Alcohol Policies:How Much Do They Really Matter?Utah Coalition Training Summit 2019

Mary Segawa, M.S.

June 20 2019

How We Got Here – Colonial Days to Early 1900’s

• European immigrants already heavy drinkers1600’s

• Kentucky and Ohio’s corn surplus made into whiskeyLate 1700’s• Average American over 15 drank more than 7 gallons of

alcohol per year (2016 – 2.35 gal)1830• More than 1/3 of states (13) had adopted some form of

prohibition1855

• Most states had dropped prohibition 1860’s

• Second wave of statewide prohibition began1880’s

Pre-Prohibition

The Saloon as a Social Institution

Photo courtesy of the National Archives

Industrialization

Industrialization brings competition• Railroad expansion• Rush to open new saloons or expand old

Competition leads to financial entanglements• Saloons indebted to brewers• Bribes for exclusive contracts.

Entanglements lead to the saloon “evils”• Open 24/7; sales to minors• The saloon-a “hell-soaked institution” and

“putrid fester spot”

The Opposition

▪ 1874: Christian Temperance Union

▪ 1873-74: The Woman’s Crusade

▪ Early 1900’s: Carry Nation becomes a force for shutting down saloons

▪ 1913: Anti-Saloon League announces goal of national prohibition

▪ 1919: 18th Amendment is ratified

Prohibition – 1920-1933

Shortcomings of the law:

▪ No uniform agreement by individuals in communities across the U.S. regarding alcohol use

▪ Federal law but enforcement largely left to local authorities

Characterized by:

▪ Lawlessness

▪ Gangsters

▪ Racketeering

▪ Bootlegging Photo courtesy of the National Archives

The 21st Amendment, 1933

Repealed the 18th Amendment

AND

Prohibited the transportation or importation of intoxicating liquors into any state, territory or possession of the United States in violation of the laws of such.

States were given the right to regulate alcohol.

“Control” and “License” States

18 states (and two Maryland counties) become “control” jurisdictions

▪ The state is a market participant, maintaining control over the wholesaling and/or retailing of one or more categories of alcoholic beverages.

30 states become “license” jurisdictions

▪ The state allows private entities to acquire a license to purchase and sell alcohol but within a regulated system. Continuation of the license is dependent upon complying with the state and federal regulations.

The 3-Tier System

Producers / Manufacturers

Wineries

Breweries

Distilleries

Private Label Brands

Importers

Wholesalers

Ensures product quality

Provides a tracking system for all products

Collects excise taxes

Retailers

Prevents illegal sales to minors

Prevents sales to intoxicated persons

Collects sales tax

Control States

Wholesale

State and Local Government

Contract Liquor Stores (AL also has private package stores)

State and/or Contract Stores

Why Regulate Alcohol

Differently

Ignoring the harms of high risk drinking comes at a high cost

Estimated cost of excessive

alcohol use in the United

States in 2010 (CDC)

$249 billion, or an average of $2.05 per

drink.

(Utah: $1.6 billion, or $2.74 per drink)

About 77% of these costs due to binge

drinking

$2 of every $5 in costs were paid by federal,

state, and local governments, i.e. tax

dollars.

Effective Alcohol PoliciesCommunity Preventive Services Task Force

Effective Interventions –General Population

• Increasing alcohol taxes

• Regulation of alcohol outlet density

• Dram shop liability

• Maintaining limits on days and hours of sale

Effective Interventions Directed to Underage Drinkers

• Enhanced enforcement of laws prohibiting sales to minors

PRICE DENSITY ACCESS ENFORCEMENT

Policies Harmful or

Not Effective

Community Preventive Services Task Force

Privatization ofretail alcohol sales

Washington

I - 1183

The InitiativeI-1183

Passed in November 2011, 59 percent to 41

percent

Heavily funded by Costco and Safeway

(over $22 million)

What Happened

Expectations Reality

Lower prices for consumers and higher tax revenues (more sales)

Higher prices – Included higher taxes to compensate for expected state revenue loss.Lost sales to neighboring states with lower prices.

More selection Small, in-state producers had difficulty getting shelf space

More availability, greater convenience

Stores selling spirits increased from 328 to about 1600 by 2019.

More business opportunities State store purchasers struggled to compete and many closed

Tight restrictions to protect youth (Minimum size of stores, higher penalties)

Less oversight – little control over kinds of products offered, including those appealing to youthIncrease in thefts

Buyer’s Remorse?

Survey of WA State voters in 2014

• One in five (20%) people who had voted “yes” said they would change their vote to “no” after seeing the outcomes of privatization; by contrast, only four percent of people who voted “no” would have changed their vote to “yes.”

Subbaraman & Kerr, 2016

Pricing and

Promotion

Uniform pricing repealed

Prices may vary greatly store to store

Ban on quantity discounts repealed

Large retailers will have advantage for lower prices

Ban on central warehousing repealed

Reduces distribution costs for retailers

Removed prohibition on spirits advertising

Density and Access

Before I-1183:328 stores, with 73 maximum hours per week

One year later:1,415 stores, with 140 maximum hours per week

Enforcement

After privatization, there was no increase in Liquor Control Board Enforcement Officers.

• Approximately one officer per 300 licensees

• Focus was on “trouble spots”

• Commitment made by agency to increase compliance checks

Data

• Dilley JA. Impact of Washington State Initiative 1183: Alcohol System Deregulation. Paper presented at Alcohol Policy 17 National Conference. Washington, DC; April 6, 2016.

• WA State Healthy Youth Survey

Impact on Use

Youth alcohol use & binge

drinking continued to

decline similar to recent trends & the US trend

More pro-alcohol beliefs

perceived among peers

Adult drinking increased

slightly

Percent of adults drinking

liquor increased

Increase in spirits sold, with a corresponding

increase in revenue

Emergency Room Visits

Data: King County (all residents) and Medicaid (minors) Emergency Department (ED) visits

Alcohol-related visits –direct or indirect cause

Statistically significant increases in alcohol-related ED visits, translating to thousands of extra visits

Minors (<21): 14% increase for youth in King Co; 25% increase for youth on Medicaid

Ages 40+: 14% increase

Effect stronger for boys vs. girls

No change for adults ages 21-39

Traffic Crashes

Increased crashes among young drivers

▪ Data: State Department of Transportation crash data for monthly Single Vehicle Nighttime Crashes (proxy for alcohol impaired driving)

▪ Among minor drivers (<21) vs. predicted crashes

▪ 35% increase among males (“extra” 21 crashes/month)

▪ 30% increase among females* (“extra” 9 crashes/month)

▪ Estimated total of 700 excess crashes among young drivers in 2 year post-law period

▪ Substantial “bump” in 6 months immediate post-law period, and overall rate remains higher than pre-law

No significant change among older driver groups* Not statistically significant at p<.05

Addictions and Treatment

Data: Monthly admissions for alcohol-related public-paid dependence treatment (inpatient, outpatient, detox) since January 2008

Used “total treatment units” in

model to adjust for changes infunding/treatment capacity

Overall treatment for adult alcohol dependence did not change

Adult alcohol re-admission treatment significantly increased

Overall youth treatment for alcohol as the primary substance increased 5-6%

Crime

Data: Crime Incidence (arrest) data from Washington State police jurisdictions, monthly counts of specific crimes

Significant increases post-law in:

BurglaryLarceny (specifically shoplifting)Stolen property

Translates to more than 10,000 “extra” crimes during the post law period

*Note: Significant decrease in drug law violations in same period (associated with marijuana legalization)

Summary

Benefits• Tax Revenue

Costs• Emergency

Dep’t Visits

• Traffic crashes

• Addictions Treatment

• Crime

• Alcohol thefts are unmeasured

~$31M ~$43 M

Continuing Challenges

▪ Tasting rooms (breweries, wineries, distilleries)

▪ Sampling (grocery stores, farmers markets)

▪ New privileges/licenses (movie theatres, spas, art galleries, boutiques, art studios, etc.)

▪ Product placement

▪ Advertising

▪ Enforcement costs

Use Your Knowledge

The history of alcohol regulation

• Toward Alcohol Control, Fosdick and Scott

Alcohol policy research

• APIS

• NABCA

• NIDA

• NIAAA

• Alcohol: No Ordinary Commodity, Babor, et.al.

Current laws and data

• Links on Dept. of Alcoholic Beverage Control website

• Youth and adult use rates and other data

• Tax rates

• Compliance rates

State and local powers and processes

• Laws

• Rule-making

• Local ordinances

Cease Opportunities

When determining talking points, consider the counter-arguments and prepare to respond

Counter

Combine research and data with personal storiesCombine

Captivate your audience by including diverse voices, especially youth Captivate

Convince others to participate, including non-traditional partnersConvince

Use Your Power

EDUCATION ADVOCACY

Questions / Discussion

Thank You

• Utah Division of Substance Abuse and Mental Health

• Julia Dilley, PhD, Multnomah County Health / Oregon Public Health Division

• Jason Kilmer, PhD, University of Washington

• Cassandra Greisen, National Alcohol Beverage Control Association

• Rick Garza, Washington State Liquor and Cannabis Board

Contact Info:Mary Segawa

mbsegawa@comcast.net360-280-8085