Toben F Nelson1, Ziming Xuan2, Thomas F Babor3, Robert D Brewer4, Frank J Chaloupka5, Paul J Gruenewald6, Harold Holder6, Michael Klitzner7, James F Mosher8, Rebecca L Ramirez9, Robert Reynolds9, Traci L Toomey10, Victoria Churchill2, Timothy S Naimi11. 1. Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota. Electronic address: tfnelson@umn.edu. 2. Division of Community Health Sciences, Boston University School of Public Health. 3. Department of Community Medicine and Health Care, University of Connecticut School of Medicine, Farmington, Connecticut. 4. Alcohol Program, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia. 5. University of Illinois at Chicago, Chicago, Illinois. 6. Prevention Research Center, Berkeley. 7. CDM Group, Bethesda. 8. Alcohol Policy Consultations, Felton, California. 9. Pacific Institute for Research and Evaluation, Calverton, Maryland. 10. Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota. 11. Division of Community Health Sciences, Boston University School of Public Health; Section of General Internal Medicine, Boston Medical Center, Boston, Massachusetts.
Abstract
BACKGROUND: Public policy can limit alcohol consumption and its associated harm, but no direct comparison of the relative efficacy of alcohol control policies exists for the U.S. PURPOSE: To identify alcohol control policies and develop quantitative ratings of their efficacy and strength of evidence. METHODS: In 2010, a Delphi panel of ten U.S. alcohol policy experts identified and rated the efficacy of alcohol control policies for reducing binge drinking and alcohol-impaired driving among both the general population and youth, and the strength of evidence informing the efficacy of each policy. The policies were nominated on the basis of scientific evidence and potential for public health impact. Analysis was conducted in 2010-2012. RESULTS: Panelists identified and rated 47 policies. Policies limiting price received the highest ratings, with alcohol taxes receiving the highest ratings for all four outcomes. Highly rated policies for reducing binge drinking and alcohol-impaired driving in the general population also were rated highly among youth, although several policies were rated more highly for youth compared with the general population. Policy efficacy ratings for the general population and youth were positively correlated for reducing both binge drinking (r=0.50) and alcohol-impaired driving (r=0.45). The correlation between efficacy ratings for reducing binge drinking and alcohol-impaired driving was strong for the general population (r=0.88) and for youth (r=0.85). Efficacy ratings were positively correlated with strength-of-evidence ratings. CONCLUSIONS: Comparative policy ratings can help characterize the alcohol policy environment, inform policy discussions, and identify future research needs.
BACKGROUND: Public policy can limit alcohol consumption and its associated harm, but no direct comparison of the relative efficacy of alcohol control policies exists for the U.S. PURPOSE: To identify alcohol control policies and develop quantitative ratings of their efficacy and strength of evidence. METHODS: In 2010, a Delphi panel of ten U.S. alcohol policy experts identified and rated the efficacy of alcohol control policies for reducing binge drinking and alcohol-impaired driving among both the general population and youth, and the strength of evidence informing the efficacy of each policy. The policies were nominated on the basis of scientific evidence and potential for public health impact. Analysis was conducted in 2010-2012. RESULTS: Panelists identified and rated 47 policies. Policies limiting price received the highest ratings, with alcohol taxes receiving the highest ratings for all four outcomes. Highly rated policies for reducing binge drinking and alcohol-impaired driving in the general population also were rated highly among youth, although several policies were rated more highly for youth compared with the general population. Policy efficacy ratings for the general population and youth were positively correlated for reducing both binge drinking (r=0.50) and alcohol-impaired driving (r=0.45). The correlation between efficacy ratings for reducing binge drinking and alcohol-impaired driving was strong for the general population (r=0.88) and for youth (r=0.85). Efficacy ratings were positively correlated with strength-of-evidence ratings. CONCLUSIONS: Comparative policy ratings can help characterize the alcohol policy environment, inform policy discussions, and identify future research needs.
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