:

  • Ahern, J.; Margerison-Zilko, C.; Hubbard, A.; and Galea, S. Alcohol outlets and binge drinking in urban neighborhoods: The implications of nonlinearity for intervention and policy. American Journal of Public Health 103(4):E81–E87, 2013.

  • Erickson, D.J.; Carlin, B.P.; Lenk, K.M.; et al. Do neighborhood attributes moderate the relationship between alcohol establishment density and crime? Prevention Science 16(2):254–264, 2015.

  • Foster, S.; Trapp, G.; Hooper, P.; et al. Liquor landscapes: Does access to alcohol outlets influence alcohol consumption in young adults? Health and Place 45:17–23, 2017.

  • Grubesic, T.H.; Pridemore, W.A.; Williams, D.A.; and Philip-Tabb, L. Alcohol outlet density and violence: The role of risky retailers and alcohol-related expenditures. Alcohol and Alcoholism 48(5):613–619, 2013.

  • Gruenewald, P.J.; Remer, L.G.; and LaScala, E.A. Testing a social ecological model of alcohol use: The California 50-city study. Addiction 109(5):736–745, 2014.

  • Halonen, J.I.; Kivimaki, M.; Virtanen, M.; et al. Living in proximity of a bar and risky alcohol behaviours: A longitudinal study. Addiction 108(2):320–328, 2013.

  • Han, D.; Shipp, E.M.; and Gorman, D.M. Evaluating the effects of a large increase in off-sale alcohol outlets on motor vehicle crashes: A time-series analysis. International Journal of Injury Control and Safety Promotion 22(4):320–327, 2015.

  • Pridemore, W.A.; and Grubesic, T.H. A spatial analysis of the moderating effects of land use on the association between alcohol outlet density and violence in urban areas. Drug and Alcohol Review 31(4):385–393, 2012.

  • Pridemore, W.A.; and Grubesic, T.H. Community organization moderates the effect of alcohol outlet density on violence. British Journal of Sociology 63(4):680–703, 2012.

  • Quick, M.; Law, J.; and Luan, H. The influence of on-premise and off-premise alcohol outlets on reported violent crime in the region of Waterloo, Ontario: Applying Bayesian spatial modeling to inform land use planning and policy. Applied Spatial Analysis and Policy 10(3):435–454, 2017.

  • Rowland, B.; Toumbourou, J.W.; and Livingston, M. The association of alcohol outlet density with illegal underage adolescent purchasing of alcohol. Journal of Adolescent Health 56(2):146–152, 2015.

  • Snowden, A.J.; and Pridemore, W.A. Alcohol and violence in a nonmetropolitan college town: Alcohol outlet density, outlet type, and assault. Journal of Drug Issues 43(3):357–373, 2013.

  • Snowden, A.J.; and Pridemore, W.A. Off-premise alcohol outlet characteristics and violence. American Journal of Drug and Alcohol Abuse 40(4):327–335, 2014.

  • Zhang, X.; Hatcher, B.; Clarkson, L.; et al. Changes in density of on-premises alcohol outlets and impact on violent crime, Atlanta, Georgia, 1997–2007. Preventing Chronic Disease 12:E84, 2015.

Additional References:

  • Ahern, J.; Balzer, L.; and Galea, S. The roles of outlet density and norms in alcohol use disorder. Drug and Alcohol Dependence 151:144–150, 2015.

  • Ayuka, F.; Barnett, R.; and Pearce, J. Neighbourhood availability of alcohol outlets and hazardous alcohol consumption in New Zealand. Health and Place 29:186–199, 2014.

  • Azar, D.; White, V.; Coomber, K.; et al. The association between alcohol outlet density and alcohol use among urban and regional Australian adolescents. Addiction 111(1):65–72, 2016.

  • Badland, H.; Mavoa, S.; Livingston, M.; et al. Testing spatial measures of alcohol outlet density with self-rated health in the Australian context: Implications for policy and practice. Drug and Alcohol Review 35(3):298–306, 2016.

  • Cameron, M.P.; Cochrane, W.; Gordon, C.; and Livingston, M. Alcohol outlet density and violence: A geographically weighted regression approach. Drug and Alcohol Review 35(3):280–288, 2016.

  • Cederbaum, J.A.; Petering, R.; Hutchinson, M.K.; et al. Alcohol outlet density and related use in an urban black population in Philadelphia public housing communities. Health and Place 31:31–38, 2015.

  • Cunradi, C.B.; Mair, C.; Ponicki, W.; and Remer, L. Alcohol outlet density and intimate partner violence-related emergency department visits. Alcoholism: Clinical and Experimental Research 36(5):847–853, 2012.

  • Day, P.; Breetzke, G.; Kingham, S.; and Campbell, M. Close proximity to alcohol outlets is associated with increased serious violent crime in New Zealand. Australian and New Zealand Journal of Public Health 36(1):48–54, 2012.

  • Dukes, J.W.; Dewland, T.A.; Vittinghoff, E.; et al. Access to alcohol and heart disease among patients in hospital: Observational cohort study using differences in alcohol sales laws. British Medical Journal 353:i2714, 2016.

  • Freisthler, B.; Holmes, M.R.; and Wolf, J.P. The dark side of social support: Understanding the role of social support, drinking behaviors and alcohol outlets for child physical abuse. Child Abuse and Neglect 38(6):1106–1119, 2014.

  • Freisthler, B.; Johnson-Motoyama, M.; and Kepple, N.J. Inadequate child supervision: The role of alcohol outlet density, parent drinking behaviors, and social support. Children and Youth Services Review 43:75–84, 2014.

  • Giesbrecht, N.; Huguet, N.; Ogden, L.; et al. Acute alcohol use among suicide decedents in 14 U.S. states: Impacts of off-premise and on-premise alcohol outlet density. Addiction 110(2):300–307, 2015.

  • Goldstick, J.E.; Brenner, A.B.; Lipton, R.I.; et al. A spatial analysis of heterogeneity in the link between alcohol outlets and assault victimization: Differences across victim subpopulations. Violence and Victims 30(4):649–662, 2015.

  • Gorman, D.M.; Ponicki, W.R.; Zheng, Q.; et al. Violent crime redistribution in a city following a substantial increase in the number of off-sale alcohol outlets: A Bayesian analysis. Drug and Alcohol Review 37(3):348–355, 2018.

  • Halonen, J.I.; Kivimaki, M.; Pentti, J.; et al. Association of the availability of beer, wine, and liquor outlets with beverage-specific alcohol consumption: A cohort study. Alcoholism: Clinical and Experimental Research 38(4):1086–1093, 2014.

  • Halonen, J.I.; Kivimaki, M.; Virtanen, M.; et al. Proximity of off-premise alcohol outlets and heavy alcohol consumption: A cohort study. Drug and Alcohol Dependence 132(1–2):295–300, 2013.

  • Han, D.; and Gorman, D.M. Exploring spatial associations between on-sale alcohol availability, neighborhood population characteristics, and violent crime in a geographically isolated city. Journal of Addiction 2013:6, 2013.

  • Hobday, M.; Chikritzhs, T.; Liang, W.B.; and Meuleners, L. The effect of alcohol outlets, sales and trading hours on alcohol-related injuries presenting at emergency departments in Perth, Australia, from 2002 to 2010. Addiction 110(12):1901–1909, 2015.

  • Iritani, B.J.; Waller, M.W.; Halpern, C.T.; et al. Alcohol outlet density and young women's perpetration of violence toward male intimate partners. Journal of Family Violence 28(5):459–470, 2013.

  • Jennings, J.M.; Milam, A.J.; Greiner, A.; et al. Neighborhood alcohol outlets and the association with violent crime in one mid-Atlantic city: The implications for zoning policy. Journal of Urban Health 91(1):62–71, 2014.

  • Kearns, M.C.; Reidy, D.E.; and Valle, L.A. The role of alcohol policies in preventing intimate partner violence: A review of the literature. Journal of Studies on Alcohol and Drugs 76(1):21–30, 2015.

  • Lipton, R.; Yang, X.W.; Braga, A.A.; et al. The geography of violence, alcohol outlets, and drug arrests in Boston. American Journal of Public Health 103(4):657–664, 2013.

  • Maimon, D.; and Browning, C.R. Underage drinking, alcohol sales and collective efficacy: Informal control and opportunity in the study of alcohol use. Social Science Research 41(4):977–990, 2012.

  • Matheson, F.I.; Creatore, M.I.; Gozdyra, P.; et al. A population-based study of premature mortality in relation to neighbourhood density of alcohol sales and cheque cashing outlets in Toronto, Canada. British Medical Journal Open 4(12):e006032, 2014.

  • McKinney, C.M.; Chartier, K.G.; Caetano, R.; and Harris, T.R. Alcohol availability and neighborhood poverty and their relationship to binge drinking and related problems among drinkers in committed relationships. Journal of Interpersonal Violence 27(13):2703–2727, 2012.

  • Morrison, C.; Smith, K; Gruenewald, P.J.; et al. Relating off-premises alcohol outlet density to intentional and unintentional injuries. Addiction 111(1):56–64, 2016.

  • Morton, C.M. The moderating effect of substance abuse service accessibility on the relationship between child maltreatment and neighborhood alcohol availability. Children and Youth Services Review 35(12):1933–1940, 2013.

  • Morton, C.M.; Simmel, C.; and Peterson, N.A. Neighborhood alcohol outlet density and rates of child abuse and neglect: Moderating effects of access to substance abuse services. Child Abuse and Neglect 38(5):952–961, 2014.

  • Paschall, M.J.; Grube, J.W.; Thomas, S.; et al. Relationships between local enforcement, alcohol availability, drinking norms, and adolescent alcohol use in 50 California cities. Journal of Studies on Alcohol and Drugs 73(4):657–665, 2012.

  • Paschall, M.J.; Lipperman-Kreda, S.; and Grube, J.W. Effects of the local alcohol environment on adolescents' drinking behaviors and beliefs. Addiction 109(3):407–416, 2014.

  • Pearson, A.L.; Bowie, C.; and Thornton, L.E. Is access to alcohol associated with alcohol/substance abuse among people diagnosed with anxiety/mood disorder? Public Health 128(11):968–976, 2014.

  • Pereira, G.; Wood, L.; Foster, S.; and Haggar, F. Access to alcohol outlets, alcohol consumption and mental health. PLoS ONE 8(1):e53461, 2013.

  • Ray, J.G.; Turner, L.; Gozdyra, P.; et al. On-premise alcohol establishments and ambulance calls for trauma, assault, and intoxication. Medicine 95(19):e3669, 2016.

  • Richardson, E.A.; Hill, S.E.; Mitchell, R.; et al. Is local alcohol outlet density related to alcohol-related morbidity and mortality in Scottish cities? Health and Place 33:172–180, 2015.

  • Roman, C.G.; and Reid, S.E. Assessing the relationship between alcohol outlets and domestic violence: Routine activities and the neighborhood environment. Violence and Victims 27(5):811–828, 2012.

  • Rowland, B.; Toumbourou, J.W.; Satyen, L.; et al. Associations between alcohol outlet densities and adolescent alcohol consumption: A study in Australian students. Addictive Behaviors 39(1):282–288, 2014.

  • Rowland, B.; Toumbourou, J.W.; Satyen, L.; et al. The relationship between the density of alcohol outlets and parental supply of alcohol to adolescents. Addictive Behaviors 39(12):1898–1903, 2014.

  • Scherer, M.; Romano, E.; Caldwell, S.; and Taylor, E. The impact of retail beverage service training and social host laws on adolescents' DUI rates in San Diego County, California. Traffic Injury Prevention 19(2):111–117, 2018.

  • Schofield, T.P.; and Denson, T.F. Temporal alcohol availability predicts first-time drunk driving, but not repeat offending. PLoS ONE 8(8):e71169, 2013.

  • Shih, R.A.; Mullins, L.; Ewing, B.A.; et al. Associations between neighborhood alcohol availability and young adolescent alcohol use. Psychology of Addictive Behaviors 29(4):950–959, 2015.

  • Shimotsu, S.T.; Jones-Webb, R.J.; MacLehose, R.F.; et al. Neighborhood socioeconomic characteristics, the retail environment, and alcohol consumption: A multilevel analysis. Drug and Alcohol Dependence 132(3):449–456, 2013.

  • Snowden, A.J.; and Freiburger, T.L. Alcohol outlets, social disorganization, and robberies: Accounting for neighborhood characteristics and alcohol outlet types. Social Science Research 51:145–162, 2015.

  • Spoerri, A.; Zwahlen, M.; Panczak, R.; et al. Alcohol-selling outlets and mortality in Switzerland— the Swiss National Cohort. Addiction 108(9):1603–1611, 2013.

  • Stockwell, T.; Zhao, J.H.; Martin, G.; et al. Minimum alcohol prices and outlet densities in British Columbia, Canada: Estimated impacts on alcohol-attributable hospital admissions. American Journal of Public Health 103(11):2014–2020, 2013.

  • Stockwell, T.; Zhao, J.H.; Marzell, M.; et al. Relationships between minimum alcohol pricing and crime during the partial privatization of a Canadian government alcohol monopoly. Journal of Studies on Alcohol and Drugs 76(4):628–634, 2015.

  • Toomey, T.L.; Erickson, D.J.; Carlin, B.P.; et al. Is the density of alcohol establishments related to nonviolent crime? Journal of Studies on Alcohol and Drugs 73(1):21–25, 2012.

  • Waller, M.W.; Iritani, B.J.; Christ, S.L.; et al. Relationships among alcohol outlet density, alcohol use, and intimate partner violence victimization among young women in the United States. Journal of Interpersonal Violence 27(10):2062–2086, 2012.

  • Waller, M.W.; Iritani, B.J.; Flewelling, R.L.; et al. Violence victimization of young men in heterosexual relationships: Does alcohol outlet density influence outcomes? Violence and Victims 27(4):527–547, 2012.

  • Wilkinson, C.; and Livingston, M. Distances to on- and off-premise alcohol outlets and experiences of alcohol-related amenity problems. Drug and Alcohol Review 31(4):394–401, 2012.

  • Young, R.; Macdonald, L.; and Ellaway, A. Associations between proximity and density of local alcohol outlets and alcohol use among Scottish adolescents. Health and Place 19:124–130, 2013.

  • Zhao, J.H.; Stockwell, T.; Martin, G.; et al. The relationship between minimum alcohol prices, outlet densities and alcohol-attributable deaths in British Columbia, 2002–2009. Addiction 108(6):1059–1069, 2013.

Notes:

Effectiveness ratings are based on estimated success in achieving targeted outcomes. Cost ratings are based on a consensus among research team members of the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number and design of studies.

Retain

state-run alcohol retail stores

(where applicable)

Under this strategy, campuses and local and state governments support existing state control systems for wholesale and off-premises retail distribution whereby a state sets the prices of alcohol and gains profit/revenue directly rather than solely from taxation. Retention of the state system may reduce alcohol outlet density and pricing competition among commercial distributors.


Effectiveness:star star = Moderate effectiveness

Cost:$$ = Mid-range

Barriers:### = Higher

Primary Modality:

Public Health Outreach:B = Broad

Research Amount:**** = 5 or more longitudinal studies

Potential Resources:

See related studies in References, which concluded that privatization of retail alcohol sales leads to increases in excessive alcohol consumption.

References:

References from 2019 update:

  • Fell, J.C.; Scherer, M.; Thomas, S.; and Voas, R.B. Assessing the impact of twenty underage drinking laws. Journal of Studies on Alcohol and Drugs 77(2):249–260, 2016.

  • Kerr, W.C.; Williams, E.; and Greenfield, T.K. Analysis of price changes in Washington following the 2012 liquor privatization. Alcohol and Alcoholism 50(6):654–660, 2015.

  • Romano, E.; Scherer, M.; Fell, J.; and Taylor, E. A comprehensive examination of U.S. laws enacted to reduce alcohol-related crashes among underage drivers. Journal of Safety Research 55:213–221, 2015.

  • Scherer, M.; Fell, J.C.; Thomas, S.; and Voas, R.B. Effects of dram shop, responsible beverage service training, and state alcohol control laws on underage drinking driver fatal crash ratios. Traffic Injury Prevention 16:S59–S65, 2016.

  • Tabb, L.P.; Ballester, L.; and Grubesic, T.H. The spatio-temporal relationship between alcohol outlets and violence before and after privatization: A natural experiment, Seattle, WA 2010–2013. Spatial and Spatio-temporal Epidemiology 19:115–124, 2016.

Notes:

Effectiveness ratings are based on estimated success in achieving targeted outcomes. Cost ratings are based on a consensus among research team members of the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number and design of studies.

Enact

false/fake ID lawsa

Under this strategy, local, state, and federal governments may enact laws to hold producers of fake IDs accountable for creating illegal identification products. These laws may also: (1) hold users of fake or false identification accountable for misrepresenting their age and/or identity, (2) make it illegal to loan or transfer an ID to an underage person, and (3) allow retailers to seize a fake ID from an underage person.


Effectiveness:star star = Moderate effectiveness

Cost:$$ = Mid-range

Barriers:## = Moderate

Primary Modality:

Public Health Outreach:B = Broad

Research Amount:*** = 5 or more cross-sectional studies or 1 to 4 longitudinal studies

Potential Resources:

For information about intervention designs and implementation, check the articles in the References tab.

References:

  • Fell, J.C.; Fisher, D.A.; Voas, R.B.; et al. The relationship of underage drinking laws to reductions in drinking drivers in fatal crashes in the United States. Accident Analysis and Prevention 40(4):1430–1440, 2008.

  • Fell, J.C.; Scherer, M.; Thomas, S.; and Voas, R.B. Assessing the impact of twenty underage drinking laws. Journal of Studies on Alcohol and Drugs 77(2):249–260, 2016.

  • Fell, J.C.; Scherer, M.; Thomas, S.; and Voas, R.B. Effectiveness of social host and fake identification laws on reducing underage drinking driver fatal crashes. Traffic Injury Prevention 15:S64–S73, 2014.

  • Markowitz, S.; Poe-Yamagata, E.; Andrews, T.; et al. Estimating the relationship between alcohol policies and criminal violence and victimization. German Economic Review 13(4):416–435, 2012.

  • Romano, E.; Scherer, M.; Fell, J.; and Taylor, E. A comprehensive examination of U.S. laws enacted to reduce alcohol-related crashes among underage drivers. Journal of Safety Research 55:213–221, 2015.

Notes:

a = New intervention (2019)

Effectiveness ratings are based on estimated success in achieving targeted outcomes. Cost ratings are based on a consensus among research team members of the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number and design of studies.

Retain or enact restrictions on

hours of alcohol sales

Under this strategy, campuses or local and state governments retain or enact policies limiting the hours during which alcohol may be sold legally.


Effectiveness:star star = Moderate effectiveness

Cost:$ = Lower

Barriers:## = Moderate

Primary Modality:

Public Health Outreach:B = Broad

Research Amount:**** = 5 or more longitudinal studies

Potential Resources:

See related studies in References, which describe the detrimental consequences associated with extended hours of alcohol sales.

References:

References from 2019 update

  • de Goeij, M.C.M.; Veldhuizen, E.M.; Buster, M.C.A.; and Kunst, A.E. The impact of extended closing times of alcohol outlets on alcohol-related injuries in the nightlife areas of Amsterdam: A controlled before-and-after evaluation. Addiction 110(6):955–964, 2015.

  • Green, C.P.; Heywood, J.S.; and Navarro, M. Did liberalising bar hours decrease traffic accidents? Journal of Health Economics 35:189–198, 2014.

  • Hobday, M.; Chikritzhs, T.; Liang, W.B.; and Meuleners, L. The effect of alcohol outlets, sales and trading hours on alcohol-related injuries presenting at emergency departments in Perth, Australia, from 2002 to 2010. Addiction 110(12):1901–1909, 2015.

  • Kypri, K.; McElduff, P.; and Miller, P. Restrictions in pub closing times and lockouts in Newcastle, Australia five years on. Drug and Alcohol Review 33(3):323–326, 2014.

  • Levine, N. The location of late night bars and alcohol-related crashes in Houston, Texas. Accident Analysis and Prevention 107:152–163, 2017.

  • Marcus, J.; and Siedler, T. Reducing binge drinking? The effect of a ban on late-night off-premise alcohol sales on alcohol-related hospital stays in Germany. Journal of Public Economics 123:55–77, 2015.

  • Sanchez-Ramirez, D.C.; and Voaklander, D. The impact of policies regulating alcohol trading hours and days on specific alcohol-related harms: A systematic review. Injury Prevention 24(1):94–100, 2018.

  • Wilkinson, C.; Livingston, M.; and Room, R. Impacts of changes to trading hours of liquor licences on alcohol-related harm: A systematic review 2005–2015. Public Health Research & Practice 26(4):e2641644, 2016.

Notes:

Effectiveness ratings are based on estimated success in achieving targeted outcomes. Cost ratings are based on a consensus among research team members of the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number and design of studies.

Retain ban on

Sunday sales

(where applicable)b

Under this strategy, campuses and local and state governments support existing bans on Sunday sales of alcohol for offsite consumption. (No state bans such sales for onsite consumption.)


Effectiveness:star star = Moderate effectiveness

Cost:$ = Lower

Barriers:## = Moderate

Primary Modality:

Public Health Outreach:B = Broad

Research Amount:**** = 5 or more longitudinal studies

Potential Resources:

NIAAA, Alcohol Policy Information System: Sunday Sales

For more information about intervention designs and implementation, check the articles in the References tab.

References:

References from 2019 update

  • Han, S.; Branas, C.C.; and MacDonald, J.M. The effect of a Sunday liquor-sales ban repeal on crime: A triple-difference analysis. Alcoholism: Clinical and Experimental Research 40(5):1111–1121, 2016.

  • Markowitz, S.; Poe-Yamagata, E.; Andrews, T.; et al. Estimating the relationship between alcohol policies and criminal violence and victimization. German Economic Review 13(4):416–435, 2012.

  • Yoruk, B.Y. Legalization of Sunday alcohol sales and alcohol consumption in the United States. Addiction 109(1):55–61, 2014.

Notes:

b = Intervention changed position in the matrix

Effectiveness ratings are based on estimated success in achieving targeted outcomes. Cost ratings are based on a consensus among research team members of the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number and design of studies.

Enact

social host provision laws

Social host provision laws are enacted by local or state governments to hold accountable adults who supply alcohol to those under age 21.


Effectiveness:star star = Moderate effectiveness

Cost:$ = Lower

Barriers:## = Moderate

Primary Modality:

Public Health Outreach:B = Broad

Research Amount:*** = 5 or more cross-sectional studies or 1 to 4 longitudinal studies

Potential Resources:

Ventura County Behavioral Health Department, Model Social Host Liability Ordinance (2005)

For more information about intervention designs and implementation, check the articles in the References tab.

References:

References from 2019 update

  • Fell, J.C.; Scherer, M.; Thomas, S.; and Voas, R.B. Assessing the impact of twenty underage drinking laws. Journal of Studies on Alcohol and Drugs 77(2):249–260, 2016.

  • Fell, J.C.; Scherer, M.; Thomas, S.; and Voas, R.B. Effectiveness of social host and fake identification laws on reducing underage drinking driver fatal crashes. Traffic Injury Prevention 15:S64–S73, 2014.

  • Fell, J.C.; Fisher, D.A.; Voas, R.B.; et al. The relationship of underage drinking laws to reductions in drinking drivers in fatal crashes in the United States. Accident Analysis and Prevention 40(4):1430–1440, 2008.

  • Markowitz, S.; Poe-Yamagata, E.; Andrews, T.; et al. Estimating the relationship between alcohol policies and criminal violence and victimization. German Economic Review 13(4):416–435, 2012.

  • Paschall, M.J.; Lipperman-Kreda, S.; Grube, J.W.; and Thomas, S. Relationships between social host laws and underage drinking: Findings from a study of 50 California cities. Journal of Studies on Alcohol and Drugs 75(6):901–907, 2014.

  • Romano, E.; Scherer, M.; Fell, J.C.; and Taylor, E. A comprehensive examination of U.S. laws enacted to reduce alcohol-related crashes among underage drivers. Journal of Safety Research 55:213–221, 2015.

  • Scherer, M.; Romano, E.; Caldwell, S.; and Taylor, E. The impact of retail beverage service training and social host laws on adolescents' DUI rates in San Diego County, California. Traffic Injury Prevention 19(2):111–117, 2018.

Notes:

Effectiveness ratings are based on estimated success in achieving targeted outcomes. Cost ratings are based on a consensus among research team members of the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number and design of studies.

Implement

beverage service training programs: Sales to intoxicated

This type of program can be implemented at the campus, community, or state level to require training of those who sell or serve alcohol to recognize signs of intoxication, slow the service of alcohol, and cut off individuals who are obviously intoxicated. Note: Rating based on studies of programs in a few establishments.


Effectiveness:star = Lower effectiveness

Cost:$$$ = Higher

Barriers:(At college level) # = Lower; (At state/local level) ## = Moderate

Primary Modality:

Public Health Outreach:B = Broad

Research Amount:**** = 5 or more longitudinal studies

Potential Resources:

NIAAA, Alcohol Policy Information System, Beverage Service Training

For more information about intervention designs and implementation, check the articles in the References tab.

References:

  • Review:
    Bolier L, Voorham L, Monshouwer K, Hasselt Nv, & Bellis M. Alcohol and drug prevention in nightlife settings: A review of experimental studies. Substance Use and Misuse, 46(13):1569–91, 2011.

References from 2019 update

  • Fell, J.C.; Fisher, D.A.; Yao, J.; and McKnight, A.S. Evaluation of a responsible beverage service and enforcement program: Effects on bar patron intoxication and potential impaired driving by young adults. Traffic Injury Prevention 18(6):557–565, 2017.

  • Toomey, T.L.; Lenk, K.M.; Erickson, D.J.; et al. Effects of a hybrid online and in-person training program designed to reduce alcohol sales to obviously intoxicated patrons. Journal of Studies on Alcohol and Drugs 78(2):268–275, 2017.

  • Trolldal, B.; Brannstrom, L.; Paschall, M.J.; and Leifman, H. Effects of a multi-component responsible beverage service programme on violent assaults in Sweden. Addiction 108(1):89–96, 2013.

Notes:

Effectiveness ratings are based on estimated success in achieving targeted outcomes. Cost ratings are based on a consensus among research team members of the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number and design of studies.

Implement

beverage service training programs: Sales to underage

This type of program can be implemented at the campus, community, or state level to require training of those who sell or serve alcohol to verify the age of young customers, recognize false identification documents, and refuse sales to those under the legal drinking age. Note: Rating based on studies of programs in a few establishments.


Effectiveness:star = Lower effectiveness

Cost:$$$ = Higher

Barriers:(At college level) # = Lower; (At state/local level) ## = Moderate

Primary Modality:

Public Health Outreach:B = Broad

Research Amount:**** = 5 or more longitudinal studies

Potential Resources:

NIAAA, Alcohol Policy Information System, Beverage Service Training

For more information about intervention designs and implementation, check the articles in the References tab.

References:

  • Review:
    Bolier L, Voorham L, Monshouwer K, Hasselt NV, & Bellis M. Alcohol and drug prevention in nightlife settings: A review of experimental studies. Substance Use and Misuse, 46(13):1569–91, 2011.

References from 2019 update
None

Notes:

Effectiveness ratings are based on estimated success in achieving targeted outcomes. Cost ratings are based on a consensus among research team members of the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number and design of studies.

Enact

keg registration laws

Keg registration laws, enacted at the local or state level, require alcohol retailers to place a unique identifier on a keg and record the purchaser’s name and address at the time of sale. Keg registration enables law enforcement agents to identify and hold responsible the adult who provided the alcohol, should underage drinking occur.


Effectiveness:star = Lower effectiveness

Cost:$$$ = Higher

Barriers:## = Moderate

Primary Modality:

Public Health Outreach:B = Broad

Research Amount:*** = 5 or more cross-sectional studies or 1 to 4 longitudinal studies

Potential Resources:

NIAAA, Alcohol Policy Information System, Retail Sales: Keg Registration

For more information about intervention designs and implementation, check the articles in the References tab.

References:

References from 2019 update:

  • Fell, J.C.; Scherer, M.; and Voas, R.B. The utility of including the strengths of underage drinking laws in determining their effect on outcomes. Alcoholism: Clinical and Experimental Research 39(8):1528–1537, 2015.

  • Fell, J.C.; Scherer, M.; Thomas, S.; and Voas, R.B. Assessing the impact of twenty underage drinking laws. Journal of Studies on Alcohol and Drugs 77(2):249–260, 2016.

  • Romano, E.; Scherer, M.; Fell, J.C.; and Taylor, E. A comprehensive examination of U.S. laws enacted to reduce alcohol-related crashes among underage drivers. Journal of Safety Research 55:213–221, 2015.

Notes:

Effectiveness ratings are based on estimated success in achieving targeted outcomes. Cost ratings are based on a consensus among research team members of the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number and design of studies.

Establish an

alcohol-free campus

Under this strategy, a campus bans the sale, distribution, or consumption of alcohol on campus property.


Effectiveness:star = Lower effectiveness

Cost:$$ = Mid-range

Barriers:### = Higher

Primary Modality:

Public Health Outreach:B = Broad

Research Amount:*** = 5 or more cross-sectional studies or 1 to 4 longitudinal studies

Potential Resources:

For information about intervention designs and implementation, check the articles in the References tab.

References:

  • Knight JR, Wechsler H, Kuo MC, Seibring M, Weitzman ER, & Schuckit MA. Alcohol abuse and dependence among U.S. college students. Journal of Studies on Alcohol, 63(3):263–70, 2002.

  • Paek HJ & Hove T. Determinants of underage college student drinking: Implications for four major alcohol reduction strategies. Journal of Health Communication, 17(6):659–76, 2012.

  • Voas RB, Johnson M, Turrisi RJ, Taylor D, Honts CR, & Nelsen L. Bringing alcohol on campus to raise money: Impact on student drinking and drinking problems. Addiction, 103(6):940–50, 2008.

  • Walter G & Kowalczyk J. The effectiveness of alcohol policies in 4-year public universities. Journal of Community Health, 37(2):520–28, 2012.

  • Wechsler H, Lee JE, Gledhill-Hoyt J, & Nelson TF. Alcohol use and problems at colleges banning alcohol: Results of a national survey. Journal of Studies on Alcohol, 62(2):133–41, 2001.

  • Williams J, Chaloupka FJ, & Wechsler H. Are there differential effects of price and policy on college students’ drinking intensity? Contemporary Economic Policy, 23(1):78–90, 2005.

  • Williams J, Pacula R, Chaloupka F, & Wechsler H. Alcohol and marijuana use among college students: Economic complements or substitutes? Health Economics, 13(9):825–43, 2004.

References from 2019 update
None

Notes:

Effectiveness ratings are based on estimated success in achieving targeted outcomes. Cost ratings are based on a consensus among research team members of the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number and design of studies.

Conduct

campus-wide social norms campaign

Under this strategy, a campus conducts a campus-wide awareness campaign that informs students about actual quantity and frequency of alcohol use among their fellow students, with the intent of changing their perception of what is normal or acceptable. (NOTE: Strategy does not seek to reduce alcohol availability, one of the most effective ways to decrease alcohol use and its consequences.)


Effectiveness:star = Lower effectiveness

Cost:$$ = Mid-range

Barriers:# = Lower

Primary Modality:

Public Health Outreach:B = Broad

Research Amount:**** = 5 or more longitudinal studies

Potential Resources:

National Social Norms Institute at the University of Virginia

For more information about intervention designs and implementation, check the articles in the References tab.

References:

References from 2019 update

  • Foxcroft, D.R.; Moreira, M.T.; Santimano, N.; and Smith, L.A. Social norms information for alcohol misuse in university and college students. Cochrane Database of Systematic Reviews 2015(1): CD006748, 2015.

Notes:

Effectiveness ratings are based on estimated success in achieving targeted outcomes. Cost ratings are based on a consensus among research team members of the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number and design of studies.

Require

alcohol-free programming

Under this strategy, a campus hosts alcohol-free events to provide students with social alternatives to parties and bars where alcohol is being served. (Note: Strategy does not seek to reduce alcohol availability, one of the most effective ways to decrease alcohol use and its consequences.)


Effectiveness:? = Too few robust studies to rate effectiveness—or mixed results

Cost:$$$ = Higher

Barriers:# = Lower

Primary Modality:

Public Health Outreach:F = Focused

Research Amount:** = 2 to 4 studies but no longitudinal studies

Potential Resources:

Resources identified only for strategies rated effective.

References:

References from 2019 update
None

Notes:

Effectiveness ratings are based on estimated success in achieving targeted outcomes. Cost ratings are based on a consensus among research team members of the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number and design of studies.

Implement

safe-rides program

Safe-rides programs are conducted by a campus or the local community to provide free or low-cost transportation, such as taxis or van shuttles, from popular drinking venues or events to residences or other safe destinations. (Note: Strategy does not seek to reduce alcohol availability, one of the most effective ways to decrease alcohol use and its consequences.)


Effectiveness:? = Too few robust studies to rate effectiveness—or mixed results

Cost:$$$ = Higher

Barriers:## = Moderate

Primary Modality:

Public Health Outreach:F = Focused

Research Amount:** = 2 to 4 studies but no longitudinal studies

Potential Resources:

Resources identified only for strategies rated effective.

References:

  • Harding WM, Caudill BD, Moore BA, & Frissell KC. Do drivers drink more when they use a safe ride? Journal of Substance Abuse, 13:283–90, 2001.

  • Caudill BD, Harding WM, & Moore BA. At-risk drinkers use safe ride services to avoid drinking and driving. Journal of Substance Abuse, 11:149–59, 2000.

References from 2019 update

  • Sarkar, S.; Andreas, M.; and de Faria, F. Who uses safe ride programs: An examination of the dynamics of individuals who use a safe ride program instead of driving home while drunk. American Journal of Drug and Alcohol Abuse 31(2):305–325, 2005.

Notes:

Effectiveness ratings are based on estimated success in achieving targeted outcomes. Cost ratings are based on a consensus among research team members of the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number and design of studies.

Conduct

shoulder tap campaigns

Shoulder tap campaigns are a method used to enforce minimum legal drinking age laws whereby undercover youth, supervised by local law enforcement, approach adults outside alcohol establishments and ask them to purchase alcohol on their behalf. When a violation occurs, law enforcement issues warnings or citations to the adult.


Effectiveness:? = Too few robust studies to rate effectiveness—or mixed results

Cost:$$$ = Higher

Barriers:## = Moderate

Primary Modality:

Public Health Outreach:B = Broad

Research Amount:** = 2 to 4 studies but no longitudinal studies

Potential Resources:

Resources identified only for strategies rated effective.

References:

  • Fabian LEA, Toomey TL, Lenk KM, & Erickson DJ. Where do underage college students get alcohol? Journal of Drug Education, 38(1):15–26, 2008.

  • Toomey TL, Fabian LEA, Erickson DJ, & Lenk KM. Propensity for obtaining alcohol through shoulder tapping. Alcoholism: Clinical and Experimental Research, 31(7):1218–23, 2007.

References from 2019 update
None

Notes:

Effectiveness ratings are based on estimated success in achieving targeted outcomes. Cost ratings are based on a consensus among research team members of the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number and design of studies.

Enact

social host property laws

Social host property laws are enacted by local or state governments to hold accountable adults who permit underage drinking to occur on property they control. The primary purpose of social host property laws is to deter underage drinking parties.


Effectiveness:? = Too few robust studies to rate effectiveness—or mixed results

Cost:$$$ = Higher

Barriers:## = Moderate

Primary Modality:

Public Health Outreach:B = Broad

Research Amount:0 = No studies

Potential Resources:

Resources identified only for strategies rated effective.

References:

No studies

Notes:

Effectiveness ratings are based on estimated success in achieving targeted outcomes. Cost ratings are based on a consensus among research team members of the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number and design of studies.

Require

unique design for state ID cards for age < 21

Under this strategy, states adopt a unique design for identification cards (e.g., vertical instead of horizontal state driver licenses) for those under age 21 so that age of the card holder is easier to identify.


Effectiveness:? = Too few robust studies to rate effectiveness—or mixed results

Cost:$$$ = Higher

Barriers:## = Moderate

Primary Modality:

Public Health Outreach:B = Broad

Research Amount:*** = 5 or more cross-sectional studies or 1 to 4 longitudinal studies

Potential Resources:

Resources identified only for strategies rated effective.

References:

References from 2019 update

  • Bellou, A.; and Bhatt, R. Reducing underage alcohol and tobacco use: Evidence from the introduction of vertical identification cards. Journal of Health Economics 32(2):353–366, 2013.

Notes:

Effectiveness ratings are based on estimated success in achieving targeted outcomes. Cost ratings are based on a consensus among research team members of the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number and design of studies.

Implement

bystander interventions

In this context, bystander intervention programs offered by campuses are designed to increase a student’s capacity and willingness to intervene when another student may be in danger of harming him/herself or another person due to alcohol use. Bystander intervention programs also are used to reduce consequences of drug use, sexual assault, and other problems. NOTE: This strategy does not seek to reduce alcohol availability, one of the most effective ways to decrease alcohol use and its consequences.


Effectiveness:? = Too few robust studies to rate effectiveness—or mixed results

Cost:$$ = Mid-range

Barriers:# = Lower

Primary Modality:

Public Health Outreach:F = Focused

Research Amount:* = 3 or fewer studies

Potential Resources:

Resources identified only for strategies rated effective.

References:

References from 2019 update

Silver, B.R.; and Jakeman, R.C. College students' willingness to engage in bystander intervention at off-campus parties. Journal of College Student Development 57(4):472–476, 2016.

Notes:

Effectiveness ratings are based on estimated success in achieving targeted outcomes. Cost ratings are based on a consensus among research team members of the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number and design of studies.

Prohibit

alcohol use/service at campus social events

Under this strategy, a campus bans the sale and consumption of alcoholic beverages at social events held on campus property.


Effectiveness:? = Too few robust studies to rate effectiveness—or mixed results

Cost:$ = Lower

Barriers:## = Moderate

Primary Modality:

Public Health Outreach:B = Broad

Research Amount:0 = No studies

Potential Resources:

Resources identified only for strategies rated effective.

References:

No studies

Notes:

Effectiveness ratings are based on estimated success in achieving targeted outcomes. Cost ratings are based on a consensus among research team members of the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number and design of studies.

Establish

amnesty policies

Under an amnesty policy, a campus does not impose sanctions on a student who seeks help for another student in danger of serious harm or death from alcohol use, even if the help seeker has been drinking underage or has provided the alcohol to an underage peer. Amnesty policies also may be known as medical amnesty or Good Samaritan policies, and some exist at the state level. (Note: Strategy does not seek to reduce alcohol availability, one of the most effective ways to decrease alcohol use and its consequences.)


Effectiveness:? = Too few robust studies to rate effectiveness—or mixed results

Cost:$ = Lower

Barriers:# = Lower

Primary Modality:

Public Health Outreach:F = Focused

Research Amount:*** = 5 or more cross-sectional studies or 1 to 4 longitudinal studies

Potential Resources:

Resources identified only for strategies rated effective.

References:

References from 2019 update
None

Notes:

Effectiveness ratings are based on estimated success in achieving targeted outcomes. Cost ratings are based on a consensus among research team members of the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number and design of studies.

Require

Friday morning classes

Under this strategy, a campus requires classes on Friday mornings to discourage excessive alcohol use by students on Thursday evenings. (Note: Strategy does not seek to reduce alcohol availability, one of the most effective ways to decrease alcohol use and its consequences.)


Effectiveness:? = Too few robust studies to rate effectiveness—or mixed results

Cost:$ = Lower

Barriers:# = Lower

Primary Modality:

Public Health Outreach:B = Broad

Research Amount:** = 2 to 4 studies but no longitudinal studies

Potential Resources:

Resources identified only for strategies rated effective.

References:

  • Paschall MJ, Kypri K, & Saltz RF. Friday class and heavy alcohol use in a sample of New Zealand college students. Journal of Studies on Alcohol, 67(5):764–9, 2006.

  • Wood PK, Sher KJ, & Rutledge PC. College student alcohol consumption, day of the week, and class schedule. Alcoholism: Clinical and Experimental Research, 31(7):1195–1207, 2007.

  • Ward RM, Cleveland MJ, & Messman-Moore TL. Latent class analysis of college women’s Thursday drinking. Addictive Behaviors, 38(1):1407–13, 2013.

References from 2019 update
None

Notes:

Effectiveness ratings are based on estimated success in achieving targeted outcomes. Cost ratings are based on a consensus among research team members of the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number and design of studies.

Establish

standards for alcohol service at campus social events

Under this strategy, a campus establishes policies that set certain constraints on alcohol sales, such as a limited number of alcoholic beverages per person, availability of food and non-alcoholic beverages, no self-service, and required beverage service training.


Effectiveness:? = Too few robust studies to rate effectiveness—or mixed results

Cost:$ = Lower

Barriers:# = Lower

Primary Modality:

Public Health Outreach:B = Broad

Research Amount:*** = 5 or more cross-sectional studies or 1 to 4 longitudinal studies

Potential Resources:

Resources identified only for strategies rated effective.

References:

References from 2019 update

  • Croff, J.M.; Leavens, E.; and Olson, K. Predictors of breath alcohol concentrations in college parties. Substance Abuse Treatment, Prevention, and Policy 12(10), 2017.

Notes:

Effectiveness ratings are based on estimated success in achieving targeted outcomes. Cost ratings are based on a consensus among research team members of the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number and design of studies.

Establish

substance-free residence halls

Under this strategy, a campus bans the possession and consumption of all substances within its residence halls. (Note: Strategy does not seek to reduce alcohol availability, one of the most effective ways to decrease alcohol use and its consequences.)


Effectiveness:? = Too few robust studies to rate effectiveness—or mixed results

Cost:$ = Lower

Barriers:# = Lower

Primary Modality:

Public Health Outreach:F = Focused

Research Amount:** = 2 to 4 studies but no longitudinal studies

Potential Resources:

Resources identified only for strategies rated effective.

References:

  • Odo J, McQuiller L, & Stretesky P. An empirical assessment of the impact of RIT’s student alcohol policy on drinking and binge drinking behavior. Journal of Alcohol & Drug Education, 44(3):49–67, 1999.

  • Wechsler H, Lee JE, Nelson TF, & Kuo M. Underage college students' drinking behavior, access to alcohol, and the influence of deterrence policies. Findings from the Harvard School of Public Health College Alcohol Study. Journal of American College Health, 50(5):223–36, 2002.

  • Wechsler H, Lee JE, Nelson TF, & Lee H. Drinking levels, alcohol problems and secondhand effects in substance-free college residences: Results of a national study. Journal of Studies on Alcohol, 62(1):23–31, 2001.

  • Williams J, Pacula R, Chaloupka F, & Wechsler H. Alcohol and marijuana use among college students: Economic complements or substitutes? Health Economics, 13(9):825–43, 2004.

References from 2019 update
None

Notes:

Effectiveness ratings are based on estimated success in achieving targeted outcomes. Cost ratings are based on a consensus among research team members of the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number and design of studies.

Prohibit

beer kegs

A ban on beer kegs is an approach taken by a campus or local or state government in an effort to decrease the amount of alcohol at parties. Campus bans may apply to specific settings, such as athletic events or tailgate parties.


Effectiveness:? = Too few robust studies to rate effectiveness—or mixed results

Cost:$ = Lower

Barriers:(At college level) # = Lower; (At state/local level) ### = Higher

Primary Modality:

Public Health Outreach:B = Broad

Research Amount:*** = 5 or more cross-sectional studies or 1 to 4 longitudinal studies

Potential Resources:

Resources identified only for strategies rated effective.

References:

  • Kilmer JR, Larimer ME, Parks GA, Dimeff LA, & Marlatt GA. Liability management or risk management? Evaluation of a Greek system alcohol policy. Psychology of Addictive Behaviors, 13(4):269–78, 1999.

References from 2019 update
None

Notes:

Effectiveness ratings are based on estimated success in achieving targeted outcomes. Cost ratings are based on a consensus among research team members of the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number and design of studies.

Establish

minimum age requirements to serve/sell alcohol

Under this strategy, a campus or local or state government establishes requirements specifying how old someone must be to serve or sell alcohol. Requirements may differ by type of alcohol establishment (e.g., off- vs. on-premises establishments and type of alcohol—beer, wine, or spirits) and may include exceptions under certain circumstances.


Effectiveness:? = Too few robust studies to rate effectiveness—or mixed results

Cost:$ = Lower

Barriers:## = Moderate

Primary Modality:

Public Health Outreach:B = Broad

Research Amount:** = 2 to 4 studies but no longitudinal studies

Potential Resources:

Resources identified only for strategies rated effective.

References:

Note: Previous references have been removed since they did not assess the policy directly.

References from 2019 update

  • Fell, J.C.; Fisher, D.A.; Voas, R.B.; et al. The relationship of underage drinking laws to reductions in drinking drivers in fatal crashes in the United States. Accident Analysis and Prevention 40(4):1430–1440, 2008.

  • Fell, J.C.; Scherer, M.; Thomas, S.; and Voas, R.B. Assessing the impact of twenty underage drinking laws. Journal of Studies on Alcohol and Drugs 77(2):249–260, 2016.

  • Romano, E.; Scherer, M.; Fell, J.C.; and Taylor, E. A comprehensive examination of U.S. laws enacted to reduce alcohol-related crashes among underage drivers. Journal of Safety Research 55:213–221, 2015.

Notes:

Note: Research amount decreased from original CollegeAIM because studies indirectly measuring the approach were replaced with a fewer number of direct studies since published. (Previous references have been removed since they did not assess the policy directly.)

Effectiveness ratings are based on estimated success in achieving targeted outcomes. Cost ratings are based on a consensus among research team members of the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number and design of studies.

Implement

party patrols

Party patrols are a community-based approach in which campus or local teams, made up of police and sometimes volunteers, visit locations where there have been reports and complaints about noisy party activity or visit addresses associated with keg registrations to determine whether underage drinking is taking place. If illegal activity is occurring, the police cite any adults who appear to have facilitated underage drinking and cite those drinking underage.


Effectiveness:? = Too few robust studies to rate effectiveness—or mixed results

Cost:$ = Lower

Barriers:## = Moderate

Primary Modality:

Public Health Outreach:B = Broad

Research Amount:*** = 5 or more cross-sectional studies or 1 to 4 longitudinal studies

Potential Resources:

Resources identified only for strategies rated effective.

References:

References from 2019 update
None

Notes:

Effectiveness ratings are based on estimated success in achieving targeted outcomes. Cost ratings are based on a consensus among research team members of the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number and design of studies.

Increase

cost of alcohol license

Under this strategy, a state or local government increases the cost of an alcohol license, thereby increasing the cost of operating an alcohol establishment and potentially increasing the price of alcohol and reducing the density of alcohol establishments in a given area.


Effectiveness:? = Too few robust studies to rate effectiveness—or mixed results

Cost:$ = Lower

Barriers:## = Moderate

Primary Modality:

Public Health Outreach:B = Broad

Research Amount:* = 1 study that is not longitudinal

Potential Resources:

Resources identified only for strategies rated effective.

References:

  • Cohen, D.A.; Mason, K.; and Scribner, R. The population consumption model, alcohol control practices, and alcohol-related traffic fatalities. Preventive Medicine 34(2):187–197, 2002.

References from 2019 update
None

Notes:

Effectiveness ratings are based on estimated success in achieving targeted outcomes. Cost ratings are based on a consensus among research team members of the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number and design of studies.

Prohibit

home delivery of alcohol

Under this strategy, local or state governments prohibit home delivery of alcohol, either by local establishments or over the Internet, with the intent of preventing underage alcohol sales.


Effectiveness:? = Too few robust studies to rate effectiveness—or mixed results

Cost:$ = Lower

Barriers:## = Moderate

Primary Modality:

Public Health Outreach:B = Broad

Research Amount:** = 2 to 4 studies but no longitudinal studies

Potential Resources:

Resources identified only for strategies rated effective.

References:

  • Fletcher LA, Toomey TL, Wagenaar AC, Short B, & Willenbring ML. Alcohol home delivery services: A source of alcohol for underage drinkers. Journal on Studies of Alcohol and Drugs, 61(1):81–4, 2000.

  • Kuo MC, Wechsler H, Greenberg P, & Lee H. The marketing of alcohol to college students: The role of low prices and special promotions. American Journal of Preventive Medicine, 25(3):204–11, 2003.

References from 2019 update

  • Van Hoof, J.J.; Van den Wildenberg, E.; and De Bruijn, D. Compliance with legal age restrictions on adolescent alcohol sales for alcohol home delivery services (AHDS). Journal of Child & Adolescent Substance Abuse 23(6):359–361, 2014.

Notes:

Effectiveness ratings are based on estimated success in achieving targeted outcomes. Cost ratings are based on a consensus among research team members of the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number and design of studies.

Enact

noisy assembly laws

Noisy assembly laws, enacted at the local or state level, give law enforcement legal cause to enter a private residence if a gathering of more than one person in a residential area or building produces noise that unreasonably disturbs the peace, quiet, or repose of another. Such laws also enable law enforcement to enter residences where they have reason to suspect underage drinking is occurring.


Effectiveness:? = Too few robust studies to rate effectiveness—or mixed results

Cost:$ = Lower

Barriers:## = Moderate

Primary Modality:

Public Health Outreach:B = Broad

Research Amount:0 = No studies

Potential Resources:

Resources identified only for strategies rated effective.

References:

No studies

Notes:

Effectiveness ratings are based on estimated success in achieving targeted outcomes. Cost ratings are based on a consensus among research team members of the relative program and staff costs for adoption, implementation, and maintenance of a strategy. Actual costs will vary by institution, depending on size, existing programs, and other campus and community factors. Barriers to implementing a strategy include cost and opposition, among other factors. Public health reach refers to the number of students that a strategy affects. Strategies with a broad reach affect all students or a large group of students (e.g., all underage students); strategies with a focused reach affect individuals or small groups of students (e.g., sanctioned students). Research amount/quality refers to the number and design of studies.