What have alcohol control legislation and regulation accomplished since the repeal of Prohibition and the publication of the landmark Toward Liquor Control?
The first objective—to reduce lawlessness—has indeed been accomplished.
Alcohol control policies have reduced lawlessness—bootleggers and crime syndi- cates trafficking in alcohol are out of business for the most part. People accept most alcohol control policies and laws and penalties are relatively light (e.g., fines, driver’s license suspensions, short jail terms). The legal drinking age is honored most of time, but not always. The off-premises sale and availability has shifted much alcohol-related behavior to the home where public control is mostly absent.
In short, most laws related to alcohol control are obeyed. One major exception n
n
Policy, Regulation, and Legislation n 89
is the legal age restrictions, the one remaining form of prohibition, which seems to work the least well. As Table 5.1 indicates, a large and growing proportion of underage youths continue to report using alcohol.
The second objective—to encourage temperance—has not been successful.
Alcohol control policies are not designed to stop drinking or abstinence, but to promote the orderly, quiet, and socially acceptable production, sale, and consump- tion of alcohol. Decriminalization of most alcohol consumption, production and sales, and the creation of laws that are perceived as not too restrictive has turned
Table 5.1 Alcohol Use in Lifetime among Persons Age 12 to 17 and Persons Age 18 to 25 during the Years 1966 to 2002, by Gender: Percentages, Based on 2002 National Survey on Drug Use and Health
Age 12 to 17 Age 18 to 25 Year Total Male Female Total Male Female
1966 17.9 25.3 10.9 70.5 79.1 62.9
1970 20.8 27.4 14.2 75.3 83.8 67.5
1974 29.0 36.0 22.5 79.5 87.1 72.2
1978 29.2 36.2 22.7 82.5 89.3 75.8
1982 30.3 35.6 25.1 83.9 87.9 80.0
1986 30.6 36.7 24.5 82.2 87.2 77.6
1990 28.9 34.1 24.0 80.9 85.7 76.3
1994 28.1 30.9 25.2 81.8 86.4 77.2
1998 31.2 33.4 29.0 82.0 85.2 78.9
2002 43.4 43.4 43.4 86.7 88.0 85.4
Source: Table 47.2B, Substance Abuse and Mental Health Ser- vices Administration, Office of Applied Studies, National Survey on Drug Use and Health, Washington, D.C.: U.S. Department of Health & Human Services, 2002.
Note: Percentages are calculated using a weighted ratio esti- mate where the numerator is the weighted sum of all lifetime users within each age group for a specific year and the denominator is the weighted sum of all persons within each age group for the same year. Lifetime drug use status and age group, for each specified year, were determined using the age, date of first use, and inter- view date for each respondent. See Results from the 2002 National Survey on Drug Use and Health: National Findings.
alcohol into a major industry with its own legitimate economic and business elite interested in maintaining order and obedience to law to preserve profits.
The 1934 report even argues that reducing habitual drinking and prevention would really have to come from other agencies/entities (e.g., home, church, fam- ily, public health professionals). The creation in 1971 of the National Institute on Alcohol Abuse and Alcoholism was a formal effort to record alcohol trends and occurrences with a goal of alcohol abuse prevention. Although there have been some efforts to promote health concerns related to alcohol consumption and there is strong popular support for some public health concerns (e.g., package labeling and drunk-driving laws), the alcohol industry typically has resisted most efforts to diminish alcohol consumption. Public support for alcohol policies to limit drink- ing is fairly broad but variable (i.e., 88 percent support labeling, 82 percent support more prevention, 80 percent server training, 60 percent counter ads, 43 percent more taxes, 35 percent restricted store hours, 31 percent higher drinking age [Geis- brecht and Greenfield 1999]).
Repeal did turn consumption away from hard liquor to beer. Decriminalization and regulation turned a crime-ridden problem of violence that some argued could not be changed to something that is manageable, routine, and generally accepted.
The patterns of legislative activity suggest that we will see little beyond tinkering with the current alcohol control policies. More emphasis will be placed on public health, but much of any success in this arena will likely be driven by economic ben- efits from reducing the costs of health and insurance through further controlling alcohol consumption.
The example of alcohol control policy in this country is illustrative of the bal- ance among competing interests. As with tobacco control, there is an age limit, excise taxes are collected, sales are regulated, and restrictions exist for sale, use, and consumption of the product. Public health campaigns for tobacco have had an impact on behavior and resulted in declining sales that have been partially off- set by increased international sales. The alcohol industry is wary of public health campaigns because of the same fear of reduced sales, but without the opportunity for increased international markets because many other countries have established international and domestic alcohol industries. The approach to alcohol control might also be a promising approach to illegal drug control. Many of the same arguments for continuing the prohibition on existing illegal drugs are the same raised about alcohol (e.g., it is addictive, it destroys families, it is immoral, it will corrupt children). Prohibition policies on illegal drugs have resulted in many of the same evils found with alcohol prohibition, violence, disrespect for law, increased law enforcement costs, lack of control over purity, and spread of disease. Although addiction and destruction of families would be likely to continue as it did with alcohol, legalization and regulation might actually decrease the likelihood of these consequences through controlling the strength and availability in ways to address the negative effects of drugs. There is experience in other countries with legalized drug control, and the experience from alcohol legalization in the United States
Policy, Regulation, and Legislation n 91
suggests that the benefits might indeed outweigh the negatives, but the political will is not there because a much smaller proportion of the population uses drugs than uses alcohol. The power of public health programs and campaigns against lawlessness can have a strong impact on legislation and policy change as witnessed through alcohol control. It is likely that any major changes in current alcohol policy will result from increased public recognition of health risks and costs that begin to affect their own behaviors in relation to alcohol.