1. Environmental Prevention and Underage Drinking Kathryn Stewart Safety and Policy Analysis International and Prevention Research Center Lafayette, California MADD National Conference, September 2012

2. Age 21 Laws have been effective!

3. Effects of Age 21 Laws  Reduction in alcohol consumption  Reduction in drinking driver fatal crashes  Reduction in alcohol-related homicides, suicides, unintentional injuries

4. Evidence of MLDA 21 Law Effectiveness Drinking Drivers Over Age 21 involved in fatal crashes: the decrease since1982 -33% Drinking Drivers Under Age 21 involved in fatal crashes: the decrease since1982 -62% MLDA 21 accounted for much of the difference (Hedlund, et al., 2001)

5. Reduction in Impaired Driving since Drinking Age Raised in U.S. Drivers 20 and Younger

6. Percent of 15-16 Year Olds Reporting Drinking in the Past 30 Days

7. Percent of 15-16 Year Olds Reporting Intoxication in the Last 30 Days

8. Alcohol kills 4X more kids under 21 than all illegal drugs combined.

9. ALCOHOL: #1 Problem and Choice of Drug in the United States “Each day, more than 7,000 kids in the United States under age 16 take their first drink” (IOM Report, 2004)

10. Most kids drink to get drunk, consuming four to five drinks at one time. (NIAAA, 2006)

11. Recent Attention: Surgeon General’s Call to Action Reducing Underage Drinking: A Collective Responsibility 2003 Report to Congress The Surgeon General’s Call to Action To Prevent and Reduce Underage Drinking 2007 Alcohol is... easy for youth to access prominent in entertainment media advertised in venues that reach youth disproportionately cheaper than 30-40 years ago ______________ Kids get access from adults in social and retail settings Focus efforts on adults and engage entire society

12. Underage Drinking in America http://faceproject.org/

13. Underage Drinking is Not an Underage Problem Youth usually obtain alcohol – either directly or indirectly – from adults. Efforts to reduce underage drinking, therefore, need to focus on adults and must engage the society at large.” Institute of Medicine, National Research Council of the National Academies (2003)

14. Environmental Prevention Creating an environment in which it is harder to make the wrong choice and easier to make the right choice.

15. Environmental prevention removes focus from individual behavior and works to change the larger environment.

16. Prevention Strategies  Individual Focus on behavior change Focus on the individual and alcohol problems Focus on short term: program development  Environmental Focus on population level change Focus on social, political, legal context of alcohol problems Focus on long term: policy development

17. Assumption: Changing environmental contributors to alcohol problems will change individual behavior. Environmental change activity Change in environment Change in individuals

18. Essential Elements Enforcement Public Support Policy

19. Environmental Strategies  Advantages: Effective and Efficient Immediate Results Inherently Sustainable

20. Environmental Change Strategies  Changes community standards  Policy-oriented  Involves adult and youth participation  Involves partnership with enforcement  Addresses physical, social, political, legal, and economic factors

21. Environmental Approaches to Limitations On Underage Access Limitations on Access Enforce minimum age purchase laws: -aimed at retailers -aimed at adults -aimed at youth Strengthen minimum age purchase laws Reduce social availability Reduce overall community availability of alcohol

22. Environmental Problems: Colleges

23. Each Year College Drinking Causes: 1,825 students deaths 599,000 unintentional injuries 696,000 assaults -97,000 sexual assaults 3,360,000 students drive under the influence (Hingson et al, 2009) 2 nd hand effects by drinking peers (Wechsler et al, 2002) 31% met criteria for alcohol abuse (Knight et al, 2002) $68 billion social cost for underage drinking (PIRE 2009)

24. Problems in College Environment  Too much free time (e.g., no classes on Fridays!)  Belief that underage and binge drinking is a normal part of college life  Alcohol is available and inexpensive  Alcohol is highly promoted to students  Laws and policies are inconsistently enforced

25. Safer California Universities Project Integrated Intervention Strategies  Nuisance party enforcement operations for disruptive parties  Minor decoy operations to prevent sales of alcohol to minors  Driving-under-the-influence checkpoints  Social host ordinances that held hosts responsible for nuisance parties  Campus and local media coverage to maximize visibility

26. Outcomes  Likelihood of getting drunk at bars or restaurants much less.  Likelihood of getting drunk at off campus parties much less.  Overall likelihood of getting drunk at any location much less.

27. In addition… No Displacement

28. The Border Project Preventing alcohol-related problems at the US/Mexico Border

29. The Problem  Mexico’s drinking age is 18  Some border towns provided plentiful, cheap sources of alcohol  Young people traveled to Mexico to drink  Beverage service not always “responsible”

31. The Problem  Mexico’s drinking age is 18  Some border towns provided plentiful, cheap sources of alcohol  Young people traveled to Mexico to drink  Beverage service not always “responsible”  Heavy drinking occurred  Sometimes resulted in problems, including impaired driving on the way home

33. The Implementation Strategy  The nature and scope of the problem were explained to groups and agencies on both sides of the border  Media advocacy brought the problem to the attention of the public through compelling news coverage

34. The Change Strategies  Earlier bar closings  Stepped up DUI enforcement efforts on the US side of the border  Highly publicized enforcement of laws against crossing by youth under 18  New restrictions on Marines from Camp Pendleton

35. The Results  Dramatic decline in number of nighttime crossings by young people  Reduction in nighttime crashes involving drivers under 18  90% reduction in number of Marines driving back from the border

36. Reducing Youth Access to Alcohol in Oregon: Integrated Environmental Approaches  Reward and Reminder Program  Minor Decoy Operations  Shoulder Tap Operations  Party Patrols  Traffic Surveillance  Media Advocacy

37. Reward & Reminder

39. Community Outcomes  Reduced sales of alcohol to minors  Reduced drinking and binge drinking among high school students in communities with the most vigorous enforcement efforts  Changed community attitudes and culture

40. Conclusions Communities can create environments that reduce alcohol related problems through:  Understanding the nature of the problems  Development of appropriate policies  Strategic use of law enforcement resources  Strategic use of community awareness

41. Important Lesson  Kids are creative about finding sources of alcohol  But....

42. They don’t have to be creative  If they can just walk into a store and buy it.

43. “Mountain of Beer”

44. Focus on Enforcement  Partnership between law enforcement and the community

45. Compliance checks  Are the essential element in every community environmental strategy

46. www.resources.prev.org

47. Resources  Survey and Assessment Tools  http://www.udetc.org/s urveyandcommunity.as p http://www.udetc.org/s urveyandcommunity.as p  Training on Environmental Strategies  http://www.udetc.org/T raining.htm#Environme ntal http://www.udetc.org/T raining.htm#Environme ntal  Publications  http://www.udetc.org/P ublications.htm http://www.udetc.org/P ublications.htm

48. Resources National Electronic Seminars  http://www.udetc.org/audioconfpast.asp http://www.udetc.org/audioconfpast.asp Technical Assistance http://www.udetc.org/TechnicalAssistance.htm Underage Drinking Enforcement Training Center  http://www.udetc.org http://www.udetc.org Success Stories  http://www.udetc.org/SuccessStories.asp http://www.udetc.org/SuccessStories.asp