Relationship between 29 Alcohol Policies and Youth Drinking in the U.S

Background: Youth drinking underlies 3 of the 4 leading underlying causes of death among adolescents. Alcohol policies can reduce youth drinking, but most policy studies study the effect of the presence of a particular policy in a single location. However, the specific provisions of a particular policy may impact its effectiveness. Methods: With assistance from 10 alcohol policy experts, ‘implementation indices' based on the presence of key policy provisions were developed for 29 alcohol policies in the U.S. Implementation index scores ranging from 0 (no policy) to 1 (full implementation) were developed for each policy by state and year from 1999-2009 using data from the Alcohol Policy Information System and other sources, and were matched with corresponding biennial data about state-specific youth drinking and binge drinking rates from the Youth Risk Behavior Survey (n=194 state-years of data). Results: The relationship between individual policies, weighted for the degree to which each was implemented, and youth drinking outcomes varied considerably between policies. However, certain population-based (e.g., non-youth-specific) policies, including alcohol taxes, were associated with lower rates of youth drinking and binge drinking (e.g., β=-0.8, p<0.01 for beer excise taxes and youth drinking). Conclusions: Some alcohol control policies are more strongly associated with youth drinking than others, and some policies that are population-based may affect youth drinking. This hypothesis-generating investigation will help guide future research and policy development activities. These data will also be compared with comparative policy effectiveness ratings based on the opinion of the 10 policy experts.