Law and Policy
Public and educational policies and legislation designed to prevent alcohol abuse are evaluated here on the basis of scientific research evidence.
What Can We Do?
People have different ideas about what kind of laws and policies might reduce alcohol abuse. The prohibitionists said we should eliminate all alcohol beverages, but that didn't -- and won't -- work. Prohibition actually leads to even more problems, such as the growth of organized crime, increased disrespect for law, unregulated and dangerous beverages, increased violence, the loss of tax revenue, corruption of law enforcement and other public officials, increases in binge drinking, and many other serious problems.
Because of the clear failure of prohibition, today's prohibitionists and other reduction-of-consumption advocates now typically call for a variety of laws and other measures to reduce rather than completely prohibit consumption. They tend to believe that:
- The substance of alcohol is, in and of itself, the cause of all drinking problems.
- The availability of alcohol determines the extent to which it will be consumed; availability causes people to drink more.
- The quantity of alcohol consumed (rather than the speed with which it is consumed, the purpose for which it is consumed, the social environment in which it is consumed, etc.) determines the extent of drinking problems.
- Educational efforts should stress the problems that alcohol consumption can cause and should promote abstinence.
What do they advocate?
These beliefs lead reduction-of-consumptionists (often called neo-prohibitionists, neo-drys, or neo-Victorians) to call for such measures as:
- Increasing taxes on alcohol beverages
- Limiting or reducing the number of sales outlets
- Limiting the alcohol content of drinks
- Prohibiting or limiting advertising
- Requiring warning messages with all advertisements
- Expanding the warning labels on all alcohol beverage containers
- Expanding the display of warning signs in establishments that sell or serve alcohol beverages
- Limiting the days or hours during which alcohol beverages can be sold
- Increasing server liability for subsequent problems associated with consumption
- Limiting the sale of alcohol beverages to people of specific ages
- Decreasing the legal blood alcohol content level for driving vehicles
- Eliminating the tax deductibility of alcohol beverages as a business expense
What's The Evidence?
Many reduction-of-consumption policies and proposals are currently very popular, but what does research tell us?
Limiting or prohibiting advertising of alcohol beverages: This is one of the most extensively studied issues and the evidence regarding it is very clear: There is virtually no evidence that advertising has any significant impact on consumption levels. 1 Significantly, it has "no impact on either experimentation with alcohol or abuse of it," according to a recent definitive review of worldwide evidence 2 and supported by other reviews of the research. 3 On the other hand, there is evidence that advertising can increase a brand's market share, 4 a finding consistent with the experience and actions of advertisers. [see Alcohol Advertising]
Increasing taxes on alcohol beverages: Wouldn't increasing the cost of alcohol beverages reduce the consumption and, thereby, their abuse? This reasonable question is based on two assumptions: (1) that higher alcohol prices will reduce demand and (2) that reducing consumption will reduce abuse.
The evidence suggests that rapid price increases tend to have a temporary affect on reducing the purchase of alcohol, primarily among moderate drinkers. But, price is only one of numerous factors affecting the consumption of alcohol beverages. 5 For example, problem drinkers tend not to let cost deter them while a third of the population (abstainers) wouldn't drink if alcohol beverages were free. 6 Other research evidence indicates that overall consumption levels in a population are not related to abuse. 7 This fact is relevant to the following proposals.
Limiting or reducing the number of sales outlets and limiting the days or hours during which alcohol beverages can be sold: Numerous studies, including analyses of behavior following actual changes in state and provincial laws, fail to find any evidence supporting these proposals. 8 In fact, some investigators have found that the tougher the controls over availability, the greater the alcohol abuse. 9 For example, where taverns and other on-premise outlets are fewer and more geographically dispersed, the incidence of driving while intoxicated tends to be higher. Others have found that lower availability is associated with less frequent but very heavy drinking and other problems. 10
The experience of New Zealand is instructive. Since deregulation in 1989, the number of alcohol sales outlets has more than doubled, but the overall alcohol consumption continues to fall. There is no connection between increased availability and increased alcohol consumption. 11
The evidence from studies around the world suggests that neither limiting the number of outlets nor the days/hours of sale would be effective in reducing alcohol problems. 12 To the contrary, it might increase problems or create new ones. For example, Australian laws closing bars at six o'clock got the working men out of the establishments and possibly home to their families in time for dinner. However, they also produced the undesirable custom known as the six o'clock swill, which involves consuming as much alcohol as possible between the end of work and the six o'clock closing time. 13
Similarly, restricting the availability of alcohol can increase serious harm to some drinkers. For example, when restrictions were placed on the hours during which alcohol beverages could be sold in some urban areas, the consumption of such hazardous, often lethal, substances as rubbing alcohol and sterno fuel increased. Following this tragic discovery, restrictions were lifted and hours were extended in order to decrease consumption of toxic forms of alcohol. 13a
Requiring warning messages with all advertisements, expanding the warning labels on all alcohol beverage containers, and expanding the display of warning signs in establishments that sell or serve alcohol beverages: Studies of alcohol beverage container warnings have demonstrated that they have virtually no impact on drinking behavior, and absolutely none on drinking problems. 14 This is consistent with a review of 400 studies on the effectiveness of product warnings, which concluded that they have no impact on behavior. 15
Studies reporting awareness of warnings are highly suspect. For example, thirty-one percent of a large sample of women reported seeing the warning label in June of 1989, which was five months before it appeared on beverage containers. 16 And those who are most at risk of alcohol abuse appear to be the ones who are most strongly resistant to warnings. 17
Warning labels on advertising may actually be counterproductive, doing more harm than good. Some researchers have found that drinkers appear to consume more after viewing warning labels in a form of defiance or unconscious effort to assert their freedom and autonomy by doing what they are, in essence, told not to do. 18 The "forbidden fruit" phenomenon has been extensively documented with regard to alcohol and other products. 19
Limiting the sale of alcohol beverages to people of specific ages: Legislation that is intended to prohibit drinking customs that are embedded in a group risks failure, as did national prohibition in countries around the world, such as Iceland, Russia, Finland, and the United States. 20
Not surprisingly, age-specific prohibition appears to be ineffective in reducing either the proportion of drinkers or their drinking problems. "Statistics show that underaged persons increased their use of alcohol steadily from the 1930s to the 1960s, when legislation to curtail sales was most active." 21 Then, following the reduction of the drinking age in the 1970s, the proportion of collegians who drank trended downward. 22 In short, legislation has little impact on the drinking behaviors of young people. 23
Unfortunately, minimum age legislation sometimes backfires. For example, as one student observed, it "might be easier to hide a little pot in my room than a six pack of beer." 24 Perhaps more important, higher minimum age legislation tends to force young people to drink "underground," in unsupervised locations in which they learn undesirable alcohol attitudes and behaviors. And it may lead them to drink or to drink more: the forbidden fruit. 25 This is important because problem drinkers appear to begin their drinking at a later age than others, to have their first drinking experience outside the home, to become intoxicated the first time they drink, and to drink as an act of rebellion (open or secret) against authority. 26
Increased server liability for subsequent problems associated with consumption: Does making a public or private server of alcohol financially responsible for damage caused by serving alcohol to an intoxicated person lead to more responsible serving practices?
This question has been virtually ignored by investigators. However, one study examined the effects of two server liability cases in Texas during the 1980s. Before the lawsuits, Texans had very little liability for the consequences of their alcohol serving practices. The study found that after these two highly publicized and very controversial cases, single-vehicle nighttime crashes in Texas declined 6.5% in 1983 and 5.3% in 1994. 27 The researchers may be correct in assuming that these declines were due to the effects of the dramatic and sudden change in the law rather than any other factors. Additional research is needed to determine if increasing server liability is effective in reducing alcohol abuse, especially in the long term.
Decreasing the legal blood alcohol content level for driving vehicles: The effects of lowering the legal blood alcohol content (BAC) for drivers are unclear. 28 However, the average BAC among fatally injured drivers is .17 and about half have a BAC of .20 or higher (which is twice the legal limit in most states). 29 Thus, the problem is primarily among very heavy drinkers, who tend to be male, aged 25-35, have a history of DWI convictions, and be polydrug users. 30
Advocates of the reduction-of-consumption theory commonly promote the idea that alcohol is a "gateway" substance that leads people to use marijuana, which supposedly leads them on to use cocaine and other hard drugs. The New York State Division of Alcoholism and Alcohol Abuse presents this questionable theory as established fact by titling one of its publications, Alcohol: The Gateway Drug. 32 The "evidence" is that most people who use illegal drugs drank alcohol first. Of course, most people who use illicit drugs also drank milk, ate candy bars, and drank cola first. But only a very few of those who consume alcohol ever continue on to use cocaine or heroin. On the other hand, about a quarter of hard core drug abusers in New York City have never consumed alcohol. 33 The theory is clearly wrong, but that doesn't stop it from being promoted as truth and as a basis for the public policy of zero tolerance for youthful alcohol use.
Recent research casts further doubt on the gateway theory. Following their examination of the scientific evidence, researchers Stanton Peele and Archie Brodsky point out that the best predictors of abusive substance use are social, family, and psychological depredations that occur independent of supposed gateway linkages.
Rather than promoting the misleading gateway theory, they suggest that "What makes far more sense is to acknowledge the obvious to children -- that there is a healthy and unhealthy drinking," and explain that "Both research and common sense tell that the young people least likely to drink disruptively are those who are introduced to alcohol by moderate-drinking parents, rather than being initiated into drinking by their peers." The researchers explain that an exaggerated focus on alcohol as a supposed gateway to illegal drugs ignores the reality of responsible, moderate consumption and re-directs attention from effective measures to reduce alcohol abuse. The impact of the theory is, therefore, negative. 34
It appears that risk-takers may be more likely to skip school, to drink at an early age, to drive too fast, to engage in unprotected sex, and to use illegal drugs. 35 In that case, preventing people from engaging in the "gateway" behavior of drinking, or skipping school, or driving too fast will not prevent a risk-taker from taking drugs. Any policy based on the "gateway" theory can be expected to fail.
A Better Way
Based on the experience of societies around the world, advocates of the moderation approach to reducing alcohol problems tend to assume that:
- The misuse of alcohol, not alcohol itself, is the source
of drinking problems.
- It is important to distinguish between drinking and abuse.
- Abuse can be reduced by educating people to make one of two decisions -- abstinence or responsible (moderate) drinking.
- Knowledge of what is acceptable and unacceptable drinking behavior should be clear.
- The abuse of alcohol should not be tolerated under any circumstance.
- People who are going to drink as adults should gradually learn how to drink responsibility and in moderation.
Because of this, most moderationists propose that we abandon the current negative reduction-of-consumption attack upon alcohol and moderate drinking. There is much evidence that this negative approach to alcohol is based on questionable assumptions, 36 that its policies fail to achieve their objectives, 37 and that its policies may be counterproductive. 38
Stop stigmatizing alcohol as a "dirty drug," as a poison, as inherently harmful, or a substance to be abhorred and shunned. Alcohol is neither a poison nor a magic elixir capable of solving life's problems.
Stigmatizing alcohol serves no practical purpose, contributes to undesirable emotionalism and ambivalence, and increases the problems it seeks to solve. In stigmatizing alcohol, reductionists may unintentionally trivialize the use of illegal drugs and thereby encourage their use. Or, especially among younger students, they create the false impression that parents who use alcohol in moderation are drug abusers whose good example they should reject. Thus, their misguided effort to equate alcohol use with illicit drugs is likely to be counterproductive.
Begin new policies that place the alternative of responsible (moderate) drinking on an equal level to the alternative of abstinence. Federal and state agencies should not unfairly promote one of these alternatives over the other; both are equally acceptable.
Make systematic efforts to clarify and promote the distinctions between acceptable and unacceptable drinking. "The absurdity of defining only 'bad' drinking is analogous to teaching a youngster how to drive only by pointing out what not to do...." 39
Firmly penalize unacceptable drinking behaviors, both legally and socially. Intoxication must never be accepted as an excuse for otherwise unacceptable behavior. While the criminal justice system has an important role to play, the most important role must be played by individual peers -- friends, relatives, loved ones, co-workers, and other significant others -- who assume personal responsibility.
Permit parents to serve alcohol to their offspring of any age, not only in the home, but in restaurants, parks and other locations, under their direct supervision. If parents wish their children to abstain as adults, they need to serve as appropriate role models and teach them the attitudes and skills they will need in a predominately drinking society. However, if they wish their children to be able to drink in moderation as adults, then they, too, need to serve as appropriate role models and teach their children pertinent attitudes and skills for drinking in moderation.
Promote educational efforts to encourage moderate use of alcohol among those who choose to drink. Moderate drinking and abstinence should be presented as equally acceptable or appropriate choices. Those who choose to drink should not force drinking upon abstainers and those who choose not to drink should have comparable respect for those who do.
Research clearly does not support the theory that restrictive legislation is the answer to solving the problem of alcohol abuse.
Alcohol problems will be reduced primarily to the extent that we, as individuals, take personal responsibility for our own drinking. They will also be reduced further to the degree that we effectively promote either moderation or abstinence among those with whom we interact.
filed under: Legal Issues
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