Academic journal article Alcohol Research

Regulating Availability: How Access to Alcohol Affects Drinking and Problems in Youth and Adults

Academic journal article Alcohol Research

Regulating Availability: How Access to Alcohol Affects Drinking and Problems in Youth and Adults

Article excerpt

In addition to increasing beverage taxes or prices as a means to reduce alcohol accessibility, policymakers also may limit alcohol availability through laws and regulations that (1) proscribe sales to underage youth; (2) allow the monopolization of production, distribution, or sales of alcohol; and (3) reduce physical access to alcohol by reducing numbers of outlets or limiting hours and days of sale. These restrictions on availability have been declared effective for reducing alcohol abuse and related problems in major policy reviews (Anderson et al. 2009; Campbell et al. 2009; Popova et al. 2009) and often are the focus of community-based prevention programs (e.g., Guide to Community Preventive Services 2011). This article provides a brief history of availability studies over the past 60 years, points out the limitations of some of this work, and provides some guidelines for the future. It concludes with some general observations about the social ecology of alcohol outlets and suggests how this larger conceptual framework can integrate these research efforts. The intent is to provide a guide to relevant concepts, literature, and research questions for students and researchers new to this area of study.

HISTORICAL BACKGROUND

With the exception of the United States' experiment with prohibition, policymakers generally have taken more moderate approaches to regulating the availability of alcohol. In the early and mid-20th century, policymakers in Scandinavia and the United Kingdom experimented with regulations intended to reduce or minimize alcohol problems by rationing alcohol, monopolizing sales through State agencies, and otherwise restricting alcohol markets. Alcohol-policy researchers benefited from these experiments when science-based alcohol-policy studies were pioneered by researchers in these countries (see Babor et al. 2003; Bruun et al. 1975; Edwards et al. 1994). Alcohol-policy research in the United States lagged far behind, with the earliest work performed by economists in the 1960s (e.g., Simon 1966) and modern quantitative studies getting under way in the 1980s. Hoadley and colleagues (1984) and Ornstein and Hannsens (1985) performed the first large-scale, State-level statistical analyses of alcohol-control laws and their relationships to alcohol sales, suggesting that populations living in monopoly States, or States with other restrictive control systems, drank less and had fewer alcohol-related problems.

Theoretical approaches to understanding the effects of alcohol-control regulations on alcohol use and problems were in a fairly primitive state in the 1980s. Researchers relied upon some general assumptions about the effects of regulation on the costs of alcohol (e.g., convenience costs plus real costs summarized as full costs; see Chaloupka et al. 1998) and the Ledermann hypothesis (Ledermann 1956), which posits that changes in average drinking levels would affect heavy use and problems. The full-cost model assumed that reduced availability would increase the costs of alcohol to individual drinkers, resulting in decreased purchases, use, and problems. The Ledermann hypothesis restated observed statistical associations between average use and problems, occasionally rationalized by reference to general forms of social or cultural influence (Gmel and Rehm 2000; Skog 1985). Both approaches received general support in the research literature (see Single 1988), but neither adequately addressed the structural aspects of alcohol-distribution systems (e.g., the effects of alcohol monopolies; see Cook 2007) or the specific effects of drinking contexts on problems (e.g., violent assaults related to alcohol outlets; see Parker 1993). More comprehensive approaches to detailing the social ecological mechanisms that shape drinking patterns and behaviors began to appear in the 1990s (Babor et al. 2003; Parker 1993; Stockwell and Gruenewald 2001). Before discussing this theoretical work, the following section will review the many empirical advances that were made during this time. …

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