The Science

The Community Guide
The Guide to Community Preventive Services (the Community Guide) is a collection of evidence-based findings of the Community Preventive Services Task Force and serves as a resource to communities selecting interventions to improve health and prevent disease. The Task Force is a nonfederal group of public health and prevention researchers and experts. The Community Guide uses a science-based approach to determine whether an intervention works and is cost effective.
Find out more about the Guide and Task Force here.


The Task Force found the following strategies showed strong and sufficient evidence for effectiveness in reducing excessive alcohol use
RECOMMENDED FOR | |
Increasing taxes | Avoiding price increases of alcohol including price promotions and drinks discounts |
Regulation of alcohol outlet density | Using zoning and licensing to limit the concentration of places that alcohol is sold in a given area |
Maintaining limits on days and hours of sale | Preserving existing limits on days of alcohol sales at on- and off-premise locations and avoiding an increase of hours of sale of two or more hours for on-premise locations |
Dram Shop Liability | Providing civil liability when the sale of alcohol to an intoxicated person results in harm or injury to an innocent party |
Enhancement of enforcement of laws prohibiting alcohol sales to minors | Conducting compliance checks of retail alcohol sales locations |
Electronic screening and brief interventions | Using electronic devices -- phone, computer, etc. -- to facilitate delivery of traditional screening interventions for alcohol use |
RECOMMENDED AGAINST | |
Privatization of retail alcohol sales | Privatization occurs when the role of government (e.g., city, county, state) in retail alcohol sales is removed from one or more alcohol beverage types allowing for commercial sale of alcohol and changing regulatory oversight. |
INCONCLUSIVE | |
Responsible Beverage Service Training | Positive impacts found in several studies, but studies could not necessarily by applied to population at large. More evidence is needed. |
Overservice law enforcement initiatives | Too few studies available to rigorously analyze impact |
Social Host Ordinance | Not reviewed by the Task Force directly. Other studies show an association with 1) decreased alcohol use at private parties but no changes in other contexts and 2) reduction in rate of alcohol-related road deaths among 18-20 year old but no reductions in drinking. |


Privatization of retail alcohol sales was recommended against based on the evidence. Privatization occurs when the role of government (e.g., city, county, state) in retail alcohol sales is removed from one or more alcohol beverage types allowing for commercial sale of alcohol and changing regulatory oversight.
Further, the Task Force found insufficient evidence regarding the following interventions: responsible beverage service training and overservice law enforcement initiatives. These and other interventions require additional research for further consideration.

Structural and systemic changes at the population level
can have the greatest impact on health


Adult alcohol use is
associated with underage
drinking due to…

What does the evidence base tell us?
Policies that reduce the availability and affordability of alcohol are associated with reduced...
REDUCED
overall and excessive drinking
motor vehicle crashes
violence
mental health problems
chronic disease incidence


Alcohol and Inequities

Alcohol harm paradox
Those of lower SES experience more alcohol-related harms despite those of higher SES drinking more on average

Clustering of alcohol outlets in Black and Latinx/-e communities

Targeted advertising to BIPOC and LGBTQ+ communities

Women experience more severe alcohol-related harms despite drinking less than men on average
