People living in states with stronger alcohol policy environments have a substantially lower likelihood of any binge drinking, frequent binge drinking, and high-intensity binge drinking, according to a new study by researchers at the Boston University School of Public Health (BUSPH) and Boston Medical Center (BMC), published in the current issue of the American Journal of Public Health.
Specifically, the study found, each 10 percentage point increase in the strength of a state's alcohol policy score (reflecting more effective and/or better implemented alcohol policies) was associated with an 8 percent reduced likelihood of a person engaging in any binge drinking or binge drinking five or more times in the past 30 days; and a 10 percent reduced likelihood of consuming 10 or more drinks while binge drinking. In determining the results, researchers accounted for a variety of factors associated with alcohol consumption, such as age, sex, race, religion, income, geographic region, urban-rural differences and levels of police and alcohol enforcement personnel.
"This study shows that alcohol policies matter -- and matter a lot -- for reducing a person's risk of binge drinking, which is a leading cause of premature death and disability in the U.S.," said Ziming Xuan, lead author of the study and an assistant professor of community health sciences at BUSPH. "Our findings pertain not only to those who binge drink occasionally, but to those who do so frequently, or who consume the largest amounts of alcohol on any given occasion."
Binge drinking is responsible for more than half of the 80,000 alcohol-attributable deaths in the United States each year, and three-quarters of the $224 billion in annual economic costs. It is defined as consuming four or more drinks (for women) and five or more drinks (for men) during a drinking occasion. State binge drinking information for adults aged 18 years of age and older was obtained from the Behavioral Risk Factor Surveillance System surveys from 2005-2010.
Researchers analyzed data on 29 alcohol policies that are tracked by the Alcohol Policy Information System and other data sources. These policies were rated by an expert panel, based on their theoretical effectiveness and the degree to which were fully implemented in a particular state and year.
Among all policies assessed, those raising the price of alcohol and those reducing its physical availability were the most protective against binge drinking. Within those two policy categories, higher alcohol taxes and reduced numbers of alcohol outlets accounted for approximately half of the effect of all 29 policies combined.
"Unfortunately, most states have not fully utilized available policy tools to reduce binge drinking among their citizens, despite widespread and consistent scientific evidence demonstrating their effectiveness," said the study's senior author, Dr. Timothy Naimi, a physician at BMC and associate professor at BUSPH. "If alcohol policies were a newly discovered gene, pill or vaccine, we'd be investing billions of dollars to bring them to market."
Examples of effective alcohol policies include higher alcohol taxes, having fewer outlets licensed to sell alcohol, bans on happy hours and discount drink specials, earlier bar closing times, and laws to reduce impaired driving.
- Ziming Xuan, Jason Blanchette, Toben F. Nelson, Timothy Heeren, Nadia Oussayef, Timothy S. Naimi. The Alcohol Policy Environment and Policy Subgroups as Predictors of Binge Drinking Measures Among US Adults. American Journal of Public Health, 2014; e1 DOI: 10.2105/AJPH.2014.302112
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