Alcohol policy scale and binge drinking among u.s. adults

Background: Excessive alcohol consumption is responsible for 80,000 deaths annually, and binge drinking is the most common form of excessive consumption. Some alcohol policies are effective at preventing excessive drinking and related harms at the population level. However, most policies are studied individually and little is known about how the alcohol policy environment relates to binge drinking.

Methods: Data on provisions of 29 state-level alcohol policies were extracted from the Alcohol Policy Information System and other data sources and used to derive a measure of the alcohol policy environment for each U.S. state and each year from 2000-2011. Data on state-level adult binge drinking prevalence were obtained from the Behavioral Risk Factor Surveillance System for years 2001-2011. The alcohol policy scale (APS) scores were related to adult binge drinking prevalence in linear regression models (n=561 state-year observations).

Results: APS scores and binge drinking prevalence varied substantially by state, and there was a significant inverse relationship between APS scores and binge drinking. Sensitivity analyses using different lag periods between policy exposure and drinking outcomes, or different methods of computing APS scores, did not substantially change our results. Introducing efficacy and implementation ratings optimized goodness-of-fit in statistical models (e.g., beta= -2.31, r²=0.49, p=0.0001).

Summary: The APS has internal validity and stronger policy environments are inversely associated with binge drinking. Future work is critical to understanding the role of the alcohol policy environment to reduce binge drinking by identifying highly effective combinations of policies.