1. Community Action to Reduce Binge Drinking Prevention Extension Workshop Series Brought to you by the Community Prevention Institute through its contract with the California Department of Alcohol and Drug Programs

2. DefinitionDefinition Binge (High risk ) drinking is the consumption of alcohol to the extent that harmful consequences - health, academic, legal, and others - may be expected. Binge (High risk ) drinking is the consumption of alcohol to the extent that harmful consequences - health, academic, legal, and others - may be expected.

3. Quantity and Frequency of Alcohol Use In 2002, 51 percent of persons aged 12 or older were current drinkers. In 2002, 51 percent of persons aged 12 or older were current drinkers. Current drinkers aged 12 to 17 and young adults aged 18 to 25 drank more drinks per day on the days they drank alcohol than adults aged 26 or older. Current drinkers aged 12 to 17 and young adults aged 18 to 25 drank more drinks per day on the days they drank alcohol than adults aged 26 or older. Current drinkers aged 18-25 were more likely to drive under the influence of alcohol during the past year than drinkers aged 26 or older. Current drinkers aged 18-25 were more likely to drive under the influence of alcohol during the past year than drinkers aged 26 or older. Source: The National Survey on Drug Use and Health, SAMHSA, Dec, 2003.

4. Alcohol Use and Risks among Young Adults Almost 2 in 5 young adults, aged 18-24, regardless of college enrollment, reported binge drinking. Almost 2 in 5 young adults, aged 18-24, regardless of college enrollment, reported binge drinking. Full-time students, aged 18-21 had higher rates of binge drinking than nonstudents (c. 40-60%) Full-time students, aged 18-21 had higher rates of binge drinking than nonstudents (c. 40-60%) Nonstudents, aged 18-21, reported binge rates of c. 30%-45%. Nonstudents, aged 18-21, reported binge rates of c. 30%-45%. Source: The National Survey on Drug Use and Health, SAMHSA, Dec, 2003.

5. Alcohol Use and Risks among Young Adults Non students were less likely than full-time students to use seat belts while driving Non students were less likely than full-time students to use seat belts while driving Non students were less likely than full-time students to drive while under the influence of alcohol Non students were less likely than full-time students to drive while under the influence of alcohol Source: The National Survey on Drug Use and Health, SAMHSA, Dec, 2003.

6. Alcohol Use and Risks among Young Adults In 1999, 44% of college students reported binge drinking, the same rate as in 1993. In 1999, 44% of college students reported binge drinking, the same rate as in 1993. Nearly 70% of binge-drinking college students began binge drinking in high school. Nearly 70% of binge-drinking college students began binge drinking in high school. Source: Henry Wechsler, !999 College Alcohol Study, Harvard School of Public Health. Source: Henry Wechsler, !999 College Alcohol Study, Harvard School of Public Health.

7. Students Reporting Drinking In The Last 30 Days: 20% of 8th graders 20% of 8th graders 35% of 10 th graders 35% of 10 th graders 49% of 12th graders 49% of 12th graders Source: Monitoring the Future national results on adolescent drug use: Overview of key findings, 2002. (NIH Publication No. 03-5374). Bethesda, MD: National Institute on Drug Abuse.

8. Frequent intoxication (5+ drinks per occasion within the last two weeks) 12% of 8th graders 12% of 8th graders 22% of 10 th graders 22% of 10 th graders 29% of 12th graders 29% of 12th graders Source: Monitoring the Future national results on adolescent drug use: Overview of key findings, 2002. (NIH Publication No. 03-5374). Bethesda, MD: National Institute on Drug Abuse.

9. Second-hand Effects: Impact on the Individual Unplanned/unprotected sex Unplanned/unprotected sex Fights, sexual assault Fights, sexual assault Traffic & other injuries or fatalities Traffic & other injuries or fatalities Damage to physical, cognitive & social development Damage to physical, cognitive & social development School performance School performance Contributes to homicides/suicides Contributes to homicides/suicides

10. Second-hand Effects: Impact on the Community Vandalism and property damage Vandalism and property damage Increased noise, trash Increased noise, trash Costs related to increased police calls, emergency/medical services, lost productivity, etc. Costs related to increased police calls, emergency/medical services, lost productivity, etc.

11. EFFECTIVE PRACTICES AT THE COMMUNITY LEVEL 1 Increased enforcement of MLDA (Minimum Legal Drinking Age) laws Increased enforcement of MLDA (Minimum Legal Drinking Age) laws Implementation, increased publicity, and enforcement of other laws to reduce alcohol-impaired driving Implementation, increased publicity, and enforcement of other laws to reduce alcohol-impaired driving Restrictions on alcohol retail density Restrictions on alcohol retail density NIAAA Task Force on College Drinking, (2002),“A Call to Action: Changing the Culture of Drinking at U.S. Colleges.” www.collegedrinkingprevention.gov/

12. EFFECTIVE PRACTICES AT THE COMMUNITY LEVEL 2 Increased price and excise taxes on alcoholic beverages Increased price and excise taxes on alcoholic beverages Responsible beverage service policies in social and commercial settings Responsible beverage service policies in social and commercial settings Formation of a campus community coalition Formation of a campus community coalition NIAAA Task Force on College Drinking, (2002),“A Call to Action: Changing the Culture of Drinking at U.S. Colleges.” www.collegedrinkingprevention.gov/

13. PROMISING PRACTICES Increasing publicity about enforcement of underage drinking laws/eliminating “mixed” messages Increasing publicity about enforcement of underage drinking laws/eliminating “mixed” messages Provision of “safe rides” programs Provision of “safe rides” programs Regulation of happy hours and sales Regulation of happy hours and sales NIAAA Task Force on College Drinking, (2002),“A Call to Action: Changing the Culture of Drinking at U.S. Colleges.” www.collegedrinkingprevention.gov/

14. INEFFECTIVE PRACTICES Informational, knowledge-based or values clarification interventions when used alone. Informational, knowledge-based or values clarification interventions when used alone. NIAAA Task Force on College Drinking, (2002),“A Call to Action: Changing the Culture of Drinking at U.S. Colleges.” www.collegedrinkingprevention.gov/

15. ENVIRONMENTAL STRATEGY CREATE POLICIES, NORMS AND LAWS WHICH AFFECT ENTIRE GROUPS OF PEOPLE WHERE THEY LIVE, WORK OR PLAY

16. Environmental policies make it easier to do what’s safe and healthy and harder to do what’s unsafe and unhealthy

17. Environmental policies Keep sending the same messages and thus create new norms

18. INDIVIDUAL VS ENVIRONMENTAL CHANGE CHANGE FOCUS: individual behavior FOCUS: individual behavior GOAL: personal control of alcohol GOAL: personal control of alcohol TOOLS: education, treatment, small group activities TOOLS: education, treatment, small group activities WHO: professional & client/patient WHO: professional & client/patient Lawrence Wallack et al. Media Advocacy and Public Health: Power for Prevention. Sage Publications, Newbury Park, CA, 1993. FOCUS: policy, laws, norms FOCUS: policy, laws, norms GOAL: community control of alcohol GOAL: community control of alcohol TOOLS: media and policy advocacy, social pressure TOOLS: media and policy advocacy, social pressure WHO: shared/ community power WHO: shared/ community power

19. ENVIRONMENTAL RISK FACTORS OF ALCOHOL Easy access and availability Easy access and availability Low cost and taxes Low cost and taxes Heavy advertising and promotion Heavy advertising and promotion Weak laws/Unenforced laws Weak laws/Unenforced laws High consumption/abusive drinking norms High consumption/abusive drinking norms Pro-alcohol media Pro-alcohol media

20. Easy Access & Availability Sales to minors Sales to minors High density of outlets (stores, bars) High density of outlets (stores, bars) Drive-in & gas station sales, home delivery Drive-in & gas station sales, home delivery Unmonitored service (to minors or Unmonitored service (to minors or intoxicated drinkers, open bars) intoxicated drinkers, open bars) Long sales hours Long sales hours

21. Strategies to Keep Alcohol Cheap and Consumption Up Low taxes Low taxes Cheap drinks: 2-for-1, all you can drink, discounts, free drink coupons Cheap drinks: 2-for-1, all you can drink, discounts, free drink coupons No tax on advertising No tax on advertising Shifting costs (e.g., to admission, food) - thus making each additional drink seem cheap or free Shifting costs (e.g., to admission, food) - thus making each additional drink seem cheap or free

22. Alcohol Advertising and Promotion Strategies Equate alcohol with fun, sex, music, sports, adult glamour Equate alcohol with fun, sex, music, sports, adult glamour Ignore harmful consequences Ignore harmful consequences Fail to mention abstinence Fail to mention abstinence Focus on individual responsibility Focus on individual responsibility Present alcohol as a valued product produced by good citizens Present alcohol as a valued product produced by good citizens

23. Actions to Target Youth sponsor sports, music, festivals sponsor sports, music, festivals billboards near schools & recreation billboards near schools & recreation novelty items: clothing, sports equipment, promotional items, contests, websites novelty items: clothing, sports equipment, promotional items, contests, websites help to lower drinking age help to lower drinking age

24. Norms That Increase Risk It’s only alcohol, not drugs It’s only alcohol, not drugs Drink till you drop Drink till you drop Hospitality means lots of drinks Hospitality means lots of drinks Kids have always drunk - look at me Kids have always drunk - look at me Socializing and fun = alcohol Socializing and fun = alcohol It’s all the responsibility of the individual drinker It’s all the responsibility of the individual drinker

25. The alcohol industry uses the mass media to: Promote its products and brands Promote its products and brands Target current and potential drinkers Target current and potential drinkers Gain influence (via advertising $$) to promote itself and its viewpoints Gain influence (via advertising $$) to promote itself and its viewpoints Blame youth and individual abusers Blame youth and individual abusers Downplay its role in politics and alcohol- related problems Downplay its role in politics and alcohol- related problems

26. PRICING CONTROLS RAISE EXCISE TAXES RAISE EXCISE TAXES RESTRICT PRICE PROMOTION RESTRICT PRICE PROMOTION RESTRICT DISCOUNTS RESTRICT DISCOUNTS INCREASE LICENSING FEES INCREASE LICENSING FEES INCREASE INFRACTION PENALTIES INCREASE INFRACTION PENALTIES ELIMINATE TAX EXEMPTION FOR ADVERTISING ELIMINATE TAX EXEMPTION FOR ADVERTISING

27. ACCESS CONTROLS - GENERAL LICENSE OUTLETS WITH SERVER REQUIREMENTS LICENSE OUTLETS WITH SERVER REQUIREMENTS ABC LAWS ABC LAWS RESTRICT HOURS, DAYS, LOCATIONS, LOCAL PROHIBITION RESTRICT HOURS, DAYS, LOCATIONS, LOCAL PROHIBITION RESTRICT OUTLET TYPES, NUMBER RESTRICT OUTLET TYPES, NUMBER RESTRICT SERVING PRACTICES RESTRICT SERVING PRACTICES

28. ACCESS CONTROLS - GENERAL 2 REQUIRE SERVER AND RETAILER TRAINING REQUIRE SERVER AND RETAILER TRAINING SERVER LIABILITY LEGISLATION: SERVER LIABILITY LEGISLATION: -FOR SERVERS & RETAILERS -FOR SERVERS & RETAILERS -FOR ADULTS SELLING OR PROVIDING ALCOHOL TO MINORS -FOR ADULTS SELLING OR PROVIDING ALCOHOL TO MINORS ELIMINATE SALES/SERVICE AT PUBLIC EVENTS OR LOCATIONS ELIMINATE SALES/SERVICE AT PUBLIC EVENTS OR LOCATIONS

29. ACCESS CONTROLS - YOUTH MINIMUM DRINKING AGE MINIMUM DRINKING AGE GRADUATED LICENSING AND “ZERO TOLERANCE” LEGISLATION GRADUATED LICENSING AND “ZERO TOLERANCE” LEGISLATION SERVER LIABILITY SERVER LIABILITY MERCHANT EDUCATION MERCHANT EDUCATION ENFORCEMENT OF SELLING RESTRICTIONS ENFORCEMENT OF SELLING RESTRICTIONS

30. ACCESS AND USE CONTROLS - DRIVING DUI LAWS & ENFORCEMENT DUI LAWS & ENFORCEMENT OPEN CONTAINER LAWS OPEN CONTAINER LAWS RESTRICT HOURS OF SERVICE RESTRICT HOURS OF SERVICE BAN DRIVE-IN, HOME DELIVERY AND GAS STATION SALES BAN DRIVE-IN, HOME DELIVERY AND GAS STATION SALES INTERLOCK DEVICES INTERLOCK DEVICES

31. ADVERTISING & PROMOTION CONTROLS CONTROL CONTENT AND MEDIA CONTROL CONTENT AND MEDIA REDUCE POINT OF SALE MERCHANDISING REDUCE POINT OF SALE MERCHANDISING COUNTER-ADVERTISING COUNTER-ADVERTISING REDUCE SPONSORSHIP OF SPORTS AND MUSICAL EVENTS REDUCE SPONSORSHIP OF SPORTS AND MUSICAL EVENTS HEALTH WARNING LABELS HEALTH WARNING LABELS

32. ADVERTISING AND PROMOTION CONTROLS 2 BAN ADVERTISING IN OR NEAR SCHOOLS AND CAMPUSES BAN ADVERTISING IN OR NEAR SCHOOLS AND CAMPUSES SCHOOL BANS ON WEARING OF CLOTHES WITH ADVERTISING SCHOOL BANS ON WEARING OF CLOTHES WITH ADVERTISING EDUCATE COMMUNITY ON COSTS OF ALCOHOL USE AND ABUSE EDUCATE COMMUNITY ON COSTS OF ALCOHOL USE AND ABUSE

33. ADVERTISING AND PROMOTION CONTROLS 3 INCREASE TRUTH IN ADVERTISING INCREASE TRUTH IN ADVERTISING ADVOCACY, MEDIA EVENTS, EDUCATION ABOUT THE REALITY OF ALCOHOL USE AND PROMOTION ADVOCACY, MEDIA EVENTS, EDUCATION ABOUT THE REALITY OF ALCOHOL USE AND PROMOTION CONTROL “IMAGE” PACKAGING AND LABELING CONTROL “IMAGE” PACKAGING AND LABELING

34. Youth are not the primary producers, promoters, distributors, sellers, or users of alcohol

35. .............ADULTS AND ADULT BUSINESSES ARE [adult drinkers / brewers, distillers & wine producers / bars, taverns, restaurants / mass media / advertising / merchants / etc.]

36. Youth can’t control... Alcohol Prices Alcohol Prices Alcohol Taxes Alcohol Taxes Alcohol Advertising & Promotion Alcohol Advertising & Promotion Alcohol Sales and Distribution Alcohol Sales and Distribution Alcohol Laws & Regulations...... Alcohol Laws & Regulations...... or, the government, or, the government, voters or businesses that do control these voters or businesses that do control these

37. communities can !!

38. High Impact High Feasibility Low Impact Low Feasibility Priority Grid Priority Grid

39. TARGET GROUPS Whose behavior do you want to change? Whose behavior do you want to change? May be multiple groups May be multiple groups What’s the rationale for your choice? What’s the rationale for your choice?

40. POTENTIAL TARGET GROUPS Policy makers Policy makers Media Media General Public General Public Parents Parents Alcohol providers Alcohol providers Youth Youth

41. ACTION PLAN What is the best way to achieve change? What is the best way to achieve change? What data do we need? What data do we need? What is the issue? What is the issue?

42. ACTION PLAN Who must be mobilized? Who must be mobilized? What is the message? What is the message? Who can make the change? Who can make the change?

43. ACTION PLAN What needs to be done? What needs to be done? Who will take action? Who will take action? When? When?

44. ELEMENTS OF ENVIRONMENTAL PREVENTION MODEL Data Data Community Organizing Community Organizing Policy/Strategy Goal Policy/Strategy Goal Media Advocacy Media Advocacy Enforcement Enforcement

45. SAMPLE SCENARIO 1 MEDIA REPORTS ON STUDENT DRINKING AND BAR SPECIALS PARENTS & OTHER COMMUNITY MEMBERS CONTACT POLICY MAKERS CITY COUNCIL ENACTS ORDINANCE

46. SAMPLE SCENARIO 2 POLICY MAKERS BAN DRINK SPECIALS PRICE OF DRINKS INCREASES YOUTH DRINK LESS VANDALISM DECREASES

47. MEASURING PROGRESS Public awareness Public awareness Media support Media support Policy change Policy change Second Hand Effects Second Hand Effects Drinking behavior Drinking behavior

48. NATIONAL DATA SOURCES Monitoring the Future Monitoring the Future National Survey on Drug Use and Health National Survey on Drug Use and Health NIAAA—College Drinking Prevention NIAAA—College Drinking Prevention Harvard School of Public Health, College Alcohol Study Harvard School of Public Health, College Alcohol Study SAMHSA—Clearinghouse SAMHSA—Clearinghouse

49. LOCAL & STATE DATA SOURCES California Healthy Kids Survey (CHK) California Healthy Kids Survey (CHK) ASIPS/GIS mapping ASIPS/GIS mapping Place of Last Drink (POLD) Place of Last Drink (POLD) SWITRS—California Highway Patrol SWITRS—California Highway Patrol Police Department Police Department Emergency Medical Services Emergency Medical Services Hospital Discharge Data Hospital Discharge Data

50. MODULE 8/ Overhead 2/ Page 1  What will your next step be?  What resources are available? Please see the TA request form in the front pocket of your binder! 33 Community Prevention Institute Phone: (916) 983-8929 Fax: (916) 983-5738 www.ca-cpi.org NEXT STEPS Free Technical Assistance is available through: