Alcohol access restrictions in public places
Policies can restrict the availability and use of alcohol at sporting events, other public events such as concerts and street fairs, and public spaces such as parks and beaches. Restrictions can be implemented voluntarily by event organizers or through local legislation. Efforts include total bans on alcohol consumption at certain times or places, designated drinking and alcohol-free areas, prohibition of alcoholic beverages in open containers, limits on the number of alcoholic beverages per sale, and establishment of standard enforcement procedures for monitoring and violation1, 2.
What could this strategy improve?
Expected Benefits
Our evidence rating is based on the likelihood of achieving these outcomes:
Reduced excessive drinking
Reduced underage drinking
Potential Benefits
Our evidence rating is not based on these outcomes, but these benefits may also be possible:
Reduced alcohol-related harms
What does the research say about effectiveness?
Restricting alcohol use and availability at public events and on public property is a suggested strategy to reduce excessive drinking and underage drinking1, 3, 4, 5. An Australia-based study of alcohol sale regulations at community sports clubs indicates such regulations may reduce risky alcohol consumption and alcohol-related harm6. Available evidence suggests that banning or restricting alcohol sales at public events may reduce alcohol availability for youth and may also reduce alcohol-related problems such as traffic crashes, vandalism, fighting, and other public disturbances1, 7. However, a study of U.S. universities suggests that allowing alcohol sales at college sporting events may have no significant impact on alcohol-related incidents and in-stadium offenses8. Additional evidence is needed to confirm effects4, 5, 9.
How could this strategy advance health equity? This strategy is rated inconclusive impact on disparities.
It is unclear what impact alcohol access restrictions in public places or sporting events may have on disparities in alcohol consumption and alcohol-related harms.
Blacks and Latinos experience disproportionate personal and social consequences of alcohol use, including alcohol use disorder symptoms and various social problems, compared with other racial and ethnic groups when consuming similar levels of alcohol12. For example, in 2018 6.4% of non-Hispanic white adults engaged in heavy drinking compared to non-Hispanic Black (2.9%), Hispanic (2.6%), and non-Hispanic Asian (2.0%) adults13. However, alcohol consumers who are Black or Hispanic appear more likely to experience alcohol-related injuries, accidents, and health and social consequences than consumers who are white. These racial and ethnic disparities are seen across all levels of consumption and may be most pronounced at low levels of consumption, suggesting there are environmental and cultural factors at play14, 15. Evidence suggests that the combined effects of drinking cultures, historically rooted patterns of racial discrimination and persistent socioeconomic disadvantage in racialized groups contribute to these disparities16.
What is the relevant historical background?
Alcohol is deeply rooted in American life and history. Prior to the American Revolution, alcohol was perceived as an invigorating and restorative beverage that did not spoil easily and was safer than water. Its taxation provided a major source of revenue for colonial governments17. After the American Revolution, the temperance and women’s rights movements shifted societal perspectives of alcohol and led efforts for its banishment. These efforts led to the adoption of the 18th Amendment in 1920, which banned the manufacture, sale, and transport of alcohol across the U.S., also known as Prohibition18. Prohibition ended in 1933 in large part because of the need to generate tax revenue and stimulate job growth during the Great Depression and gave states authority to regulate alcohol, and each have approached regulation differently17. Today, the federal government has limited authority to impose national-level rules and regulations and there continues to be a patchwork of alcohol regulations that vary by state. Some state legislatures have preempted local government from implementing certain regulations and laws19.
Throughout history, alcohol misuse was seen as a personal failing. This evolved over the 19th century as the addictive properties of alcohol were understood17. Alcohol use disorder is now seen as a chronic disease that is influenced by genetics, neighborhood disadvantage, stress, access to alcohol, drinking cultures and contexts, and alcohol-industry influences20, 21.
The alcohol industry is viewed by public health and academia as legitimate partners in the development of national alcohol policy. Since the 1950s the alcohol industry has intervened and influenced research and policy to help normalize drinking, reproduce industry narratives regarding the causes of alcohol harms, and reduce regulation22. For example, the alcohol industry-funds research designed to establish the benefits of alcohol use. These attempts to influence public perceptions of alcohol have the potential to confuse public opinion about the health effects of alcohol, discredit independent scientists, damage the integrity of science, and discourage or delay implementation of effective alcohol policies23.
Equity Considerations
- Are there places in your community where alcohol access restrictions are already being implemented (i.e. public parks, event venues etc.)? If not, where can alcohol access restrictions be introduced and implemented?
- Who can you partner with to bring alcohol access restrictions to your community?
- Who could benefit the most from alcohol access restrictions in their community?
Implementation Examples
Many local government ordinances regulate alcohol sales and use on public property and at public events. Santa Fe, New Mexico is an example of a city that prohibits alcohol sales on most city property10 and the City of Gulf Shores in Alabama bans alcohol consumption or possession on public beaches11. Event organizers in urban and rural areas around the country also implement restrictions and work to ensure that staff who serve alcohol beverage are trained to comply with these policies and sometimes use other strategies together, such as limiting crowd size1.
Implementation Resources
‡ Resources with a focus on equity.
HSNI-Alcohol management - Helping Services for Northeast Iowa (HSNI). Alcohol management for fairs and festivals. Increase your profits. Decrease your problems. Prevent underage drinking. Dubuque: Helping Services for Northeast Iowa (HSNI); 2012.
Footnotes
* Journal subscription may be required for access.
1 UMN-AEP - University of Minnesota Alcohol Epidemiology Program (UMN-AEP). Alcohol control policy descriptions.
2 Lenk 2010 - Lenk KM, Toomey TL, Erickson DJ, et al. Alcohol control policies and practices at professional sports stadiums. Public Health Reports. 2010;125(5):665-673.
3 IOM-Underage drinking 2004 - Institute of Medicine (IOM), National Research Council (NRC), Committee on Developing a Strategy to Reduce and Prevent Underage Drinking, Board on Children, Youth, and Families (BCYF). Reducing underage drinking: A collective responsibility. (Bonnie RJ, O’Connell ME, eds.). Washington, D.C.: National Academies Press; 2004.
4 Toomey 2008 - Toomey TL, Erickson DJ, Lenk KM, Kilian GR. Likelihood of illegal alcohol sales at professional sport stadiums. Alcoholism: Clinical and Experimental Research. 2008;32(11):1859-64.
5 Toomey 2005 - Toomey TL, Erickson DJ, Patrek W, Fletcher LA, Wagenaar AC. Illegal alcohol sales and use of alcohol control policies at community festivals. Public Health Reports. 2005;120(2):165-73.
6 Kingsland 2015 - Kingsland M, Wolfenden L, Tindall J, et al. Tackling risky alcohol consumption in sport: A cluster randomised controlled trial of an alcohol management intervention with community football clubs. Journal of Epidemiology & Community Health. 2015;69(10):993-999.
7 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.
8 Popp 2020 - Popp N, Bane A, Howell SM, Osborne B. To serve and protect: Examining the relationship between selling alcohol in college football venues and negative fan behaviors. Journal of Applied Sport Management. 2020;12(1):73-82.
9 Nelson 2013 - Nelson TF, Xuan Z, Babor TF, et al. Efficacy and the strength of evidence of U.S. alcohol control policies. American Journal of Preventive Medicine. 2013;45(1):19-28.
10 Santa Fe-Regulations - City of Santa Fe. Rules and regulations.
11 Gulf Shores-Alcohol - City of Gulf Shores. Beach rules and regulations.
12 Mulia 2017 - Mulia N, Karriker-Jaffe KJ, Witbrodt J, et al. Racial/ethnic differences in 30-year trajectories of heavy drinking in a nationally representative U.S. sample. Drug and Alcohol Dependence. 2017;170:133-141.
13 CDC-Heavy Drinking 2018 - Boersma P, Villarroel M and Vahratian A. Heavy drinking among U.S. adults, 2018. National Center for Health Statistics; 2020.
14 Delker 2016 - Delker E, Brown Q, Hasin DS. Alcohol consumption in demographic subpopulations: An epidemiologic overview. Alcohol Research: Current Reviews. 2016;38(1):7-15.
15 Witbrodt 2014 - Witbrodt J, Mulia N, Zemore SE, Kerr WC. Racial/ethnic disparities in alcohol-related problems: Differences by gender and level of heavy drinking. Alcoholism: Clinical and Experimental Research. 2014;38(6):1662-1670.
16 Vaeth 2017 - Vaeth PAC, Wang-Schweig M, Caetano R. Drinking, alcohol use disorder, and treatment access and utilization among U.S. racial/ethnic groups. Alcoholism: Clinical and Experimental Research. 2017;41(1):6-19.
17 Olson 1985 - Olson S, Gerstein DR. Alcohol in America: Taking action to prevent abuse. Washington, D.C.: The National Academies Press; 1985.
18 Aaron 1981 - Aaron P, Musto D. Temperance and prohibition in America: A historical overview. In: Alcohol and public policy: Beyond the shadow of prohibition. Moore MH, Gerstein DR eds. Washington, D.C.: The National Academies Press; 1981.
19 APIS-State Preemption - Alcohol Policy Information System (APIS). About alcohol policy.
20 Zapolski 2014 - Zapolski TCB, Pedersen SL, McCarthy DM, Smith GT. Less drinking, yet more problems: Understanding African American drinking and related problems. Psychological Bulletin. 2014;140(1).
21 Sudhinaraset 2016 - Sudhinaraset M, Wigglesworth C, Takeuchi DT. Social and cultural contexts of alcohol use: Influences in a social–ecological framework. Alcohol Research: Current Reviews. 2016;38(1):35-45.
22 Maani 2023 - Maani N, Ci Van Schalkwyk M, Petticrew M. Under the influence: System-level effects of alcohol industry-funded health information organizations. Health Promotion International. 2023;38(6):1-9.
23 Babor 2013 - Babor TF, Robaina K. Public health, academic medicine, and the alcohol industry’s corporate social responsibility activities. American Journal of Public Health. 2013;103(2):206-214.
Related What Works for Health Strategies
To see all strategies:
countyhealthrankings.org/whatworks