UCare generously supports MinnPost’s Second Opinion coverage; learn why.

Effective alcohol-related bills are unpopular; ineffective ones tend to get OK’d, U study finds

Effective alcohol-related bills are unpopular
The beer, wine and liquor industry is a powerful lobby and spends a lot of money persuading politicians and the public on which policies should — and shouldn’t — be turned into law.

States have enacted a significant number of new laws aimed at reducing alcohol-related illnesses and deaths over the past decade or so, but most of that legislation tends to be ineffective, according to a study from researchers at the University of Minnesota and Boston University.

“It’s been a longstanding notion among alcohol researchers that effective policies are unpopular and popular policies are ineffective,” said Toben Nelson, the study’s lead author and an associate professor at the U of M’s School of Public Health, in a phone interview Wednesday with MinnPost. “Our findings suggest that is true.”

The study was published recently in the journal Addiction.

For the study, Nelson and his colleagues asked leading experts to use evidence-based research to rate and rank 29 different alcohol-related policies for their effectiveness. They then looked at which of these policies were most — and least — likely to have been implemented in the 50 states and the District of Columbia between the years 1999 and 2011.

“We were able to systematically document that there has been a big increase in what we might consider less effective policies, while during that same time period, the most effective policies — the ones that tend to be studied the most and that have the strongest information about whether they work or not — those policies weren’t adopted at all,” said Nelson. “In addition, existing policies weren’t strengthened. They didn’t change over time.”

Health care equity: How do we get there?

Addressing the biggest barriers to meaningful reduction in health-care disparities
Oct. 21 breakfast event at Northrop sponsored by UCare

Eventbrite - Health Care Equity: How do we get there?

Most of the new policies implemented during the time period of the study targeted underage drinking and alcohol-impaired driving — strategies that research has shown to have the weakest effect on addressing the social and health problems caused by excessive alcohol use.

But those policies are the ones that politicians — and the alcohol industry — prefer.

The inability of our elected officials to pass laws that are effective in reducing excessive alcohol consumption has serious ramifications, Nelson and his co-authors point out in their paper. Alcohol contributes to about 80,000 deaths per year in the U.S.  And its economic burden on our economy is enormous — about $223 billion annually both in direct medical costs and in indirect costs such as lost productivity and criminal justice expenditures.

“Those are pretty staggering costs,” said Nelson, “and the states absorb a lot of those in taxpayer dollars. We don’t come even close to recovering those costs in the levies we impose on alcohol.”

Effective vs. noneffective

Effective alcohol-related strategies include raising the tax on alcohol, restricting alcohol prices at both the retail and wholesale levels, restricting the number of liquor stores and other alcohol outlets in a particular geographic area, and restricting the days and hours during which alcohol can be sold.

These policies work, said Nelson, because they help reduce access to alcohol  — and thus the problems associated with excessive drinking — across a broad population of people.

Strategies that tend not to be as effective are those aimed at specific groups, such as teenagers and drunk drivers. These include keg registration laws, ignition interlock laws for DUI offenders, and laws that impose a minimum age on people serving alcohol.

Policies aimed at educating young people about the risks of alcohol use weren’t even included in the study because research has shown they have no impact on drinking at all. “Our experts had to think that a policy was a least somewhat effective for it to be included,” Nelson explained.

Some laws aimed at youth and drunk drivers can be effective, however, including those that require graduated drivers licenses, that impose a minimum legal drinking age (21 years), that revoke drivers licenses from people found guilty of driving while over the legal alcohol limit, and that make the adult hosts of parties legally responsible for the actions of underage drinkers.

Raising awareness

Nelson and his co-authors note that “the rise of libertarian political thinking, the consolidation for the alcohol industry and changing campaign financing laws” may have influenced the implementation of alcohol-control policies over the past decade and thus account for their study’s findings.

The beer, wine and liquor industry is a powerful lobby and spends a lot of money persuading politicians and the public on which policies should — and shouldn’t — be turned into law. In 2013, the industry spent more than $23 million on campaign contributions alone, according to the Center for Responsive Politics.

Not surprisingly, the industry lobbies against any policies that might effectively lower alcohol consumption. It’s also been quite successful at drowning out the voices of public health officials who argue for more restrictive policies.

“It’s important that the general public be aware of the significant public health burden that is created by alcohol use and for the public to also be aware that there is a pretty wide range of available policy options out there that can be adopted and that actually work,” said Nelson.

Effective policies — things like excise taxes and limiting when and where alcohol can be purchased — may inconvenience and cost the average consumer of alcohol a bit more, but those policies will reap huge social and economic savings for individual states and for the country, he added.

“The most effective policies are likely to reduce the problems associated with excessive drinking because they reduce drinking overall,” write Nelson and his co-authors. “Widespread implementation of effective policies may have a negative impact on future sales of alcohol products, and on this basis are likely to be opposed by alcohol-related industries.”

“It is important to be aware of the tension between public health and economic interests when considering the adoption of alcohol control policies,” they add. “Industry may try to influence both public opinion and views of legislators about the role of policy. The tension between public health goals and industrial economic interests … probably plays a significant role in the lack of adoption of the most effective policies.”

You’ll find an abstract of the study on Addiction’s website.

You can also learn about all our free newsletter options.

Comments (4)

  1. Submitted by Todd Hintz on 10/16/2014 - 11:49 am.


    A buddy once said “don’t make rules you can’t enforce.” It’s pointless as people will just ignore them anyway and you will erode your credibility.

  2. Submitted by Ray Schoch on 10/16/2014 - 01:25 pm.

    It’s too bad

    …prohibition didn’t – and doesn’t – work. *That* would be an effective policy if only the offhand comment by the buddy of Todd Hintz wasn’t so true. I’d support prohibition of alcohol *and* other drugs if I thought it had any chance of working. It doesn’t.

    Alcohol has the same kinds of effects, on individuals who consume it, on family members, on the society at large, as do other drugs like cocaine and heroin. Liquor stores are drug emporiums in the most negative sense of the word, and liquor store clerks serve the same social role as does the guy selling a small plastic bag of some substance on the street corner – or a kilo of it in someone’s garage or basement.

    But the alcohol industry has been established for thousands of years, makes billions of dollars, employs thousands of people, pays millions across the country in various targeted taxes, and because it’s so wealthy, has an extended and effective lobbying presence in every state in the country. As a society, we decided to make it a socially-acceptable commercial enterprise after the disaster of prohibition in the 1920s showed conclusively that “Just say no” doesn’t work.

    Behaviorally, there’s no significant difference between a bunch of people gathering in someone’s living room to smoke pot while watching a movie, game or the week, or some other televised event and the same group of people gathering in the same living room to share what are euphemistically called “adult beverages” while watching the same televised event. If anything, the behavior of those consuming alcohol will be worse than that of those smoking pot.

    The impairment of judgment or behavior is simply based on consumption of a substance that impairs judgment or behavior, no matter how it’s ingested or what it’s called. State troopers and/or local police are given the sisyphean task of trying to enforce drunk driving laws by the least efficient and least effective method possible – randomly stopping drivers whose impairment is severe enough to be visible to others sharing the same roadway – instead of simply camping out near popular bars and liquor-serving eateries to give breathalyzer tests to patrons as they leave the establishment. The same tactic that nets municipalities sizable amounts of revenue from speeding tickets could be – but pointedly is not – used to raise revenue (in the name of “public safety”) from stopping drunks *before* they get behind the wheel.

    It would be VERY unpopular for law enforcement agencies to adopt this strategy because it has the potential to be quite effective, which is the point of the U’s study. A contributing factor might be that many a law enforcement officer is a consumer of alcohol him/herself.

    Or, as an alternative, what if alcohol producers – companies and their executives and employees – were held legally responsible for damages done by consumers of their product(s)? I can already hear the cries of outrage from local craft breweries and small-scale liquor producers. It ain’t gonna happen.

    Reducing consumption shrinks revenue for the producers, and while much could be done to reduce the carnage that annually takes place via workplace accidents, auto accidents, domestic abuse, child abuse, and a host of other means by which those under the influence make life less pleasant for their fellow citizens, adopting those measures would reduce shareholder value. In the current atmosphere of capitalism run amok, the business community, particularly the alcohol-related business community, isn’t going to allow those measures proven to be effective to be adopted.

  3. Submitted by Greg Kapphahn on 10/17/2014 - 09:16 am.

    There Are Some People Biologically Predisposed to Addiction

    But for the vast majority, their addictive use of alcohol, other chemicals, other people, some forms of religion (definitely not the case with every religious person or every religion), etc.,

    are based on preexisting psychological dysfunctions which pursuing their addiction allows them to express.

    This can clearly be seen in anyone who goes through a distinct personality change when in the midst of pursuing their addiction.

    Those without such dysfunctions demonstrate the effects of their chemical of choice or other pursuit, but do not become, in essence, someone they’re NOT when they’re “sober.”

    Those using addictions to express dysfunctions are using the effects of that addiction to release aspects of their personalities that they don’t normally have access to, which is why they become different people when “under the influence” of their addiction (whatever it is).

    These locked-away personality aspects, however, seem to have a life of their own – they create urges in those within whom they’re locked away – urges which cause those individuals to pursue their addiction in order that the figurative bars on their internal cages might be thrown open allowing them to escape and be freely expressed for a time.

    When those harboring such locked-away personality pieces and demonstrating the dysfunctions they cause find the help they need to heal the original traumas that caused those pieces to be locked away,…

    those locked-away personality pieces are reintegrated into their normal personalities and they find they no longer need to pursue their addictions.

    The bottom line is, if we all treated each other a good deal more kindly, especially the youngsters among us,…

    and taught and required them to do the same with each other,…

    there would be far fewer addictions among us.

    If we applied the proper healing techniques to assist those who had been rendered dysfunctional by the cruel treatment of friends, family, communities, and communities of faith,…

    many if not most addictions could be resolved.

    THIS would do far more to address our addictive and abusive use of chemicals, each other, and religion than any rules and regulations could EVER do because, in almost every case,…

    addiction is a symptom of a different problem,…

    NOT the problem, itself.

  4. Submitted by John Mark Lucas on 10/21/2014 - 01:19 pm.

    A word in favor of ignition interlocks

    While it may not be that effective across a broad population, ignition interlocks have been shown to be one of the most effective countermeasures in addressing drunk driving problems. Three key research findings (see http://www.aic.tirf.ca) that support this include:
    • More than 10 evaluations of interlock applications have reported reductions in recidivism (of those previously convicted of DWI) ranging from 35-90% with an average reduction of 64%.
    • A systematic review of 15 scientific studies for the Centers for Disease Control and Prevention (CDC) found that while interlocks were installed, the re-arrest rate of offenders decreased by a median of 67% compared to groups who did not have the device installed.
    • In a Swedish Study, the frequency of annual DWI offenses decreased by approximately 60% among offenders who completed a two-year interlock program. Similar reductions were found two to four years after removal of the device.

    Minnesota joined the 50 states that now have ignition interlock programs in 2011 for good reason. If we cannot effectively restrict access to alcohol, we can at least limit access to vehicles by those who demonstrated irresponsible behavior in the past.

    The solution for the broader problem may be different. But for a specific population group, some of these programs do make sense.

    Oh and yes, we can also address the drunk driving issue with better transit and walkable communities. And this is true for me personally. One of the disappointing aspects of moving to the US from Europe and Asia was the reduced opportunity for a couple to have a nice dinner-drink date. It’s difficult to have one person sober in a party of two. I know I’m digressing a bit here, but talk about a broad solution….

Leave a Reply