Abstract
The Complying with the Minimum Drinking Age project (CMDA) is a community trial testing effects of two interventions designed to reduce alcohol sales to minors:
- Training for management of retail alcohol establishments and
- Enforcement checks of alcohol establishments.
All intervention-community establishments in business on 1 February 1999 were offered a free, one-on-one 2-hour training program called Alcohol Risk Management Express (ARM Express). The project designed ARM Express for the self-identified decision-maker at the establishment (either an owner or manager) to encourage them to select and implement up to 19 model alcohol policies and practices, which are designed to create an operational and normative environment that supports responsible service of alcohol (see Toomey et al. 2001 for details on a larger five session version of this program).
One hundred and nineteen of the eligible intervention establishments (38%) participated in the program between February 1999 and January 2000. Furthermore, these establishments received a 1-hour booster session (to review recommended alcohol policies and update resource materials) from March to July 2001, with 96 (31%) of the establishments participating in the booster training (81% of those that had participated in the initial training session). A second, deterrence-based intervention involved enforcement checks (youth under age 21 attempting to purchase alcohol from licensed establishments) by local law enforcement.
The core outcome, propensity for alcohol sales to minors, was directly tested with research staff who attempted to purchase alcohol without showing age identification using a standardized protocol in 602 on-premise and 340 off-premise alcohol establishments. Data were collected every other week in all communities over 4 years. Mixed-model regression and Box Jenkins timeseries analyses were used to assess short- and long-term establishment-specific and general community-level effects of the two interventions.
Effects of the training intervention were mixed. Specific deterrent effects were observed for enforcement checks, with an immediate 17% reduction in likelihood of sales to minors. These effects decayed entirely within 3 months in off-premise establishments and to an 8.2% reduction in on-premise establishments.
Enforcement checks prevent alcohol sales to minors. At the intensity levels tested, enforcement primarily affected specific establishments checked, with limited diffusion to the whole community. Finally, most of the enforcement effect decayed within 3 months, suggesting that a regular schedule of enforcement is necessary to maintain deterrence.
Intervention details
Underage alcohol buyers
Servers, Enforcement
- One-on-one 2-hour training program: Alcohol Risk Management Express;
- Enforcement checks;
- Community trial
Training was based on compliance theory. Studies give mixed results. Enforcement was based on deterrence theory. Results show that enforcement reduces sales to youths. In a community trial, alcohol sales to youthful buyers decreased in intervention communities.Two strategies commonly used to reduce youth access to alcohol from alcohol retail establishments are training servers and management in responsible alcohol service (based on compliance theory) and enforcement checks, where underage buyers attempt purchases and penalties are imposed if an illegal sale is made (based on deterrence theory). Few studies have examined effects of server or management training on sales to underage youth, and results are mixed (Wolfson et al. 1996; Buka & Birdthistle 1999; Toomey et al. 2001). While studies of enforcement effects are also few, results show that enforcement has reduced sales to youth (Preusser, Williams & Weinstein 1994; Lewis et al. 1996; Scribner & Cohen 2001). Several studies combined these and other strategies as part of larger community trials to reduce youth access to alcohol, youth drinking and alcohol-related problems (Wagenaar et al. 1994; Grube 1997; Holder et al. 1997; Perry et al. 2002). Each of these community trials, using strong randomized or time-series designs, found that alcohol sales to youthful buyers decreased in intervention communities compared to control communities.
Evaluation details
- One-on-one 2-hour training program: Alcohol Risk Management Express
- Enforcement checks
- Community trial
Effects of the training intervention were mixed. Specific deterrent effects were observed for enforcement checks, with an immediate 17% reduction in likelihood of sales to minors. These effects decayed entirely within 3 months in off-premise establishments and to an 8.2% reduction in on- premise establishments. The training and booster variables were not significant for offpremise establishments meaning the training had no effects on the likelihood of illegal alcohol sales to youth, specifically on the particular establishments participating in the training. Results revealed a significant lag-3 effect of establishment training in intervention-suburban communities. Given biweekly outcome observations, this means that an increase in number of establishments trained was followed 6 weeks later by a statistically significant reduction in propensity of establishments to sell alcohol to youth in the intervention suburbs.
Wagenaar, AC, Toomey, TL, Erickson, DJ (2005). Preventing youth access to alcohol: outcomes from a multi-community time-series trial. Society for the study of Addicition, p. 335-345. An abstract for this journal article can be found in the HNT literature section here.
Wagenaar. A.C, Gehan. J, Jones-Webb. R et al (1999) Communities mobilizing for change on alcohol: lessons and results from a 15 community randomized trial, Journal of community psychology, 27(3):315-326
Wagenaar. A.C, Murray. D.M and Toomey. T.L (2000) Communities mobilizing for change on alcohol (CMCA): effects of a randomized trial on arrests and traffic crashes, Addiction 95(2):209-217
Wagenaar. A.C, Gehan. J, Jones-Webb. R et al (1999) Communities mobilizing for change on alcohol: lessons and results from a 15 community randomized trial, Journal of community psychology, 27(3):315-326
Wagenaar. A.C, Murray. D.M and Toomey. T.L (2000) Communities mobilizing for change on alcohol (CMCA): effects of a randomized trial on arrests and traffic crashes, Addiction 95(2):209-217
Abstract of these articles are to be found in the the Literature Database.
Last updated April 2016
