Serving Substance Abuse Professionals Since 1993

Last Update: 11.03.09

C O R K O N L I N E

powerpoint presentations
CORK database search
resource materials
bibliographies
clinical tools
user services
newsletters
about cork
home

CORK Bibliography: Alcohol Control Policy

98 citations. 2003 to present

Prepared: March 2009

Ahlstrom SK; Osterberg EL. International perspectives on adolescent and young adult drinking. Alcohol Research & Health 28(4): 258-268, 2004. (41 refs.)

Alcohol consumption by adolescents and young adults varies greatly in different countries and cultures, in different population groups within a country, and over time. Analyses of per capita consumption in different countries provide some information on drinking patterns of young people in various countries. School-based surveys conducted in a variety of European countries and in the United States offer more specific insight into the drinking behavior of this age group. Such surveys have analyzed variables such as age of onset of drinking; lifetime frequency of drinking; drinking to intoxication; frequency, amount, and timing of current drinking; and drinking consequences. These studies have demonstrated that drinking patterns of young people in, for example, Scandinavian, Anglo-Saxon, and Mediterranean countries vary greatly. Further analyses have explored the influence of social norms and related factors as well as alcohol availability and pricing on alcohol consumption among adolescents and young adults. The generalizability of the findings is limited, however, by the fact that most studies have been conducted in the United States and Europe.

Public Domain

Anderson P. The beverage alcohol industry's social aspects organizations: A public health warning. Addiction 99(11): 1376, 2004. (3 refs.)

Over the last 20 years the beverage alcohol industry has set up and funded social aspects organizations to manage issues that may be detrimental to its business. Social aspects organizations operate at the global level, the European level and at the country level, in high, middle and low income countries. They aim to manage issues by attempting to influence the alcohol policies of national and international governmental organizations; becoming members of relevant non-alcohol specific organizations and committees to broaden policy influence and respectability; recruiting scientists, hosting conferences and promoting high profile publications; creating social aspects organizations in emerging markets and low income countries; and preparing and promoting consensus statements and codes of practice. Social aspects organizations hold five main viewpoints which on inspection confirm their overall aim, which is to benefit the beverage alcohol industry, rather than to benefit public health or the public good. They view that: 1.) addressing patterns of drinking rather than volume of alcohol consumption is the best basis for alcohol policies; 2.) responsible drinking can be learned and that this should be the cornerstone of alcohol policy; 3.) they have an equal place at the policy table, even though the evidence that they bring to the table is not impartial; 4.) the marketing of alcoholic beverages should be self-regulated even though the industry blatantly, consistently and extensively breaks its own codes; and 5.) alcohol, despite its potential for 'abuse', confers a net benefit to society. In relating to the beverage alcohol industry, Eurocare has made the following recommendations: 1. Governments need to implement evidence based policies to reduce the harm done by alcohol, with such policies formulated by public health interests, recognizing that the viewpoints of social aspects organizations are not impartial; 2. Governmental organizations should be concerned at spending public money on programmes put forward by the social aspects organizations, since such programmes lack evidence of effectiveness; 3) A proportion of alcohol taxes, hypothecated for the purpose, should be used to fund relevant independent non-governmental organizations to implement evidence based campaigns to reduce the harm done by alcohol; 4) Governments should support non-governmental organizations that are independent of the beverage alcohol industry; 5) Independent non-governmental organizations that have a specific role with regard to safeguarding effective alcohol policy should inform and mobilize civil society with respect to alcohol-related problems, lobby for implementation of effective policy at government level, and expose any harmful actions of the beverage alcohol industry; 6) In discharging their role, non-governmental organizations mentioned in point 5 above should remain completely independent of social aspects organizations; 7) All independent scientists that are paid by or undertake work for social aspects organizations and the beverage alcohol industry should state their declarations of interest in their scientific publications; 8) Research scientists in high income countries should consider their ethical responsibility not to profit from or contribute the beverage alcohol industry's actions in low income countries; and 9) Greater vigilance and monitoring of beverage alcohol industry behaviour is needed.

Anglin L; Giesbrecht N; Ialomiteanu A; McAllister J; Ogborne A. Public perception of alcohol policy issues relating directly or indirectly to privatization: Results from a 1999 Ontario survey. Canadian Journal of Public Health 94(3): 201-206, 2003. (28 refs.)

Objective: The purpose of this study is to measure public opinion on alcohol policy issues relating to youth, litigation, outlet density, and government action. The authors comment on the implications of public opinion with regard to proposals for privatization of alcohol retailing in Ontario. Method: Using data from a 1999 provincial survey (n = 1,288), the authors examine the opinions of Ontario adults (male and female over the age of 18) on seven alcohol policy-related items. in order to identify characteristics of persons tending to express certain opinions, the opinion items are cross-tabulated with sex, age, drinking pattern, marital status, and education. A scale is created to show the level and strength of aggregate support for alcohol controls. A logistic regression confirms associations between demographic characteristics and opinions. Results: The majority expresses opinions favouring alcohol controls and disagreeing with privatization (73% of total sample against). However, differences of opinion are observed within groups, between groups, and between items. In particular, higher-risk drinkers stand out for their dislike of most control measures. Discussion: Taken as a whole, the results suggest that privatization of alcohol retailing in Ontario would run contrary to the wishes of the majority. Disapproval would probably be even stronger if more people realized there is often a connection between privatization and increased outlet density, relaxation of other controls, and less consideration for public health.

Babor T; Caetano P; Casswell S; Edwards G; Giesbrecht N; Graham K et al. The international context of alcohol policy. IN: Babor T; Caetano P; Casswell S; Edwards G; Giesbrecht N; Graham K et al. Alcohol: No Ordinary Commodity. Oxford: Oxford University Press, 2003. pp. 231-244. (70 refs.)

A thesis of this book is that alcohol is no ordinary commodity. (There was a time when this was recognized, such as agreements between colonial powers which controlled the market, and forbid export to African nations.) With the weakening international perception of alcohol as a unique commodity, national and local alcohol policies that endeavor to enforce regulations are increasingly under international attack. One of the results of the creation of the European Union, was the need to set aside long-standing alcohol policies in the Scandinavian countries, on the basis of their restricting trade. This chapter considers factors and assumptions in international trade that might be useful in countering the trend to view alcohol as any other item of trade. It considers international treaties and trade agreements and their impacts on alcohol policy, as well as summarizing key cases. similarly the role of international financial groups, such as the World Bank is considered, along with alcohol control at the international level.

Babor T; Caetano P; Casswell S; Edwards G; Giesbrecht N; Graham K et al. Alcohol policies: A consumer's guide. IN: Babor T; Caetano P; Casswell S; Edwards G; Giesbrecht N; Graham K et al. Alcohol: No Ordinary Commodity. Oxford: Oxford University Press, 2003. pp. 263-276. (7 refs.)

This chapter endeavors to provide a useful summary and posit guidance for those concerned about alcohol policy. One of the most difficult elements is to evaluate the evidence supporting different policy approaches. A very useful table has been assembled with is organized according to found major criteria: the evidence of effectiveness, the nature of research support, the extent of testing across diverse countries and cultures, and the relative cost of the intervention in terms of time, resources, and money. Other areas which are addressed within the "comments" section of the table are the target group affected by the intervention strategy, and anticipated costs. Each of the major policy areas highlighted in the book are incorporated. In addition, there are several concluding notes. One is the need to make science more accessible to policy-makers. Another is the adoption of the "precautionary principle", a public health concept that holds that preventive efforts would be undertaken even in the event of uncertainty, that the burden of proof out to be shifted to the proponents of a potentially harmful activity, that alternatives to harmful actions need to be provided, and efforts should be made to increase the level of public involvement in decision-making. There is also attention directed to attend to the needs of developing countries and the responsibilities to address their unique policy concerns and conduct the research required to make wise policy choices.

Babor T; Caetano P; Casswell S; Edwards G; Giesbrecht N; Graham K et al. Modifying the drinking environment. IN: Babor T; Caetano P; Casswell S; Edwards G; Giesbrecht N; Graham K et al. Alcohol: No Ordinary Commodity. Oxford: Oxford University Press, 2003. pp. 141-156. (80 refs.)

Given that alcohol use takes place within a cultural context it is possible to alter the context in such a way that drinking environment is changed which in turn alters the extent and magnitude of problems associated with use. The measured considered in this chapter target the drinking environment, particularly those where alcohol is sold or consumed and which are known as high risk environments. In western countries a significant proportion of drinking takes place in licensed premises. One of the efforts to reduce problems has involved responsible beverage service, and requisite training of employees and setting policy. Others include enforcement of serving practices, adoption of voluntary codes, and training bar/tavern staff in respect to the management of aggression and other problem behaviors. In some communities various community, grass roots efforts have been employed to address specific issues. Many of these may be viewed as societal harm reduction efforts.

Babor T; Caetano P; Casswell S; Edwards G; Giesbrecht N; Graham K et al. Drinking-driving countermeasures. IN: Babor T; Caetano P; Casswell S; Edwards G; Giesbrecht N; Graham K et al. Alcohol: No Ordinary Commodity. Oxford: Oxford University Press, 2003. pp. 157-172. (62 refs.)

A major aspect of efforts to reduce morbidity related to drinking involves efforts to reduce drinking and driving. This chapter begins with a discussion of the general enforcement and deterrent effects of drinking-driving laws. It provides a brief overview of patterns of drinking and driving, and then considers the impact of specific approaches. These include lowering BAC limits, the impact of enforcement, random versus selective breath testing, the role of the severity of punishment, and the role of swiftness of punishment, as well as efforts to impact recidivism, including both treatment and victim impact panels. The chapter concludes with an examination of specific strategies to reduce the risk of drinking-driving among young people and the general population, such as through designated driver and ride share programs.

Babor T; Caetano P; Casswell S; Edwards G; Giesbrecht N; Graham K et al. Pricing and taxation. IN: Babor T; Caetano P; Casswell S; Edwards G; Giesbrecht N; Graham K et al. Alcohol: No Ordinary Commodity. Oxford: Oxford University Press, 2003. pp. 101-116. (61 refs.)

Among the various strategies that states and nations use to control alcohol-related problems, the regulation of taxes and prices are among the most popular. This is not simply because governments need revenues. For a considerable period, taxation of alcoholic beverages has been used by many government to reduce the rates of harm from drinking. Economic studies in many developed and some developing regions of the world have demonstrated that increased beverage prices is related to reduction in use and correspondingly a reduction in alcohol-related problems. This chapter considers the aims, mechanism, and effects of alcohol taxation and prices, two important economic strategies. Relevant research is reviewed to evaluate how prices affect consumption and what effects of the market place moderate the effects of price increases. It is noted in summary that the evidence suggests that price clearly have an effect of the level of consumption and related problems. Counter to what might be expected, heavy drinkers too are responsive to price. Nonetheless over the last decades, the real price of alcoholic beverages has in many countries been declining, and this is generally the failure of the government to increase prices to keep pace with inflation. The major downside to the use of taxes to increase price and reduce problems is the potential rise in bootleg alcohol or illegal smuggling.

Babor T; Caetano P; Casswell S; Edwards G; Giesbrecht N; Graham K et al. Regulation of the physical availability of alcohol. IN: Babor T; Caetano P; Casswell S; Edwards G; Giesbrecht N; Graham K et al. Alcohol: No Ordinary Commodity. Oxford: Oxford University Press, 2003. pp. 117-140. (102 refs.)

This chapter considers the physical availability of beverage alcohol, meaning its accessibility or convenience, and the limits or controls on the condition of sale. There is evidence of this means of countering alcohol problems dates back to the Code of Hammurabi, over 3800 years ago. Retail markets are both formal and informal. A range of approaches are reviewed. The first includes a total or partial ban which entails means such as restricting the hours and days of sale, control of the number, location, and type of retail establishments, and the density of location of sales outlets. Research suggests that this does reduce sales and while there may be some increased consumption of home brews, this does not wholly compensate for the reduction in availability Another approach is to restrict eligibility through limiting who is able to purchase and and to sell alcohol. This might entail rationing, the amount an individual can purchases, an approach most commonly found in Scandinavia. Another approach is to set a legal age for purchase. As is noted in the discussion, this is effective, but only when the law is enforced! A related method of control is setting limits on who is allowed to sell. Yet another approach is achieved through the strength of alcoholic beverages. In turn this can be combined as is common in Europe with different ages of purchase for different strength beverages. In the chapter summary it is noted that efforts that are directed to the commercial sellers and have the weight of law are typically more successful than efforts which rely solely on persuasion and education of individual drinkers.

Babor T; Caetano P; Casswell S; Edwards G; Giesbrecht N; Graham K et al. The policy arena. IN: Babor T; Caetano P; Casswell S; Edwards G; Giesbrecht N; Graham K et al. Alcohol: No Ordinary Commodity. Oxford: Oxford University Press, 2003. pp. 245-259. (51 refs.)

This chapter focuses primarily on the question, Who makes alcohol policy? The answer differs across countries and between different levels of government within countries. However, governmental bodies do not function in isolation, and commercial interests, the media, public interest groups, the scientific community, as well as the general public may all have an impact. Each of these elements is briefly described. Several case examples are provided.

Babor T; Caetano P; Casswell S; Edwards G; Giesbrecht N; Graham K et al. Regulating alcohol promotion. IN: Babor T; Caetano P; Casswell S; Edwards G; Giesbrecht N; Graham K et al. Alcohol: No Ordinary Commodity. Oxford: Oxford University Press, 2003. pp. 173-188. (93 refs.)

Alcohol marketing has become a global industry, with international countries now moving into developing nations. The resulting coherence of marketing strategies is in part responsible for the convergence between traditional patterns of drinking and drinking in other countries. A central question is whether this varied, dynamic, and widespread promotion activity is likely to have adverse effects for public health. A major questions facing policy makers is whether, in the public interest, the promotion of alcohol should be regulated or left to industry self-regulation. A considerable body of research has been conducted which can inform the answer to these questions. The chapter summarizes findings related to the impact of advertising on individuals, the effects of alcohol advertising on young people in particular, the role of sponsorship (for example, of sports events and sports teams), and the role of internet marketing. Policy interventions are also discussed. These include industry self-regulation efforts, which typically have a limited impact. Another is legislation against alcohol advertising on broadcast media.

Babor T; Caetano P; Casswell S; Edwards G; Giesbrecht N; Graham K et al. Alcohol: No Ordinary Commodity. Oxford: Oxford University Press, 2003. (Chapter refs.)

This volume, with 16 chapters and 15 contributors, was sponsored by the World Health Organization. In preparing the report, the goal was to create a document that could inform public policy. This volume is the third in a series that has endeavored to provide information relevant to addressing what is a major contributor to morbidity and mortality worldwide. The report is organized into four sections. Following an introduction, Section II is directed to describing why alcohol is no ordinary commodity. It sets forth data on the trends and patterns of alcohol consumption, and then provides epidemiological data on the global burden of alcohol-related problems. The third part of the book is titled "The Toolkit: Strategies and Interventions." This section reviews the scientific evidence for differing approaches designed to prevent or minimize alcohol-related harm. These include pricing and taxation, regulating the physical availability of alcohol, modifying the drinking context, drinking-driving countermeasures, the regulation of alcohol promotion, education and persuasion strategies, and also early intervention and treatment services. The fourth section considers policymaking, the ingredients for effect policy at both the national and international levels, and also provides a synthesis of evidence-based strategies and interventions from a policy perspective.

Babor T; Cantano R; Casswell S; Edwards G; Giesbrecht N; Graham K et al. Summary of the WHO Report Alcohol: No ordinary commodity. A summary of the book. Addiction 98(10): 1343-1350, 2003. (1 refs.)

This article summarizes the contents of Alcohol: No Ordinary Commodity-Research and public policy (Babor et al. 2003). The first part of the book describes why alcohol is no ordinary commodity, and presents epidemiological data on the global burden of alcohol-related problems. The second part of the book reviews the scientific evidence for strategies and interventions designed to prevent or minimize alcohol-related harm: pricing and taxation, regulating the physical availability of alcohol, modifying the drinking context, drinking-driving countermeasures, regulating alcohol promotion, education and persuasion strategies and treatment services. The final section considers the policymaking process on the local, national and international levels, and provides a synthesis of evidence-based strategies and interventions from a policy perspective.

Babor T; Room R; Rehm J; Giesbrecht N; Rossow I; Osterberg E et al. No ordinary commentary: A response to our gentle critics. (editorial). Addiction 98(10): 1367-1370, 2003. (11 refs.)

This is a commentary on a chapter in the WHo Report "Alcohol: No Ordinary Commodity" by T Babor T; R Cantano; S Casswell; G Edwards ; N Giesbrecht, et al, 2003.

Babor TF; Winstanley EL. The world of drinking: National alcohol control experiences in 18 countries. (commentary). Addiction 103(5): 721-725, 2008. (18 refs.)

Baumberg B; Anderson P. Reassurance -- but not complacency -- on trade law and alcohol. A response to Osterberg. (commentary). Addiction 103(12): 1959-1960, 2008. (6 refs.)

Baumberg B; Anderson P. Trade and health: How World Trade Organization (WTO) law affects alcohol and public health. Addiction 103(12): 1952-1958, 2008. (55 refs.)

The alcohol field is becoming more aware of the consequences of world trade law for alcohol policies. However, there is a need for greater clarity about the different effects of trade on alcohol-related harm. A comprehensive review of all literature on alcohol and world trade [including World Trade Organization (WTO) disputes on alcohol], supported by a more selective review of other relevant cases, academic reports and the grey literature on trade and health. The burden of WTO law on alcohol policies depends upon the type of policy in question. Purely protectionist policies are likely to be struck down, which may lead to increases in alcohol-related harm. Partly protectionist and partly health-motivated policies are also at risk of being struck down. However, purely health-motivated policies are likely to be defended by the WTO-and to the extent that policy makers misunderstand this, they are needlessly avoiding effective ways of reducing alcohol-related harm. WTO agreements contain genuine and substantial risks to alcohol policies, and various ways of minimizing future risks are suggested. However, the 'chilling effect' of mistakenly overestimating these constraints should be avoided. Health policy makers should decide on which policies to pursue based primarily on considerations of effectiveness, ethics and politics rather than legality. As long as any effect of these policies on trade is minimized, they are overwhelmingly likely to win any challenges at the WTO.

Beaglehole R; Yach D. Globalisation and the prevention and control of non-communicable disease: The neglected chronic diseases of adults. Lancet 362(9387): 903-908, 2003. (57 refs.)

The growing global burden of non-communicable diseases in poor countries and poor populations has been neglected by policy makers, major multilateral and bilateral aid donors, and academics. Despite strong evidence for the magnitude of this burden, the preventability of its causes, and the threat it poses to already strained health care systems, national and global actions have been inadequate. Globalisation is an important determinant of non-communicable disease epidemics since it has direct effects on risks to populations and indirect effects on national economies and health systems. The globalisation of the production and marketing campaigns of the tobacco and alcohol industries exemplify the challenges to policy makers and public health practitioners. A full range of policy responses is required from government and non-governmental agencies; unfortunately the capacity and resources for this response are insufficient, and governments need to respond appropriately. The progress made in controlling the tobacco industry is a modest cause for optimism.

Berridge V. The how but not the why; more context needed. (commentary). Addiction 99(11): 1375, 2004. (3 refs.)

This is a commentary on an article in this issue on an addiction agency's collaboration with the industry.

Bickford A; Ames G; Moore R. Alcohol policy in the United States Navy. (meeting abstract). Alcoholism: Clinical and Experimental Research 28(5 Supplement): 101A-101A, 2004. (0 refs.)

Bishai DM; Mercer D; Tapales A. Can government policies help adolescents avoid risky behavior? Preventive Medicine 40(2): 197-202, 2005. (34 refs.)

Background. This study examines the extent to which policies influence participation of adolescents in alcohol and tobacco consumption and in unsafe sex. Methods. Data were obtained from the 1995 Youth Risk Behavior Surveys (YRBS) conducted by 20 different states and cities in the U.S. These data were combined with state data on cigarette taxes, vending machine laws, beer taxes, and family planning clinic availability. A model of teenage risk taking suggested that the three risk behaviors were codetermined by a common latent risk-taking propensity. We used a structural equation model (SEM) accounting for this shared latent propensity to estimate the extent of participation in terms of frequency of smoking, drinking, and the number of sex partners. Results. Estimating simultaneous equations for all three risk behaviors was statistically more efficient than equation-by-equation estimates of each behavior. Estimates indicated significant deterrent effects of beer taxes, vending machine restrictions, and increased density of family planning clinics on teenage risk behavior. Conclusions. State policies, such as taxes on beer, and restrictions on location of cigarette vending machines, and placement of family planning clinics influence adolescents' behavior. Because there is interrelationship between these behaviors, systems estimators, can offer improved estimates of these effects.

Bjerre B. Evaluation of the Swedish ignition interlock program. Traffic Injury Prevention 4(2): 98-104, 2003. (16 refs.)

The Swedish ignition interlock system for driving while intoxicated (DWI) offenders was evaluated. The author notes that the program, which is a volunteer program, was launched as a pilot project in 1999. The program differs from other programs in that it covers a period of 2 years, includes very strict medical regulations with regular checkups by a physician, does not require a prior period of hard suspension, and focuses strongly on changes in alcohol habits. A review of records from the 5 years prior to the offense indicated that DWI offenders are in a high-risk category long before their offense, with a 4-5 times higher accident rate and a 3-4 times higher rate of hospitalization due to road accidents. The following results of the present study were seen: (1) a finding that only 12% of eligible offenders participated in the program; (2) diagnosis of 60% of participants as alcohol dependent or abusing; (3) monitoring of alcohol consumption during the program through the Alcohol Use Disorders Identification Test (AUDIT) and five biological markers; (4) a noticeable reduction in alcohol consumption by the interlock users; (5) no case of recidivism by participants during the program, probably due to a high rate of compliance with the regulations; and (6) a reduction in annual accident rate for interlock users while they were in the program. It is concluded that the preliminary results are sufficiently promising that the program will be expanded to cover all of Sweden and all driver's license categories.

Briscoe S. Raising the bar: Can increased statutory penalties deter drink-drivers? Accident Analysis and Prevention 36(5): 919-929, 2004. (35 refs.)

The rate of road accidents per 100,000 vehicles registered was examined before and after the statutory penalties for drink-driving offences were doubled in New South Wales (NSW), Australia. Interrupted time-series analyses found significant increases in three non-fatal accident series after the implementation of the new penalties. The observed increase in the rate of single-vehicle night-time accidents, the accident category most likely to be alcohol-related, was not expected and runs contrary to the anticipated deterrent effect of the new laws. The failure of this policy to have an impact on aggregate-level road accident rates is discussed.

Brown M. 'Aina under the influence: The criminalization of alcohol in 19th-century Hawai'i. Theoretical Criminology 7(1): 89-110, 2003. (30 refs.)

The imposition of Western law in Hawai'i extended novel sets of regulation and control on the colonized Native Hawaiians. A primary focus of the law was the control of drinking and the native intoxicant 'awa. Using perspectives that emphasize the governing of populations through drinking and drug use, this case study shows how overlapping programs of regulation and prohibition grew out of a racialized discourse about the identity of the colonized and the colonizer. This article contributes to the governmentality literature through a sociological analysis of the complexities of regulation and criminalization.

Caetano R; Vaeth PAC; Ramisetty-Mikler S; Rodriguez LA. The Hispanic Americans Baseline Alcohol Survey: Alcoholic beverage preference across Hispanic national groups. Alcoholism: Clinical and Experimental Research 33(1): 150-159, 2009. (29 refs.)

U.S. Hispanics come from many countries in Latin America, which can lead to different beverage preferences in the United States. This paper examines choice for drinking wine, beer, and liquor across 4 Hispanic national groups: Mexican Americans, Puerto Ricans, Cuban Americans, and South/Central Americans. A sample of 5,224 individuals 18 years of age and older was selected using multistage cluster procedures from the household population in 5 metropolitan areas of the United States: Miami, New York, Philadelphia, Houston, and Los Angeles. The survey weighted response rate was 76%. Face-to-face interviews lasting 1 hour on average were conducted in the respondents' homes either in English or Spanish. Among men, beer drinkers consume the highest mean number of drinks per week in all national groups. Among women, this is true only of Puerto Ricans and Mexican Americans. Among men who drink beer, beer drinking constitutes 52 to 72% of total alcohol consumption. Among women who drink beer, beer consumption is associated with 32 to 64% of total consumption. Beer is the beverage most associated with binge drinking among Puerto Rican and Mexican American women, while among Cuban Americans and South/Central Americans this is seen for wine. Regression analyses showed no significant differences by national group in the likelihood of drinking 2 or fewer drinks (vs. no drinks) of wine, beer, or liquor. Puerto Ricans were more likely (OR = 1.47; 95% CI = 1.00-2.14) than Cuban Americans to drink 3 or more drinks (compared with no drinks) of beer. There was no association between the likelihood of binge drinking and Hispanic national group. Beverage preference across Hispanic national groups is similar. Beer is the preferred beverage. Alcohol control policies such as taxation and control of sales availability should apply equally to beer, liquor, and wine. Prevention interventions directed at different Hispanic national groups in the United States can be relatively uniform in their focus on the dangers associated with drinking different types of alcoholic beverages.

Cohen JE; Anglin L. Outlet density: A new frontier for tobacco control. (editorial). Addiction 104(1): 2-3, 2009. (19 refs.)

Commission of the European Communities. An EU Strategy to Support Member States in Reducing Alcohol Related Harm. Communication for the Commission to the Council, the European Parliament, the European Economic and Social Committee and the Committee of the Regions. Brussels: Commission of the European Communitites, 2006. (0 refs.)

In 2001, the Council requested a comprehensive strategy to reduce alcohol-related harm in Europe. This report represents a response to that request. Following an introduction the report sets forth a mandate for action, followed by a case for action. The process of consultation and assessment used in creating these recommendations is then described. This is followed by a description of the five priority themes and the relevant good practices to underpin the implementation. The first of these is Protection of young people, children and the unborn child. The specific aims for accomplishing this are Aim 1: To curb under-age drinking, reduce hazardous and harmful drinking among young people. Aim 2: To reduce the harm suffered by children in families with alcohol problems. Aim 3: To reduce exposure to alcohol during pregnancy, thereby reducing the number of children born with Foetal Alcohol Disorders. The rationale for action is that young people are often unfairly depicted as the perpetrators of alcohol problems rather than the victims. Alcohol is estimated to be a causal factor in 16% of cases of child abuse and neglect. Harmful alcohol consumption among young people has been shown to have a negative impact not only on health and social wellbeing, but also on educational attainment. . There is an increasing trend of �binge-drinking� by young people in many parts of the EU. This is exacerbated by the continued availability of alcoholic beverages to under-age consumers. The Second Theme is to reduce injuries and deaths from alcohol-related road traffic accidents. Aim 4: To contribute to reducing alcohol-related road fatalities and injuries. In setting forth the rationale it is noted that approximately one accident in four can be linked to alcohol consumption, and at least 10,000 people are killed in alcohol-related road accidents in the EU each year. Young people aged 18 to 24 are particularly in danger of having an accident. 35% to 45% of fatalities of this age group are due to traffic accidents. For young people, traffic accidents are the most common cause of death (47% ). For drink-driving accidents, two thirds of the people involved were between 15 and 34 years, and 96% were male. The Third Theme is the prevention of alcohol-related harm among adults and reduce the negative impact on. the workplace. The related aims are Aim 5: To decrease alcohol-related chronic physical and mental disorders; Aim 6: To decrease the number of alcohol related deaths.; Aim 7: To provide information to consumers to make informed choices; Aim 8: To contribute to the reduction of alcohol-related harm at the workplace, and promote workplace related actions. The rationale is that while 85% of adult individuals consume alcohol in a moderate and responsible manner, most of the time, harmful and hazardous alcohol consumption is one of the main causes of premature death and avoidable disease and furthermore has a negative impact on working capacity. While 266 million adults drink alcohol up to 20g (women) or 40g (men) per day, over 58 million adults (15%) consume above this level, with 20 million of these (6%) drinking at over 40g (women) or 60g per day (men). Looking at addiction rather than drinking levels, it is also estimated that 23 million Europeans (5% of men, 1% of women) are dependent on alcohol in any one year. The Fourth Theme is to inform, educate and raise awareness on the impact of harmful and hazardous alcohol consumption, and on appropriate consumption patterns, incorporated in Aim 9. The Fifth Theme is to develop, support and maintain a common evidence base. Aim 10: To obtain comparable information on alcohol consumption, especially on young people; definitions on harmful and hazardous consumption, on drinking patterns, on the social and health effects of alcohol; and information on the impact of alcohol policy measures and of alcohol consumption on productivity and economic development. Aim 11: To evaluate the impact of initiatives taken on the basis of this Communication.

Cook PJ. Pricing and taxation of alcohol: What is the 'right' tax rate? Comment on chapter 6: Pricing and taxation. (editorial). Addiction 98(10): 1356-1357, 2003. (6 refs.)

This is a commentary on a chapter in the WHO Report "Alcohol: No ordinary commodity by T Babor T; R Cantano; S Casswell; G Edwards ; N Giesbrecht, et al, 2003.

Cook PJ; Reuter P. When is alcohol just another drug? Some thoughts on research and policy - Response to comments. Addiction 102(8): 1192-1193, 2007. (7 refs.)

Cook PJ; Reuter P. When is alcohol just another drug? Some thoughts on research and policy. Addiction 102(8): 1183-1188, 2007. (29 refs.)

Aim: To reflect on the divergence and overlap between alcohol and illicit drugs with respect to both current policies and policy research. Results: For demand reduction, there is considerable overlap in programs and services for prevention and even more clearly for treatment. For supply controls there is mostly divergence, reflecting the difference in legal status. Research generally follows the same pattern. However, a cross-cutting research agenda on the supply side has merit. Conclusion: Even in a prohibition regime, law-enforcement agencies have considerable discretion. A systematic, pragmatic, 'evidence-based' use of that discretion to reduce harm is possible. It can be accomplished only by a continuing program of policy research that measures the harms of drug use and drug enforcement, assesses the effects of current policies on both these sources of social cost and explores alternative strategies. There is a similarly important project for alcohol and tobacco control policy. The goal for research on alcohol and tobacco is to document the extent to which supply controls can be effective in reducing harm; the additional goal for illicit drugs is to document just how much the current ideologically driven approach is costing the public.

Dakota County Public Health Department. Reducing Underage Alcohol Use in Dakota County: 2002 Progress Report. West St. Paul, MN: Dakota County Public Health Department, 2003. (0 refs.)

The purpose of the 2002 Progress Report on Youth Access to Alcohol in Dakota county is to provide an update on alcohol compliance checks conducted by local law enforcement agencies in Dakota County in 2002. The Public Health Department had adopted the following goals for 2002: (1) reduce illegal alcohol sales to underage youth; (2) Increase the number of cities that conduct at least one compliance check per licensed establishment; (3) Increase the number of local law enforcement agencies that complete the standardized data collection forms.; (4) Improve data collection on penalties imposed when there is an illegal sale. It was found that in 2002, 12% of the alcohol compliance checks conducted in Dakota Country resulted in an illegal sale. This rate is slightly higher than the prior year's 9% rate, but lower than the overall rate for the state estimated to be in the range of 15-18%. In respect to meeting other goals, there was an increase in the number of communities that conducted licensees at least once, as well as several additional towns that began to use the standardized data collection forms. Due to issues related to liquor licensing in Minnesota, limited progress was made on Goal 4.

Public Domain

de Bruijn A. No reason for optimism: The expected impact of commitments in the European Commission's Alcohol and Health Forum. (editorial). Addiction 103(10): 1588-1592, 2008. (17 refs.)

Background: Europe is the heaviest-drinking region in the world, more than 2.5 times the rest of the world's average. The Commission's conclusion: The cornerstone for the European Commission's action to decrease the alcohol-related harm of this consumption and the main emphasis for its work is the Alcohol and Health Forum, with its Task Forces on Marketing Communication and Youth-Specific Aspects of Alcohol. The Forum, which was launched in June 2007, aims to provide a common platform for all interested stakeholders. Forum members are invited to make commitments to reduce alcohol-related harm, in the form of a monitored and evaluated action plan. By 29 February 2008, 79 commitments have been provided by the members of the Forum. Appraisal of the initiative Taking into account the limited information available, the proposed commitments indicate few evidence-based approaches. A large majority of the summaries do not, or only slightly, address the relevance of their commitment and give no evidence of why their proposed action is important in reducing alcohol-related harm. Even fewer commitments mention indicators of effectiveness of the proposed actions or propose to evaluate the effectiveness of the proposed actions. Conclusion: While most economic operators in the Forum have resources to undertake actions which could be highly effective, they commit principally to educational programmes which have been found to be mainly ineffective. This, and the neglect of existing legislation, do not give reason for optimism on the impact of the proposed commitments.

Donnelly N; Briscoe S. Signs of intoxication and server intervention among 18-39-year-olds drinking at licensed premises in New South Wales, Australia. Addiction 98(9): 1287-1296, 2003. (30 refs.)

Aims: To estimate the extent of responsible service of alcohol (RSA) practice to young adults showing signs of alcohol intoxication on licensed premises in New South Wales. Design: Telephone-based cross-sectional survey. Setting: New South Wales, Australia. Participants A total of 1090 people aged 18-39 years old. Findings: Seventy-five per cent of males and 64% of females reported that they had consumed at levels for acute alcohol-related harm during the previous 12 months, with 34% of males and 24% of females reporting doing so weekly; 54% (95% CI: 51-58%) of both males and females who had consumed at acute-risk levels, reported that this last drinking occasion occurred at a licensed premises. Of these, 56% (95% CI: 51-61%) reported that they had exhibited at least one sign of overt alcohol intoxication, while 19% (95% CI: 15-23%) reported showing three or more signs of intoxication. Among those reporting at least one sign of intoxication, only 10% (95% CI: 7-15%) reported that the licensed premises staff had provided at least one of seven different responsible service initiatives, while 55% (95% CI: 48-61%) reported that they were continued to be served alcohol. While these results suggest that intoxicated patrons are not being refused service as often as they should, there was evidence for some degree of responsible service provision with around half of the 'non-intoxicated' patrons reporting that they had seen licensed premises staff intervene in some way with other 'intoxicated' patrons. Conclusions: While the majority of 18-39-year-olds report showing signs of intoxication while drinking at licensed premises in NSW, only a small minority report experiencing RSA initiatives from bar staff in response to these signs.

Donovan K; Donovan R; Howat P; Weller N. Magazine alcohol advertising compliance with the Australian Alcoholic Beverages Advertising Code. Drug and Alcohol Review 26(1): 73-81, 2007. (38 refs.)

The purpose of this study was to assess the frequency and content of alcoholic beverage advertisements and sales promotions in magazines popular with adolescents and young people in Australia, and assess the extent to which the ads complied with Australia's self-regulatory Alcoholic Beverages Advertising Code (ABAC). Alcohol advertisements and promotions were identified in a sample of 93 magazines popular with young people. The identified items were coded against 28 measures constructed to assess the content of the items against the five sections of the ABAC. Two thirds of the magazines contained at least one alcohol advertisement or promotion with a total of 142 unique items identified: 80 were brand advertisements and 62 were other types of promotional items (i.e. sales promotions, event sponsorships, cross promotions with other marketers and advertorials). It was found that 52% of items appeared to contravene at least one section of the ABAC. The two major apparent breaches related to section B-the items having a strong appeal to adolescents (34%) and to section C-promoting positive social, sexual and psychological expectancies of consumption (28%). It was also found that promotional items appeared to breach the ABAC as often as did advertisements. It is concluded that the self-regulating system appears not to be working for the alcoholic beverages industry in Australia and that increased government surveillance and regulation should be considered, giving particular emphasis to the inclusion of promotional items other than brand advertising.

Edwards G; West R; Babor TF; Hall W; Marsden J. An invitation to an alcohol industry lobby to help decide public funding of alcohol research and professional training: A decision that should be reversed. (editorial). Addiction 99(10): 1235-1236, 2004. (5 refs.)

Evans-Whipp T; Beyers JM; Lloyd S; Lafazia AN; Toumbourou JW; Arthur MW; Catalano RF. A review of school drug policies and their impact on youth substance use. (review). Health Promotion International 19(2): 227-234, 2004. (49 refs.)

Youth substance use is an important social and health problem in the United States, Australia and other Western nations. Schools are recognized as important sites for prevention efforts and school substance use policies are a key component of health promotion in schools. The first part of this paper reviews the known status of school policies on tobacco, alcohol and other illicit drugs in a number of Western countries and the existing evidence for the effectiveness of school drug policy in preventing drug use. The review shows that most schools in developed countries have substance use policies but that there is substantial variation in the comprehensiveness of these policies (i.e. the breadth of people, places and times of day that are explicitly subject to policy prohibitions), and the orientation of their enforcement (e.g. punitive versus remedial), both across and within schools. The few studies of policy impact focus solely on tobacco policy and provide preliminary evidence that more comprehensive and strictly enforced school policies are associated with less smoking. The second part of the paper introduces the International Youth Development Study, a new longitudinal research project aimed at comparing school policies and the developmental course of youth drug use in the United States, where drug policies are abstinence-based, with Australia, which has adopted a harm minimization approach to drug policy.

Federal Trade Commission; Evans JM; Dash JF; Blickman N; Peeler CL; Engle MK et al. Alcohol Marketing and Advertising: A Report to Congress. Washington DC: Federal Trade Commission, 2003. (79 refs.)

This report sets forth findings of the Federal Trade Commission (FTC) in response to a request from conferees of the House and Senate Appropriations Committees to study the impact on underage consumers of ads for new flavored malt beverages (FMB), and whether the alcoholic beverage industry has implemented recommendations contained in the FTC's 1999 report to Congress regarding alcohol industry self-regulation. The FTC's investigation indicates that adults appear to be the intended target of FMB marketing, and that the products have established a niche in the adult market. The investigation found no evidence of targeting underage consumers in the FMB market. FMB marketers placed ads in conformance with the industry standard that at least 50% of the ad's audience consists of adults aged 21 or older. Nevertheless, the 50% placement standard in effect in 2001 and 2002 permitted the ads to reach a substantial youth audience. Although it is likely that some teens drink FMBs, teen drinking continued to decline during the period when these beverages were being aggressively marketed. Self-regulation practices in the alcohol industry have shown improvement since the FTC's 1999 report. The largest improvements have occurred in the area of ad placement, with surveyed companies achieving 99% compliance with the 50% adult audience standard in 2002. The industry now has committed to a 70% placement standard and post-placement audits. The study also revealed added industry attention to the issue of ad content that may appeal to minors.

Fell JC; Ferguson SA; Williams AF; Fields M. Why are sobriety checkpoints not widely adopted as an enforcement strategy in the United States? Accident Analysis and Prevention 35(6): 897-902, 2003. (19 refs.)

Sobriety checkpoints have been used by police in the United States for at least the past two decades to enforce impaired driving laws. Research has indicated that sobriety checkpoints are effective in reducing drinking and driving and alcohol-related fatal crashes. Despite this evidence, many police agencies have been unenthusiastic about using checkpoints. Information was collected from all 50 states plus the District of Columbia on the use of sobriety checkpoints. A total of 37 states and the District of Columbia reported conducting sobriety checkpoints at least once or twice during the year. Only 11 states reported that checkpoints were conducted on a weekly basis. Thirteen states do not conduct checkpoints either because of legal or policy issues. More detailed information was collected from five states that conduct checkpoints frequently and matched with information from five similar states that conduct checkpoints infrequently. States with frequent checkpoint programs had several common features such as program themes, support from task forces and citizen activist groups, use of a moderate number of police at the checkpoints, and use of all available funding mechanisms (federal, state, local) to support them. States with infrequent checkpoints claimed a lack of funding and police resources for not conducting more checkpoints, preferred saturation patrols over checkpoints because they were more "productive," and used large numbers of police officers at checkpoints. Ways to overcome perceived barriers to checkpoint use are discussed.

Ferrence R. Learning from tobacco: Bans on commercial availability are not unthinkable. (editorial). Addiction 98(6): 720-721, 2003. (1 refs.)

Fulkerson JA. Blow and go: The Breath-Analyzed Ignition Interlock Device as a technological response to DWI. American Journal of Drug and Alcohol Abuse 12(2): 219-235, 2003. (19 refs.)

Suggests that rates of driving while intoxicated have declined substantially in the last 20 yrs as a result of public opinion combined with increased law enforcement efforts. A recent tool has been the Breath Analyzed Ignition Interlock Device. This new technology is designed to prevent persons with excessive blood alcohol levels from operating the interlocked vehicle. This 3-yr recidivism study of the ignition interlock revealed 17.5% recidivism rates for the interlock group compared to 25.3% recidivism rates for the non-interlock group, a 31% decrease. Multiple offenders and younger (under 30) offenders had significantly lower rates of subsequent arrests. The multi-offenders in the comparison group were more than twice as likely as the interlock group to have a subsequent conviction within 3 yrs. The difference was nearly the same for the under 30 age group. There was almost no difference for first offenders. Accordingly, the ignition interlock appears to significantly reduce recidivism for repeat and younger DWI offenders but offers almost no improvement for first offenders. One driver of 315 (0.32%) was charged with DWI with an interlock in place. This offender had a child provide the breath sample while she drove the vehicle.

Gary SLS; Aultman-Hall L; McCourt M; Stamatiadis N. Consideration of driver home county prohibition and alcohol-related vehicle crashes. Accident Analysis and Prevention 35(5): 641-648, 2003. (9 refs.)

This study examines the characteristics of alcohol-related crashes in wet versus dry counties in the state of Kentucky, USA and incorporates the location of driver residences through use of geographic information system (GIS) analysis. Between 1991 and 1997, 39,344 alcohol-related crashes by Kentucky residents on Kentucky State roads were reported. The location of the crash and the home ZIP code from the driver's address were used to consider distance from home in the GIS. Analysis of the crash data revealed that a similar proportion of crashes in wet and dry counties are alcohol-related but that a higher proportion of dry counties residents are involved in an alcohol-related crash. However, when the distance from home variable is considered, several results suggest that dry county residents may be driving further when consuming alcohol. In part due to the rural nature of dry counties, drivers from dry counties have both alcohol-related and non-alcohol related crashes farther from their homes than residents from wet counties. Alcohol-related crashes by dry county residents in wet counties are the greatest average distance from home while crashes by wet county residents in wet counties are the smallest average distance. Drivers from dry counties over 21 years of age have alcohol-related crashes significantly farther from home than those under 21 who would not legally be admitted to drinking establishments in the wet counties. Furthermore, residents from dry counties that do not border wet counties have alcohol-related crashes on average farther from home than the border county residents. These last three results provide circumstantial evidence that some dry county drivers may be driving to wet counties to consume alcohol thus increasing impaired driving exposure. In conclusion, by considering crash location and driver residence, these findings indicate that county-level prohibition is not necessarily effective in improving highway safety.

Gliksman L; Rylett M; Douglas RR. Aboriginal community alcohol harm reduction policy (ACAHRP) project: A vision for the future. Substance Use & Misuse 42(12-13): 1851-1866, 2007. (31 refs.)

Four First Nation communities in Ontario, Canada, formulated alcohol management policies between 1992 and 1994. An alcohol management policy is a local control option to manage alcohol use in recreation and leisure areas. Survey results indicate that decreases in alcohol use-related problems related to intoxication, nuisance behaviors, criminal activity, liquor license violations, and personal harm were perceived to have occurred. Furthermore, having policy regulations in place did not have an adverse effect on facility rentals. Bond administrators and facility staff in each community felt the policy had had a positive effect on events at which alcohol was sold or served.

Grant M. The rush to regulate: Commentary on the EU report by Peter Anderson. (editorial). Drugs: Education, Prevention and Policy 13(6): 489-492, 2006. (16 refs.)

The article comments on the report "Alcohol in Europe" prepared by Peter Anderson for the European Union. The author mentions that the conclusions and recommendations of the report focus entirely upon strengthening government regulation and the need for research and advocacy to increased regulation, which he thinks seems at odds with current practice at the inter-government level, both globally and regionally in Europe.

Greenaway J. Agendas, venues and alliances: New opportunities for the alcohol control movement in England. Drugs: Education, Prevention and Policy 15(5): 487-501, 2008. (35 refs.)

Alcohol issues and problems are once again being given a high political and media profile in Britain. However, the tendency of the alcohol control lobby to adopt a rationalist approach and to over rely on the persuasive powers of science may jeopardize policy initiatives. The political system of Britain today is inherently flexible and the way in which scientific knowledge and evidence is translated via the media and by political intermediaries is important. It is suggested that both cultural change and policy shifts can come about if attention is paid to both the venue and the discourse in which alcohol issues are debated, allowing new alliances to flourish.

Greenberg MD; Morral AR; Jain AK. Drink-driving and DUI recidivists' attitudes and beliefs: A longitudinal analysis. Journal of Studies on Alcohol 66(5): 640-647, 2005. (33 refs.)

Objective: Cross-sectional survey research has shown correlations between drink-driving behavior and people's beliefs concerning the riskiness, social acceptability and morality of driving under the influence of alcohol. The current study examines the association between such beliefs and subsequent alcohol-impaired driving in a sample of offenders who were driving under the influence (DUI). Method: Repeated inter-views were conducted with 182 multiple DUI offenders. Baseline data included measures of moral and prescriptive beliefs concerning alcohol-impaired driving (internal behavioral controls), perceived risks of criminal punishment and crashes associated with alcohol-impaired driving (external behavioral controls) and perceived peer-group attitudes toward alcohol-impaired driving (social control). The dependent variable in the study was a measure of self-reported alcohol-impaired driving over the preceding 2 years, collected at 2-year follow-up from baseline. Results: Results from multiple regression modeling showed significant protective effects associated with the beliefs that driving after drinking is immoral and that random police sobriety checks are a good idea (internal control items). Results also showed that a social desirability control measure was predictive of increased risk, at follow-up, for driving after drinking. Conclusions: These results suggest that internal controls may protect against alcohol-impaired driving behavior, even in a high-risk sample of repeat DUI offenders. The results also suggest that future policy interventions to curtail drink-driving might profitably be designed to promote these sorts of behavioral controls.

Grube JW; Nygaard P. Alcohol policy and youth drinking: Overview of effective interventions for young people. IN: Stockwell T; Gruenewald PJ; Toumbourou JW; Loxley W, eds. Preventing Harmful Substance Use: The Evidence Base for Policy and Practice. New York: John Wiley & Sons, Ltd, 2005. pp. 113-127. (45 refs.)

Alcohol policy refers to (1) formal legal and regulatory mechanisms, rules, and procedures for reducing the consumption of alcohol or risky drinking behaviors; and (2) enforcement of these measures. Policy approaches to preventing and reducing drinking and drinking problems among youth have traditionally focused on limiting access to alcohol or on direct deterrence of young drinkers or those who supply alcohol to them. The aim of such policies is to increase the "full price" of alcohol to young people by increasing resources necessary for them to obtain it or the potential costs for possessing or consuming it. More recently, policies have begun to focus on harm reduction. Harm reduction policies attempt to prevent or reduce alcohol problems by targeting heavy drinking, drinking in risky situations, or by moderating the relationship between drinking and problem outcomes, without necessarily affecting overall consumption. Based on the available evidence, the most effective policies appear to be: (1) taxation or price increases; (2) increases in the minimum drinking age; (3) zero tolerance; and (4) graduated licensing. Random breath testing, sobriety check points, and dram shop liability appear promising for reducing drinking and drinking problems based on studies with the general population, although there is less evidence for their effectiveness specifically with young people. The evidence is growing for the effects of license restrictions (e.g., limiting outlet density or hours of sale). There is some support for responsible beverage service programs, particularly those that are mandated or motivated by reduction of liability. The evidence on advertising restrictions is conflicting. Evidence that designated driver and safe rides programs, warning labels, social host liability, and keg registration are effective strategies for preventing drinking or drinking problems among young people is lacking. Overall, there is insufficient research to evaluate the effects of many alcohol policies on alcohol consumption or problems among young people. Such research should be conducted to inform policy and evaluate policies as they are implemented. Finally, it is clear from the available research that policies cannot be effective unless accompanied by enforcement and by awareness on the part of the intended targets of the policy and enforcement efforts.

Gruenewald PJ; Ponicki WR; Holder HD; Romelsjo A. Alcohol prices, beverage quality, and the demand for alcohol: Quality substitutions and price elasticities. Alcoholism: Clinical and Experimental Research 30(1): 96-105, 2006. (27 refs.)

Background: Although the published literature on alcohol beverage taxes, prices, sales, and related problems treats alcoholic beverages as a simple good, alcohol is a complex good composed of different beverage types (i.e., beer, wine, and spirits) and quality brands (e.g., high-, medium-, and low-quality beers). As a complex good, consumers may make substitutions between purchases of different beverage types and brands in response to price increases. For this reason, the availability of a broad range of beverage prices provides opportunities for consumers to mitigate the effects of average price increases through quality substitutions; a change in beverage choice in response to price increases to maintain consumption. Methods: Using Swedish price and sales data provided by Systembolaget for the years 1984 through 1994, this study assessed the relationships between alcohol beverage prices, beverage quality, and alcohol sales. The study examined price effects on alcohol consumption using seemingly unrelated regression equations to model the impacts of price increases within 9 empirically defined quality classes across beverage types. The models enabled statistical assessments of both own-price and cross-price effects between types and classes. Results: The results of these analyses showed that consumers respond to price increases by altering their total consumption and by varying their brand choices. Significant reductions in sales were observed in response to price increases, but these effects were mitigated by significant substitutions between quality classes. Conclusions: The findings suggest that the net impacts of purposeful price policy to reduce consumption will depend on how such policies affect the range of prices across beverage brands.

Gual A. Who is responsible for irresponsible drinking? (commentary). Addiction 99(11): 1376, 2004. (3 refs.)

This is a commentary on an article in this issue ( An addiction agency's collaboration with the industry: Moo Joose as a case study Addiction, 99, 1370-1374) on the relationship of alcohol beverage industry and policy groups.

Harwood EM; Bernat DH; Lenk KM; Vazquez MJ; Wagenaar AC. Public opinion in Puerto Rico on alcohol control policies. Hispanic Journal of Behavioral Sciences 26(4): 426-445, 2004. (52 refs.)

This article discusses the first study to assess public opinion of alcohol policies in Puerto Rico. In 2001, a telephone survey of 514 adults on the island assessed levels of support for 20 alcohol control policies covering five domains: (a) raising alcohol taxes, (b) restricting alcohol consumption in public places, (c) punishing adult providers of alcohol, (d) restricting youth access to alcohol, and (e) restricting marketing of alcohol. Results show high-level support for all alcohol policies, especially for restrictions on alcohol consumption in public places (93% to 95% support) and increases in alcohol taxes earmarked for alcohol treatment, prevention, and education (92% support). Multiple regression analyses reveal older respondents, compared to younger respondents, and respondents reporting lower levels of alcohol consumption were more supportive of alcohol control policies. Results demonstrate a willingness in Puerto Rico to consider public policy solutions to social and health problems associated with drinking.

Heeb JL; Gmel G; Zurbrugg C; Kuo M; Rehm J. Changes in alcohol consumption following a reduction in the price of spirits: A natural experiment in Switzerland. Addiction 98(10): 1433-1446, 2003. (84 refs.)

Aims: To discover what changes in alcohol consumption had occurred in subgroups defined by age, sex, volume of drinking and drinking occasions, following a reduction in the price of spirits in Switzerland in July 1999.Design Quasi-experimental. Longitudinal general-population survey with baseline 3 months before and follow-up 3 months after price change. Participants Probabilistic telephone sample of 1347 individuals with at least monthly consumption on average in the previous 6 months at both interviews, The response rate at baseline was 74.8% and the attrition rate from baseline to follow-up 20.2%,Measurements Alcohol consumption was assessed by means of a beverage-specific graduated-frequency measure. High volume of drinking was defined as 40 + g/day for men and 20 + g/day for women. Binge drinking was defined as six + drinks on an occasion for men and four + drinks for women. Findings Spirits consumption increased significantly (by 28.6%) in the total sample, and specifically in young males and in individuals who were low-volume drinkers at baseline. Consumption of alcohol overall, or of wine or beer. did not change significantly. No indication of effects of substitution was found. Conclusions: Spirits consumption showed price-responsiveness in the early post-intervention period. This finding is of particular interest, as (a) the increase in spirits consumption took place at a time of generally declining consumption of alcohol in Switzerland: and (b) in contrast to the findings of most studies, the intervention, namely price reduction, increased availability.

Higuchi S; Matsushita S; Maesato H; Osaki Y. Japan: Alcohol today. (review). Addiction 102(12): 1849-1862, 2007. (86 refs.)

Aims: The purpose of this paper is to outline alcohol availability, alcohol consumption and related harm, alcohol control policy and prevention programmes in Japan, few of which have been discussed in either the Japanese or English literature. Methods: Data were collected primarily from the following two sources: statistics and survey results issued by the national government, including surveys funded by the government; and papers published since 2000, identified by searching the MEDLINE and Igaku-Chuo-Zasshi databases. These data were assessed regarding their quality and summarized. Some data presented here were produced specifically for this review. Results: Although per capita alcohol consumption has tended to decline for more than 10 years, it has remained at a high level. Diversification of the drinking population has progressed rapidly, specifically in women, among whom alcohol consumption has increased sharply. Cross-sectional data suggest that alcohol consumption is associated with serious health and social consequences. Existing longitudinal data suggest that alcohol-related problems, especially health problems, have increased steadily over the past several decades, with few exceptions, including alcohol-related fatal road traffic accidents. Alcohol policy and prevention programmes have not developed to a level that can control these problems adequately. Specifically, the high availability of alcoholic beverages, including the lack of restrictions on sales and advertising and decreasing prices, are noted. Conclusions This review provides basic information regarding alcohol availability and alcohol consumption and related harm that may facilitate the improvement of existing alcohol control measures in Japan and encourage the development of new alcohol control measures. This research revealed the scarcity of longitudinal data regarding alcohol consumption and its consequences, and the lack of several important variables, such as disability adjusted life years, for improving our understanding of the comprehensive status of alcohol in Japan.

Hirschfeld LM; Edwardson KL; McGovern MP. A systematic analysis of college substance use policies. Journal of American College Health 54(3): 169-176, 2005. (9 refs.)

College substance use policies provide guidelines for student behavior and influence campus culture. Although they are the primary environmental strategy to address campus substance use, policies have not been systematically compared and studied. We constructed a systematic review method to examine the accessibility, comprehensiveness, enforcement procedures, and clarity of college substance use policies. We developed an objective evaluation scheme for each of these 4 dimensions and then applied it to documented substance use policies from a sample of colleges and universities (N = 24). Policies were found to vary considerably but tended to specify compliance with local laws and emphasize student health and well-being. The next stage of campus policy review should examine actual implementation, evaluate potential differentiating factors among institutions, and assess the influence of policy on campus climate and student outcomes.

Holder HD. Alcohol and the Community: A Systems Approach to Prevention. Cambridge: Cambridge University Press, 2006

An individual's decision to use alcohol and the frequency, quantity and situation in which drinking takes place are the result of a combination of biological and social factors. Drinking is not only a personal choice, but also a matter of custom and social behaviour, and is influenced by access and economic factors including levels of disposable income and cost of alcoholic beverages. Until prevention efforts cease to focus narrowly on the individual and begin to adopt broader community perspectives on alcohol problems and strategies to reduce them, these efforts will fail. The author challenges the current implicit models used in alcohol problem prevention and demonstrates an ecological perspective of the community as a complex adaptive system composed of interacting subsystems, an appreciation and understanding of which offers a new approach to the prevention of alcohol dependence and alcohol-related problems. The book is organized into 8 chapters. following an introduction, the author begins the discussion a discussion of the patterns of consumption and influences on consumption patterns. Attention then turns to what are considered different subsystems influencing consumption, each a subject of an individual chapter. These include retail sales, and the role of alcohol availability and promotion; formal regulations, including rules, their administration and enforcement; social norms, and community values that influence drinking patterns; legal sanction that are involved in the prohbition of drinking; and the social/economic/health consequences as they are recognized by the community. The concluding chapter addresses the need for and community level approaches to alcohol problems.

Holder HD. Community prevention of young adult drinking and associated problems. Alcohol Research & Health 28(4): 245-249, 2004. (21 refs.)

This article briefly summarizes three evidence-based community intervention trials sponsored by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Designed to reduce alcohol use among youth and young adults, these trials demonstrate the potency of community interventions that can influence the price, availability, drinking context, and perceived risks of heavy drinking among young people. The effectiveness of comprehensive, research-based local prevention efforts is confirmed by research examining other programs to reduce alcohol sales to youth as well as the harm caused by alcohol use among youth and young adults, including alcohol-related traffic accidents and assaults. By restructuring the total alcohol environment in a way that can be self-sustaining, these interventions are more likely to be effective than one-time interventions.

Public Domain

Horlings E; Scoggins A. An Ex Ante Assessment of the Economic Impacts of Economic Impacts of EU Alcohol Policies. Technical Report. Leiden, The Netherlans: RAND Corporation, 2006. (69 refs.)

This report was commissioned by the European Commission, as one of the background papers preparatory to creating a comprehensive alcohol policy for the European Union. This paper deals with an assessment of the current macroeconomic impacts of alcohol use and likely impacts of various policy options. It begins with an examination of the nature and extent of the problems posed by alcohol use. It then reviews how alcohol use is linked in macroeconomic development. The results of that analysis are used to review four policy options. The report concludes with a chapter that examines economic indicators that could be used to evaluate specific policy objectives. The report then draws conclusions and provides recommendations. For each of six policy objectives (related to drink driving, under-age drinking, hazardous and harmful drinking, families & children, violence, and economic development) each of multiple approaches are rated on a scale from 1-4 in terms of effectiveness. The same goals and means are then assessed in terms of cost-effectiveness. The report examines multiple themes in an elegant and useful fashion. There are 28 tables and 21 figures.

Ivy JD. No Saloon in the Valley: The Southern Strategy of Texas Prohibitionists in the 1880s. Waco TX: Baylor University Press, 2003

The author of this book integrates multiple disciplines -- frontier history, southern culture, and national politics -- to examine social strategies that fueled the Texas alcohol prohibition movement in the 1880s. He contends that Texas prohibitionists, predominantly Baptists who were aligned with the beginnings of a statewide organization, developed a southern strategy that characterized prohibition as a reform with southern roots in Texas. To appeal to male voters anxious about their role in post-Reconstruction southern society, the Texas prohibitionists overtly distanced themselves from northern evangelical reformers ("long-haired men and short-haired women") who had been champions of the abolition of slavery, religious radicalism, or feminism. Although this strategy won the support of the majority of white males with close ties to the former Confederacy, it failed to persuade a majority of Texas voters to embrace prohibition. In the election of 1887, final returns on a ballot measure to amend the state constitution to impose alcohol prohibition gave the prohibitionists fewer than 130,000 votes out of nearly 350,000 cast.

Public Domain

Jackson KM; Sher KJ; Park A. Drinking among college students: consumption and consequences. IN: Galanter M, ed. Recent Developments in Alcoholism, Volume 17. Alcohol Problems in Adolescents and Young Adults: Epidemiology, Neurobiology, Prevention, Treatment. New York: Kluwer Academic/Plenum Press, 2005. pp. 85-118. (49 refs.)

This chapter considers college drinking. It begins with a comparison of college students to age peers who are not in college. Data on the patterns of drinking among college students is presented, along with the prevalence of associated problems � academic difficulties, driving, violence, and alcohol use disorders. There is also discussion of individual factors that predict drinking: gender, race, family history of alcoholism, personality, drinking motives and expectancies, There is also a summary of inter-campus and intra-campus factors that influence drinking. These include college residence, the presence of the Greek system, and athletics. The chapter concludes with a discussion of the long-term consequences of college drinking.

Kerr-Correa F; Hegedus AM; Sanches AF; Trinca LA; Kerr-Pontes LRS; Tucci AM. Differences in drinking patterns between men and women in Brazil. IN: Obot IS; Room R, eds. Alcohol, Gender and Drinking Problems: Perspectives from Low and Middle Income Countries. Geneva: World Health Organization, 2005. pp. 49-68. (73 refs.)

There is very relatively little data on alcohol/drug use in Brazil. There is an extremely tolerant attitude toward alcohol consumption. Federal law that regulated alcohol advertising allows beverages with alcohol content lower than 13% to be considered food. Therefore beer an be advertised in prime TV slots and targeted at teenagers. The general population essentially views beer as almost a soft drink. The most popular alcoholic beverage is "cachaca" or "pinga" a distiller beverage, with a 40% alcohol content. It accounts for 80% of all distilled beverages consumed. Minimum drinking age are largely unenforced. There are no laws controlling operating hours for bars, regulate licenses or limit where alcohol can be bought. The BAC for driving is 0.06%, but there are not enough devices or police to enforce it. While little enforced a law in the city of Sao Paulo had banned sales in commercial facilities near state highways, it still has had an impact on driving and drinking. In addition there are no health warning labels or sponsorship restrictions. A summary of the data from the GENACIS study are provided. Among the highlights is that abstinence in all age groups is high, about 45% for both men and women.. The significant difference between genders is that men are four times as likely than women to be heavy drinkers, and women are twice as likely as men to be infrequent light drinkers. Employed women had drinking patterns more closely resembling that of men. Drinking alone was the only predictor of heavy drinking among women.

Kisely S. Applying the lessons of tobacco and alcohol control to cannabis. (editorial). Canadian Journal of Psychiatry 53(12): 799-799, 2008. (5 refs.)

Knight JR; Harris SK; Sherritt L; Kelley K; Van Hook S; Wechsler H. Heavy drinking and alcohol policy enforcement in a statewide public college system. Journal of Studies on Alcohol 64(5): 696-703, 2003. (19 refs.)

Objective: To assess the association between heavy drinking and alcohol policy enforcement following the institution of a new system-wide alcohol policy at Massachusetts public colleges and universities. Method: Students (N = 1,252; 59% women) at 11 study schools completed a questionnaire that assessed drinking behaviors and alcohol-associated problems. College deans and campus security officers completed questionnaires assessing policy implementation and enforcement. We compared heavy drinking rates among the 11 schools and measured the association between schools' heavy episodic drinking rates and enforcement index scores based on deans' and security officers' reports of policy enforcement. Results: Rates of heavy episodic drinking varied widely among the 11 schools (range: 36%-71%). The percentage of students reporting strict/very strict policy enforcement also varied widely (35%-90%). In this small sample of colleges, heavy drinking rates among students living on campus tended to be negatively associated with stricter alcohol policy enforcement reports by security officers (Pearson's r = -0.64, p < .05) and the association appeared to be linear. Heavy drinking was not associated with enforcement reports by deans (Pearson's r = 0.17, p = NS). Conclusions: Within this single state system, stricter enforcement by campus security officers of policies that limit underage drinking tends to be associated with lower rates of heavy drinking by students.

Kraus L; Muller S; Pabst A. Alcohol control policy. review (German). Suchttherapie 9(3): 103-110, 2008. (101 refs.)

Objective: To effectively prevent alcohol-related acute and social problems as well as morbidity and mortality, an evidence-based alcohol control policy is needed. This paper discusses the options, policies and the implementation of alcohol control policies in Germany. Results: Evaluation of the effectiveness of alcohol control policies and their implementation shows that an evidence-based alcohol control policy is possible in Germany. Structural measures reducing the availability and demand for alcohol have proven to be the most effective. Conclusion: In the course of ail evidence-based alcohol control policy the adoption and implementation of structural alcohol policies should be prioritized.

Krevor B; Capitman JA; Oblak L; Cannon JB; Ruwe M. Preventing illegal tobacco and alcohol sales to minors through electronic age-verification devices: A field effectiveness study. Journal of Public Health Policy 24(3-4): 251-268, 2003. (24 refs.)

Efforts to prohibit the sales of tobacco and alcohol products to minors are widespread. Electronic Age Verification (EAV) devices are one possible means to improve compliance with sales to minors laws. The purpose of this study was to evaluate the implementation and effectiveness of EAV devices in terms of the frequency and accuracy of age verification, as well as to examine the impact of EAV's on the retailer environment. Two study locations were selected: Tallahassee, Florida and Iowa City, Iowa. Retail stores were invited to participate in the study, producing a self-selected experimental group. Stores that did not elect to test the EAV's comprised the comparison group. The data sources included: 1) mystery shopper inspections: two pre- and five post-EAV installation mystery shopper inspections of tobacco and alcohol retailers; 2) retail clerk and manager interviews; and 3) customer interviews. The study found that installing EAV devices with minimal training and encouragement did not increase age verification and underage sales refusal. Surveyed clerks reported positive experiences using the electronic ID readers and customers reported almost no discomfort about being asked to swipe their IDs. Observations from this study support the need for a more comprehensive system for responsible retailing.

Lapham SC; Gruenwald PJ; Remer L; Layne L. New Mexico's 1998 drive-up liquor window closure. Study I: Effect on alcohol-involved crashes. Addiction 99(5): 598-606, 2004. (21 refs.)

Aims: To determine the spatial relationship between drive-up liquor window locations and alcohol-related traffic crashes for 2 years before and after New Mexico banned drive-through alcohol sales. Design: Current liquor licenses, crash data, roadway information and US Census data were used in this analysis. Cross-sectional and longitudinal regression analyses were applied to the entire state, and to Albuquerque only. Findings: Of all NM liquor licenses, 189 (9%) included drive-up sales, which co-occurred with on- or off-premise licenses (94%). The rate of non-pedestrian alcohol-related crashes relative to non-pedestrian total crashes showed an increasing trend prior to closure and a decreasing trend after the closure. Cross-sectional analyses in Albuquerque revealed that the percentage of alcohol-involved crashes was not related to densities of on- or off-premise outlets per kilometer of roadway, or to percentage of drive-up outlets. Statewide, the percentage of drive-up outlets was not significantly related to the percentage of alcohol-related crashes within census tracts but was associated positively with the percentage of alcohol-related crashes in surrounding census tracts. There was no statistically significant relationship between number of drive-ups and percentage of alcohol-related crashes in either longitudinal model. Conclusions: Despite the declining rate of alcohol-related crashes following closure of drive-up liquor windows, both in Albuquerque and statewide, regression models using spatial data do not demonstrate definitively an association between the decline and the closure of the drive-up liquor windows.

Lapham SC; Skipper BJ. New Mexico's 1998 drive-up liquor window closure. Study II: Economic impact on owners. Addiction 99(5): 607-611, 2004. (20 refs.)

Aims: This study examined the economic impact of the New Mexico legislative action closing drive-up liquor windows on the retail establishments that operated them. Design: A telephone survey was conducted 20 months after the closure seeking information and owners' opinions about how their outlets had changed since the closure and how this affected their business. In addition, 2 years of aggregated pre- and post-closure total gross receipts revenues were obtained from the New Mexico Taxation and Revenue Department, with convenience stores as a comparison group. Findings: Interviews were completed for 149 of 220 establishments. Over one-quarter of former drive-up liquor windows (28%) had been converted to 'step-in' sales, defined as an outside door where customers can stop and enter the premises while their car is running. Almost two-thirds (61%) of owners reported decreased annual gross revenues following closure, with a reported average 15% reduction in alcohol sales. This is consistent with findings of decreased gross receipts for operators of non-urban, but not urban, drive-up liquor windows compared to convenience store gross receipts. Almost three-quarters (72%) of those surveyed would re-open the drive-up window if the law were rescinded. Conclusion: Over one-quarter of the drive-up owners converted to step-in alcohol sales that still allow a form of drive-up liquor sales. Despite this, the forced closure of New Mexico's drive-up liquor windows negatively impacted total sales and liquor sales revenues of establishments that operated them.

Latimer WW; Harwood EM; Newcomb MD; Wagenaar AC. Measuring public opinion on alcohol policy: A factor analytic study of a US probability sample. Addictive Behaviors 28(2): 301-313, 2003. (20 refs.)

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

Lavigne AM; Francione C; Wood MD; Laforge R; DeJong W. Predictors of college student support for alcohol control policies and stricter enforcement strategies. American Journal of Drug and Alcohol Abuse 34(6): 749-759, 2008. (23 refs.)

Objectives: With alcohol-related problems remaining a concern on college campuses, prevention efforts are increasingly directed to addressing the environmental factors that encourage consumption. This study examined students' support for alcohol control policies, correlates of that support, and actual vs. perceived peer support. Methods: Telephone interviews were conducted with a random sample of 510 college students. We conducted a three-step hierarchical regression analysis to examine predictors of policy support. Levels of personal and perceived peer support for alcohol control policies were compared. Results: Findings revealed a high level of policy support among students, with variability in support by gender, alcohol consumption levels, and drinking and driving tendencies. Additionally, compared to the percentage of students who supported each policy, a smaller percentage thought other students were supportive. Conclusions: Results provide valuable insights to inform the development of media campaigns and other environmental management initiatives.

Lenton S. Policy from a harm reduction perspective. Current Opinion in Psychiatry 16(3): 271-277, 2003. (76 refs.)

Purpose of review: The present review addresses recent literature on the effectiveness of reducing drug-related harm in a number of domains that might be promoted, facilitated, hindered or prohibited by drug policy. Recent findings: Increasingly, there is recognition among health professionals, the judiciary and the public that it is possible to design a system of drug control that has less of an emphasis on criminal law. However, for countries contemplating models of drug law other than strict prohibition, the three main international drug treaties limit the scope of changes to domestic laws. During the past 25 years alcohol policies have shifted from reducing the total population consumption to addressing risky drinking situations and patterns of use in order to reduce alcohol-related problems. With regard to drug use, the evidence supports needle and syringe provision schemes in the community; prison drug substitution treatment and needle exchange programmes; removal of criminal penalties for minor cannabis offences; and supervised injecting facilities in localized areas with open, public drug scenes and associated amenity problems. Schemes that divert drug offenders from the criminal justice system to treatment are increasingly common, but their effectiveness is yet to be demonstrated. Provision of naloxone hydrochloride to heroin users and their friends and family to aid in management of heroin overdose has promise, but more research is needed before widespread distribution can be advocated. Summary: Clinical and research practitioners should use their influence to call for policy that facilitates interventions that have been shown to be effective in reducing drug-related harm.

Levintova M. Russian alcohol policy in the making. Alcohol and Alcoholism 42(5): 500-505, 2007. (52 refs.)

Aims: This paper examines implementation of the 2005 federal alcohol control law in the Russian Federation. Methods: The documents on the Russian Federation federal legislation on the control of the production and turnover of ethyl alcohol, and ethyl alcohol containing products, news reports, research, and historical documents were gathered and analysed for implementation barriers. Results: Consumption of alcoholic beverages, especially spirits, has been one the most significant public health problems in Russia for many centuries. Prior attempts to control alcohol consumption have been unsuccessful, in part due to the governments reliance on alcohol revenue, and its inability to implement creative and manageable solutions in the light of the high drinking rates. Implementation of this legislation has been a challenge in Russia because of administrative oversight, lack of organizational preparation, and corruption. Conclusions: The law discussed in this paper presented a window of opportunity to ameliorate the deteriorating health status and reverse the impending mortality crisis. However, a number of barriers presnted substantial setbacks toward realization of this legislation.

Lewis MA. "Dousing a Fiery Spirit": Prohibition enforcement and racial repression in Durham North Carolina, 1922-1926. , 2003. (0 refs.)

Most of the previous literature on the prohibition era describes the Eighteenth Amendment as a "noble experiment" that failed under the weight of government neglect, organized crime, and official corruption. Past studies illustrate these conditions through newspaper reports, and conclude that the lesson of prohibition is that such drastic measures to legislate morals cannot work. This paper takes as its starting point the notion that what prohibition "working" would have meant at the time would have varied by who was enforcing it, thus, to focus on what prohibition did not do (completely stopping the drinking of alcoholic beverages) misses the mark. Instead, this paper starts by looking at what people enforcing prohibition did do. Employing data gathered from police department records for Durham, NC, for the years 1922-1926, I demonstrate that prohibition laws, at least in this one city, were used more to reinforce the existing racial caste system than they were to deter the use of alcohol.

Loxley W. Introduction to section on legislative and regulatory perspectives. IN: Stockwell T; Gruenewald PJ; Toumbourou JW; Loxley W, eds. Preventing Harmful Substance Use: The Evidence Base for Policy and Practice. New York: John Wiley & Sons, Ltd, 2005. pp. 239-243. (8 refs.)

The chapters in this section consider a range of legislative and regulatory options. Chapters 5.2 and 5.3 deal with tobacco and alcohol by, respectively, proposing alternative regulatory frameworks for tobacco, and evaluating the efficacy of alcohol law enforcement under current frameworks. Chapters 5.4 and 5.5 consider currently illicit drugs-first, cannabis, in which the current legal framework is itself under review, and then alternatives to traditional procedures in criminal justice for illicit drug using offenders. Finally, Chapter 5.6 reminds us that communities are not all alike and that social, cultural and structural differences should be taken into consideration when determining regulatory strategies to reduce drug-related harm.

Mann RE; Smart RG; Stoduto G; Adlaf EM; Vingilis E; Beirness D et al. The effects of drinking-driving laws: A test of the differential deterrence hypothesis. Addiction 98(11): 1531-1536, 2003. (50 refs.)

Aims: Ontario introduced an Administrative Driver's Licence Suspension (ADLS) law in 19 9 6, whereby a person with a blood alcohol level over the legal limit of 80 mg% or who refused to provide a breath sample, would have his or her driver's licence suspended immediately for a period of 90 days, We test the differential deterrence hypothesis which would predict that social or lighter drinkers would be more affected by the Administrative Driver's License Suspension law than heavier drinkers. Design Data from the 19 9 6 and 19 9 7 cycles of the Ontario Drug Monitor, a general population survey of Ontario adults (monthly cross-sectional surveys). were employed (response rate 64-67%, ). Analyses were restricted to drivers who reported at least some drinking during the last year (n = 382 7). The total number of drinks consumed during the past 12 months was analysed with analysis of variance. Findings We found that the mean alcohol consumption of those who reported drinking-driving increased significantly after the ADLS was introduced, whereas the alcohol consumption of those who did not drive after drinking remained the same. Conclusions The limits of this study include a lack of comparison data from regions without ADLS. a reliance on self-report measures, possible age restrictions of the findings and the fact that only an inferential test of the differential deterrence hypothesis is permitted by the data. Despite these limitations, these findings are consistent with the prediction that lighter or more moderate drinkers will tend to stop driving after drinking completely, and thus drop out of the drinking-driving population when the ADLS law was introduced, leaving heavier drinkers in this population. It will be important to continue to examine the dynamics of differential deterrence over a longer interval.

Margolis SA; Ypinazar VA; Muller R. The impact of supply reduction through alcohol management plans on serious injury in remote indigenous communities in remote Australia: A ten-year analysis using data from the Royal Flying Doctor Service. Alcohol and Alcoholism 43(1): 104-110, 2008. (34 refs.)

Aims: To assess the impact of supply reduction through Alcohol Management Plans (AMP) on the rate of serious injuries in four indigenous communities in remote Australia. Methods: An ecological study used the database of the Royal Flying Doctor Service (RFDS) to calculate trauma retrieval rates for 8 years pre- and 2 years post-AMP in four remote communities covering a period from 1 January 1995 to 24 November 2005. All serious injuries in these communities required aero-medical retrieval. Results: Serious injury resulted in a total of 798 retrievals during the observation period. One-sided analysis of variance for repeated measurements over the 10 years demonstrated a significant (P = 0.021) decrease of injury retrieval rates after the introduction of the AMP. Similarly, a comparison of linear trends of injury retrieval rates pre- and post-AMP also resulted in a significant decrease (P = 0.022; one-sided paired t-test). Comparisons of injury retrieval rates of just the 2 years pre- and post-AMP also revealed a significant reduction (P = 0.001; paired t-test), with an averaged 52% decline. Identical comparisons of retrieval rates for causes other than injury revealed no significant changes. Conclusion: This impact evaluation provides evidence that AMP was effective in reducing serious injury in the assessed indigenous communities.

Miller T; Snowden C; Birckmayer J; Hendrie D. Retail alcohol monopolies, underage drinking, and youth impaired driving deaths. Accident Analysis and Prevention 38(6): 1162-1167, 2006. (20 refs.)

Objective: To explore associations of state retail alcohol monopolies with underage drinking and alcohol-impaired driving deaths. Data: Surveys on youth who drank alcohol and binge-drank recently and their beverage choices; census of motor vehicle fatalities by driver blood alcohol level. Methods: Regressions estimated associations of monopolies with under-21 drinking, binge drinking, alcohol-impaired driving deaths, and odds a driver under 21 who died was alcohol-positive. Results: About 93.8% of those ages 12-20 who consumed alcohol in the past month drank some wine or spirits. In states with a retail monopoly over spirits or wine and spirits, an average of 14.5% fewer high school students reported drinking alcohol in the past 30 days and 16.7% fewer reported binge drinking in the past 30 days than high school students in non-monopoly states. Monopolies over both wine and spirits were associated with larger consumption reductions than monopolies over spirits only. Lower consumption rates in monopoly states, in turn, were associated with a 9.3% lower alcohol-impaired driving death rate under age 21 in monopoly states versus non-monopoly states. Alcohol monopolies may prevent 45 impaired driving deaths annually. Conclusions: Continuing existing retail alcohol monopolies should help control underage drinking and associated harms.

Montgomery JM; Foley KL; Wolfson M. Enforcing the minimum drinking age: State, local and agency characteristics associated with compliance checks and Cops in Shops programs. Addiction 101(2): 223-231, 2006. (32 refs.)

Aims: To identify state, local and organizational characteristics associated with local law enforcement agencies' implementation of two dramatically different approaches to enforcement of underage drinking laws: compliance checks and Cops in Shops programs. Compliance checks use underage decoys to attempt to purchase alcohol from retail merchants, while Cops in Shops programs deploy undercover law enforcement officers in alcohol outlets to detect and cite persons under the age of 21 who attempt to purchase alcohol. Design: Cross-sectional telephone interview conducted as part of the Tobacco Enforcement Study (TES), which examined enforcement of laws related to youth access to tobacco. Setting Data were collected in 1999 among law enforcement agencies in all 50 states of the United States. Participants: Representatives of city police departments, departments of public safety, sheriffs or county police were included (n = 920 local agencies). Measurements: Alcohol compliance checks and Cops in Shops programs were the primary outcomes. Covariates included state level policies (e. g. beer tax), agency resources (e. g. number of sworn officers) and community demographics (e. g. college dormitory population). Findings Local enforcement agencies were more likely to perform alcohol compliance checks than to have a Cops in Shops program (73.9% compared to 41.1% in cities > 25000 and 55.7% compared to 23.9% in cities <= 25000). Conducting compliance checks for tobacco age-of-sale laws was positively associated with alcohol compliance checks and Cops in Shops (OR 3.30, P < 0.001; OR 1.84, P = 0.001, respectively). Having a Drug Abuse Resistance Education (DARE) officer was negatively related to conducting compliance checks (OR 0.67, P = 0.03). Special community policing units were associated with departments having Cops in Shops programs (OR 1.80, P = 0.006). Conclusions: This study used a nationally representative sample of communities to better understand state and local factors that shape local law enforcement agencies' use of two distinct approaches to underage drinking enforcement. The strong link observed between tobacco and alcohol compliance checks may indicate a culture within some law enforcement agencies supporting strict enforcement of age-of-sale laws.

Munro G. Drinks industry organizations should carry warning labels: A brief reply to commentaries. Addiction 99(11): 1380, 2004. (7 refs.)

This is a response to commentaries on the author's article published in this issue: An addiction agency's collaboration with the drinks industry: Moo Joose as a case study. The case study highlights the tensions inherent in collaborations between the beverage industry and community substance abuse agencies.

Munro G; Learmonth A. 'An unacceptable risk': The problem of alcoholic milk. (review). Drug and Alcohol Review 23(3): 345-349, 2004. (26 refs.)

In 2002 Wicked Holdings Pty Ltd, a company formed for the purpose of marketing alcoholic milk, applied to the Director of Liquor Licensing Victoria (LLV) for a wholesale licence to distribute a beverage known as 'Moo Joose'. This article outlines the case against alcoholic milk as the ultimate 'alcopop'. The argument encompasses the risk that alcoholic milk would reinforce and increase existing levels of under-age drinking in Australia, the risk it would reduce the age of initiation into drinking and the potential for alcoholic milk to be mistaken for a 'healthy' version of alcohol and a 'safe' alcoholic beverage. When LLV refused the application for a licence, Wicked Holdings appealed to the Victorian Civil and Administrative Tribunal. Following a public hearing the Tribunal confirmed LLV's decision to refuse a licence on the grounds the product posed an unacceptable risk to the health and well-being of young people.

Murray A. Decreasing number of young licence holders and reduced number of accidents. A description of trends in Sweden. Accident Analysis and Prevention 35(6): 841-850, 2003. (17 refs.)

The role of alcohol is an important factor in motor vehicle accidents in many countries, particularly concerning fatal accidents. Efforts to reduce alcohol related crashes in recent years has been the adoption of the "Scandinavian model." In the Scandinavian countries it is an offence to drive with a blood alcohol level beyond a certain limit. In Sweden there are two blood alcohol concentrations (BAC) limits. A lower limit for drunken driving and a higher one for aggravated drunken driving. The lower limit changed from 50 to 20 mg% on the 1 July 1990 and the higher from 150 to 100 mg% on the 1 of February 1994. Thus, the lower limit was implemented already when the age cohort born in 1972 became 18 years old and was effective for both age cohorts, but the higher limit was not implemented until the earlier age cohort became 22 years old. It means that only the later age cohort had this stricter limit for aggravated drunk driving. Because of the strict alcohol policy, the number of alcohol related accidents are less in Sweden than in many other countries. However, in fatal accidents and in accidents leading to serious injury alcohol is still an important factor in Sweden. The proportion of accidents that are alcohol related (the driver is suspected of being under the influence of alcohol) in the two age cohorts are presented by severity of the injury and which indicate a greater percentage of alcohol related accidents among fatalities and accidents leading to serious injury than among accidents leading to minor injury and a greater percentage for men than for women. Alcohol related fatalities for women born in 1977 was the only exception. The small number of fatalities for women makes these percentages uncertain. Comparing the men born in 1972 and 1977, the percentage of alcohol related accidents decreased from 16.5 to 12.0% among fatalities, but on the other hand it increased from 12.9 to 15.0% among accidents leading to serious injury. The percentage of alcohol related accidents among those leading to minor injury stayed almost the same. The percentage of alcohol related accidents of those leading to serious or minor injury was very much the same for women in both age cohorts. Thus, the proportion of alcohol related accidents did not change in a systematic way either for men or women. This means, that there is no indication, that the reduction in accident rates can be explained by a decrease in drunk driving. A reduction of car driving and an accompanying reduction of drunk driving seems a more probable explanation.

Nelson JP. Advertising bans, monopoly, and alcohol demand: Testing for substitution effects using state panel data. Review of Industrial Organization 22(1): 1-25, 2003. (36 refs.)

Using a panel of 45 states for the period 1982-1997, this study analyzes the importance of several restrictive alcohol regulations, including advertising bans for billboards, bans of price advertising, state monopoly control of retail stores, and changes in the minimum legal drinking age. In contrast to previous research, the study allows for substitution among beverages as a response to a regulation that targets a specific beverage. A restrictive law that applies only to one beverage (or one form of advertising) can result in substitution toward other beverages (or non-banned media). Allowing for substitution means that the net effect on total alcohol consumption is uncertain, and must be determined empirically. The empirical results demonstrate that monopoly control of spirits reduces consumption of that beverage, and increases consumption of wine. The effect on beer is positive, but is not statistically significant. The net effect on total alcohol is significantly negative. Higher minimum legal drinking age laws have negative effects on beverage and total alcohol consumption. Bans of advertising do not reduce total alcohol consumption, which partly reflects substitution effects. The study thus demonstrates the possible unintended consequences of restrictive alcohol regulations.

Nelson WR. Power of philosophy, policies, programs, practices, and participation: Alcohol-related institutional congruence and college students' attitudes and behaviors. Dissertation Abstracts International 63(8): 2812A, 2003

This study examined the relationships between alcohol-related institutional congruence and student participation in alcohol-related programs, and college students' attitudes and behaviors relative to alcohol. Interview data were obtained from administrators, faculty, and students (total n = 33), supplemented by documentary evidence. Findings indicate that alcohol-related institutional congruence has a positive effect on students' attitudes and behaviors related to alcohol, while having an incongruent philosophy negatively affects students. Student participation in alcohol-related policy and program development also has a positive effect on their alcohol-related attitudes and behaviors. Eight guidelines are presented to enhance alcohol-related institutional congruence: (1) have an official written philosophy on alcohol; (2) minimize exceptions to school policy; (3) have strong enforcement of residence life alcohol policies; (4) integrate alcohol education and abuse prevention activities; (5) promote cooperation and communication among school officials, city leaders, and local bar owners; (6) increase student involvement in alcohol-related programs; (7) raise the level of priority given to the school alcohol committee; and (8) eliminate any school social normative marketing campaign or similar initiatives.

Nemtsov A. Russia: Alcohol yesterday and today. Addiction 100(2): 146-149, 2005. (1 refs.)

The author traces the history of alcohol use in Russia. Alcohol was uncommon through the late 15th century. At that time alcohol was primarily an urban phenomenon. Vodka which was introduced in the 15th and 16th century but until the mid-18th century it was rarely more than 20%. The transitions are described which involved changes in taxation, the migrations to the cities. The "modern" era of heavy drinking might be set in the 1950s, when the level of consumption began to rise, and the nature of drinking began to change, with heavy drinking no longer tied to holidays, and was no longer restricted to males and older people. Gorbachev launched a wide-ranging anti-alcohol campaign in 1985, and in a three year period, consumption dropped and life expectancy among men increased. However, the campaign was short lived. Consumption has risen to 15 l in the cities and is even higher in rural areas. There are a host of alarming negative health consequences -- a decrease in life expectancy, with approximately 30% of all mortality linked to alcohol. With the demise of the Soviet Union, the facilities for treatment also decreased markedly. The impediments to government action are outlined.

Nusbaumer MR, Reiling DM. Where problems and policy intersect: Servers, problem encounters and targeted policy. Drugs: Education, Prevention and Policy 10(1): 21-29, 2003. (25 refs.)

In an effort to broaden and design server intervention policies more efficiently, this research examines the work location where the greatest intersection between the point of policy intervention (licenced servers) and the problem (intoxicated customers) occurs. Given the historic policy focus on servers, this research examines perceptions of all licenced servers, rather than those employed in selected settings. A six-page questionnaire was mailed to a random probability sample of all licenced servers. The sample was drawn from an official list of all individually licenced servers in the State of Indiana, USA. Bivariate and regression analyses were conducted on the 938 responses received. The analyses indicated that licenced servers' perception of their frequency of encounters with intoxicated customers is highly variable, and dependent upon numerous work location variables. The most important variable was type of establishment, particularly nightclubs and hotel or motel bars. The results suggest the need for targeted policy-making efforts, such as differential licensing and training on the basis of establishment type, which would result in more effective use of scarce resources.

Office of National Drug Control Policy. The Challenge in Higher Education. Confronting and Reducing Substance Abuse on Campus. Washington DC: Office of National Drug Control Policy, 2004. (0 refs.)

This report is directed to the campus community. Following an introduction there are three major sections. the first discusses the scope of drug problems on campuses. The next section sets forth the major components of campus programs: the need for accurate information; the importance of institutional support; creation of campus drug/alcohol policy; program development; collaborating with the community; and the harnessing the power of perceptions. The next section sets forth several case studies. There is also a section of further resources as well as a guide to common campus drugs, which provides a brief description of the drug, route of administration, associated morbidity, street names, and use patterns on campuses.

Osterberg E. What Are the Most Effective and Cost-Effective Interventions In Alcohol Control?. Copenhagen: World Health Organization, Regional Office for Europe, 2004. (24 refs.)

The issue: Europe plays a significant role in the production, trade and consumption of alcoholic beverages; it also carries a heavy social and economic burden of alcohol-related problems. Alcohol consumption is estimated to be responsible for about 10% of the total disease burden, increasing the risk of liver cirrhosis, certain cancers, high blood pressure, stroke and congenital malfunctions, among other problems. Furthermore, it increases the risk of many social problems such as family disintegration, absenteeism, poor productivity, financial hardships, unintentional injuries, traffic accidents, criminal behaviour, violence, homicide and suicide. Findings: There is substantial evidence showing that an increase in alcohol prices reduces consumption and the level of alcohol-related problems. In most countries and especially in countries with low alcohol tax rates, tax-induced price increases on alcohol beverages lead to increases in state tax revenues and decreases in state expenses related to alcohol-related harms. The effects of price increases, like the effects of other alcohol control measures, differ among countries, depending on such factors as the prevailing alcohol culture and public support for stricter alcohol controls. However, the effects on alcohol-related harms are definite and the costs low, making it a cost-effective measure. In addition, stricter controls on the availability of alcohol, especially via a minimum legal purchasing age, government monopoly of retail sales, restrictions on sales times and regulations of the number of distribution outlets are effective interventions. Given the broad reach of all these measures, and the relatively low expense of implementing them, they all are highly cost-effective. Furthermore, most measures against drunk-driving, such as sobriety check points, random breath testing, lowered blood alcohol concentration limits, suspension of driver's licenses, graduated licensing for novice drivers, and brief interventions for hazardous drinkers also receive high effectiveness ratings. There is good research support for these drunk-driving interventions. Thus these interventions are applicable in most countries and are relatively inexpensive to implement and sustain. Server liability and enforcement of on-premise regulations combined with community mobilization seem to be strategies with some impact without being too costly. However, they do not reach offpremise drinking. Server training in responsible beverage service is unlikely to have an effect if it is not backed by the threat of suspending the licenses of those who continue to serve underage drinkers or intoxicated patrons. If youthful drinking is seen as a specific alcohol policy problem, increasing the legal age limit for purchasing or selling alcoholic beverages is the most immediate and effective measure. Various educational approaches have been developed to reduce alcohol consumption. Although they are growing in popularity, there is little evidence of their effectiveness. Similarly, current research findings only show limited effects both on advertising and advertising bans.

Parker RN. Alcohol and violence: Connections, evidence and possibilities for prevention. Journal of Psychoactive Drugs Supplement 2: 157-163, 2004. (30 refs.)

This article reviews a number of theoretical and substantive arguments and models concerning the link between alcohol and violent crime which have appeared in the research literature in the past decade. These arguments and models form a firm foundation for the expectation that alcohol plays a causal role in violent crime, and that interventions designed to reduce or eliminate this link between alcohol and violence have the potential to become effective violence prevention policies. Four studies on the relationship between alcohol and violence are summarized, including one in which a natural alcohol policy experiment is evaluated. Taken together, these studies provide substantial empirical evidence that alcohol policy can be an effective crime prevention tool.

Pennock P. The evolution of U.S. temperence movements since repeal: A comparison of two campiagns to control alcoholic beverage marketing, 1950s and 1980s. The Social History of Alcohol and Drugs 20(1): 14-65, 2005. (79 refs.)

This paper compares the politics of a failed religious movement to ban alcohol advertising in the 1950s with the politics of a more secular, and partially successful, movement to regular alcohol marketing in the 1970s and 1980s. Although the contexts of the two marketing control movements were quite different, the continuities were equally striking. Both employed arguments about youth, social order, and the power of mass media.

Pennock PE. Advertising Sin and Sickness. The Politics of Alcohol and Tobacco Marketing, 1950-90. DeKalb IL: Northern Illinois University Press, 2007

This book is organized into three parts. Part I deals with the alcohol industry and the efforts, between 1947 and 1958, to ban alcohol advertising. It addresses attitudes toward temperance in the larger society and the alcohol industry's efforts to resist regulation. Part II focuses upon the tobacco industry. The highlights of these efforts, occurring in the context of the emerging antismoking movement, were the battle to regulate tobacco marketing in the 1960s, followed by the debates over warning labels, and efforts to restrict advertising. Part III considers the alcohol marketing restrictions introduced in the 1970s and 1980s, and what the author describes as a new temperance movement. The intertwining of political, legal and scientific research threads of the debate are presented. The concluding chapter deals with the elusive quest for restraints.

Picone GA; Sloan F; Trogdon JG. The effect of the tobacco settlement and smoking bans on alcohol consumption. Health Economics 13(10): 1063-1080, 2004. (39 refs.)

In the last few years, the price of cigarettes has increased considerably in the USA. In addition, a number of states have also imposed smoking bans. These increases in the cost and barriers to smoking have created a natural experiment to study relationships between smoking and drinking behaviors. In this study, we employ data from the first six waves of the Health and Retirement Survey (HRS) to analyze the effects of smoking bans and cigarette prices on alcohol consumption. We also test if past cigarette and alcohol consumption affect current alcohol consumption as predicted by co-addiction models. We estimate dynamic panel models using GMM estimators. Our approach allows us to obtain consistent estimates irrespective of the number of time periods. The three main findings of this study are: (1) there is positive reinforcement effect of past cigarette consumption on current alcohol consumption, (2) smoking bans reduce alcohol consumption and (3) there is a positive effect of cigarette prices on alcohol consumption.

Powers EL; Wilson JK. Access denied: The relationship between alcohol prohibition and driving under the influence. Sociological Inquiry 74(3): 318-337, 2004. (30 refs.)

Alcohol prohibition continues to be a policy pursued by more than 10 percent of the counties in the United States. However, many questions exist about the effectiveness of prohibition policies for controlling social maladies such as accidents and fatal injuries related to driving under the influence (DUI). In this research, a situational crime prevention framework is used to evaluate the hypothetical relationship between countywide alcohol prohibition and incidents of DUI. We focus specifically on county-level comparisons of DUI arrests in Arkansas where slightly more than half of the counties are "dry" (sale of alcohol to the general public is prohibited). Utilizing police reports of DUI arrests we examine whether the dry county distinction is indeed associated with fewer DUI arrests than found in wet counties. Findings indicate that the dry county distinction does not result in significantly lower rates of DUI arrest when law enforcement variables are considered. These findings are analyzed and implications for future research are discussed.

Reid Howie Associates, Ltd. Liquor Licensing and Public Disorder: Review of Literature on the Impact of Licensing and Other Controls/Audit of Local Initiatives. Edinburgh Scotland: Scottish Executive Social Research, 2003. (68 refs.)

This study presents a review of the literature on the impact of licensing and other controls, including an audit of local initiatives, that is pertinent to liquor licensing and public disorder. The Nicholson Committee is currently carrying out a review of liquor licensing in Scotland with the findings of this report to be used to control the availability of alcohol and reduce the underlying causes of alcohol misuse. Chapter 1 outlines the background and the overall context of the work with details of the methodology provided. Chapter 2 presents the findings of the literature review, and Chapter 3 gives the results of the audit of initiatives in Scotland. The most effective means of controlling the availability of alcohol seems to be through licensing (including the imposition of conditions upon licenses, addressing hours of operation or sale). Chapter 4 brings together the implications of all of these findings. Analyses suggest that there have been a range of studies of the effectiveness of measures to regulate alcohol sales and consumption. However, there is a need for some caution in applying the results directly to Scotland. The literature review does, nonetheless, provide an indication of measures which can be seen to have an impact upon crime and disorder, and the report suggests that this, taken alongside the findings from work undertaken in Scotland, can provide useful evidence to inform the work of the Nicholson Committee. Findings suggest that longer hours of alcohol sales may be linked to alcohol-related crime and disorder.

Public Domain

Reinarman C. Librarians and other subversives: Truth can be a casualty of drug wars, too. International Journal of Drug Policy 16(1): 1-4, 2005. (9 refs.)

This essay is based on a paper presented at the national meeting of the Substance Abuse Librarians and Information Specialists (SALIS). It is noted that librarians can be subversive to the extent they preserve the past and the documents that are vital to understanding social problems. It is noted that "reality" is not a naturally occuring event but is socially constructed, and understanding changes over time. Substance abuse is a field with more than its share of "official truths" which at times do not fare well over time. Several examples are provided from the alcohol and drug field over the past 25 years. For example in 2004, after the election of George W. Bush, the United Nations Office of Drug Control was "invited" to change its language or risk losing US funding. The request was to refrain from references to harm reduciton and needle exchange. In the mid-1990s thethe US State Department asked agencies to avoid use of the phrase "harm reduction" as it was purported to be a code for legalization. In May 2004 ABC News broadcast a special report on ecstasy. It was in reponse to the retraction of a research paper in Science that purported to show that a single dose equivalent to recreational use led to "severe" and "profound" brain damage, including symptoms similar to those of Parkiinson's disease. The resarch being reported was seriously flawed: (1) the "ecstasy" was actually methamphetamine; (2) the dose was many times that typically ingested ; and (3) the doses were injected rather than taken orally the form taken by human users. The retraction became a story because the original story had been widely hyped. In the Regan era, NIDA issued a "nomenclature memorandum" with a column of terms that were henceforth forbidden in NIDA proposals, reports, and plublicatons derived from NIDA-funded research. There was also a list of "approved" terms. For example, the phrase "illicit drug use" was forbidden, and the approved term being "illict drug abuse."

Richter L; Vaughan RD; Foster SE. Public attitudes about underage drinking policies: Results from a national survey. Journal of Public Health Policy 25(1): 58-77, 2004. (19 refs.)

We conducted a national telephone survey of 900 adults in the United States to examine the attitudes of the adult public regarding underage drinking and a series of alcohol control policies aimed at reducing it. Three versions of the survey instrument were administered, each to one-third of the sample, with the versions varying in the stipulations of the policy options. Results showed high levels of public support for most of the alcohol control policies, with relatively lower support for those that would result in restrictions on adults' access to alcohol. Respondents' support of the policy options was significantly related to their sociodemographic and attitudinal characteristics, such as sex, age, drinking frequency, and level of concern about underage drinking. The findings provide important guidelines to policymakers interested in garnering support for policies aimed at curtailing underage drinking.

Ritson B. Alcohol licesing laws: Proposals for changes in Scottish law. Alcohol and Alcoholism 39(1): 2-7, 2004. (9 refs.)

Scotland, England and Wales, and Ireland have each recently reviewed how licensing laws might influence the increasing levels of alcohol-related problems in each of these countries. Each legislature has arrived at somewhat different recommendations. Scotland may move towards liberalization, albeit within firm guidelines. It is unknown whether emphasis on local review, server training and some restrictions on bar venues offering discount pricing, will be sufficient to alter current trends in alcohol-related problems.

Roizen R. How does the nation's "alcohol problem" change from era to era: Stalking the social logic of problem-definition transformation since repeal. IN: Tracy SW; Acker CJ, eds. Altering American Consciousness: The History of Alcohol and Drug Use in the United Sates, 1800-2000. Amherst MA: University of Massachusetts Press, 2004. pp. 61-87. (126 refs.)

At the beginning of the 20th century alcohol stood considerably higher on the social/political agenda than it has since. For one, post Prohibition repeal, the national attention was faced with the Great Depression, growing fascism abroad, and before long, World War II. This chapter considers the changes in perceptions of alcohol problems from era to era. The current understanding might be attributable in significant measure to AA and educational and policy initiatives such as the National Council on Alcoholism and Yale School of Alcohol Studies, which emerged of the 1940s and early 1950s and posited alcoholism not alcohol as the central problem. In the mid-1970's there was another shift in the alcohol paradigm, with a returning attention to alcohol, which emerged as part of a public health approach and was marked by the rise of MADD, attention to underage drinking, which is described in part as moving 'forward into the past.'

Room R. Effects of alcohol controls: Nordic research traditions. Drug and Alcohol Review 23(1): 43-53, 2004. (34 refs.)

Drawing on a recent review of studies of the impact of alcohol control changes in the Nordic countries (particularly Finland, Norway and Sweden), this paper reviews the development of research traditions of such studies in the Nordic countries. From the Nordic experience, there is evidence of variation in the effects of policy changes by demographic segment, by type of problem and by drinking pattern and amount. Policy changes have often had their greatest effect on heavier drinkers. Big reductions in alcohol taxes in Denmark in 2003 and Finland in 2004 offer a new chance to study whose drinking changes how much, and in what contexts, in a collaborative study comparing northern Sweden with Finland, Denmark and southern Sweden.

Room R. Rethinking alcohol, tobacco and other drug control. (editorial). Addiction 98(6): 713-716, 2003. (9 refs.)

Saltz RF. Preventing alcohol-related problems on college campuses - Summary of the final report of the NIAAA Task Force on College Drinking. Alcohol Research & Health 28(4): 249-251, 2004. (17 refs.)

This article summarizes a report issued in 2002 by a Task Force on College Drinking, which drew upon a series of expert panels. . This review provides an overview of the importance of addressing college student use. It then summarizes the major findings. The recommendations are organized into tiers, those approaches found effective with college populations, those successful with other groups and thus might be applied to college age youth. Among those discussed are cognitive-behavioral skills trainings, and brief motivation enhancement, and also efforts to create an environment that restricts availability. The third tier are those with with logical and theoretical promise, but without comprehensive evaluation, e.g. consistent enforcement of campus policies, regulation of happy hour promotions, and normative educational efforts. Tier four are programs which to date have not demonstrated effectiveness, such as pure educational programs.

Public Domain

Scottish Executive Social Research. Liquor Licensing and Public Disorder: Review of literature on the impact of licensing and other controls/audit of local initiatives. Edinburgh Scotland: Scottish Executive Social Research, 2003. (68 refs.)

Public Domain

Selvanathan S; Selvanathan EA, eds. The Demand for Alcohol, Tobacco and Marijuana: International Evidence. London: Ashgate Publishing, 2005

Using a diverse database with statistics from some 30 developed and developing countries, the authors present a detailed statistical portrait of the consumption of food, soft drinks, tobacco, alcohol, and marijuana around the world. This data is then used to a model developed by the authors for determining the effect of consumer income and the prices of goods on consumption behavior. The model and data are also used to assess the alcohol and tobacco control policies of a number of countries. Data is summarized in over 100 tables and figures.

Shaffer ER; Brenner JE. International trade agreements: Hazards to health? International Journal of Health Services 34(3): 467-481, 2004. (21 refs.)

Since the 1980s, neoliberal policies have prescribed reducing the role of governments, relying on market forces to organize and provide health care and other vital human services. In this context, international trade agreements increasingly serve as mechanisms to enforce the privatization, deregulation, and decentralization of health care and other services, with important implications for democracy as well as for health. Critics contend that social austerity and "free" trade agreements contribute to the rise in global poverty and economic inequality and instability, and therefore to increased preventable illness and death. Under new agreements through the World Trade Organization that cover vital human services such as health care, water, education, and energy, unaccountable, secret trade tribunals could overrule decisions by democratically elected officials on public financing for national health care systems, licensing and training standards for health professionals, patient safety and quality regulations, occupational safety and health, control of hazardous substances such as tobacco and alcohol, the environment, and affordable access to safe water and sanitation. International negotiations in 2003 in Cancun and in Miami suggested that countervailing views are developing momentum. A concerned health care community has begun to call for a moratorium on trade negotiations on health care and water, and to reinvigorate an alternative vision of universal access to vital services.

Shaffer ER; Waitzkin H; Brenner J; Jasso-Aguilar R. Global trade and public health. American Journal of Public Health 95(1): 23-34, 2005. (51 refs.)

Global trade and international trade agreements have transformed the capacity of governments to monitor and to protect public health, to regulate occupational and environmental health conditions and food products, and to ensure affordable access to medications. Proposals under negotiation for the World Trade Organization's General Agreement on Trade in Services (GATS) and the regional Free Trade Area of the Americas (FTAA) agreement cover a wide range of health services, health facilities, clinician licensing, water and sanitation services, and tobacco and alcohol distribution services. Public health professionals and organizations rarely participate in trade negotiations or in resolution of trade disputes. The linkages among global trade, international trade agreements, and public health deserve more attention than they have received to date.

Snow P; Wallace S; Staiger P; Stolz-Grobusch B. "As long as it doesn't spill over into class": Harms arising from students' alcohol use, and the role of policy in reducing them. International Journal of Drug Policy 14(1): 5-16, 2003. (27 refs.)

While there is considerable evidence about the prevalence of student alcohol use, little empirical work has examined the range and level of exposure to alcohol-related risks facing student populations, and the views of key stakeholders about these. This study was conducted at a large multi-campus university in order to gauge the scale and severity of students' alcohol-related problems, and ways in which these may be mitigated. Student perspectives on campus based policy making with respect to alcohol were also canvassed. This study utilised a range of evaluative instruments, including standardised questionnaire protocols, structured interviews and focus groups. Data gained from students showed a large level of exposure to alcohol-related harm, and staff informants reported student harms such as drink-driving, interpersonal aggression, social nuisance, inadequate security, sexually risky behaviour, and physical malaise. As a group, students seem receptive to campus-based policies that have a harm reduction focus, but are less supportive of institutionalised measures aimed at the student body. Given the divergence of views about the harms arising from student drinking, and a general repudiation of institutional policy measures which may lessen these, the development of harm-reducing policy on alcohol remains challenging.

Stockwell T. A cross-cutting research agenda on alcohol, tobacco and other drugs: Where to start? (editorial). Addiction 102(8): 1191-1192, 2007. (16 refs.)

This is a commentary on the article by Cook and Reuter (this issue) which reflects on the similarities and disparities in the response to licit and illicit drugs. For demand reduction, there is considerable overlap in programs and services for prevention and even more clearly for treatment. For supply controls there is mostly divergence, reflecting the difference in legal status. Policy research is required to explore the impact of these differences. Among the questions that need to be addressed are the costs to the public from a prohibitionist policy toward illlict drugs.

Taylor DM; Johnson MB; Voas RB; Turrisi R. Demographic and academic trends in drinking patterns and alcohol-related problems on dry college campuses. Journal of Alcohol and Drug Education 50(4): 35-54, 2006. (25 refs.)

Restricting alcohol consumption on campus is a measure often used by college administrators to prevent alcohol abuse and alcohol-related problems. The effect of dry campus policies on alcohol consumption and alcohol-related problems, however, remains poorly understood. This report will compare characteristics of two dry campuses with descriptions of general college drinking trends with respect to students 'demographic and social/academic characteristics. At two Western universities, 9,073 undergraduates aged 18 and older were surveyed between 2000 and 2004. Drinking and alcohol-related problems found on the dry campuses were similar to national trends on college campuses. Results suggest campus alcohol policies limit drinking on campus but do not prevent previously identified demographic and academic college drinking patterns.

Terry-McElrath YN; Harwood EM; Wagenaar AC; Slater S; Chaloupka FJ; Brewer RD et al. Point-of-purchase alcohol marketing and promotion by store type. United States, 2000-2001. MMWR. Morbidity and Mortality Weekly Report 52(14): 310-313, 2003. (10 refs.)

Alcohol consumption is the third leading preventable cause of death in the United States, accounting for approximately 100,000 deaths annually. Recent studies have focused on alcohol marketing as a potentially important contributor to alcohol consumption, particularly among underage drinkers (3). Point-of-purchase (POP) (i.e., on-site) marketing, including alcohol advertising and placement, can increase alcohol sales and consumption substantially, thereby increasing the risk for various alcohol-related health outcomes, including alcohol-impaired driving and interpersonal violence (5--7). To assess the type and frequency of POP alcohol marketing. This report summarizes the results of a study that collected and analyzed store observation data during 2000-2001 from 3,961 alcohol retailers in 329 communities throughout the United States. The data suggest that point of purchase marketing is extensive in certain story types frequented by teenagers and young adults. In each alcohol retail establishment, field staff observed the presence of various POP alcohol marketing characteristics in a standardized manner, including 1) exterior and interior advertisements for alcoholic beverages and the intensity of such advertising, 2) alcohol beverage control signage (e.g., health warnings), 3) alcohol-branded functional objects provided free to retailers (e.g., counter change mats with an alcohol company logo), 4) beer placement (e.g., single cans or bottles chilled in buckets near checkout locations) or not chilled on shelf), and 5) the presence of low-height advertisements (i.e., advertisements placed within 3.5 feet of the floor, in the sight line of children and adolescents as opposed to adults). The majority of stores (94%) had some form of POP alcohol marketing (i.e., store exterior, store interior, and/or parking lot or other property advertising and/or alcohol-branded functional objects). Exterior alcohol advertisements were observed in 39% of stores ; 27% of stores had high-intensity exterior advertising�. Compared with supermarkets, liquor stores (odds ratio [OR] = 176.8), convenience stores (OR = 48.2), convenience/gas stores (OR = 42.3), small grocery stores (OR = 24.5), and drug stores/pharmacies (OR = 15.5) were more likely to have high-intensity exterior alcohol advertising. Interior alcohol advertisements were observed in 92% of stores, and 37% of stores had high-intensity interior advertising�. Liquor stores (OR = 18.5), convenience/gas stores (OR = 4.8), convenience stores (OR = 3.9), and small grocery stores (OR = 3.5) were more likely than supermarkets to have high-intensity interior advertisements. Low-height advertisements were found in 44% of stores. Low-height advertising was more common in liquor stores (OR = 5.1) and in convenience/gas stores (OR = 2.2) than in supermarkets. Less than half (48%) of the stores in the sample had alcohol control or counter-alcohol signage, with no statistically significant differences by store type. Approximately half (51%) of the stores provided at least one alcohol-branded functional object. These objects were more likely to be in liquor stores (OR = 4.2), convenience stores (OR = 1.8), and small grocery stores (OR = 2.0) than in supermarkets . Among all types of stores, beer was located most commonly in coolers (96%), in floor displays (44%), on shelves (23%), and as singles in ice buckets (16%). Single beers in ice buckets, located most often near checkout locations, were most likely to be found in convenience stores (27%), convenience/gas stores (18%), and small grocery stores (27%). Shelf displays of beer were most common in supermarkets (47%) and drug stores (43%); 1% of stores placed beer behind a counter or in a closed or locked cabinet. This is significant because POP marketing can increase total beer sales by as much as 17% and influences consumer purchase behavior, with 70% of a buyer's purchasing choice occurring after the buyer enters the retail establishment. Persons aged 21--27 years are more likely to purchase beer in convenience stores and liquor stores than in supermarkets and drug stores, and 75% of teenagers shop at convenience or convenience/gas stores weekly. Therefore, aggressive POP marketing in convenience and liquor stores might influence young adults, underage persons, and adolescents disproportionately. These age groups also have the highest rates of binge drinking and alcohol-impaired driving (1). The findings in this report are subject to at least two limitations. First, the communities and retail stores included in this study might not be representative of all communities and stores in the United States. Second, although retailer selection was random, no effort was made to ensure that the various store types were represented proportionally. Few POP alcohol marketing guidelines exist. Given the efficacy and widespread use of POP alcohol marketing, policy makers and public health agencies should work with liquor control boards to curb sales practices that could either increase risky drinking (e.g., selling iced single beers, particularly near checkout counters, which might increase drinking and driving) or promote drinking among young adults, adolescents, and children (e.g., high-intensity or low-height advertising).

Public Domain

Toomey TL; Wagenaar AC. Physical availability: A firm base for building the next decade of alcohol research, policy and practice. comment on chapter 7: Regulating the physical availability of alcohol. (editorial). Addiction 98(10): 1357-1358, 2003. (8 refs.)

This is a commentary on a chapter in the WHo Report "Alcohol: No ordinary commodity by T Babor T; R Cantano; S Casswell; G Edwards ; N Giesbrecht, et al, 2003.

Treno AJ; Grube JW; Martin SE. Alcohol availability as a predictor of youth drinking and driving: A hierarchical analysis of survey and archival data. Alcoholism: Clinical and Experimental Research 27(5): 835-840, 2003. (23 refs.)

Background: Much attention has recently been directed toward developing preventive interventions to reduce drinking and driving through efforts to limit the numbers and locations of alcohol outlets at the community level. Although evaluations of these efforts have suggested linkages between alcohol outlets and problem outcomes, they have not addressed the linkage between outlets and drinking and driving among youth. The analysis reported here investigates the relationship between alcohol outlet densities and underage drinking and driving as self-reported on two telephone surveys conducted in California. Methods: These analyses were based on data obtained from two telephone surveys conducted by the Prevention Research Center and archival data collected by the California Department of Alcoholic Beverage Control and the US Census Bureau. The sample for the first survey consisted of 15- to 20-year-old adolescents and young adults contacted by telephone, using a random digit dialing of exchanges in the greater San Francisco Bay Area. A second set of survey data was similarly collected by a random sample of households throughout California, and the Bay Area subset was also used for this analysis. Results: At the individual level, older respondents were more likely to report drinking and driving and riding with drinking drivers, whereas females and Asians were less so. At the aggregate or city-level, alcohol outlet density, as measured by the number of on- and off-premises establishments licensed to sell alcohol, was associated with both drinking and driving and riding with drinking drivers. These effects were moderated by a number of individual level effects, with younger respondents and females more likely to be affected by outlet densities. Conclusions: The findings here provide support for the implementation of policies targeting alcohol outlet density reductions. Areas with large numbers of such outlets provide ample opportunities to youth for alcohol purchases.

Virtual Media Resources. State Alcohol Advertising Laws: Current Status and Model Policies. Washington, DC: Center on Alcohol Marketing and Youth, Georgetown University, 2003. (16 refs.)

The alcohol industry spends more than $4.5 billion each year marketing its products. Underage youth are exposed heavily to this marketing with its youthful themes and images and its placements in media with large youth audiences. The concern about alcohol marketing and underage drinking has been heightened by recent findings in the scientific research community. Studies have established that alcohol advertising exposure influences a young person's beliefs about alcohol and his/her intention to drink. They also suggest that advertising may have a direct impact on youth drinking practices and drinking problems. These findings are bolstered by similar studies of tobacco advertising, which has been shown to influence the likelihood of young teenagers experimenting with tobacco. In response to this concern, public health advocates are increasingly urging policymakers to consider counter-advertising campaigns. State public health departments in California, Massachusetts and Florida made critical strides in reducing underage smoking rates in their states in recent years by sponsoring tobacco counter-advertising campaigns.6 Research indicates that this approach should also be used as part of a comprehensive public health strategy to reduce underage drinking. This report undertakes the first nationwide examination, state by state, of the existing tools state officials have at their disposal to reduce youth exposure to alcohol advertising and marketing. States have systems already in place for administering alcohol advertising regulations, usually (but not always) housed in an Alcoholic Beverage Control (ABC) state agency. Alcohol producers, distributors and retailers must obtain state licenses to do business in a state. Although specific authority varies by state, in general, the ABC agencies have broad authority to enact regulations (based on state statutes), investigate potential violations, and impose administrative sanctions. In control states, which operate retail and/or wholesale operations, retail advertising practices can be established through operational procedures. These factors point to the importance to the public health community of exploring the potential role of ABC agencies in regulating alcohol advertising. This report takes the initial step in this exploration. It identifies key state regulatory strategies that can be effective in reducing youth exposure to alcohol advertising and assesses current state practices, evaluating each state's current law and providing a means for each state to evaluate priorities for enforcement and statutory and regulatory reform. The findings are presented for each state.

Wagenaar AC; Lenk KM; Toomey TL. Policies to reduce underage drinking: A review of the literature. IN: Galanter M, ed. Recent Developments in Alcoholism. Volume 17: Alcohol Problems in Adolescents and Young Adults -- Epidemiology, Neurobiology, Prevention, Treatment. New York: Kluwer Academic, 2005. pp. 275-297. (49 refs.)

This paper reviews the literature on numerous alcohol control policies that may affect underage drinking and related problems. For each policy, there is a summary of the published studies on the effectiveness of the policy in the general population. It provides a more detailed review of studies that specifically addressing the effectiveness of the policy reducing underage drinking and drinking-related problems. The research is organized into four categories based on the amount of research. Policies with extensive research include those dealing with minimum legal drinking age and alcohol taxes/prices. Both of these approaches have been shown to lower underage consumption and results in fewer health and social problems for those under 21. Policy approaches with moderate research include server/manager training and advertising restrictions. The research to date has been primarily with the general populations, and results are mixed. Policies with minimal research include compliance checks; seller-server liability; community/public event restrictions; happy hour restrictions; social host liability; and public drinking restriction. The authors conclude that some of these may have promise, e.g. compliance checks, but research is to date too limited. Policies with no research include home delivery restrictions; restriction of specific products, server minimum age, shoulder-tap enforcement (loitering outside alcohol establishments and trying to get someone to purchase alcohol for underage persons); false age-identification regulations; and public drinking restrictions.

Wagenaar AC; Lenk KM; Toomey TL. Policies to reduce underage drinking: A review of the recent literature. IN: Galanter M, ed. Recent Developments in Alcoholism, Volume 17. Alcohol Problems in Adolescents and Young Adults: Epidemiology, Neurobiology, Prevention, Treatment. New York: Kluwer Academic/Plenum Press, 2005. pp. 277-300. (84 refs.)

This paper reviews the scientific literature on a variety of control policy that may affect underage drinking and related problems. For each policy the article summarizes the published literature, and then provides a more detailed on the application of that policy to campus populations. The article is organized in terms of the level of research that is available. Policies with extensive drinking include minimum drinking age laws, and alcohol taxes/prices. Policies with moderate research include server/manager training and advertising restrictions. Policies with minimal research include compliance checks, seller/server liability, community/public event restrictions, happy hour restrictions, social host liability, keg registration, warning signs, and public drinking restrictions. Polices with no research findings to evaluate their effectiveness include home delivery restrictions, server minimum ages, false ID regulations, restricting specific products (e.g. single servings, or sweet-flavored beverages).

Wagenaar AC; Toomey TL; Erickson DJ. Complying with the minimum drinking age: Effects of enforcement and training interventions. Alcoholism: Clinical and Experimental Research 29(2): 255-262, 2005. (50 refs.)

This article summarizes the proceedings of a symposium presented at the 2004 Research Society on Alcoholism meeting in Vancouver, British Columbia, organized by Alexander C. Wagenaar and chaired by Mark S. Goldman. The purpose of the symposium was to present the design and outcomes from a recently completed multi-community controlled time-series trial entitled Complying with the Minimum Drinking Age (CMDA), which tested two approaches for enhancing the effectiveness of the legal drinking age policy: training of alcohol retailers, and police enforcement at alcohol establishments. Specific presentations were: (1) Introduction and Overview of the CMDA project by Alexander C. Wagenaar, (2) CMDA Interventions by Traci L. Toomey, (3) CMDA Measurement, Statistical Methods and Results by Darin J. Erickson, and (4) Conclusions, Implications and Future Applications by Alexander C. Wagenaar. Results from the trial show: (1) minimal effects of the brief version of Alcohol Risk Management training for alcohol outlet management, (2) significant effects of enforcement checks in reducing sales of alcohol to youth, (3) a concentration of effects in specific alcohol outlets experiencing an enforcement check with little diffusion of effects to other outlets in the community not experiencing a check, and (4) a substantial decay of enforcement effects over the three months following a specific check. In short, results showed significant and substantial specific deterrence effects, and little training effects. Results also illustrated the utility and strength of the controlled time-series trial research design. Additional research on temporal and geospatial distribution of community-level intervention effects is warranted.

Warner J. 'Ask the physician': The modern relevance of an 18th century public health crisis. (editorial). Addiction 98(2): 139-140, 2003. (14 refs.)

Warner KE. To educate or not to educate: Is that the question? (editorial). Addiction 102(9): 1352-1353, 2007. (13 refs.)

This is a reponse to Giesbrecht's article on the need to re-evaluate conventional approahces to alcohol education. The author presents lessons that might be drawn from an examination of the nicotine-tobacco publich health efforts around tobacco.

Weatherburn D; Jones C; Freeman K; Makkai T. Supply control and harm reduction: Lessons from the Australian heroin 'drought'. Addiction 98(1): 83-91, 2003. (29 refs.)

Aims: To examine the effects of supply-side drug law enforcement on the dynamics of the Australian heroin market and the harms associated with heroin. Setting Around Christmas 2000, heroin users in Sydney and other large capital cities in Australia began reporting sudden and significant reductions in the availability of heroin. The changes, which appear to have been caused at least in part by drug law enforcement, provided a rare opportunity to examine the potential impact of such enforcement on the harm associated with heroin. Design: Data were drawn from a survey of 165 heroin users in South-Western Sydney, Australia; from the Drug Use Monitoring in Australia (DUMA) project; from NSW Health records of heroin overdoses; and from the Computerized Operational Policing System (COPS) database. Findings: Heroin price increased, while purity, consumption and expenditure on the drug decreased as a result of the shortage. The fall in overall heroin use was accompanied by a significant reduction in the rate of overdose in NSW. However, the health benefits associated with the fall in overdose may have been offset by an increase in the use of other drugs (mainly cocaine) since the onset of the heroin shortage. There does not appear to have been any enduring impact on crime rates as a result of the heroin 'drought'. Conclusion: Supply control has an important part to play in harm reduction; however, proponents of supply-side drug law enforcement need to be mindful of the unintended adverse consequences that might flow from successfully disrupting the market for a particular illegal drug.

Wechsler H; Lee JE; Nelson TF; Lee H. Drinking and driving among college students: The influence of alcohol-control policies. American Journal of Preventive Medicine 25(3): 212-218, 2003. (31 refs.)

Studies have reported high rates of heavy episodic drinking and alcohol-related problems, including drinking and driving, among college students. However, most studies have been conducted in single colleges or states. This study used a national sample to examine policy factors associated with alcohol-involved driving. Methods: A random sample of full-time students (N=10,904) attending a nationally representative sample of 4-year colleges in 39 states (n=119) completed self-administered questionnaires. The questionnaire examined driving after consuming any alcohol, driving after greater-than or equal to5 drinks, and riding with a high or drunk driver. Individual-level data about driving after greater-than or equal to5 drinks were linked to information on the policy environment at both local and state levels and to ratings of enforcements for drunk driving laws. Results: Drinking and driving behaviors are prevalent among a minority of college students and differ significantly among student subgroups. Students who attend colleges in states that have more restrictions on underaged drinking, high volume consumption, and sales of alcoholic beverages, and devote more resources to enforcing drunk driving laws, report less drinking and driving. Conclusion: The occurrence of drinking and driving among college students differs significantly according to the policy environment at local and state levels and the enforcement of those policies. Comprehensive policies and their strong enforcement are promising interventions to reduce drinking and driving among college students.

WHO Regional Office for Europe; Aruaudova A. Seventh Futures Forum: On unpopular decisions in public health. Copenhagen: World Health Organization, 2005. (0 refs.)

Public health decisions often create strong public resistance from the people who do not expect to benefit from them. Opposition arises because people are afraid that the proposed changes will deprive them of services, rights or freedoms. The most outspoken opponents of a decision are usually those who anticipate suffering individual or collective financial, social or political losses. Thus, decision-makers are frequently confronted with a situation of controversy. On the one hand, their professional judgement tells them that a certain decision is necessary because it will bring health gains; they therefore have to go ahead with it. On the other hand, they understand that this decision may be potentially unpopular and may trigger resistance. The WHO's 7th Futures Forum aimed to identify tools for making public health decisions more acceptable and popular. This report summarizes the discussions at the Seventh Futures Forum held in November 2004 in St Julian's, Malta. This Futures Forum based its work on presenting practical cases from countries followed by open discussions and an exchange of experience and ideas. Each section outlines one specific problem and the key points from the country case studies and summarizes the debate on that problem. The summary highlights some approaches that all participants agreed would usually work in their country and, separately, some solutions on which there is no consensus that may be useful in one country but not applicable to another. Section 1 deals with how policy-makers can adjust to the public while remaining firm in pursuing health objectives; section 2 focuses on the ways of measuring the public demand (tobacco is used as the case example); section 3 describes practices and ideas for predicting how the public will accept a decision; section 4 pulls together the ideas shared by the participants on how to make public health decisions more popular, using alcohol as the case example; and section 5 discusses the issue of popularity in the light of the divergent roles governmental health officials play in managing unpopular decisions. The concluding section sets forth specific suggestion for making public health efforts more popular and acceptable.

WHO Regional Office for Europe; Aruaudova A. What Are the Most Effective and Cost-Effective Interventions in Alcohol Control?. Copenhagen: World Health Organization Regional Office for Europe, 2004. (24 refs.)

This is a Health Evidence Network (HEN) synthesis report on the most effective and cost-effective interventions in alcohol control. Evidence shows the most effective approach is to implement a combination of: increases in alcohol prices, reduction in the availability of alcohol, and measures against drunk driving andunderage drinking. A report from the Health Evidence Network reviews the evidence on effective and costeffective interventions in alcohol control and outlines considerations for policy-making. This report is HEN's response to a question from a decision-maker. It provides a synthesis of the best available evidence, including a summary of the main findings and policy options related to the issue. HEN, initiated and coordinated by the WHO Regional Office for Europe, is an information service for public health and health care decision-makers in the WHO European Region. Other interested parties might also benefit from HEN. This HEN evidence report is a commissioned work and the contents are the responsibility of the authors. They do not necessarily reflect the official policies of WHO/Europe. The reports were subjected to international review, managed by the HEN team.

Public Domain

Williams TT; Jason L; Pokorny SB. Youth attitudes towards tobacco control laws: The influence of smoking status and grade in school. Journal of Child & Adolescent Substance Abuse 17(2): 1-14, 2007. (28 refs.)

This study examined adolescent attitudes towards tobacco control laws. An exploratory factor analysis, using surveys from over 9,000 students; identified the following three factors: (1) youth attitudes towards the efficacy of tobacco control laws, (2) youth attitudes towards tobacco possession laws and (3) youth attitudes towards tobacco sales laws. Findings revealed that smokers reported less favorable attitudes towards the efficacy of tobacco control laws, tobacco possession laws, and tobacco sales laws than non-smokers. In addition, youth in lower grade levels reported more support for the efficacy of tobacco control laws and tobacco possession laws than those in higher grades. Findings indicate that there are different dimensions of youth attitudes towards tobacco control laws, and that smoking status and grade in school have important relationships to these different factors. This understanding might better allow the perspectives of youth to be an additional consideration when developing and implementing laws aimed at minimizing underage smoking.

Wodak A; Cooney A. Should cannabis be taxed and regulated? Drug and Alcohol Review 23(2): 139-141, 2004. (27 refs.)

The authors note that after a century of prohibition, Australia's cannabis industry is the same financial size as it gold industry, twice the size of the wine industry and three-quarters the size of the nation's beer industry. The annual revenues associated with cannabis are estimated to be $5 billion. The origins of the nations cannabis policy are reviewed, which date to 1925 and a League of Nations International meeting in 1925 that acted to prohibit cannabis. The impact of transferring this income to the legitimate economy, as well as reduction in costs related to its illicit status are considered. Considered in this equation is the net effect of such a policy on health, social and economic costs. It is noted that a significant proportion of criminal justice resources are related to cannabis offences, though compared to other illicit drugs, there appears to be a relatively low level of crime associated with cannabis. Similarly, compared to tobacco and alcohol, the health costs are said to be modest. In addition there is discussion of the potential benefits from separating the cannabis market from the markets for other illicit drugs. The manner in which a licit cannabis could be organized is noted.

Zeigler DW. The alcohol industry and trade agreements: A preliminary assessment. (review). Addiction 104(Supplement 1): 13-26, 2009. (102 refs.)

To review trade agreements, their relation to alcohol control policy and examine the role of the alcohol industry in supporting and attempting to influence trade policy. Review of peer review, public health advocacy literature (both pro and con on free trade), business, press and government documents on trade agreements, assess current and potential challenges by trade agreements to alcohol control policy and investigate the means and extent of industry influence in trade agreements. 'Free' trade agreements reduce trade barriers, increase competition, lower prices and promote alcohol consumption. However, international treaties, negotiated by free trade experts in close consultation with corporate lobbyists and without significant, if any, public health input, governments and corporations contain significant provisions that will result in increased alcohol consumption and may challenge public health measures of other nations as constraints on trade. Conversely, alcohol control measures seek to reduce access and consumption, raise prices and restrict advertising and product promotion. The prospect is for increased alcohol consumption and concomitant problems throughout the world. Trade agreements challenge effective alcohol control policies. The alcohol industry seeks to influence agreements and can be expected to work through trade agreements to reduce tariffs, increase market access and seek to restrict effective domestic regulations. Further research is needed on the impact of trade agreements and the ongoing role of the industry. Advocates must recognize the inherent conflicts between unbridled free trade and public health, work to exclude alcohol from trade agreements, counter industry influence and protect alcohol control policies.