This Fact Sheet provides advocates and policymakers with the basics about what is meant by environmental approaches to prevention, how this approach differs from other approaches, and offers examples of environmental preventive interventions.
- What is the environmental approach to prevention to alcohol-related problems? Environmental approaches to prevention focus on changing the environment in which a person consumes alcohol rather than the behavior of the individual drinker. Environmental approaches seek to change the physical, social, economic and legal circumstances that enable access to alcohol, heavier drinking and related problems in communities. Effective environmental interventions include:
- restrictions on licensing businesses that sell alcohol,
- restrictions on hours of operation of licensed businesses that sell alcohol,
- increased alcoholic beverage prices, and
- enforcement of the minimum legal drinking of 21 years. These kinds of interventions can be established at the state and local governmental levels and supported by a broad range of community-based organizations.1
- How does the environmental approach differ from other approaches? Environmental prevention approaches focus on reducing the availability of alcohol and enforcement of alcohol control policies. Individual approaches focus on helping individuals make good decisions about alcohol use. Examples of individual-based strategies include:
- educating individuals about the personal costs resulting from problem drinking and
- enhancing youth refusal skills to reduce problem drinking. It is the focus on knowledge and decision-making versus limiting opportunities for individuals to obtain and misuse alcohol that best clarifies the difference between individual and environmental approaches. Environmental approaches can help to reduce alcohol problems without relying on individuals to make good decisions, which is problematic, especially after drinking alcoholic beverages. Effective environmental approaches help reduce the health, social, and economic consequences of alcohol use in communities, such as:
- alcohol-related traffic crashes,
- alcohol-involved violence, and
- underage drinking.
- Why the environmental approach? Individual approaches have not been shown to be highly effective and do not adequately address problems faced by the whole community. Moreover, because the majority of people who consume alcohol are light and moderate drinkers, most alcohol-related problems arise in these groups rather than among heavier drinkers who are often the target of individual prevention efforts.2 By addressing the environments within which drinking occurs, the environmental approach to prevention can reduce alcohol-related harm experienced by drinkers and non-drinkers who suffer secondary consequences and enhance other approaches by creating a social climate that reinforces prevention messages and efforts, including those of individually-oriented prevention programs.
- What research has been conducted on the effectiveness of environmental policies addressing alcohol-related harm? For nearly four decades, the Prevention Research Center (PRC) has been funded by the U.S. National Institute on Alcohol Abuse and Alcoholism to investigate environmental causes and correlates of alcohol use, abuse, and alcohol-related problems in communities in the United States and to establish the bases for effective environmental prevention efforts. Enhancing both the science-base for the development of novel preventive interventions and the practice of implementing and evaluating these interventions in community settings, PRC researchers have pursued their work across a diverse range of geographic areas, populations and settings such as:
- local studies of drinking in high-risk settings,
- studies of the effects of local, state and national alcohol policies on drinking patterns and problems. Some examples of state-level interventions include:
- effectiveness of increasing tax rates,3 and
- keeping the minimum drinking at age 21.4 Examples of research on community level interventions include:
- the effectiveness of stricter local social host ordinances5 and
- high visibility enforcement focusing on high risk drinking settings in college communities.6
In the next five years, PRC scientists will expand environmental research by studying drinking contexts and their effect on alcohol use and harms among youth and adults, including how different ethnic groups experience alcohol use and alcohol-related problems. An additional focus will be studying how drinking contexts affect individuals with alcohol use disorders. Here is a brief description of each project:
- Individual-environment interactions that accelerate and maintain underage drinking and related problems.
- Large-scale social processes that support drinking and problems across US communities.
- The environmental conditions that lead to high-risk drinking among Mexican American and other young adults living near the Mexican-American border.
- Social contexts of drinking that encourage or protect drinkers from progressing to problem drinking and alcohol use disorders.
- The social factors related to early alcohol and substance use initiation and the progression to problem drinking.
- Effective mechanisms by which to provide communities with information and guidance to create healthy drinking environments.7
1 Studies supporting these environmental interventions include:
- Gruenewald, P.J., Grube, J.W., Saltz, R. and Paschall, M.J. (2017) Environmental Approaches to Prevention: Communities and Contexts. In S.C. Miller, D.A. Fiellin, R.N. Rosenthal, R. Saitz (Eds.), Principles of Addiction Medicine 6th Edition. Chevy Chase, MD: American Society of Addiction Medicine;
- Gruenewald, P.J., Treno, A.J., Holder, H.D. & LaScala, E.A. (2016) Community-based approaches to the prevention of substance use related problems. In: Ken Sher (Ed.) Oxford Handbook of Substance Use Disorders. Oxford: Oxford University Press.
2 Gruenewald, P. J., & Treno, A. (2006). Understanding the prevention paradox: Drinkers and drinking. A comment on Skog (2006). Addiction, 101(2), 162-163.
3 Ponicki, W.R., Gruenewald, P.J., & LaScala, E.A. “Joint impacts of minimum legal drinking age and beer taxes on US youth traffic fatalities, 1975-2001,” Alcoholism: Clinical and Experimental Research, 31(5):804-813, 2007.
4 Gruenewald, P.J., Treno, A.J., Ponicki, W.R., Huckle, T., Yeh, L.C., & Casswell, S. “Impacts of New Zealand’s lowered minimum purchase age on context specific drinking and related risks,” Addiction, 10: 1757-1766, 2015. PMCID: PMC4609246
5 Paschall, M. J., Lipperman-Kreda, S., Grube, J. W., & Thomas, S. (2014). 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.
6 Saltz, R.L. & Paschall, M.J. “Replication of Safer California University Intervention Effects on Intoxication among College Students.” Paper presented at the Kettil Bruun Society meeting in Turin, Italy, June 6-10, 2015.
7 More information about PRC studies based on the environmental approach are available at the PRC website: https://www.prev.org/RESEARCH-Environmental-Approaches-to-Prevention.html