An alcohol policy scale to characterize the alcohol policy environment in u.s. states

Background: Alcohol control policies can reduce excessive alcohol consumption and related harms, but they are typically evaluated individually in isolation from one another. A measure is needed to characterize the alcohol control environment and groups of policies in each state.

Methods: A panel of 10 alcohol policy experts nominated and rated the efficacy of state-level alcohol policies for reducing outcomes in four domains: adult binge drinking, youth binge drinking, adult drinking and driving, and youth drinking and driving. Furthermore, a system was developed for rating the implementation of specific policies based on the presence or absence of specific provisions. Data on 29 state-level alcohol policies were from the Alcohol Policy Information System and other data sources and weighted by efficacy and implementation to derive a measure of the alcohol policy environment for all four outcome domains by state and year from 1999-2011(a sample of n=650 state-years).

Results: The Alcohol Policy Scale (APS) for each outcome domain showed substantial variation between states; APS scores were generally normally distributed. There was strong internal consistency among five methods of calculating the APS scores (r>0.50 between all methods).

Summary: It is feasible to measure the aggregate alcohol policy environment in the United States. In future research we will examine the relationship between APS scores and alcohol-related outcomes. Policy scales can play an important role in understanding how policy can influence patterns of alcohol use and related outcomes.