Effectiveness of Policies Maintaining or Restricting Days of Alcohol Sales on Excessive Alcohol Consumption and Related Harms

Abstract

Local, state, and national laws and policies that limit the days of the week on which alcoholic beverages may be sold may be a means of reducing excessive alcohol consumption and related harms. The methods of the Guide to Community Preventive Services were used to synthesize scientific evidence on the effectiveness for preventing excessive alcohol consumption and related harms of laws and policies maintaining or reducing the days when alcoholic beverages may be sold. Outcomes assessed in 14 studies that met qualifying criteria were excessive alcohol consumption and alcohol-related harms, including motor vehicle injuries and deaths, violence-related and other injuries, and health conditions.

Qualifying studies assessed the effects of changes in days of sale in both on-premises settings (at which alcoholic beverages are consumed where purchased) and off-premises settings (at which alcoholic beverages may not be consumed where purchased). Eleven studies assessed the effects of adding days of sale, and three studies assessed the effects of imposing a ban on sales on a given weekend day. The evidence from these studies indicated that increasing days of sale leads to increases in excessive alcohol consumption and alcohol-related harms and that reducing the number of days that alcoholic beverages are sold generally decreases alcohol-related harms. Based on these findings, when the expansion of days of sale is being considered, laws and policies maintaining the number of days of the week that alcoholic beverages are sold at on- and off-premises outlets in local, state, and national jurisdictions are effective public health strategies for preventing excessive alcohol consumption and related harms.

Introduction

Excessive alcohol consumption in the U.S. is responsible for approximately 79,000 deaths per year, making it the third-leading cause of preventable death.¹ Approximately 15% of U.S. adults aged ≥18 years and approximately 29% of high school students in the U.S. report binge drinking (consuming five or more drinks per occasion for men, and four or more drinks per occasion for women).2, 3 The direct and indirect economic costs of excessive drinking in 1998 were $184.6 billion.⁴ The reduction of excessive alcohol consumption is thus a matter of major public health and economic interest; this objective is a central goal in the U.S. public health agenda for the year 2010.⁵

This review examines the utility of enacting or maintaining limits on the days of the week on which alcoholic beverages may be sold (“days of sale”) as a strategy to prevent excessive alcohol consumption and related harms. The limitation of days of sale of alcoholic beverages is here defined as “applying regulatory authority to limit the days that alcoholic beverages may be sold at on- and off-premises alcoholic beverage outlets.” Limiting may be either maintaining existing limits (e.g., on the sale of alcoholic beverages on Sundays) or extending current limits (e.g., eliminating Sunday sales by repealing current authorization for such sales). Days of sale may be regulated at national, state, or local levels. On-premises retailing refers to the sale of alcoholic beverages for consumption at the point of sale (e.g., at bars, restaurants, or clubs); off-premises retailing refers to the sale (e.g., at package stores, liquor stores, grocery stores, or convenience stores) of contained alcoholic beverages for consumption elsewhere. Because most of the studies reviewed consider removing limits on days of sale (e.g., allowing sale of alcoholic beverages on Sunday when Sunday sales had previously not been allowed), the intervention of public health interest for the review is the study control condition (i.e., maintaining limits on days of sale).

In the U.S., policies restricting the days of sale currently apply to Sundays only. There are several variations on the regulation of Sunday alcohol sales in the U.S. including full bans, reduced hours relative to other days of the week, restrictions on the sale of alcoholic beverages with a high alcohol content, and the authorization of local decision making.⁶ A total of fourteen states (Alabama, Arkansas, Connecticut, Georgia, Illinois, Indiana, Kansas, Kentucky, Minnesota, Nebraska, Oklahoma, South Carolina, Tennessee, and Utah), ban alcohol sales at off-premises retail alcohol outlets on Sundays. Fourteen states (Alaska, California, Colorado, Florida, Hawaii, Idaho, Kentucky, Montana, Nevada, New Hampshire, Oregon, Vermont, Wisconsin, and Wyoming) do not restrict Sunday alcohol sales. The remaining 22 states and the District of Columbia allow Sunday sales with restrictions regarding hours and/or types of alcoholic beverages sold. Outside of the U.S., current policies restricting the days of sale may apply to days other than Sunday (e.g., some countries prohibit alcohol sales on Saturdays).

In the U.S., the control of days and hours of sale at the local level is often pre-empted by state regulations prohibiting local authorities from enacting stricter alcohol control regulations in the state in general.7, 8 However, in some states, counties and other local jurisdictions are allowed to establish their own alcohol control policies. The nature of this authority varies by state and may allow cities or counties to have reduced hours from those stipulated by the state; have the same hours on Sunday as available during the rest of the week; or limit the sale of alcohol on Sundays to specific areas or locations. Fourteen states provide for local authority regarding days of sale, and four more allow Sunday sales in limited locations within the state.⁶ In 1995, New Mexico repealed a ban on off-premises alcohol sales on Sundays, but also allowed local jurisdictions to hold referenda to restore a local ban on Sunday sales. Alaska and Kentucky also allow counties to independently restrict alcohol sales.

This review addresses the effects on excessive alcohol consumption and related harms of maintaining or increasing restrictions on the days of sale at on- or off-premises outlets.