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Alcohol outlet density restrictions

Evidence Rating

Scientifically Supported

Health Factors

Use regulatory authority to reduce the density of alcohol beverage outlets (i.e., places that sell alcohol) or to limit increases in the density of such outlets. Regulation is often implemented through licensing or zoning processes (CG-Alcohol). State and local processes vary depending on the alcohol control system in place (APIS). 

Expected Beneficial Outcomes (Rated)

  • Reduced excessive drinking

  • Reduced alcohol-related harms

Other Potential Beneficial Outcomes

  • Reduced underage drinking

Evidence of Effectiveness

There is strong evidence that increasing alcohol outlet density increases alcohol consumption and alcohol-related harms; using regulatory authority (e.g., licensing and zoning) to reduce or limit outlet density can reduce excessive alcohol consumption and related harms (CG-Alcohol, Campbell 2009, Jernigan 2013, NIAAA-College drinking 2002).

Government policies that limit or ban establishments that sell or serve alcohol, or otherwise reduce alcohol outlet density, have been shown to reduce both consumption and harm, particularly in isolated environments without other sources of alcohol  (CG-Alcohol). Such policies are suggested strategies to reduce drinking among college students and other underage drinkers (RAND-Imm 2007, NIAAA-College drinking 2002).

Impact on Disparities

No impact on disparities likely

Implementation Examples

California and Nebraska are examples of states that have undertaken efforts to reduce alcohol outlet density (CAMY-Alcohol outlet density).

Implementation Resources

CAMY-Alcohol outlet density - Sparks M, Jernigan DH, Mosher JF. Strategizer 55 - Regulating alcohol outlet density: An action guide. Alexandria: Community for Anti-Drug Coalitions of America (CADCA); Center on Alcohol Marketing and Youth (CAMY), Johns Hopkins Bloomberg School of Public Health; 2011.

Jernigan 2013 - Jernigan D, Sparks M, Yang E, Schwartz R. Using public health and community partnerships to reduce density of alcohol outlets. Preventing Chronic Disease. 2013;10.

Citations - Evidence

* Journal subscription may be required for access.

NIAAA-College drinking 2002 - Task Force of the National Advisory Council on Alcohol Abuse and Alcoholism, National Institutes of Health (NIH). A call to action: Changing the culture of drinking at US colleges. Rockville: National Institute on Alcohol Abuse and Alcoholism (NIAAA); 2002.

RAND-Imm 2007 - Imm P, Chinman M, Wandersman A, et al. Preventing underage drinking: Using Getting To Outcomes™ with the SAMHSA strategic prevention framework to achieve results. Santa Monica: RAND Corporation; 2007: Technical Report 403.

CG-Alcohol - The Guide to Community Preventive Services (The Community Guide). Excessive alcohol consumption.

Campbell 2009 - Campbell C, Hahn R, Elder R, et al. The effectiveness of limiting alcohol outlet density as a means of reducing excessive alcohol consumption and alcohol-related harms. American Journal of Preventive Medicine. 2009;37(6):556–69.

Jernigan 2013 - Jernigan D, Sparks M, Yang E, Schwartz R. Using public health and community partnerships to reduce density of alcohol outlets. Preventing Chronic Disease. 2013;10.

Citations - Implementation Examples

* Journal subscription may be required for access.

CAMY-Alcohol outlet density - Sparks M, Jernigan DH, Mosher JF. Strategizer 55 - Regulating alcohol outlet density: An action guide. Alexandria: Community for Anti-Drug Coalitions of America (CADCA); Center on Alcohol Marketing and Youth (CAMY), Johns Hopkins Bloomberg School of Public Health; 2011.

Date Last Updated

Sep 5, 2014