Research ArticleEfficacy and the Strength of Evidence of U.S. Alcohol Control Policies
Section snippets
Background
Alcohol is a leading cause of morbidity, mortality, social problems, and economic costs in the U.S. and worldwide.1, 2, 3, 4, 5, 6, 7 Systematic reviews have identified a number of policies that can reduce excessive alcohol consumption and related harm,8, 9, 10 but little is known about the relative effects of multiple policies enacted in the same jurisdiction or how multiple policies function synergistically in practice. Tools are needed to compare the relative efficacy of policies and assess
Methods
The Delphi method provides guidance for areas of research where scientific information is controversial, incomplete or lacks precision, in order to synthesize expert opinion.15, 16 Ten alcohol policy experts from academia, government and the private sector, and representing different areas of expertise, including law, epidemiology, psychology, sociology, economics, and community organizing, were invited to participate on the basis of their expertise and contributions to either alcohol policy
Policy Efficacy Ratings
Table 1 displays the efficacy and strength-of-evidence ratings for each outcome (e.g., binge drinking and alcohol-impaired driving) among general and youth populations in quartiles across all 47 policies. The average efficacy ratings of the 47 alcohol policies in four outcome domains ranged from 2.5 to 2.8, a rating between somewhat effective (a score of 2) and effective (a score of 3; Table 2). Alcohol excise taxes were rated as the most effective policy in all four groups.
The mean efficacy
Discussion
The comparative rating of state alcohol control policies described in this paper builds on prior work1, 4, 6, 8, 9, 10, 11, 12, 13, 14 by (1) assessing policies specific to the U.S.; (2) examining a larger number of policies than have been examined in previous research; (3) using an expert panel with a modified Delphi approach to overcome gaps in existing research for certain policies and the relative lack of research directly comparing policies to one another; (4) rating policies using uniform
Acknowledgements
This work was funded by a grant from the National Institute of Alcohol Abuse and Alcoholism (R01 AA018377; T. Naimi, PI). The content of this manuscript does not necessarily represent the views of the National Institute of Alcohol Abuse and Alcoholism or the NIH.
No financial disclosures were reported by the authors of this paper.
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