Using Enforcement to Reduce Underage Drinking Michael Sparks Alcohol Policy Specialist Michael@sparksInitiatives.com

Please answer, in the chat box: Question Please answer, in the chat box: What campus are you from? What is your role in prevention? Do you work with a coalition?

Today’s Discussion Public Health Model of Prevention Laws as one type of environmental prevention Logic Model of Community Influences of Underage Drinking The role of law enforcement in reducing underage drinking

How familiar are you with environmental approaches/strategies? Poll #1 How familiar are you with environmental approaches/strategies? Very familiar Kind of familiar Not familiar

Alcohol-Related Problems Public Health Model Individual Alcohol Environment Alcohol-Related Problems

College Party

What works: Reviews of the U.S. and global research literature CDC Guide to Community Preventive Services

Policy Approaches to Prevention Formal legal and regulatory mechanisms, rules, and procedures for reducing risky behaviors (e.g., the consumption of alcohol or risky drinking behaviors) Implementation and enforcement of these measures Most approaches to reducing youth drinking depend on educational approaches—especially school-based education. Limited—a few hours, kids returned to a context where alcohol id readily available and glamorized. Policy approaches try to address the context of drinking.. Grube & Nygaard, 2001; Toomey & Wagenaar, 1999

The Environmental Perspective: Targets the social, physical or public environment where sales/use occurs Views alcohol and other drug problems not just as individual addiction, but rather as the collective reflection of community norms and practices Targets are policy makers and others with authority to change environments Seeks to change physical, legal, economic & social processes of communities

The Role of Laws in Environmental Prevention

Purpose of Enforcement of Alcohol Policies Decrease availability of alcohol by increasing economic costs and opportunity costs Deter drinking, heavy drinking, or drinking-related problem behaviors Moderate relations between drinking and problem outcomes In sum, alcohol policy focuses on three processes: (1) decreasing availability of alcohol by increasing the opportunity costs associated with obtaining it, including convenience or opportunity costs. (2) Reducing consumption or problems through deterrence or increases in costs through penalties or sanctions. In case of minors such costs may include penalties incurred for MIP or attempted purchase. (3) Decrease involvement in problem behaviors by decreasing relative costs of alternative behaviors (e.g., free rides, public transportation, locating outlets where driving is not required). The overall goal is to increase the relative full costs

Laws Community Norms

Focus on Enforcement Itself

Discussion Questions What are the conditions in your community that require some sort of enforcement action?

Levels of Enforcement Institutional Community Society Parent Home Teacher/Administrator School Community Association/Watch Neighborhood Police City Sheriff County Society ABC, DPS State ATF, TTB Federal

Levels of Enforcement Institutional Community Society Parent Home Teacher/Administrator School Community Association/Watch Neighborhood Police City Sheriff County Society ABC State ATF, TTB Federal

Only 2 of every 1000 occasions of underage drinking result in arrest Arrest Rate Only 2 of every 1000 occasions of underage drinking result in arrest Slide # 592 Source: Wagenaar & Wolfson, 1994

Action Against Outlets Only 5 of every 100,000 occasions of underage drinking result in action against outlet. Slide # 593 Source: Wagenaar & Wolfson, 1994

Deterrence Theory Legal threat of punishment encourages or prevents behavior Punishment must be: Certain Swift Severe General and specific deterrence

Laws are effective when they are perceived as… Legitimate Practical Effective Proportional to the problem

The Role of Coalitions in Promoting Effective Enforcement Key Coalition Functions: Include enforcement agency in all deliberations regarding enforcement of policy at the start of the policy process Build strong organizational and personal relationships with key enforcement personnel Identify shared self-interest associated with enforcement Take responsibility for making the case to the community for the importance of enforcement Creatively collaborate to address enforcement’s financial constraints associated with implementation Use the media to publically support enforcement activities and give credit to enforcement agency when they are carried out

Question Can you please type into your chat box examples of enforcement strategies you have implemented.

A Logic Model for Reducing Underage Drinking… A Logic Model for Reducing Underage Drinking….. The Role of Enforcement in Impacting Alcohol-Related Problems

Underage Drinking: Basic Research Evidence: Population Prevention Effects Strong Moderate Low (target group only) None (no target or population) Visible Enforcement Retail Availability of Alcohol to Youth Alcohol-Related Problems (Traffic crashes, Injuries, School performance. Unsafe sex, Violence, etc.) Price Social Availability of Alcohol to Youth Underage Drinking Laws Underage Drinking Drinking Beliefs Community Norms About Youth Drinking Family, School, and Peer Influence Drinking Context Alcohol Promotion (Advertising, Point of Sale Promotion , Sponsorship of Community Events) Holder/Saltz: Pacific Institute for Research and Evaluation

Underage Drinking: Evidence-based Theory of Change Retailer Training & rewards Compliance checks, citations, license loss Retail Sale of alcohol to youth Underage drinking laws Visible enforcement Social availability of alcohol to youth (parties, peers, families) Underage Drinking Party patrol, Shoulder taps, Beer keg registration Local alcohol policy Family, School, & Peer Influence Community norms about youth drinking Legal risks for providing alcohol to underage Media advocacy

Does Enforcement Work?

Minimum Legal Drinking Age

James Fell et al. The Impact of Underage Drinking Laws on Alcohol-Related Fatal Crashes of Young Drivers Alcohol Clin Exp Res, 2009 Methods Analysis of the Fatality Analysis Reporting System from 1982-2004 Examined the effects of the minimum legal drinking age of 21 on the ratio of drinking to non-drinking drivers under age 21 in fatal crashes Controlled for: Zero Tolerance Laws Graduated License Night Restrictions Use/Lose laws Administrative License Revocation .10, .08 BAC per se Mandatory seat belt laws Per capita beer consumption Unemployment rate Vehicle miles traveled Frequency of sobriety checkpoints Number of licensed drivers Ratio of drinking to non-drinking drivers Age 26+ in fatal crashes Ratio of drinking to non-drinking drivers age 26+ in fatal crashes

Fell et al., Alcohol Clin Exp Res, 2009 (cont) Results Minimum legal drinking age was independently associated with a 16% decline in the ratio of drinking to non-drinking drivers in fatal crashes under age 21 Other laws that independently predicted lower involvement of drinking drivers under age 21 in fatal crashes: Use/Lose laws ↓5% Zero tolerance laws ↓5% 0.08% BAC limit ↓ 8% 0.10% BAC limit ↓ 7% Administrative license ↓ 5% revocation (ALR) Seat belt laws ↓ 3%

Fell et al., Alcohol Clin Exp Res, 2009 (cont) Conclusions Minimum legal drinking age of 21 reduced involvement of drinking drivers under 21 in fatal crashes (16%) Zero tolerance laws and Use/Lose laws targeted drivers under 21 also produced reductions Laws targeting drinking drivers of all ages also reduced involvement of drinking drivers under 21 in fatal crashes (0.08% and .10% BAC limits, ALR, seat belt laws)

… but there’s more than just minimum legal drinking age laws!

DUI Enforcement General vs specific enforcement Sobriety checkpoints Saturation patrols Revocation/suspension Ignition interlock Last drink Check-in programs

Sobriety Checkpoints Restrict traffic flow in a designated area and check drivers for signs of impairment Primarily general deterrence – increase perceived risk High visibility – media coverage Random breath test vs selective Blitz vs regular Shults, Elder, Sleet et al (2001) Review studies from 1980-2000 12 RBT studies: average 18% decrease across outcomes 11 SBT studies: average 20% decrease across outcomes

Recently updated previous checkpoint review Added 15 studies from 2000-2012 10 studies examined alcohol-involved fatal crashes -> 8.9% decrease Other 5 studies found decreases in: % drivers above .08 (28-64%) alcohol-involved fatalities/VMT (4.6%) alcohol-involved collisions (19%) nighttime crashes (22%) Task Force Finding “The Community Preventive Services Task Force recommends publicized sobriety checkpoint programs based on strong evidence of effectiveness in reducing alcohol-impaired driving.”

DUI Checkpoints Key Resource: http://www. nhtsa DUI Checkpoints Key Resource: http://www.nhtsa.gov/people/injury/alcohol/saturation_patrols/SatPats2002.pdf Common Challenges Generating community/political will Finding overtime dollars for police Ensuring training on checkpoint best-practices Supporting development of materials for dissemination at checkpoint Ensuring visibility -- using media to publicize checkpoints before and after event

Upstream DUI Enforcement It is too late once an intoxicated individual gets behind the wheel It is difficult to identify and apprehend intoxicated drivers It has been estimated that less than 1/1000 DUI trips results in an arrest (Miller, Spicer, Levy, & Lestina, 1998) Car crashes are but one of the many negative health consequences associated with intoxication Focusing exclusively on DUI enforcement may send the message that, as long as someone is not driving, it is OK to get intoxicated

Have your coalition/group participated in sobriety checkpoints? Poll #2 Have your coalition/group participated in sobriety checkpoints? Yes No

Underage Compliance Checks Sting or Decoy buys Police hire an underage (<21 years old) individual to attempt to purchase alcohol If an illegal sale is made, citation issued to either the seller or the establishment Penalty may vary from warning to a fine to a liquor license suspension/revocation (usually depending on previous citations)

Compliance Check Effectiveness Growing research literature that compliance checks are effective CDC conducted a review of studies that examined ‘enhanced enforcement’ – programs that increased or intended to increase frequency of compliance checks 8 studies from 1994-2005 all 8 studies examined sales to a decoy average 42% reduction 3 studies examined alcohol consumption 20% reduction 2-7% reduction 4-6% relative decrease

Compliance Check Effectiveness Task Force Finding “The Community Preventive Services Task Force recommends enhanced enforcement of laws prohibiting sale of alcohol to minors, on the basis of sufficient evidence of effectiveness in limiting underage alcohol purchases. Further research will be required to assess the degree to which these changes in retailer behavior affect underage drinking.” source: Elder, Lawrence, Janes, et al. (2007). Enhanced enforcement of laws prohibiting sale of alcohol to minors: systematic review of effectiveness for reducing sales and underage drinking. Transportation Research E-Circular 2007;Issue E-C123:181-8.

Compliance Checks Key Resource: http://www. udetc Compliance Checks Key Resource: http://www.udetc.org/aps/ComplianceChkDB.htm Common Challenges Generating community/political support Generating police support Finding overtime dollars for police Convincing state Liquor Control to partner Building support for prosecuting violators

Has your coalition/group supported or sponsored compliance check? Poll #3 Has your coalition/group supported or sponsored compliance check? Yes No

Party Patrols/Social Host Laws

Problem Setting: Residential Parties Party Patrols/Social Host Laws Problem Setting: Residential Parties Son held drunken party for 600 friends after banishing parents to bedroom of their multi-million-dollar mansion By Mail Foreign Service UPDATED: 20:55 EST, 14 October 2010

Intent of Social Host Policies Change community CULTURE and CONDITIONS Change the FOCUS from underage drinker to provider/enabler Decrease PROVISION Decrease furnishing alcohol to an underage person Change CONTEXT and SETTING Deter underage drinking parties

Social Host: the Evidence Viewed as a useful tool by law enforcement officers (Oceanside, CA and Vista, CA—see Evalcorp, 2009a) May result in changes in youth norms related to the riskiness of drinking (Long Beach City, NY—unpublished data) May result in fewer calls for service, either overall, or related to disturbances. For example, Petaluma, CA had 9.3% fewer calls for service related to disturbances from the year prior to passage (2006) to the second year after passage (2009) (Petaluma, CA—unpublished data). San Diego County had 8% fewer disturbance calls from the year preceding passage (2002) to the year following passage (2004) of its SHO (UDETC, 2003)

Party Patrols Enforcement strategy that targeting community high priority underage drinking party areas. arranged to both deter parties (through LE visibility) and find and address parties that are going on (through LE action). Law enforcement reports that party patrols can be effective deterrents if there are existing laws on the books that hold adults or other responsible parties accountable for underage drinking parties in homes. Are an important part of any community intervention to prevent underage and high risk drinking. They do tackle the high risk environments of home parties that we are describing and there is a strong evidence base behind them. These enforcement strategies, however, are only as good as the level of enforcement, visibility/community engagement (HV) and the policies that support them. Regarding home parties, for example, without policies that hold adults accountable for underage drinking taking place in their home, law enforcement often struggle to address and deter underage drinking parties in their community.

Party Dispersal An ongoing party is often difficult for officers to “break it up” with maximum impact on deterring underage parties from happening in the future and preventing teens from fleeing the scene. Party dispersal training gives officers and departments a strong foundation to systematically address parties and hold underage drinkers and providers responsible.

Landlord Lease Agreements Language that landlords include in leases that prohibit underage parties from occurring. There are often fines and penalties that escalate to eviction. Can effectively reduce the number of rental properties in which loud and unruly parties occur; if, strongly enforced and adopted by all/most landlords.

Party Patrols/Social Host Laws Key Resource: http://www. udetc Party Patrols/Social Host Laws Key Resource: http://www.udetc.org/documents/Party_Patrol_Guidebook.pdf http://venturacountylimits.org.s94613.gridserver.com/resource_documents/model_sho_fnl_nashville.pdf Common Challenges Identifying/adopting policy to enforce Generating community/political support for policy Generating police support to use resources Finding overtime dollars for police Training law enforcement to use enforcement techniques Building support for prosecuting violators

Has your coalition/group supported or sponsored party patrols? Poll #4 Has your coalition/group supported or sponsored party patrols? Yes No

Poll #5 Has your coalition/group supported or sponsored the adoption of a social host ordinance? Yes No

Three Enforcement Strategies Frequently Used By Coalitions Compliance checks for sales to minors at off-premise outlets Party patrols/social host laws DUI checkpoints

Which of these strategies are you most interested in considering? Poll #6 Which of these strategies are you most interested in considering? DUI Checkpoints Party Patrols Social Host Laws Compliance Checks Landlord Lease Agreements WHY?????

Questions About Enforcement Strategies to Reduce Alcohol Related Problems?

Safer California Universities Project Goal: To evaluate the efficacy of a “Risk Management” approach to alcohol problem prevention NIAAA grant #R01 AA12516 with support from CSAP/SAMHSA. Bob Saltz: Prevention Research Center

Integrated Intervention Strategies for Off-Campus Parties Compliance Checks DUI Check Points Party Patrols Pass Social Host “Response Cost” Ordinance A Social Host Safe Party Campaign

Practical Significance At each campus, 900 fewer students drinking to intoxication at off-campus parties and 600 fewer getting drunk at bars/restaurants during the fall semester at intervention schools relative to controls. Equivalent to 6,000 fewer incidents of intoxication at off-campus parties and 4,000 fewer incidents at bars & restaurants during the fall semester at Safer intervention schools relative to controls

In addition… No Displacement

So…What are the Implications for Your Coalition?

Thank You!