SHOWCASE OF EVIDENCEBASED ENVIRONMENTAL
STRATEGIES
Presented by: Workgroup on Evidence-Based
Practice (WEB)
Presented for CAST
Date: January 26, 2011
Agenda

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Brief history/goals of WEB group
Definitions of evidence-based
Logic models for preventing DUI and underage
drinking
Overview of enforcement strategies
Lunch
Review of additional environmental strategies
Question and Answers
Next Steps
Background on WEB
WEB (Workgroup on Evidence-Based) began in
January 2010 as condition of SPF-SIG.
 Wanted the Cohort 4 states to learn from previous
states about what works.
 Wanted continued update of the literature.
 WEB should work to compile literature that is
customize for each state’s priorities.

Who is on the WEB?


Co-chairpersons: Drs. Pam Imm and Abby Fagan
Community and state-level experts
 See



handouts of presenters/agencies
Coaches attend WEB meetings
Staffed by PIRE and other DAODAS staff
Report to the Executive Committee and to the
Governor’s Council
Goals of WEB



Compile literature on the evidence-based
practices for the state’s priorities.
Ensure the use of EBP in the counties
Current Roles:
 Compile
literature on EBP for CAST
 Provide training on EBP for CAST
 Provide recommendations for SC Toolkit
 Provide recommendations to Governor’s Council
about the county strategic plans
Format for Showcase
Overview of strategy
 Key terms/definitions
 Relation to logic model and needs/conditions
 Needs assessment data sources to review
 How do we know it is evidence-based?
 Current status in South Carolina
 What are the key elements of implementation?

WEB MEMBERS

Dr. Pam Imm, Chair
LRADAC

Dr. Abigail Fagan, Co-Chair
University of South Carolina

Barbara Brown
Clemson University

Ann Crawley
Community Initiatives, Inc.

Regina Creech
Region 4 Capacity Coach, Ernest E.
Kennedy Center

Rhonda DiNovo
West Columbia Police Dept.

Dawn Hancock
Region 3 Capacity Coach, Circle Park
Behavioral Health Services
WEB MEMBERS (cont.)

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Donna Herchek
Counseling Services of Lancaster
Lou Anne Johnson
Region 1 Capacity Coach, The Phoenix Center
Beth Mackinem
SC Dept. of Education
Pam Rush
Axis 1 Center of Barnwell
Curtis Reece
The Phoenix Center
Eunika Simons
Richland School District 2
Kim Smith
SC Dept. of Education
Kristy Stoneburner
Region 2 Capacity Coach, LRADAC
Lorene Welch
SC PTA
WEB STAFF

Steven Burritt
PIRE

Michael George
PIRE

Crystal Gordon
DAODAS

Kerry McLoughlin
DAODAS

Elaine Dowdy Melvin
PIRE

Michelle Nienhius
DAODAS

Brenda Powell
DAODAS
Overview of Evidence-Based
Strategies
Dr. Abigail Fagan, University of South Carolina
Dr. Pam Imm, Lexington/Richland Alcohol and Drug Abuse Council
Prepared for CAST: Jan 26, 2011
What Does Evidence-Based Mean?
OVER THE LAST THREE YEARS,
OVER 220 COMMUNITIES HAVE
STARTED NEW D.A.R.E.
PROGRAMS!
The Community Trials
Intervention produced
significant results, including:
decreased alcohol sales to
youth and decreased binge
drinking.
“Even little ones can think and respond
when guided with Love and Logic."
-Linda, Anderson, CA
Grandparent
Program Evaluation
On the one hand….
On the other hand…
Ask two questions:
1. Does it work?
2. How do you know
it works?
Does it Work?

Yes (“Pretty good” evidence)
 There
are meaningful changes in the outcomes you
are interested in for participants or communities who
received the intervention
 Look
for actual statements regarding changes (e.g.,
statistics and graphs)
 There
are no harmful effects on participants
Percent Drinking Alcohol
Effects of the Life Skills Training
Program on Adolescent Alcohol Use
35
30
25
20
15
10
5
0
Control Group
LST Students
Source: Botvin, Baker, Dusenbury, Botvin, & Diaz, 1995
Does it Work?

YES! (the “Best” evidence)
Effects were sustained over time
Effects were replicated in multiple
studies
And were shown for a variety of
populations
And were assessed by independent
evaluators
How do you know it works?

Effects were found during a strong, carefully
conducted study
 One group, pre/post test design: the most common
type of study; results may not be as valid
 Quasi-experimental design: participants are nonrandomly assigned to intervention and “comparison”
groups
 Experimental research design: participants are
randomly assigned to receive the intervention or not
(i.e., involves a “control group”)
Why have a comparison group?
Guards against falsely concluding that an
effective program didn’t work
 Guards against falsely concluding that an
ineffective program did work
Helps rule out other possible
explanations for the change

How do you know it works?

Other important questions to ask:
 How
many participants were involved in the
study?
 How many participants dropped out of the
research project (why?)?
 What happened to participants in the control
group?
How is this relevant for your work?
The WEB group has reviewed the evidence
and will summarize what works regarding
environmental strategies
 It’s still important to look at the details of how
well and for whom these strategies are
effective. Fortunately, much of the research
has been done for you and the WEB has
consolidated the research for you.

What is meant by environmental
strategies?


Looks to change the conditions in the environment.
Individual change:
 Focus:
Individual behavior
 Goal: Personal control of alcohol
 Tools: Education, treatment, small group activities
 Who: Professional and client; educator and student
What is meant by environmental
strategies? (cont.)


Move from individual to environmental
Environmental change
 Focus:
policy, laws, norms
 Goal: Community control of alcohol
 Tools: Media and policy advocacy, social pressure
 Who: Coalitions, stakeholders, community organizers
Foundation of Key Principles

Substance use is a public health challenge
requiring a public health approach.
Host
(individual)
Agent
(ATOD)
Environment
(social, physical, other
contexts of use)
SELECT SOURCES: IOM, 2004; SAMHSA/CSAP, SPF Grants, 2004 -
Foundation of Key Principles (Cont.)

A complex system of factors produces
substance use and related problems.
• Multiple points of
intervention
• Varied levels of
influence
• Assessment
• Then comprehensive
and synergistic
approach
SELECT SOURCES: Birckmayer et al.,
2004; IOM, 2004
Foundation of Key Principles (Cont.)

Prevention requires a shift from “select an
intervention” to “prevention by design” for
widespread impact
•
•
From “intervention-based” approach focused on
individuals
To a “diagnostic” approach focused on
SCIENTIFIC
population-level change
SUBSTANCE USE
and RELATED
CONSEQUENCES
Intervening
Variables,
R/P Factors
KNOWLEDGE
ABOUT
PREVENTION
STRATEGIES
SELECT SOURCES: SAMHSA/CSAP, SPF Grants, 2004 - ; Green & Kreuter, 1999
Existing Products, Research, and TA
Examples of Advances in the Last Five Years
Reducing
Underage
Drinking
The Surgeon
General’s Call
To Action
2005
Assessing
Drug Abuse
NIDA / CEWG
2006
Environmental
Strategies
Guide
Logic Model on
Underage
Drinking
2007
Getting To
Outcomes:
SPF
Assessing The
Fidelity SPF
Cross-Site
2008
Epidemiology
Workgroup
Toolkit
$’s and Cents
Cost Benefit
Analyses
2009
IOM Report on
Preventing
Disorders
Trends in
Underage
Drinking NIAAA
2010
Task Force on
Prevention
Services Findings
Underage Drinking/DUI
What do we know?
 Economic availability – Strong evidence that PRICE
reduces use and associated harms
 Retail availability – Strong evidence that physical and
commercial access reduces use and associated harms
•
•
•
•
•
Minimum purchase age laws
Outlet density restrictions
Prohibition of minors from bars
Controls on who can sell and when
Internet monitoring
 Enforcement is directly related to policies – strong
evidence that threat of and actual enforcement deters
use and reduces associated harms
Underage Drinking/DUI
What do we know? (Cont.)
 Social availability and access (intervention
evidence is limited yet evolving)
 Minor in possession laws
 Penalizing adult procurement for youth
 Interventions evolve as sources evolve
 Media/Promotion most effective when supporting
specific policies or enforcement efforts

By itself, little effect on behavior
 Some lessons to be learned from tobacco
 Norms are related to policies and behavior, but
temporal relationship less clear
What types of environmental strategies work to
reduce underage drinking and DUI?

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


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Enforcement (compliance checks, traffic safety checkpoints)
Happy Hour restrictions
Restricting sales at Public Events
Responsible Beverage Service
Social Host Laws
Graduated Drivers’ License Laws
Keg Registration
Reducing Alcohol Outlet Density
Increasing Taxes on Sales of Alcohol
How do I know which to pick?





Pull out logic models (DUI/underage drinking)
You are to create a strategic plan (it will never be
one strategy)
Pick your strategies based on the data collected
from needs/resource assessment
Should be a match between what needs assessment
data are telling you and what environmental
strategies you choose.
Examples of good match and not so good
INCREASING TAXES ON
SALES OF ALCOHOL
EUNIKA SIMONS
R E C O N N E C TI N G – R I C H L A N D 2
Increasing Taxes on Sales of Alcohol
 Overview: The overall price of alcohol affects how
much people will consume, which in turn, affects the
level of alcohol-related problems.
 The primary way to make alcohol more expensive is
through increasing taxes on the sale of alcohol.
 Research indicates that higher taxes lead to a reduction
in the levels and frequency of drinking and heavy
drinking among youth, lower traffic fatality rates and
reduced incidence of some types of crime.
Terms
 Adjusting taxes to the rate of inflation: One
way to raise taxes is to “catch up” the current tax rate
to what it should be after accounting for inflation and
then index the alcohol taxes to increase with inflation
for future years.
 Alcoholic Beverage Control States: Certain
states have a state monopoly over the wholesale
and/or retail pricing and distribution of some or all
categories of alcoholic beverages. (Southeastern
control states: Alabama, North Carolina, Mississippi)
How does it work?
 Decreasing access/availability of alcohol by raising
prices through tax increases.
Current Status in SC
South Carolina Alcohol Sales Tax Rates (per
gallon) January 2009
South Carolina
Rates
Average
National Rates
National Rank
Spirits Tax
$5.42
$5.94
21st
Table Wine Tax
$1.08
$0.79
11th
Beer Tax
$0.77
$0.27
4th
In short, South Carolina has close to an average sales tax on
spirits, a high tax on wine, and a very high tax on beer.
Key Elements of Implementation
 Determine what the current tax rate is
for your state/community.
 Learn what the exact rate is in your
state.
 Conduct analysis on what tax rate
should be raised to.
Key Elements of Implementation (cont.)
 Compile data and evidence that supports
alcohol tax increases.
 Begin building community support for
this strategy from lawmakers, key
stakeholders and the public at large.
 Identify immediate, intermediate and
long-term outcomes of the strategy.
Relation to Logic Model
 Key Risk Factors
 Social norms favorable toward use
 Easy retail/social access
 Low or discount pricing
 Data Sources
 Environmental Scan
 Community/Key Leader Surveys
 Department of Revenue
 Alcohol Commission
Alcohol Tax Increases
 Implemented at state and federal levels
 Are beverage-specific
 Based on the amount of beverage purchased
Not on the sales price
 Effects erode over time





Inflation
Industry promotions
Price reductions to offset taxes
Need to adjust tax amount
 Support based on 73 studies
 Reductions in consumption and harms
Controlling Alcohol Outlet Density and Location
 Overview: Geographic areas with increased alcohol
outlet density have increased levels of heavy drinking
and alcohol-related problems, including violence,
crime, alcohol-related traffic crashes and injuries.
Geographic buffers between alcohol establishments
and youth-related areas (schools, parks) help reduce
accessibility by making it less prevalent in their
immediate environment.
Definitions/Terms
 Alcohol licensee: Paid $ to receive a license to
serve alcohol on premise or off-premise (or both)
from Department of Revenue (DOR).
 Alcohol outlet density: Number of outlets that can
sell alcohol within a given geographic area



Geographic density
Economic density
Population density
Relation to Logic Model
 Key risk factors:
 Social norms favorable toward use
 Easy retail/social access
 Insufficient enforcement
 Data sources:
Youth surveys (CTC)
 Environmental scan
 Community/key leader surveys
 Crash data

How do we know it is evidence-based?
 Higher density contributes to increased alcohol-
related problems including sales to minors. Both Off
and On premise outlet density is positively related to
frequency of underage driving after drinking and
riding with drinking drivers among 16-20 year old
youth.
 Outlet density related to drinking and drinkingrelated problems among college students.
Evidence (continued)
 The CDC Task Force on Community Preventive
Services recommends the use of regulatory authority
(e.g., through licensing and zoning) to limit alcohol
outlet density on the basis of sufficient evidence of a
positive association between outlet density and
excessive alcohol consumption and related harms.
Resources
 Campbell CA, Hahn RA, Elder R, Brewer R, Chattopadhyay S, Fielding
J, Naimi TS, Toomey T, Briana Lawrence B, Middleton JC, Task Force
on Community Preventive Services. The effectiveness of limiting
alcohol outlet density as a means of reducing excessive alcohol
consumption and alcohol-related harms. Am J Prev Med
2009;37(6):556-9.
 Task Force on Community Preventive Services. Recommendations for
reducing excessive alcohol consumption and alcohol-related harms by
limiting alcohol outlet density. Am J Prev Med 2009;37(6):570-1.
Application for License/Permit
 Public notification of intention to sell alcohol (e.g.,
newspaper)


Who is applying and address of location
To object, written protest must be notified by (date) including:
Name, address, and telephone number of person filing
 Specific reasons why the application should be denied
 That the person protesting is willing to attend a hearing (if
requested by the applicant)
 That the person resides in the same county where the proposed
place of business is located or within five miles of the business,
and name/address of applicant and location

Address
 Protests must be mailed to Department of Revenue
 Attn: ABL
 P O Box 125
 Columbia, SC 29214
 Fax: 803-898-5899
Key elements of implementation
 Determine law (local and state)
 Get champions on your side
 Ensure a geographic buffer zone of about 1000 feet
between outlet and schools, playgrounds,
residential neighborhoods, etc
 Work to restrict these outlets
 Consider conditional permits
 Increase community’s awareness/knowledge that
they can protest issuance (newspaper)
Media
 Media is a powerful resource but is NOT EFFECTIVE
on its own.
 Couple media efforts with other activities; publicize
the activities of other activities (e.g., compliance
check activities, merchants who don’t sell, school TV
stations, sobriety checkpoints).
 Combined with multi-component community
efforts /variety of new media options
 Deterrent effect – increase perceived risk of
detection
Take-Away Messages
 A complex system [still] produces substance use
 Prevention is more than packaged programs and strategies
– it is a strategic, comprehensive design process of
planning, implementation, and evaluation
 No single program component or strategy can prevent
multiple and complex risk behaviors, reduce related harms,
and achieve widespread and lasting change.
 Need individual and population-based approaches that
target high risk situations and use in general
Take-Away Messages Cont.
 Education programs (alone, small, limited effects) should be used
within broader environmental approaches to address availability of
alcohol
 Policies need to target both underage drinkers AND the general
population

Help eliminate adult suppliers and role models

Reduce social acceptability of adult provision
 Researchers, policymakers, and practitioners all have important
perspectives. We can advance the field by working and learning
together!
Questions and Answers
 Let’s talk!!
 Please complete evaluation forms
 Use the technical assistance providers available to
you.
KEG REGISTRATION
Beth Mackinem
SC Department of
Education
Keg Registration
Overview of the Keg Registration Law:
 Requires kegs of beer to be tagged with an
identification number and information to be recorded
about the purchaser;
 Sometimes a deposit is required as an incentive to
keep the keg properly tagged; and
 Easier to track the whereabouts of kegs and the
individuals using them including underage youth and
the adults who provided the keg for them.
Definition/Terms
South Carolina terms:
•
“Keg” means a container of beer with a capacity of
5.16 gallons or more that is designed to dispense
beer directly from the container in an off-premises
location.
•
“Retail licensee” means the holder of a retail beer or
wine license issued by the South Carolina
Department of Revenue.
Relation to Logic Model
Key Risk Factors:
Easy social access;
Social Norms encouraging use;
Insufficient enforcement of laws;
and
Easy retail access
How do we know it is evidence based?
According to the Community Anti-Drug
Coalitions for America (CADCA), keg registration
reduces the overall rates of traffic deaths among
the general population. Keg registration enhances
the control of youth access to alcohol outside of
licensed establishments.
Keg registration allows retailers to keep track of
when a keg is purchased and who purchased the
keg. Keg registration also gives law enforcement
information needed to determine the responsible
party for the purchase.
How do you know it works?
 Adults may be dissuaded from purchasing a keg for a group of
underage youth if that purchase will be able to be tracked back to
them. Anyone who purchases a keg must sign paperwork that states
that they cannot provide alcohol to anyone under the age of 21 and that
the beer in the keg will not be consumed by anyone under the age of 21.
 A retail licensee cannot sell a keg of beer without gathering the
purchasers information and verifying the accuracy of the information
by obtaining driver’s license information from the purchaser. A
retailer can lose their beer or wine license for violation of this law.
 A paper compiled by the Illinois Higher Education Center for Alcohol,
Other Drug and Violence Prevention indicates that there is not
sufficient data on the effectiveness of keg registration, however
advocates indicate that it decreases the supply which in turn decrease
consumption.
Current Status in South Carolina
South Carolina has a keg legislation law that went
into effect January 1, 2008.
 The Alcohol Beverage License (ABL) holder must
attach a Keg Identification Tag to the keg
 Must
complete
the
State-approved
Keg
Registration Form.
 The license holder must keep the Keg
Identification Tag and the Keg Registration Form,
for a period of not less than 90 days from the
date the keg was sold to the consumer.
Current Status in South Carolina (cont.)
 The SC Department of Revenue will furnish the
Keg Identification Tag to any license holder upon
written request and proper proof of licensure.
 The Keg Identification Tag is furnished without
cost to the license holder.
 The license holder must furnish his/her ABL
license number and acknowledge receipt of the
numbered Keg Identification Tag(s).
 Any SC Department of Revenue office can furnish
the license holder a limited number of Keg
Identification Tags.
Current Status in South Carolina (cont.)
About the Keg Identification Tag
 Designed by the SC Department of Revenue
 Is approximately 4”x 5”, and is a 2-color water-resistant and
tear-resistant poly film tag, bearing consecutive numbers
and the State of South Carolina image.
 Contains certain relevant statutory portions advising the
license holder on how to attach the tag
 Has a warning to the public that it is unlawful to remove,
alter or obliterate the Keg Identification Tag, punishable by
a fine of up to $500 and/or imprisonment of not more than
30 days.
 Has blank lines for the license holder to record his name,
address and ABL License Number.
Key elements of implementation
The license holder, before making any keg sale to a consumer,
must record and keep the following information on the Keg
Registration Form:
 The date of the sale and the Keg Identification Number.
 The name, address and birth date of the purchaser.
 The driver's license or identification card number furnished by
the purchaser.
 A statement by the purchaser attesting that the information
furnished to the license holder is accurate and acknowledging
that unless authorized by law, it is unlawful to transfer beer to a
person under the age of twenty-one.
 The date the keg was returned to the license holder and
whether the Keg Identification Tag was returned with the tag
properly affixed.
 The Keg Registration Form must be available for inspection by
the Department of Revenue or law enforcement agencies
during normal business hours.
Resources
 Illinois Higher Education Center for Alcohol, Other Drug and Violence
Prevention, Spring 2005, Statewide Mandatory Keg Registration
http://www.eiu.edu/~ihec/documents_pdf/rb_link_keg_registration.doc ,
accessed on January 18, 2011.
 Imm, Pamela , Matthew Chinman, Abraham Wandersman, David
Rosenbloom, Sarah Guckenburg and Roberta Leis. Preventing Underage
Drinking: Using Getting To Outcomes™ with the SAMHSA Strategic
Prevention Framework to Achieve Results. Santa Monica, CA: RAND
Corporation, 2007. http://www.rand.org/pubs/technical_reports/TR403
 South Carolina Department of Revenue website for the keg registration
instructions and required forms,
http://www.sctax.org/Forms+and+Instructions/default.htm
 The Evidence for Environmental Strategies – Drug Free Communities New
Grantee Meeting, Washington, DC – December 7, 2010,
http://www.preventionworksinseattle.org/uploads/Evidence-4EnvironmentalStrategies-CD-12-2010.pdf , accessed on January 18, 2011.
RESPONSIBLE BEVERAGE SERVICE
Barbara Brown
Clemson University
Responsible Alcohol Sales (RAS) &
Beverage Service (RBS) Strategy
Overview of strategy
 Responsible Alcohol Sales training (RAS) and
Responsible Beverage Service (RBS) training helps
employees and managers understand state laws and
corporate social responsibility policies and procedures.
 It is a good best line of liability defense for alcohol sales
and service by educating on strategies to avoid illegally
selling to underage youth and intoxicated patrons.
Key Definitions/Terms
 Alcohol licensee: Paid $ to receive a license to serve alcohol on premise
or off-premise (or both) from Department of Revenue.
_ Alcohol Licensee
_ On-premise Licensee
_ Off-premise Licensee
_ On/Off-premise Licensee
 Corporate Social Responsibility: The concept of an organization taking
responsibility for its impact on society and the environment.
(www.science.org.au/NOVA/034/034glo.htm)
 “Protect, Respect, and Remedy”…a United Nations framework
 (www.reports-and-materials.org/Ruggie-UN-draft-businessprincipals)
RESPONSIBLE SALES AND SERVICE TRAINING
 Alcohol Sales and Service trainings aim to reduce alcohol
related harm.
 Be aware of social aspects organizations of the alcohol
industry who may provide research, training and provide
policy recommendations.
 Three programs approved by State Department of Revenue:
 Palmetto Retailers Education Program (PREP)
www.prepmerchant.org
 ServSafe (on-premise alcohol sales & food safety)
www.servsafe.com
 TIPS (on & off-premise alcohol sales www.gettips.com
RAS & RBS Training on
Responsible Policies & Procedures
Information about:
 laws and penalties
 the importance of avoiding sales to minors to protect the
health and well-being of everyone in the community
 how to recognize false IDs
 how to refuse a sale safely
 proper management techniques and policies to encourage
compliance with the law
(From: Pacific Institute for Research and Evaluation)
Relation to Logic Model
Key risk factors:
 Easy retail/social access
Data sources:
 Environmental scan
 Community/key leader surveys
 State Licensee Data
 Compliance Check Data
 Where else?
How do we know it is evidence-based?
These types of programs (RBS training) help reduce
alcohol sales to underage youth.
Also, they help protect licensees and their employees as
well.
Nearly all evaluations in training bar staff in responsible
beverage service when backed up with enforcement have
demonstrated improved knowledge and attitudes among
participants. (Anderson & Baumberg, 2006)
Evidence
 There is growing evidence for the impact of strategies that alter the
drinking context in reducing the harm done by alcohol.
 These strategies are primarily applicable to drinking in bars and
restaurants, and their effectiveness relies on adequate enforcement.
 Passing a minimum drinking age law, for instance, will have little
effect if it is not backed up with a credible threat to remove the
licenses of outlets that repeatedly sell to the under-aged.
 Such strategies are also more effective when backed up by community
based prevention programs
Anderson, P., and Baumberg, B. (June 2006), Alcohol in Europe A Public Health Perspective A Report for the European
Commission, Institute for Alcohol Studies, U.K.
Effectiveness
“Intensive, high quality, face to face server
training, when accompanied by strong and active
management support, is effective in reducing the
level of intoxication in patrons,” (Shults, 2001).
An Oregon study showed that a server training
program reduced single-vehicle nighttime injury
crashes by 23% (Jones and Lacey, 2001).
http://www.nhtsa.gov/people/injury/airbags/countermeasures/pages/Chapt1/5p1RespBevSe
Effectiveness
A rigorous server 18-hour RST program for
management and staff and the revision of
establishment policies and job descriptions at a US
Navy Base resulted in customer intoxication being
cut in half (Saltz,1987).
University of Minnesota, (2009) Alcohol Epidemiology Program, Responsible
Beverage Server Training, Retrieved from:
http://www.epi.umn.edu/alcohol/policy/rbst.shtm
Need
Food and beverage industry forecast that consumers are
expected to increase their purchases of alcohol in bars and
restaurants in 2011 by 1.9%, from Business Wire
Technomic news release, December 8, 2010.
Current Status in SC
 Server training is only required of an individual if they
are convicted of selling to youth
 Alcohol liability insurers often offer discounts for having
all staff trained
 1,671 participants trained in PREP in FY’10 (dropped 2
straight years)
Current Status in SC (cont.)
 Only 11% of clerks ticketed for underage sales in FY’10
indicated they had taken a merchant education class
 DAODAS & CAST recommend PREP, a rigorous delivery
and monitoring system is in place which includes pre &
post surveys and tracking
 Many establishment (like grocery stores) say they do
their own training
Key Elements of Implementation
The alcohol industry can provide server training and
monitoring to:
 insure adherence to the law; and
 reduce risk of harmful consequences of intoxication,
harmful patterns of drinking, and the risk of drinking and
driving.
Resources
Alcohol Epidemiology Program, Responsible Beverage Service Training
http://www.epi.umn.edu/alcohol/policy/rbst.shtm
Alcohol Policy
http://www.alcoholpolicy.niaaa.nih.gov
FACE, 105 West Fourth St., Clare, MI 48617, 1-800-822-3223,
http://www.facecatalog.org
Imn, P., Chinman, M., Wendersman, A., Rosenblum, D., Guchenberg, S., Leis, R.
(2007), Preventing Underage Drinking Using Getting To Outcomes with
SAMHSA Strategic Prevention Framework to Achieve Results, A Rand Health
Technical Report supported by the Substance Abuse and Mental Health Service
Administration, Santa Monica, CA: Rand Corporation,
Retrieved from:
http://www.rand.org/content/dam/rand/pubs/technical_reports/2007/RAND_
TR403.pdf
Pacific Institute for Research and Evaluation, http://www.pire.org
Underage Drinking Enforcement Training Center,
http://www.udetc.org/documents/responsible_sales.pdf
ENFORCEMENT STRATEGIES
Steven Burritt
Michael George
Pacific Institute for Research
and Evaluation (PIRE)
Compliance Checks
 Overview: When retail outlets intentionally or
unintentionally sell alcohol to those under 21, it
increases the availability to youth. SC high school
surveys reveal direct retail purchase is the most
common access method for @ 10% of them.
Key Definitions/Terms
 On-Premise: Place where the alcohol is
consumed where it is bought (Bar, restaurant,
hotel, etc.)
 Off-Premise: Place where alcohol is sold but not
consumed (store)
 Administrative Violation: Ticket written
against license holder rather than clerk; must
have state powers to write
 UCI: Underage Cooperating Individual (the
youth)
Relation to Logic Model
 Key risk factors:
 Social norms favorable toward use
 Easy retail access
 Insufficient enforcement of laws
 Data sources:
AET Compliance Data
 YRBS
 SC CTC

How do we know it is evidence-based?
 Numerous PIRE/OJJDP publications identify
compliance checks as evidence-based, when
appropriately coupled with merchant awareness and
application of sanctions
 Direct connection between youth use and rate of
illegal sales (Oregon study; Dent, Grube, & Biglan,
2005)
 Dozens of studies and examples of reductions in
youth access (including SC)
Resources
 PIRE/OJJDP. Guide to Conducting Alcohol
Purchase Surveys. (www.udetc.org)
 DAODAS/PIRE. Compliance Check Instructions.
(http://chweb.pire.org/scdocuments/)
 DAODAS/PIRE. SC Compliance Check Planning
Guide. (http://chweb.pire.org/scdocuments/)
 Regional AET Trainings
Current status in SC

AETs did 6,438 checks in FY ’10
Buy rate: 14.5%
 Steady drop from 20.3% in FY ’07
 Almost every county has conducted through AETs



SLED now does relatively few; complaint-driven
See much more on compliance data in Prevention Outcomes
Annual Reports (Chapter 5) found at
(http://chweb.pire.org/scdocuments/)
Key elements of implementation
 Do not neglect merchant notification—let them
know you are coming! (vaguely)
 Couple with offering merchant education, to
violators and non-violators
 Partner w/ SLED when possible so administrative
violations are written
Public Safety Checkpoints
 Overview: There is substantial and consistent
evidence from research that highly publicized,
highly visible, and frequent sobriety checkpoints in
the United States reduce impaired driving fatal
crashes by 18% to 24% (Fell, Lacey, & Voas, 2004).
Checkpoints are used in South Carolina by state
and local law enforcement agencies working in
communities to deter drink driving motorists.
Key Definitions/Terms
 Low staffing checkpoints: These checkpoints involve
4-5 officers, are highly mobile, and typically short in
duration (45 minutes to 1 hr). This type of checkpoint
important for agencies with lower resources in personnel,
yet want to affect impaired driving in their community.
 Full scale checkpoints: These checkpoints can involve
10-12 officers. Depending on the location for the
checkpoint, this strategy may involve more officers,
especially if it is a multi-jurisdictional checkpoint.
 High visibility enforcement: Strict enforcement
combined with a strong public message from either earned
or paid media
Relation to Logic Model
 Key risk factors:
 Social norms favorable toward use
 Insufficient enforcement of laws
 Data sources:
AET/LEN checkpoint data
 Crash data provided from Office of Highway Safety
through CAST
 YRBS/SC CTC
 Information obtained from impaired drivers about “last
place of drinking”

How do we know it is evidence-based?
 Many studies point to the effectiveness of
checkpoints for reducing drink-driving crashes,
when conducted in manner consistent with high
visibility enforcement practices (Lacey, et al., 2006;
Fell, et al., 2004; Clapp, et al., 2005).
Resources
 Regional AET Trainings
 Law Enforcement Networks (www.sclen.org)
 AET Public Safety Checkpoint video
 NHTSA Public Safety Checkpoint Guidelines
Current status in SC





In 2010, there were about 4,600 checkpoints conducted in
South Carolina (source is SCDPS)
Also in 2010, SC law enforcement made 24,430 arrests for
DUI (not just at checkpoints-source is SCDPS)
Averages to one checkpoint conducted every 3 days
in every county in South Carolina
Existing partnership through SCLEN (www.sclen.org),
SCHP, and local law enforcement to conduct public safety
checkpoints
Some AETs & LENs conduct checkpoints and compliance
checks at same time
Key elements of implementation
 Utilize data sources, such as crash and arrest
data to determine checkpoint locations
 Enroll state and local law enforcement agencies
to conduct checkpoints
 Conduct earned media events publicizing
checkpoints
 Inform public why and where checkpoints are
being held to increase perception of likelihood that
impaired driving motorists will be apprehended.
 Once checkpoints are held, inform public of results
References
 Babor, T. (2010). Alcohol : no ordinary commodity : research and
public policy (pp. xv, 360 p.). Oxford ; New York: Oxford University
Press.
 Beck, K. H., & Moser, M. L. (2006). Does the Type of Exposure to a
Roadside Sobriety Checkpoint Influence Driver Perceptions Regarding
Drunk Driving? [Article]. American Journal of Health Behavior, 30(3),
268-277.
 Clapp, J. D., Johnson, M., Voas, R. B., Lange, J. E., Shillington, A., &
Russell, C. (2005). Reducing DUI among US college students: results of
an environmental prevention trial. Addiction, 100(3), 327-334.
 Fell, J. C., Ferguson, S. A., Williams, A. F., & Fields, M. (2003). Why
are sobriety checkpoints not widely adopted as an enforcement strategy
in the United States? [doi: DOI: 10.1016/S0001-4575(02)00097-0].
Accident Analysis & Prevention, 35(6), 897-902.
References
 Fell, J. C., Lacey, J. H., & Voas, R. B. (2004). Sobriety Checkpoints:
Evidence of Effectiveness Is Strong, but Use Is Limited. [Article].
Traffic Injury Prevention, 5(3), 220-227. doi:
10.1080/15389580490465247
 Lacey, J. H., Ferguson, S. A., Kelley-Baker, T., & Rider, R. P. (2006)
Low-Manpower Checkpoints: Can They Provide Effective DUI
Enforcement in Small Communities? [Article]. Traffic Injury
Prevention, 7(3), 213-218. doi: 10.1080/15389580600696686
 National Highway Traffic Safety Administration. (2006, April). LowStaffing Sobriety Checkpoints. (DOT HS 810 590). Washington, DC:
Retrieved from
http://www.nhtsa.dot.gov/people/injury/enforce/LowStaffing_Checkp
oints/images/LowStaffing.pdf.
 Ross, H. L. (1992). Reasons for Nonuse of Sobriety Checkpoints.
[Legislative Materials]. Police Chief, 59(11), 58-63.
Party Patrols/Controlled Party Disperals
 Overview: Youth usually consume alcohol in groups
(parties). Safely dispersing a party means many
young drunk drivers off the road, lots of underage
drinking prevented, and youth getting appropriate
sanctions that could alter their behavior. Also, party
dispersals are one of the few approaches that can
lead to identifying social providers, the main source
of alcohol for youth.
Key Definitions/Terms
 Controlled Dispersal: A systematic enforcement
response to a party that is zero-tolerance and
efficiently and safely ends the party
 Party Patrols: Proactive efforts to identify
underage drinking parties
Relation to Logic Model
 Key risk factors:
 Social norms favorable toward use
 Easy social access
 Insufficient enforcement of laws
 Data sources:
AET Party Patrol Data
 YRBS
 SC CTC

How do we know it is evidence-based?
 “Promise of effectiveness” in PIRE/OJJDP’s
“Strategies to Reduce Underage Alcohol Use”
Resources
 PIRE/OJJDP. Preventing and Dispersing
Underage Drinking Parties. (www.udetc.org)
 NEW!: Party Patrols: Best Practice Guidelines for
College Communities. (www.udetc.org)
 Regional AET Trainings
Current status in SC

AETs did 150 dispersals in FY ’10


952 tickets written; 705 underage drinking, 68 transfer
AETs reported 140 parties “prevented” in FY ’10

Down from 231 in FY ‘09
Key elements of implementation
 Officers can be trained in operational best practices
 Communities can help by generating public
support, sending in “tips” about parties, perhaps
even volunteer assisting in dispersals
 Source investigation is important component
Shoulder Taps
 Overview: A “compliance check” for potential adult
providers of alcohol to youth, usually strangers. A
cooperating youth asks adults entering a retail
establishment to buy alcohol for them. Those who
do are ticketed. SC CTC data show 2% of youth
indicated this was their preferred method of getting
alcohol.
Key Definitions/Terms
 Third-party Transaction: Another term for a
“shoulder tap:
 UCIs: Underage Cooperating Individual
Relation to Logic Model
 Key risk factors:
 Social norms favorable toward use
 Easy social access
 Insufficient enforcement of laws
 Data sources:
AET Shoulder Tap Data
 SC CTC

How do we know it is evidence-based?
 Included in PIRE/OJJDP’s “Strategies to Reduce
Underage Alcohol Use” though noted as “less well
researched”
Resources
 PIRE/OJJDP. Reducing Third-Party Transactions
of Alcohol. (www.udetc.org)
 Regional AET Trainings
Current status in SC
AETs
did 55 shoulder tap operations
in FY ‘10
10
counties
573 adults approached; 33 purchased
6%
violation rate
Down from 10% in FY ‘09
Key elements of implementation
 Must clear with local prosecutors first
 Youth security is paramount
 Those who sell often have past offenses
 Should target “hot spots” based on other
information, complaints
Fake ID Checks
 Overview: Fake IDs are
highly prevalent among
underage college students, and are strongly
associated with heavy drinking. In one study of
1,098 students, approximately 21% admitted to
possessing a fake id at one time. Understanding
how underage youth obtain fake ids could aid law
enforcement and school personnel in their
enforcement responsibilities, and might further
elucidate the extent and means by which students
“make ethical compromises” to gain illegal access
to alcohol.
Key Definitions/Terms
 Fake IDs – false identification used by underage
youth to obtain access to alcohol. “Fake ID”
covers the use of an actual counterfeit or forged
identification card or the use of a bona fide
identification. Fake ID includes state issued
driver’s license, non-driver identification,
student identification card or any similar item.
Relation to Logic Model
 Key risk factors:
 Social norms favorable toward use
 Insufficient enforcement of laws
 Easy retail access
 Data sources:

AET data
How do we know it is evidence-based?
 Though it is difficult to assess whether strict
enforcement of possessing of false ID curtails
continued attempts to gain another false ID,
research indicated possessing false ID predicted
heavy drinking. The research further indicated
that server training, including confiscation of
fake IDs, and refusal to serve, reduced the use of
fake ID. Enforcement of false ID laws is part of
the environmental strategies meant to curtail
possession and use of alcohol by underage youth
(Martinez, Rutledge, & Sher, 2007).
Resources
 Regional AET Trainings
 UDETC “Law Enforcement Guide to False
Identification”
 South Carolina Department of Motor Vehicles,
Office of Integrity and Accountability
References
 Martinez, J. A., Rutledge, P. C., & Sher, K. J. (2007). Fake
ID ownership and heavy drinking in underage college
students: Prospective findings. Psychology of Addictive
Behaviors, 21(2), 226-232. doi: 10.1037/0893164x.21.2.226
 Martinez, J. A., & Sher, K. J. (2010). Methods of “fake ID”
obtainment and use in underage college students.
[Article]. Addictive Behaviors, 35(7), 738-740. doi:
10.1016/j.addbeh.2010.03.014
 Pacific Institute for Research and Evaluation. (2009).
Law Enforcement Guide of False Identification.
Beltsville, MD: Underage Drinking Enforcement Training
Center Retrieved from http://www.udetc.org.
Current status in SC





Unclear about current status but nationally the use of fake &
fraudulent IDs is challenging
Anecdotal information from South Carolina law
enforcement indicates this is a problem here, too.
SCDMV conducts fake ID training & it is a module within
Regional 2-Day AET training
Training involving national UDETC trainers is being
planned for late March 2011
Training will build capacity for SC Instructors to hold
regional classes
Key elements of implementation
 Provide merchant training that includes the
process of the discovery of false or fake
identification commonly possessed by underage
youth
 Ensure law enforcement officers know methods for
determining false or fake identification cards
Ann Crawley
Community Initiatives, Inc.



Hold adults accountable for serving or
providing alcohol to minors
Hold adults responsible for underage
drinking that happens on property they own,
lease, or control
Vary from state to state; may provide criminal
and civil penalties; may be covered under
dram shop laws that normally cover
commercial services only





Dram shop laws and social host liability laws
through legislative action
Section 61-4-90: transfer of beer/wine for
underage person’s consumption
Section 61-4-50: Sales of beer/wine to
underage persons
Section 61-6-4070: transfer of liquor to
underage persons
Section 61-6-4080: sales of liquor to
underage persons



Common Law Decisions: criminal, civil,
administrative penalties-monetary fines & jail
sentences
Negligence Liability: Criminal misdemeanor
for selling or serving alcohol to minor or
intoxicated persons
Dram Shop Law: Holds servers responsible
for harm that intoxicated or underage
patrons cause other persons or themselves


National data show Social Host Laws are a strong
deterrent if providers believe they will be sued if
injury or death occurs as a result of their
provision of alcohol to minors or intoxicated
persons
Research shows Social Hosts Laws to be effective:
an analysis of data from all 50 states reveals
Social Hosts Laws were associated with
reductions in drinking and driving incidents and
with reduction of heavy drinking among youth
16-25 and in older adults




DAODAS provides public information and
education, CAST will provide programs/projects
addressing social hosting-related problems
Drug Free Communities Support grantee
coalitions provide public information & education
and engage communities in public policy issues
and environmental strategies
Local, county, and state law enforcement
endorsed new, stronger Social Host Laws and
enforce the laws
Can’t stop now!



Review recent data in your area of concern
that show youth are accessing alcohol from
their homes or from adults (include data on
other means of accessibility as baseline)
Determine the link of this data to other ATOD
problems in your area
Develop case that shows how Social Host
Laws could limit access and availability of
alcohol to youth and reduce ATOD-related
problems in your area






Obtain and strengthen community support for your
strategy (youth, parents, merchants, law
enforcement, elected officials, gatekeepers, etc.)
Increase public awareness of problem
Identify any gaps that may exist within current law
and draft statement to enhance/strengthen
legislation
Hold meetings with those in key positions to affect
change in existing laws
Work with law enforcement to ensure only current
laws are being enforced
Identify immediate, intermediate, & long-term
outcomes of this strategy & continue to monitor &
evaluate program





SOCIAL NORMS ACCEPTING AND/OR
ENCOURAGING USE
EASY SOCIAL ACCESS
INSUFFICIENT ENFORCEMENT OF LAWS
INSUFFICIENT LAWS AND POLICIES
Any ideas for strategies? Let’s hear them!








Social Host Liability, 2010 FACE
27 Laws to Lose By, South Carolina DAODAS
SC Code of Laws Title 61, Chapters 4 & 6
Throwing a Party? Are You Protected from Law?:
www.thatmoney.com
Social Host Liability/Underage Drinking: Clemson
University
Social host liability for minors and underage drunk-driving
accidents: Journal of Health Economics 29 (2010) 241-249
SC law regarding liability for alcohol at parties, host
liability: www/avvo.com/legal-answers/sc-law-regardingliability-for-alcohol-at-parties-9381
Impacting Community Norms:
http://drugfreeactionalliance.org/occe_strat1.php
Overview of Strategy:
Happy Hour Restrictions
Happy Hour Restrictions:
 Limits or bans placed on events that promote over-
consumption or binge drinking: happy hours,
ladies’ night, all-you-can-drink specials or
unlimited beverages at a fixed price for a fixed
period of time are examples.
Key terms/definitions
 Cover charge: Entry fees imposed on the
consumer for the purpose of recovering
financial losses incurred because of reduced
drink prices.
 Drink Contests: Contests that involve
drinking and award alcoholic beverages as
prizes to the winners.
 Two-for-Ones: Discounted alcoholic
beverages in which the consumer receives
two drinks for the price of one drink.
Relation to logic model and
needs/conditions
 Low or discounted pricing
 More drinking
 Related to higher binge-drinking rates
How do we know it is evidence
based (resources)
 Research shows that as the price of alcohol
decreases, alcohol consumption, intoxication
and drinking/driving increases, especially
among minors. (Chaloupka, et al., 2002)
 Promotions such as happy hours, drinking
contests and all you can drink specials
encourage over-consumption by reducing
prices. These promotions lead to tragic
circumstances. Restricting them can prevent
negative outcomes. (Grossman, et al., 1998)
 The Harvard School of Public Health
conducted a study in 2001 that demonstrated
a significant correlation between lower drink
prices and higher binge drinking rates among
colleges across the US. The study also
demonstrated a reduction in self-reported
drinking and driving rates when laws limited
underage access to alcohol. The reduction
was even greater when these laws were
actively enforced. (Wechsler, et al., 2003;
NHTSA, 2002; NHTSA, 2004)
Current Status in South Carolina
 Prohibits two for ones, free beverages.
 Regular drink prices may be reduced
between 4:00p.m.-8:00p.m. only.
 All on-premise spirits sales must be
containers of 1.75 oz. or less (mini-bottles)
 No minimum age to sell if alcohol is sold in
sealed containers.
 Must be 21 to pour or mix.
 Must be 18 to serve.
 No law preventing a patron from removing the open
container from a restaurant.
 Open containers are permitted in the trunk or luggage
compartment of a vehicle.
 Off-premise: may serve alcohol Monday through
Saturday, 24 hours, cease at midnight. Prohibited on
Sundays.
 On-premise: may serve Monday through Saturday,
beer and wine 10a.m.-2:00a.m., for liquor cease at
midnight on Saturdays. Local option, election day
sales are prohibited.
Key elements of implementation
1.
2.
3.
4.
5.
Demonstrate a direct link between “Happy Hour”
promotions and alcohol problems and costs in the
community.
Determine the type of Happy Hour restrictions
already in place.
Determine the degree to which the current policies
are being enforced.
Determine if the evidence you have collected
warrants actions to develop or change existing
policies.
Begin to develop new or enhanced regulation or
policy that addresses the gaps you have identified.
6.
7.
8.
9.
10.
11.
Increase the community’s awareness and
understanding of the issue. Gather community
support.
Educate key people about the data. Make sure key
people have two or three talking points on alcoholrelated problems related to happy hour promotions.
Provide examples to the community on suggested
new or revised happy hour regulations.
Meet with city council members. Work with law
enforcement.
Identify immediate, intermediate, and long-term
outcomes for the strategy.
Monitor and evaluate progress.
Overview of Strategy
Restricting Alcohol Sales at
Public Events and Festivals
Restricting Alcohol Sales at Public
Events and Festivals:
 Policies that control the availability and use of
alcohol at public venues, such as concerts,
street fairs, community festivals, and sporting
events.
 Restrictions can be implemented voluntarily
by event coordinators or through local
legislation.
 Alcohol restrictions can range from a total
ban on alcohol consumption to the posting of
warning posters that detail risks of alcohol
consumption.
Key terms/definitions
 Alcohol sponsorship: The alcohol industry
utilizes community events to market its
brands and products.
Relation to logic model and
needs/conditions
 Social Norms accepting and/or encouraging
use
 Easy social access
How do we know it is evidence based
(resources)
 Research shows that the propensity for illegal
alcohol sales at festivals is very high
 However, the effectiveness of this strategy
has not been thoroughly evaluated
Current Status in South
Carolina: Five Points
Key elements of implementation
1.
2.
3.
4.
5.
Determine your community’s ordinances/restrictions
related to the sale of alcohol at public events.
Use the information you have gathered regarding
problems as a basis to create change.
Write letters to event organizers or sponsors of
public events describing the problems caused by
unrestricted sales of alcohol. Explain how
restrictions can help with these problems.
Ensure that key informants are available to educate
the community about the data.
Strengthen community support from event
organizers, law enforcement, and other key officials.
6. Assist event organizers with getting training
for servers.
7. Identify immediate, intermediate, and longterm outcomes of the strategy.
8. Monitor and evaluate progress.