I’ve been doing a series on drunk driving and alcohol-related harm (which can also include impaired work performance, domestic trouble, violence, crime, risky sex, fetal disorders, brain damage and many other health problems). Can – and should – we do more to control alcohol?
Last time, I wrote about programs designed to curb alcohol abuse through persuasion. But the evidence that they work is, well, less than persuasive. So is it time to start cutting people off?
With the help of a fine recent literature review by Peter Anderson, Dan Chisholm, and Daniela C. Fuhr in the medical journal The Lancet, we can look at the totality of the evidence on alcohol control, including policies to limit its availability through regulations.
Here’s one we already have: the minimum drinking age (MDA) of 21. We have a really good idea what the effects of MDAs are because we have neat natural experiments to study; states started reducing age limits (starting in 1969) and then turned around and began raising them (starting in 1976). What happened when they did?
As reported by Ann T. McCartt and Bevan B. Kirley, a sample of 33 studies found that forbidding alcohol for 18-21 year olds reduced alcohol-related crashes in that age group by between 10 to 16 percent. This effect has been consistently demonstrated, though perhaps it’s smaller than one might have hoped for.
Raising the MDA further is probably out of the question. But there are ways we could enforce it more strictly, like extending initiatives that allow parents to be sued if underage drinkers leave their home and get into fatal crashes. Worthwhile, or worringly draconian?
In the other direction, there is a movement out there to lower the MDA to 18, on the fairly logical grounds that if you’re old enough to vote or register for Selective Service you should be old enough to drink. Some college presidents think that campus drinking could actually be brought under better control if all students were legal.
And it should be noted that in Europe most MDAs are between 16 and 18, and their DUI problems are less severe than ours (though as I’ve noted, their other DUI-related policies, like blood alcohol content limits, are generally stricter).
Still, whatever the merits of these arguments, the evidence unsurprisingly shows that lowering the MDA would result in more road deaths.
(It’s interesting how much wiser we grow as we age. As a philosophically immature 18 year old, I considered the MDA one of our most iniquitous public policies, but just three years later I had a profound theoretical breakthrough and suddenly realized it is resoundingly just. Today, I think a cutoff at age 41 would be ideal.)
I went to college in Boston, where liquor stores were closed on Sundays. I can attest to the fact that this cut down on our Sunday alcohol consumption. (I guess we must have cleaned out the stash on Saturday nights.)
Studies have backed this observation up. I have not seen numbers on whether limiting the hours alcohol can be served would decrease drunk driving per se, but Sergio Duailibi and colleagues found that when the Brazilian city of Diadema enforced a cutoff in alcohol sales at 11pm (most bars had been open 24 hours), there was a 29 percent drop in the murder rate.
As for a reasonable step in this direction that might not totally ruin our good times, what about allowing bars to stay open as late as they do now but requiring them to stop selling alcohol an hour before closing time? This would give people a chance to sober up before they hit the road. A similar policy seems to work reasonably well for sporting events.
What’s the evidence on regulating the number of alcohol outlets? Fewer bars and liquor stores might theoretically translate into lower alcohol consumption and DUI. However, the limited data are inconclusive. Indeed, it is possible that having fewer alcohol outlets might actually lead to more driving, and thus more accidents, as people head to those places that are open.
Then again, a persuasive body of research has indeed linked a high density of alcohol outlets with other forms of alcohol-related harm. Nobody wants to return to Prohibition, but some tightening of the granting of liquor licenses might at least be worth some consideration.
When was the last time a bartender refused you service or took away your keys on the grounds you’d had one too many? Katharine Ker and Paul Chinnock have found very little evidence that programs designed to get bars and restaurants to limit alcohol abuse have proven effective.
In large part this is because serving places don’t follow through on the initiatives, which is understandable enough given the economic incentives they face. And it is consistent with evidence I showed you earlier, which demonstrated that educational material produced by the alcohol industry sometimes actually promotes positive views of drinking, and that promises by the alcohol industry to restrict advertising usually don’t seem to bite.
So in sum it seems as if certain types of restrictions on alcohol availability might bear fruit. But are these the best way to go? Economists might not think so. For the most part, they believe that price signals (e.g. through taxation), not regulations, are a more promising tool for shaping behavior.
Why? Here’s one example. At heart, many programs designed to mitigate alcohol-related harm involve raising the “generalized costs” of drinking (in terms of time, money, hassle, etc.). But taxing people in the currency of time or discomfort (e.g. by making them drive farther to buy beer) would raise no revenue and indeed would ultimately cost the government money (fewer liquor license fees and less sales tax revenue). On the other hand, increasing alcohol taxes would actually raise money for the public coffers even as it limits destructive behavior.
Another issue is that these regulatory policies might be considered an unnecessarily blunt instrument. Cutting off bar service an hour early would penalize all drinkers, not just those who have shown a predilection for mixing alcohol and dangerous behavior.
Coming up I’ll look at the impacts of raising alcohol prices, and of policies that target drunk driving more directly.