PREVENTION UPDATES The Higher Education Center for Alcohol and Other Drug Abuse and Violence Prevention February 2004 The Role of State, Community, and Institutional Policy in the Prevention of College Alcohol by Laurie Davidson, M.A., and Christene DeJong The most widespread health and safety problem on college and university campuses in the United States today is high-risk alcohol use and related consequences. The heavy, episodic use of alcohol that 44 percent of college students engage in1 results in a myriad of consequences for both drinkers and nondrinkers, ranging from disturbed study and vandalism to assault and even death.2 Alcohol use may have a significant impact on student retention as well. Campus administrators perceive that approximately 27 percent of all dropouts are related to alcohol and other drugs.3 Recent reports also confirm that alcohol use has significant adverse effects on cities and towns surrounding colleges and universities.4 Community members living within a mile of campus report chronic problems such as noise, vandalism, public drunkenness, vomiting, and public urination-all of which degrade the quality of neighborhood life.4 Many college administrators and community members realize that there is no single cause of students' heavy alcohol use and therefore no single remedy for the problem. A comprehensive approach is required, one that addresses multiple levels of influence. Individual factors and group processes influence drinking behavior, and strategies to address these two levels are part of a comprehensive approach.5 But drinking behavior also is influenced by institutional factors, community factors, and public policies at the state and federal level.5 Strategies, programs, and activities addressing these last three levels constitute an environmental management approach to alcohol problem prevention.6 Whether implemented at the institutional, community, state, or federal level, policy change is a particularly powerful environmental strategy, with the potential to reduce high-risk alcohol use and its consequences. Yet despite the preponderance of evidence supporting environmental approaches,1,5,6,7 campus alcohol problem prevention efforts continue to be weighted heavily in favor of individual educational strategies that research shows are limited in effectiveness when used alone.8 "On most campuses, prevention efforts have concentrated on intrapersonal factors, interpersonal processes, and a subset of institutional factors. Less attention has been paid to factors in the local community that affect student alcohol use; calls by campus officials for changes in state or federal policy remain rare."5 Statewide initiatives to prevent college alcohol and other drug problems have provided a support structure that campuses can use to address institutional and community factors. In 45 states, campus administrators, state government officials, and state and local community prevention advocates have collaborated to form campus and community coalitions working to change the campus and community environment.9,10,11 These local efforts may include attempts to change city or town ordinances related to the sale or service of alcohol.12 Statewide initiatives also are an ideal vehicle for campus administrators to speak out in support of state policy change.5 This publication aims to encourage campus administrators in a state to work together to introduce policies that make the environment less supportive of high-risk alcohol use. Beginning with a general definition of policy, it goes on to review specific alcohol policy options cited in recent reviews of the scientific literature. It also suggests concrete actions that campus administrators can take to encourage key stakeholders, including policymakers, to review existing policy and serve as catalysts for change. What Is Policy? People often think policy is synonymous with the passage of local, state, or federal legislation. In addition to formal legislation, however, "policy" also refers to organizational practices, regulations, enforcement, program operations, and allocation of resources.13 Who makes policy decisions? Citizens vote on local ordinances or state referenda, legislators pass laws and allocate funding, and appointed government officials implement decisions about programs and resources. Administrators of private organizations make decisions with far-reaching policy implications as well. To illustrate the wide array of decisions that specifically affect alcohol policy, table 1 provides some examples of policymakers and the areas of policy they can influence at the state, county, community, or organizational level ____________________ Table 1 Policymaker influences on alcohol policy ABC regulatory and enforcement officials--Enforcement of bar/liquor store regulations State directors of public health, substance abuse, mental health, transportation, and education--Overall prevention planning; distribution of state and federal funds for problems such as underage drinking, substance abuse, and impaired driving; allocation of funding specific to college alcohol and other drug problem prevention State legislature--Legislation to control access to alcohol; allocation of funds for liquor law enforcement, prevention, and treatment programs Philanthropic foundation--Funding priorities for prevention, early intervention, and treatment County or community treatment agencies and recovery organizations-- Allocation of services to population ____________________ Using Policy to Change the Campus and Community Environment Perhaps the most compelling reason in favor of a policy strategy is that it is more efficient to reach a smaller number of policymakers, who in turn can introduce changes that would affect all students, than it is to intervene one student at a time.14 Recent scholarly reviews suggest that many state laws and local ordinances are effective or promising in addressing campus alcohol use. For example, several policies have succeeded in reducing college students' access to alcohol by controlling the cost, sale, and distribution of alcohol.15,16 As the price of alcohol increases, for example, consumption decreases.15,17 Based on Toomey and Wagenaar's review of policy research,15 a National Institute on Alcohol Abuse and Alcoholism (NIAAA) task force recommended that college presidents, campus officials, and student and community leaders explore several policy strategies. Similarly, in its report to the U.S. Congress outlining a strategy to reduce underage drinking, the National Academy of Sciences, Institute of Medicine (IOM) urged communities and states to strengthen enforcement of existing laws and to promote compliance. Table 2 summarizes the recommendations of these two reports. A state may have strong laws related to alcohol sales and service but lack the resources or structures to apply them. Allocating state funds for enforcement of these laws also is a policy decision. What Campus Administrators Can Do The decision about how policy change can support local prevention efforts must be determined through careful analysis of the state, community, and institutional alcohol problems and current policies. A campus task force reporting to the president can undertake an assessment of current problems and a comprehensive review of existing policy and can help to develop effective institutional policies to reduce alcohol-related problems on campus.6 (See the U.S. Department of Education's Higher Education Center publications for a process for reviewing and changing campus policy.18,19 ) As part of an overall effort to create environmental change, campus officials should support the formation or ongoing work of a campus and community coalition that addresses alcohol problems in the town or city surrounding the campus. For example, if an assessment of local conditions shows that the number of bars and taverns in close proximity to campus is very high, a coalition could curtail access to alcohol by working to change local zoning ordinances to reduce the density of alcohol outlets.20 If data show that it is relatively easy for underage students to purchase alcohol, a coalition might work to establish a communitywide training and enforcement program for responsible hospitality.21 Table 2 contains other examples of local policies for administrators to consider to reduce alcohol availability. Campus administrators also should consider working with other campuses for policy change at the state level. Statewide college AOD prevention initiatives, now under way in 45 states, are an ideal vehicle for campuses to take such collaborative steps.9 Several states have convened community forums for college presidents and interested community members as a first step toward launching a statewide initiative to reduce alcohol-related problems on campus. Key policymakers should be invited to offer visible support for such efforts, which have been shown to be effective in mobilizing campus and community coalitions to bring about environmental change. A statewide initiative also brings campus officials together to assess the strength of local and state support for preventing high-risk alcohol use by college students and underage alcohol use generally. Possible questions, based on the policy examples listed in table 2, include but are not limited to the following: * Are funding and staffing sufficient to enforce existing laws? Without sufficient and consistent enforcement many laws are ineffective in reducing high-risk drinking.15 * Is there funding to staff and organize statewide college prevention initiatives that support the development of campus and community collabora- tions? Can funding be made available, from either state or federal sources, to provide training to increase campus and community coalitions' ability to implement prevention that works? * Do licensing and administrative procedures effectively deter alcohol sales to minors and those who might become intoxicated? Are the fines too small, and other consequences too minor, to provide a strong enough incentive to obey the law? Are license suspensions too short-term? * How are limits placed on the density of alcohol outlets within a town or city? Do towns and cities have sufficient control over outlet density and hours and days of sale? Once a critical policy issue is identified, a campus administrator or statewide initiative leader could develop a briefing paper for policymakers or organize a community forum on the issue. For example, the University of Nebraska, Lincoln (UNL), hosted a community forum in 1999 that brought together retailers, government officials, police, and community leaders to discuss the problems and issues related to false identification. Of particular concern was the fact that existing analog technology made it easy for individuals seeking replacement licenses to submit false identification, as there were no digital files against which to check documents and verify name, address, and age. As a result, minors were acquiring false licenses and identification cards from the state Department of Motor Vehicles and using them to obtain alcohol. The license, made with a laminate pouch and typewriter, could be easily manipulated and altered by minors. In the year following the community forum, a proposal for a digital driver's license system was submitted at a policy symposium for communities throughout Nebraska hosted by NU Directions, The Robert Wood Johnson Foundation-funded coalition at UNL. After the symposium, the coalition launched an advocacy initiative with a press conference, legislative testimony by members of a broad statewide coalition that included NU Directions, and the distribution of information packets to state senators in collaboration with the Department of Motor Vehicles. Thanks to these efforts, a bill mandating a digital driver's license passed the Nebraska legislature and was signed into law in 2001.22 The Pennsylvania statewide college prevention initiative, a partnership among the Pennsylvania Liquor Control Board (PLCB), the Pennsylvania Association of Colleges and Universities, and The Network: Addressing Collegiate Alcohol and Other Drug Issues, identified the need to increase campus administrators' influence on their communities' liquor-licensing decisions. As a result, the PLCB adopted a policy of informing campus officials about liquor license hearings in communities bordering campuses. Although local citizens had always had the opportunity to voice their opinions at these license hearings, the PLCB's advance notification to campus administrators strengthened their ability to oppose the granting of licenses. In the spring of 2000, for example, the PLCB notified Scranton University that a liquor license was being transferred within the Scranton municipality. At the local hearing, Scranton University's vice president of student affairs testified that establishing another outlet near campus was not in the best interest of either the university or the surrounding community. As a result of the university's testimony, the PLCB denied the transfer. Following this course of events, the PLCB asked all of Pennsylvania's 144 campuses to designate representatives to be notified of any license action in their respective counties. Finally, presidents and trustees should speak out in support of the policy measures described in table 2. These measures could help institutions of higher education do a better job of ensuring campus safety and maintaining an academic environment conducive to their students' intellectual and social development. Faculty can do the same, either as advocates or as researchers who can provide expert testimony in support of proposed laws and regulations.6 ____________________ Table 2. Selected policies to reduce high-risk and underage drinking÷ NIAAA college drinking report1 and IOM report on underage drinking16 Policy Strategy Levels of Implementation Increase effectiveness and enforcement of minimum drinking age laws (IOM+NIAAA): *Expand compliance checks in retail outlets. State, Community *Deter adults from purchasing for minors. State, Community, Institutional *Implement zero tolerance laws. State *Enact graduated driver licensing laws. State *Prevent use of false IDs. State, Community, Institutional Implement and publicize other laws designed to reduce alcohol-impaired driving (NIAAA). State, Community, Institutional Restrict alcohol retail outlet density (NIAAA). Community Increase prices and excise taxes on alcoholic beverages (IOM+NIAAA). State, Community Implement training for those who sell and serve alcohol in social and community settings (IOM+NIAAA). State, Community, Institutional Regulate happy hours and sales (NIAAA). State, Community Strengthen dram shop liability statutes (IOM). State Regulate Internet alcohol sales (IOM). State Implement sobriety checkpoints (IOM). State, Community Support campus and community mobilization to reduce underage drinking (IOM+NIAAA). State, Community, Institutional Fund the development and evaluation of programs (IOM+NIAAA). State, Community, Institutional ____________________ Conclusion Campus administrators have much to gain-improvements in student health and safety and increased rates of retention and program completion-by spearheading or joining existing efforts to change local and state laws and regulations related to underage drinking, substance abuse and impaired driving, and liquor licensing. Recent definitive reports can offer administrators guidance about which alcohol policies to consider when assessing local and statewide needs and problems. Campus administrators and state policymakers must continue to work together to reshape the college environment and reduce high-risk alcohol and other drug use. The Resources section of this publication provides information to help you get started collecting information about state policies and local ordinances. The U.S. Department of Education's Higher Education Center staff can help you identify other sources of information and support, including assistance identifying campus, state, and local policy and enforcement issues specific to your state and locale. Laurie Davidson (ldavidson@edc.org) is associate director for services to local, state, regional, and national organizations at the Higher Education Center for Alcohol and Other Drug Abuse and Violence Prevention; Christene DeJong is a former research assistant at the Center. References 1. Task Force of the National Advisory Council on Alcohol Abuse and Alcoholism, National Institute on Alcohol Abuse and Alcoholism. A Call to Action: Changing the Culture of Drinking at U.S. Colleges(Washington, D.C.: National Institutes of Health, 2002). 2. Hingson, R. W.; Heeren, T.; Zakocs, R. C.; Kopstein, A.; and Wechsler, H. "Magnitude of Alcohol-Related Mortality and Morbidity among U.S. College Students Ages 18-24." Journal of Studies on Alcohol 63: 136-144, 2002. 3. Personal communication from David Anderson, director, Center for the Advancement of Public Health, George Mason University, e-mail February 19, 2004. 4. Wechsler, H.; Lee, J. E.; Hall, J.; Wagenaar, A. C.; and Lee, H. "Secondhand Effects of Student Alcohol Use Reported by Neighbors of Colleges: The Role of Alcohol Outlets." Social Sciences and Medicine 55: 425-435, 2002. 5. DeJong, W., and Langford, L. M. "A Typology for Campus-Based Alcohol Prevention: Moving toward Environmental Management Strategies." Journal of Studies on Alcohol, supplement no. 14: 140-147, 2002. 6. DeJong, W.; Vince-Whitman; C.; Colthurst, T.; Cretella, M.; Gilbreath, M.; Rosati, M.; and Zweig, K. Environmental Management: A Comprehensive Strategy for Reducing Alcohol and Other Drug Use on College Campuses (Washington, D.C.: U.S. Department of Education, Higher Education Center for Alcohol and Other Drug Prevention, 1998). 7. Hingson, R.; Berson, J.; and Dowley, K. "Interventions to Reduce College Student Drinking and Related Health and Social Problems," in Alcohol: Minimising the Harm, Plant, M.; Single, E.; and Stockwell, T., eds.(London: Free Association Books, 1997). 8. Larimer, M. E., and Cronce, J. M. "Identification, Prevention, and Treatment: A Review of Individual-Focused Strategies to Reduce Problematic Alcohol Consumption by College Students." Journal of Studies on Alcohol, supplement no. 14: 148-163, 2002. 9. "Statewide Initiatives and the Environmental Approach" (Washington, D.C.: U.S. Department of Education, Higher Education Center for Alcohol and Other Drug Prevention). Retrieved December 22, 2003, from www.edc.org/hec/swi/environmental-management.html. 10. DiFulvio, G. D.; Capitani, J. C.; and Davidson, L. "Case Study Evaluation of Statewide College Alcohol Prevention Initiatives." Poster session presented at American Public Health Association 131st Annual Meeting and Exposition, November 18, 2003. 11. Deucher, R. M.; Block, C.; Harmon, P. N.; Swisher, R.; Peters, C.; and DeJong, W. "A Statewide Initiative to Prevent High-Risk Drinking on Ohio Campuses: An Environmental Management Case Study." Journal of American College Health, in press. 12. The Silver Gate Group. A Matter of Degree Advocacy Initiative: Case Histories in Reducing High-Risk Drinking among College Students(Princeton, N.J.: The Robert Wood Johnson Foundation, 2003). 13. Brownson, R. C., and Malone, B. R. "Communicating Public Health Information to Policy Makers," in Brownson, R. C.; Remington, P. L.; Nelson,D.E.; Parvanta, C., eds. Communicating Public Health Information Effectively: A Guide for Practitioners(Washington, D.C.: American Public Health Association, 2002). 14. Langford, L. M. "Using Policy as Part of a Public Health Approach." Paper presented at meeting of Health and Human Development, Education Development Center, Inc., November 3, 2003. 15. Toomey, T. L., and Wagenaar, A. C. "Environmental Policies to Reduce College Drinking: Options and Research Findings." Journal of Studies on Alcohol, supplement no.14: 193-205, 2002. 16. Bonnie, R. J., and O'Connell, M. E. eds. Reducing Underage Drinking: A Collective Responsibility (Washington, D.C.: National Academy of Sciences, Institute of Medicine, 2003). 17. Chaloupka, F. J., and Wechsler, H. "Binge Drinking in College: The Impact of Price, Availability, and Alcohol Control Policies." Contemporary Economic Policy 14: 112-124, 1996. 18. DeJong, W., and Langenbahn, S. Setting and Improving Policies for Reducing Alcohol and Other Drug Problems on Campus: A Guide for Administrators (Washington, D.C.: U.S. Department of Education, Higher Education Center for Alcohol and Other Drug Prevention, reprinted 1997). 19. Pittayathikhun, T.; Ku, R.; Rigby, D.; Mattsson, M.; and DeJong, W. Complying with the Drug-Free Schools and Campuses Regulations [34 CFR Part 86]: A Guide for University and College Administrators (Washington, D.C.: U.S. Department of Education, Higher Education Center for Alcohol and Other Drug Prevention, 1997). 20. DeJong, W., and Epstein J. C. Strategizer 34: Working in Partnership with Local Colleges and Universities (Alexandria, Va.: Community Anti-Drug Coalitions of America, 2000). 21. Colthurst, T. "Prevention Update: Responsible Hospitality" (Washington, D.C.: U.S. Department of Education, Higher Education Center for Alcohol and Other Drug Prevention, February 2004). 22. NU Directions Campus-Community Coalition. NU Directions Campus-Community Coalition Five Year Report 1998-2003 (Lincoln, Nebr.: University of Nebraska, Lincoln, 2003). Resources The U.S. Department of Education's Higher Education Center for Alcohol and Other Drug Abuse and Violence Prevention www.higheredcenter.org The Higher Education Center can provide assistance with state, community, and institutional policy issues to campus officials and to the leaders of statewide college prevention initiatives. Alcohol Epidemiology Program (AEP) www.epi.umn.edu/alcohol/ Alcohol Policy Information System (APIS) http://alcoholpolicy.niaaa.nih.gov Alcohol Policies Project www.cspinet.org/booze College Alcohol Policies www.collegedrinkingprevention.gov/policies/ Community Anti-Drug Coalitions of America www.cadca.org The Community Tool Box (CTB) http://ctb.ku.edu Enforcing the Underage Drinking Laws Training Center www.udetc.org/default.htm The Network Addressing Collegiate Alcohol and Other Drug Issues www.thenetwork.ws/ For additional information, contact: The Higher Education Center for Alcohol and Other Drug Abuse and Violence Prevention, EDC, 55 Chapel Street, Newton, MA 02458-1060 1-800-676-1730 - TDD Relay Friendly, Dial 711 HigherEdCtr@edc.org - www.higheredcenter.org This publication was funded by the Office of Safe and Drug-Free Schools at the U.S. Department of Education under contracts number ED-99-CO-0094 and ED-04- CO-0137 with Education Development Center, Inc. The contracting officer's representative was Richard Lucey, Jr. The content of this publication does not necessarily reflect the views or policies of the U.S. Department of Education, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. government. This publication also contains hyperlinks and URLs for information created and maintained by private organizations. This information is provided for the reader's convenience. The U.S. Department of Education is not responsible for controlling or guaranteeing the accuracy, relevance, timeliness, or completeness of this outside information. Further, the inclusion of information or a hyperlink or URL does not reflect the importance of the organization, nor is it intended to endorse any views expressed, or products or services offered.