RESEARCH

Environmental Strategies to Reduce Community Alcohol Problems: A Randomized Trial

Component Directors: M.J. Paschall, Ph.D. and Robert Saltz, Ph.D.

Introduction

Over the past five decades great progress has been made in preventing underage alcohol use and problem use by adolescents and young adults.  Laws that increased the minimum drinking age to 21 and lowered permissible blood alcohol levels to 0.08 saved and continue to save thousands of lives every year.  Laws that provide for strict and sure penalties of a young person found driving after drinking, laws that prohibit sales to underage youth or intoxicated persons, and ordinances against public drunkenness also contribute to reductions in alcohol-related accidents and injuries among young people.  Unfortunately, enforcement of these laws by state and local authorities is often limited and inconsistent. 

To improve and evaluate alcohol law enforcement operations by city police, we are conducting a study in 24 midsize California cities.  In half of the cities, we are working with the police and local community agencies to achieve the following:

  1. Helping servers at bars and restaurants identify and refuse sales to underage and intoxicated  drinkers through Responsible Beverage Service (RBS) training
  2. Checking to make sure that stores that sell alcohol do not sell to underage youth (Compliance Checks),
  3. Performing undercover operations to identify bars which regularly sell to intoxicated persons (Undercover Operations),
  4. Stopping drivers at roadsides to determine if they have been drinking (Sobriety Checkpoints),
  5. Patrolling neighborhoods to uncover parties and/or gatherings  at which underage youth and young adults may be drinking (Party Patrols), and
  6. Working with community-based organizations and local media to publicize these enforcement efforts (Enforcement Visibility).  The ad shown depicting a young man taking a breathalyzer test with a blood alcohol concentration at the .08 legal limit emphasizes the potential cost of such a violation as well as the fact that local police are actively enforcing DUI laws.  This advertisement was posted throughout the bar district of the city and on the screen in movie theaters.  Resources for alcohol law enforcement activities are often limited, so increasing the visibility of enforcement activities can be a cost-effective, complementary strategy.

Research Goals and Activities

We are focusing on the following activities in the 12 intervention cities and comparing them to 12 control cities (where no activities are being implemented):

  1. Improving implementation of environmental prevention strategies (aligning alcohol law enforcement operations and enforcement visibility activities);
  2. Increasing public awareness of alcohol law enforcement operations;
  3. Reducing the physical and social availability of alcohol to young people;
  4. Changing attitudes regarding the availability of alcohol, the acceptability of alcohol use, and the likelihood of getting caught by police for violations of alcohol policies;
  5. Determining whether there is a significant reduction in alcohol use, excessive drinking and related problems (alcohol-related motor vehicle crashes, violent assaults, injuries) among young people in 12 intervention cities compared to 12 control cities.

We implemented the following environmental strategies in 12 intervention cities:

  1. We trained employees who sell or serve alcohol (e.g., bartenders, wait staff, sales clerks) in Responsible Beverage Service training to reduce alcohol sales/service to underage youth and intoxicated patrons;
  2. We instituted Minor Decoy Operations or “compliance checks” at licensed retail establishments enforced by local enforcement officers to reduce alcohol sales to underage youth;
  3. We introduced undercover operations by plainclothes police officers in local bars to observe and reduce over-service of alcohol to intoxicated patrons;
  4. We organized DUI (driving under the influence) sobriety checkpoints and surveillance of motor vehicle activity by local enforcement officers to reduce drinking and driving;
  5. We organized neighborhood surveillance or “party patrols” by local enforcement officers in patrol cars to reduce underage drinking and nuisance parties in private settings; and
  6. We publicized local alcohol enforcement activities through various media channels (e.g., radio, newspapers, and social media).

These “environmental prevention strategies” focus on changing the community environment with respect to alcohol use.  If local laws are consistently enforced and young people are aware of these enforcement activities in their communities they may be deterred from drinking too much alcohol and putting themselves in harmhold-rsquo;s way.

Discoveries (Evidence of Findings)

Some key discoveries from our research are summarized below.

  • Environmental Prevention Strategies Can Reduce Community Alcohol-Problems
    We are now beginning to see positive impacts of intervention activities implemented from 2013 to 2015 on alcohol-related problems.  The figure below shows that DUI crashes resulting in injuries declined in intervention cities related to control cities from 2013 to 2015.  These encouraging results are due to increased enforcement of laws restricting alcohol service to intoxicated people in bars and restaurants, and enforcement of DUI laws coupled with visibility activities to enhance the impact of alcohol law enforcement. We are also seeing evidence for declines in violence in intervention cities relative to controls.
  • Communities and Police Can Successfully Work Together to Reduce Alcohol Use and Problems among Young People
    Community-based organizations and local police do not always work effectively together to address community alcohol problems.  They are sometimes pulling in different directions with different goals and objectives.  CBOs typically wish to prevent alcohol-related problems before they take place.  Police instead are typically reacting to problems after they occur.   This project successfully unites CBOs and police to work together to identify enforcement activities to reduce alcohol-related problems among young people, then publicize these enforcement activities for greater impact.  Greatest effects are obtained when specific enforcement activities are visible and occur at specific times and places for particular audiences.  This approach has a greater impact on alcohol use and related problems among youth than law enforcement operations alone.
  • Socially Hosted Parties are Potentially Dangerous and Preventable
    Underage drinkers most often obtain alcohol from their own homes, at their friendshold-rsquo; homes, or at parties with many other underage (and some of-age) drinkers.  Sometimes adults act as the “social hosts” of these parties and provide underage drinkers with alcohol in their homes.  At other times adults can be held liable for use of alcohol by underage drinkers on their property even if they are not present.  We found that cities with more stringent and enforceable social host laws had fewer episodes of underage drinking at parties and private settings than cities with less stringent social host laws or no social host law.  Social host laws may be an effective strategy for reducing the social availability of alcohol to youth and preventing underage drinking in potentially high-risk settings, particularly with consistent enforcement.
  • Effective Police Action Can Reduce Underage Drinking
    Every state in the US has an alcohol beverage control (ABC) agency responsible for regulating alcohol production, distribution, and sales.  But in relatively few states does the ABC actively contribute to alcohol enforcement activities.  In California the state ABC has contributed substantially to city enforcement activities and we have demonstrated that these efforts reduce underage alcohol use and heavy drinking.  Enforcement of underage drinking laws can help to change community perceptions regarding the acceptability of underage drinking.