Alcohol research and social policy: an overview.

By its very nature, the phenomenon of alcohol consumption creates many opportunities for social policy development and implementation. Alcohol is a part of our culture and is widely used in many social and ceremonial activities. Its manufacture and sale produce revenue for the government, through taxes, and income for citizens, through business profits and employment. For some people, moderate alcohol use also may provide health benefits.

The use of alcohol also has negative implications for the social, economic, and health status of both those who use it and society at large. About 14 million Americans meet medical diagnostic criteria for alcohol abuse or alcoholism (Grant et al. 1991). The consequences of alcohol abuse and dependence cost the Nation an estimated $99 billion (Rice 1993) and 100,000 deaths each year (National Institute on Alcohol Abuse and Alcoholism [NIAAA] 1993). Alcohol misuse is estimated to be involved in about one-half to two-thirds of homicides, one-fourth to almost one-half of serious assaults, one-third of suicides, and more than one-fourth of rapes (Martin 1992). In addition, 20 to 40 percent of patients in urban hospital beds have alcohol problems, regardless of the conditions for which they were initially hospitalized (Moore et al. 1989).

Alcohol sales and consumption are regulated for economic, health, and social purposes. To achieve these purposes, many agencies at the Federal, State, and local levels develop and carry out policies that affect the distribution and use of alcohol. Choosing among policies to accomplish the greater good is not easy, and one policy always runs the risk of being at cross-purposes with another. Science can help make the task of choosing among policies more rational.

This article provides an overview of how alcohol policies are developed in the United States and examines the role of science in the development of three specific policies: raising the minimum legal drinking age (MLDA), requiring health warning labels on alcoholic beverage containers, and formulating recommendations concerning the risks and benefits of moderate drinking.

What Is Alcohol Policy in the United States?

U.S. alcohol policies generally fall into two categories: (1) those intended to influence individual drinking practices and (2) those aimed at regulating the supply of alcoholic beverages.

Policies to influence individual drinking patterns have included publicly financed information and education programs, as well as State and local laws establishing penalties for drinking and driving. One example of a policy designed to increase public awareness of several specific health risks of alcohol consumption is the requirement for a health warning label on alcoholic beverage containers sold in the United States. Another policy is the requirement of individual States for mandatory sentencing of persons convicted of drinking and driving offenses.

Some policies are designed to limit access to alcohol. Policies in this category include raising the MLDA; restricting the number, location, and business hours of alcoholic beverage sales outlets; and prohibiting the promotion of alcoholic beverages on college campuses. In addition "dram shop" laws influence the drinking environment to help prevent adverse alcohol-related consequences. These laws hold drinking establishments and, in some cases, private hosts liable for alcohol-related damages caused by a person to whom they have served alcoholic beverages.

Who Influences Policy Development?

Alcohol-related policy development in the United States is complex. Federal, State, and local governments are involved in regulation, and nongovernmental bodies, such as citizen and industry organizations, seek to influence policy directions.

Federal Agencies. The major responsibility for policy determination at the Federal level rests with the U.S. Congress, which passes laws; the …