Strategies to Reduce Excessive Alcohol Use

alcohol bottles

Community strategies can help communities create environments that reduce excessive alcohol use. Health care providers can screen adults for excessive alcohol use.

Community Strategies

The strategies listed below can help communities create social and physical environments that reduce excessive alcohol use. These strategies are recommended by the Community Preventive Services Task Force, an independent, nonfederal, unpaid panel of public health and prevention experts, based on systematic reviews of their effectiveness in reducing excessive alcohol use and related harms, including deaths due to excessive drinking.

Increase Alcohol Taxes

Alcohol taxes increase the price of alcohol at the federal, state, or local level on beer, wine, or distilled spirits. Increasing the price of alcohol by 10% would be expected to reduce overall alcohol consumption by an average of about 7% across beverage types. The more you increase the price on alcohol, the more you can potentially reduce excessive alcohol use and related harms.

Regulate Alcohol Outlet Density

Alcohol outlet density means the number and concentration of alcohol retailers (such as bars, restaurants, and liquor stores) in an area. Reducing alcohol outlet density can help reduce excessive alcohol use and related harms. City, county, or state governments can regulate the number of places that sell alcohol through licensing or zoning processes.

Commercial Host “Dram Shop” Liability Laws

Laws that hold alcohol retail establishments liable (at fault) for injuries or harms caused by illegal sales or service to intoxicated or underage (younger than 21 years of age) customers help reduce harms from excessive alcohol use, including deaths from motor vehicle crashes.

Maintain or Limit Days or Hours of Sale

States or communities may limit the days or the hours that alcohol can legally be sold or served. States that have repealed bans on Sunday alcohol sales have experienced an increase in alcohol-related harms (such as, motor vehicle crash deaths) on the day when alcohol sales were previously prohibited. Similarly, increasing hours of sale by two hours or more has been associated with an increase in harms related to excessive alcohol consumption (such as motor vehicle crash injuries).

Enhance Enforcement of Laws Prohibiting Sales to Minors

The minimum legal drinking age is 21 years in all states in the United States. Enhanced enforcement of the minimum legal drinking age can reduce sales to minors (younger than 21 years) in retail settings (such as bars, restaurants, and liquor stores), thereby helping to reduce youth access to alcohol.

Clinical Strategies

U.S. Preventive Services Task Force (USPSTF) Recommendations Related to Alcohol Use

Unhealthy Alcohol Use in Adolescents and Adults: Screening and Behavioral Counseling Interventions

“The USPSTF recommends screening for unhealthy alcohol use in primary care settings in adults 18 years or older, including pregnant women, and providing persons engaged in risky or hazardous drinking with brief behavioral counseling interventions to reduce unhealthy alcohol use.”

Grade: B Recommendation.

Alcohol Screening and Brief Intervention Provided in Clinical Settings

Health care providers can screen adults, including pregnant women, for excessive alcohol use to identify people whose levels or patterns of alcohol use place them at increased risk of alcohol-related harms. Health care providers can then recommend or offer treatment services to those at risk. Brief counseling interventions for adults who drink excessively have been found to positively affect several patterns of excessive drinking, including heavy episodic (binge) drinking and high average weekly intake of alcohol.

Alcohol Screening and Brief Intervention Provided Using Electronic Devices (e-SBI)

The Community Preventive Services Task Force recommends the use of electronic devices such as computers, telephones, or mobile devices to provide screening and brief intervention for excessive alcohol use. Instead of having a clinician offer screening and brief intervention face-to-face, Electronic Screening and Brief Intervention (e-SBI) uses electronic devices such as computers, telephones, or mobile devices to provide information and personalized feedback about the risks and consequences of excessive alcohol use and offer advice designed to reduce excessive alcohol use.