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Preventing Excessive Alcohol Consumption

Excessive alcohol consumption is a risk factor for many health and social problems, contributing to 88,000 deaths each year in the United States.1 In 2006, the estimated economic cost of excessive drinking in the U.S. was $223.5 billion.2 Drinking too much can cause immediate harm such as injuries from motor vehicle crashes, violence, and alcohol poisoning, and drinking too much over time can cause chronic diseases, such as cancer and heart disease.1 This is designed to help public health program planners, community advocates, educators, and policymakers find proven intervention strategies—including programs, services, and policies—for preventing excessive alcohol consumption and related harms. It can help decision-makers in both public and private sectors make choices about what intervention strategies are best for their communities. This summarizes information in The Guide to Community Preventive Services (The Community Guide), an essential resource for people who want to know what works in public health. Use the information to help select intervention strategies you can adapt for your community to:

1.Reduce excessive alcohol use, including binge drinking and underage drinking.

2. Reduce the risk of chronic conditions such as liver disease, high blood pressure, heart disease, and cancer.

3. Reduce violent crime, motor vehicle injuries, and alcohol-exposed pregnancies.

4. Reduce youth access to alcohol.


Increasing alcohol taxes. Increasing the price of alcohol by raising taxes has proven effective in reducing consumption, leading to fewer deaths and injuries due to motor vehicle crashes, liver disease, violence, and other alcohol-related problems. For every 10% increase in price, alcohol consumption is expected to decrease by more than 7%. Public health effects are expected to be proportional to the size of the tax increase. Higher alcohol prices may also reduce underage drinking.

*Dram shop liability. Dram shop (or commercial host) liability refers to laws that hold alcohol retailers liable for injuries or deaths caused by a patron who was illegally served or sold alcohol because they were either intoxicated or under the age of 21 at the time of service. Commercial host liability is effective in preventing and reducing alcohol-related harms. For example, there was a median 6.4% reduction in deaths resulting from motor vehicle crashes in states with commercial host liability. �Regulation of alcohol outlet density. Alcohol outlet density refers to the number and concentration of alcohol retailers (e.g. bars, restaurants, and liquor stores) in an area. Higher alcohol outlet density is associated with excessive alcohol use and related harms, including injuries and violence. Alcohol outlet density is often regulated by licensing or zoning regulations. States vary in the extent to which they allow local governments to regulate the licensing and placement of retail alcohol outlets.

*Electronic screening and brief interventions (e-SBI). The delivery of screening and brief interventions for excessive alcohol use using electronic devices, such as computers, is effective for reducing self-reported excessive alcohol consumption and alcohol-related problems among intervention participants. Some e-SBI programs are fully automated while others combine screening by a health professional with the automated delivery of counseling services. The use of e-SBI can reduce the amount of time required to deliver screening and counseling services.

*Enhanced enforcement of laws prohibiting sales to minors. Enforcing minimum drinking age laws through retailer compliance checks and sanctions is effective in reducing sales of alcohol to minors in commercial settings by a median of 42 percent. Enhanced enforcement programs are often part of multi-component, community-based efforts to curb underage drinking.

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