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Abstract
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AIMS: To examine state alcohol control policy implementation by policy efficacy and intent.
DESIGN: A descriptive longitudinal analysis of policy implementation. SETTING: The United States, 1999-2011. PARTICIPANTS: 50 states and the District of Columbia. MEASUREMENTS: 29 state-level policies were rated based on an implementation rating (IR; range = 0.0-1.0) gathered from the Alcohol Policy Information System, government and industry reports, and other sources; and expert judgment about policy efficacy for addressing binge drinking and alcohol-impaired driving among the general population and youth, respectively. FINDINGS: On average, implementation of the most effective general population policies did not change (mean IR 0.366 in 1999; 0.375 in 2011; slope for annual change = 0.001; 95% confidence interval for the slope -0.001, 0.002). In contrast, implementation increased over time for less effective policies (mean IR 0.287 in 1999; 0.427 in 2011; slope for annual change compared with most effective policies = 0.009; slope 95% CI 0.002-0.007), youth-oriented policies (mean IR 0.424 in 1999; 0.511 in 2011; slope for annual change compared with most effective policies = 0.007; slope 95% CI 0.005-0.009), and impaired driving policies (mean IR 0.493 in 1999; 0.608 in 2011; slope for annual change compared with most effective policies = 0.0105; slope 95% CI 0.007-0.014).
CONCLUSIONS: Implementation of politically palatable state alcohol policies, such as those targeting youth and alcohol-impaired driving, and less effective policies increased during 1999-2011 in the US, while the most effective policies that may maximally protect public health remained underused.
Language: en |