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Excessive Alcohol Use

PSR | 2013




Excessive alcohol use is responsible for about 88,000 deaths and 2.5 million years of potential life lost in the United States each year.1 Excessive alcohol use cost the US economy $223.5 billion, or $1.90 a drink, in 2006, $0.80 of which was paid by governments.2 Binge drinking (five or more drinks per occasion for men or four or more drinks per occasion for women) is responsible for more than half the deaths, two-thirds of the years of potential life lost, and three-quarters of the costs resulting from excessive alcohol use.2,3

The Prevention Status Reports highlight—for all 50 states and the District of Columbia—the status of the following policies and practices:

These policies and practices are recommended by the Community Preventive Services Task Force because scientific studies support their effectiveness in reducing excessive alcohol consumption and related harms.

Other strategies supported by scientific evidence include avoiding further privatization of retail alcohol sales7 and providing adults (including pregnant women) with screening and brief intervention for excessive alcohol use.8


Policies & Practices

State beer tax

State beer tax refers to the amount of state excise tax, in dollars, per gallon of beer containing 5% alcohol by volume. State beer excise tax does not include any additional taxes, such as those based on price rather than volume (e.g., ad valorem or sales taxes) that states may have implemented at the wholesale or retail level.

The Community Preventive Services Task Force "recommends increasing the unit price of alcohol by raising taxes based on strong evidence of effectiveness for reducing excessive alcohol consumption and related harms. Public health effects are expected to be proportional to the size of the tax increase."4 The Task Force review found that a 10% increase in the price of beer would likely reduce beer consumption by approximately 5%.4

Status of state beer taxes, United States (as of January 1, 2012)

 

Bar chart showing Status of state beer taxes, United States (as of January 1, 2012 ). Green: In 3 states, the beer excise tax was ≥$1.00 per gallon. Yellow: In 4 states, the beer excise tax was $0.50–$0.99 per gallon. Red: In 43 states, the beer excise tax was $0.00–$0.49 per gallon. Data were not available for 1 states. (State count includes the District of Columbia.)
(State count includes the District of Columbia.)
 
± How the ratings were determined

States were rated green, yellow, or red based on state beer tax levels. States with higher tax levels were rated green, states with intermediate tax levels were rated yellow, and states with lower tax levels were rated red.

Green

As of January 1, 2012, the state beer tax was ≥$1.00 per gallon.

Yellow

As of January 1, 2012, the state beer tax was $0.50–$0.99 per gallon.

Red

As of January 1, 2012, the state beer tax was $0.00–$0.49 per gallon.


 

State distilled spirits tax

State distilled spirits tax refers to the amount of state excise tax, in dollars, per gallon of distilled spirits containing 40% alcohol by volume. State distilled spirits excise tax does not include any additional taxes, such as those based on price rather than volume (e.g., ad valorem or sales taxes) that states may have implemented at the wholesale or retail level. For states with different tax rates for distilled spirits sold off-sale (e.g., at liquor stores) and on-sale (e.g., at restaurants), the off-sale tax rate has been reported.

The Community Preventive Services Task Force “recommends increasing the unit price of alcohol by raising taxes based on strong evidence of effectiveness for reducing excessive alcohol consumption and related harms. Public health effects are expected to be proportional to the size of the tax increase.”4 The Task Force review found that a 10% increase in the price of distilled spirits would likely reduce distilled spirits consumption by approximately 8%.4

Status of state distilled spirits taxes, United States (as of January 1, 2012)

 

Bar chart showing Status of state distilled spirits taxes, United States (as of January 1, 2012). Green: In 3 states, the distilled spirits excise tax was ≥$8.00 per gallon. Yellow: In 10 states, the distilled spirits excise tax was $4.00–$7.99 per gallon. Red: In 21 states, the distilled spirits excise tax was $0.00–$3.99 per gallon. Data were not available for 17 states . (State count includes the District of Columbia.)
(State count includes the District of Columbia.)


± How the ratings were determined

States were rated green, yellow, or red based on state distilled spirits tax levels. States with higher tax levels were rated green, states with intermediate tax levels were rated yellow, and states with lower tax levels were rated red.

Green

As of January 1, 2012, the state distilled spirits tax was ≥$8.00 per gallon.

Yellow

As of January 1, 2012, the state distilled spirits tax was $4.00–$7.99 per gallon.

Red

As of January 1, 2012, the state distilled spirits tax was $0.00–$3.99 per gallon.


 

State wine tax

State wine tax refers to the amount of state excise tax, in dollars, per gallon of wine containing 12% alcohol by volume. State wine excise tax does not include any additional taxes, such as those based on price rather than volume (e.g., ad valorem or sales taxes) that states may have implemented at the wholesale or retail level.

The Community Preventive Services Task Force "recommends increasing the unit price of alcohol by raising taxes based on strong evidence of effectiveness for reducing excessive alcohol consumption and related harms. Public health effects are expected to be proportional to the size of the tax increase."4 The Task Force review found that a 10% increase in the price of wine would likely reduce wine consumption by approximately 6%.4

Status of state wine taxes, United States (as of January 1, 2012)

 

Bar chart showing Status of state wine taxes, United States (as of January 1, 2012). Green: In 2 states, the wine excise tax was ≥$2.00 per gallon. Yellow: In 7 states, the wine excise tax was $1.00–$1.99 per gallon. Red: In 30 states, the wine excise tax was $0.00–$0.99 per gallon. Data were not available for 12 states . (State count includes the District of Columbia.)
(State count includes the District of Columbia.)


± How the ratings were determined

States were rated green, yellow, or red based on state wine tax levels. States with higher tax levels were rated green, states with intermediate tax levels were rated yellow, and states with lower tax levels were rated red.

Green

As of January 1, 2012, the state wine tax was ≥$2.00 per gallon.

Yellow

As of January 1, 2012, the state wine tax was $1.00–$1.99 per gallon.

Red

As of January 1, 2012, the state wine tax was $0.00–$0.99 per gallon.


 

Commercial host (dram shop) liability

Commercial host (dram shop) liability laws hold alcohol retailers liable for alcohol-attributable harms (e.g., injuries or deaths resulting from alcohol-related motor vehicle crashes) caused by patrons who were illegally sold or served alcohol because they were either intoxicated or under the minimum legal drinking age of 21 years at the time of service. State commercial host liability laws are considered to have major limitations if they 1) cover underage patrons or intoxicated adults but not both, 2) require increased evidence for finding liability, 3) set limitations on damage awards, or 4) set restrictions on who may be sued.10,11

The Community Preventive Services Task Force concluded that "dram shop liability is effective in preventing and reducing alcohol-related harms."5 For example, the Task Force review found that states with commercial host liability had a median 6.4% reduction in deaths resulting from motor vehicle crashes.5

Status of commercial host (dram shop) liability laws, United States (as of January 1, 2011)

 

Bar chart showing Status of commercial host (dram shop) liability laws, United States (as of January 1, 2011). Green: 21 states had commercial host liability with no major limitations. Yellow: 24 states had commercial host liability with major limitations. Red: 6 states had no commercial host liability. (State count includes the District of Columbia.)
(State count includes the District of Columbia.)


± How the ratings were determined

States were rated green, yellow, or red according to the following criteria:

Green

As of January 1, 2011, state had commercial host liability with no major limitations.

Yellow

As of January 1, 2011, state had commercial host liability with major limitations.

Red

As of January 1, 2011, state had no commercial host liability.

± More information on this indicator

 

Local authority to regulate alcohol outlet density

Alcohol outlet density refers to the number and concentration of alcohol retailers (e.g., bars, restaurants, liquor stores) in an area. Greater alcohol outlet density is associated with excessive alcohol use and related harms, including injuries and violence.6

Local authority to regulate alcohol outlet density refers to the extent to which a local government can implement zoning (land use) or licensing controls over the number of alcohol retailers in its geographic area. States can limit the authority of local governments to regulate alcohol outlet density, thereby diminishing local governments’ ability to implement this prevention strategy.12

The Community Preventive Services Task Force "recommends the use of regulatory authority (e.g., through licensing and zoning) to limit alcohol outlet density on the basis of sufficient evidence of a positive association between outlet density and excessive alcohol consumption and related harms."6

Status of local authority to regulate alcohol outlet density, United States (as of January 1, 2012)

 

Bar chart showing Status of local authority to regulate alcohol outlet density, United States (as of January 1, 2012). Green: 18 states had exclusive local or joint state/local alcohol retail licensing. Yellow: 24 states had exclusive state alcohol retail licensing but with local zoning authority or other mixed policies. Red: 8 states had exclusive state alcohol retail licensing. The District of Columbia was not rated because this measure applies only to states.


± How the ratings were determined

States were rated green, yellow, or red according to the following criteria:

Green

As of January 1, 2012, the state had exclusive local or joint state/local licensing, meaning that the state government either fully delegated or shared the authority to license alcohol retailers with local governments.

Yellow

As of January 1, 2012, the state had exclusive state licensing with local zoning authority or other mixed policies, meaning that the state government had exclusive authority to license alcohol retailers but granted local governments zoning (land use) authority or had other mixed policies.

Red

As of January 1, 2012, the state had exclusive authority to license alcohol retailers, thereby preempting local governments from regulating alcohol outlet density.


 

Prevention Status Reports: Excessive Alcohol Use, 2013

The files below are PDFs ranging in size from 100K to 500K.

Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming


References

  1. CDC. Alcohol and Public Health: Alcohol-Related Disease Impact (ARDI) [database]. Accessed Dec 13, 2013.
  2. Bouchery EE, Harwood HJ, Sacks JJ, et al. Economic costs of excessive alcohol consumption in the United States, 2006. American Journal of Preventive Medicine 2011;41:516–24; and correction, American Journal of Preventive Medicine 2013;44:198.
  3. CDC. Alcohol-attributable deaths and years of potential life lost, United States, 2001. MMWR 2004;53:866–70.
  4. Community Preventive Services Task Force. Preventing excessive alcohol consumption: increasing alcohol taxes. In: Guide to Community Preventive Services. Updated Jun 2007.
  5. Community Preventive Services Task Force. Preventing excessive alcohol consumption: dram shop liability. In: Guide to Community Preventive Services. Updated Mar 2010.
  6. Community Preventive Services Task Force. Preventing excessive alcohol consumption: regulation of alcohol outlet density. In: Guide to Community Preventive Services. Updated Feb 2007.
  7. Community Preventive Services Task Force. Preventing excessive alcohol consumption: privatization of alcohol retail sales. In: Guide to Community Preventive Services. Updated Apr 2011.
  8. US Preventive Services Task Force. Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse. Updated Oct 2012.
  9. Kanny D, Liu Y, Brewer RD, Garvin WS, Balluz L. Vital signs: binge drinking prevalence, frequency, and intensity among adults—United States, 2010. MMWR 2012;61:14–9.
  10. Substance Abuse and Mental Health Services Administration. Report to Congress on the Prevention and Reduction of Underage Drinking. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2011.
  11. Mosher JF, Cohen EN, Jernigan DH. Commercial host (dram shop) liability: current status and trends. American Journal of Preventive Medicine 2013;45:347–53.
  12. Mosher JF, Treffers R. State pre-emption, local control, and alcohol retail outlet density regulation. American Journal of Preventive Medicine 2013;44:399–405.

 

 

 
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