Reducing Youth Access to Alcohol: Findings from a Community‐Based Randomized Trial

Abstract

Underage drinking continues to be an important public health problem and a challenge to the substance abuse prevention field. Community-based interventions designed to more rigorously control underage access to alcohol through retailer education and greater enforcement of underage drinking laws have been advocated as potentially effective strategies to help address this problem, but studies designed to evaluate such interventions are sparse. To address this issue we conducted a randomized trial involving 36 communities to test the combined effectiveness of five interrelated intervention components designed to reduce underage access to alcohol. The intervention was found to be effective in reducing the likelihood that retail clerks would sell alcohol to underage-looking buyers, but did not reduce underage drinking or the perceived availability of alcohol among high school students. Post hoc analyses, however, revealed significant associations between the level of underage drinking law enforcement in the intervention communities and reductions in both 30-day use of alcohol and binge drinking. The findings highlight the difficulty in reducing youth drinking even when efforts to curtail retail access are successful. Study findings also suggest that high intensity implementation of underage drinking law enforcement can reduce underage drinking. Any such effects of enhanced enforcement on underage drinking appear to be more directly attributable to an increase in perceived likelihood of enforcement and the resultant perceived inconveniences and/or sanctions to potential drinkers, than to a reduction in access to alcohol per se.

Adolescents, alcohol, and marijuana: Context characteristics and problems associated with simultaneous use

“…Limited research has found that situational (e.g., lack of adult supervision, alcohol availability, and lack of enforcement) and social (e.g., group size) context characteristics contribute to increased adolescent alcohol use (Bersamin et al, 2016; Grune et al, 2017; Jackson et al, 2016; Lipperman-Kreda et al, 2015). Characteristics of drinking or substance use contexts may influence alcohol or substance use and problems through increased access and opportunities to engage in risky behaviors (Flewelling et al, 2013; Ryan et al, 2010) or through social modeling, social pressure, or social norms (Chan et al, 2017; Handren et al, 2016). If we understand the situational and social contexts in which young people are likely to use substances simultaneously and experience problems, we can develop interventions that target use and risks within these contexts.…”

Using social marketing to create communities for our children and adolescents that do not model and encourage drinking

“…RYAA consisted of: reward and reminder visits to alcohol outlets, media advocacy (including articles in local papers and school newsletters on underage drinking); enforcement (compliance checks in alcohol outlets); and community coordination (including presentations and training). The evaluation consisted of annual surveys of 11th grade students and alcohol purchase surveys (decoy buyers) (Flewelling et al, 2013). Consistent with other studies, the intervention was found to be particularly effective in reducing sales to minors but did not impact on perceived availability or self-reported drinking.…”

“…This is reflected in the fact that those programs which have been effective have had clearly defined messages and interventions for each target group; for example, the implementation of SPF in Eau Claire County (Eddy et al, 2012); and in the conclusion by those who have evaluated enforcement approaches to underage supply that there is a need to concurrently address formal and informal supply (SchellemanOffermans et al, 2012, Flewelling et al, 2013.…”

Effects of a responsible retailing mystery shop intervention on age verification by servers and clerks in alcohol outlets: A cluster randomised cross‐over trial

“…The lack of a control group, however, makes interpretation of these results difficult. Positive results were also found in a multisite randomized trial in 36 Oregon communities that tested a comprehensive intervention that included a mystery shop program, but also enforcement compliance checks, media, and other community strategies [32]. ID-checking increased by 18% in intervention communities compared with 9% in control communities.…”