title: Retail alcohol monopolies, underage drinking, and youth impaired driving deaths.
abstract: OBJECTIVE
  To explore associations of state retail alcohol monopolies with underage drinking and alcohol-impaired driving deaths.
  
  
  METHODS
  Surveys on youth who drank alcohol and binge-drank recently and their beverage choices; census of motor vehicle fatalities by driver blood alcohol level.
  
  
  METHODS
  Regressions estimated associations of monopolies with under-21 drinking, binge drinking, alcohol-impaired driving deaths, and odds a driver under 21 who died was alcohol-positive.
  
  
  RESULTS
  About 93.8% of those ages 12-20 who consumed alcohol in the past month drank some wine or spirits. In states with a retail monopoly over spirits or wine and spirits, an average of 14.5% fewer high school students reported drinking alcohol in the past 30 days and 16.7% fewer reported binge drinking in the past 30 days than high school students in non-monopoly states. Monopolies over both wine and spirits were associated with larger consumption reductions than monopolies over spirits only. Lower consumption rates in monopoly states, in turn, were associated with a 9.3% lower alcohol-impaired driving death rate under age 21 in monopoly states versus non-monopoly states. Alcohol monopolies may prevent 45 impaired driving deaths annually.
  
  
  CONCLUSIONS
  Continuing existing retail alcohol monopolies should help control underage drinking and associated harms.
authors.affiliation: Pacific Institute for Research and Evaluation, Calverton, MD 20705, USA. Miller@pire.org
authors.forename: Ted
authors.initials: T
authors.lastname: Miller
authors.forename: Cecelia
authors.initials: C
authors.lastname: Snowden
authors.forename: Johanna
authors.initials: J
authors.lastname: Birckmayer
authors.forename: Delia
authors.initials: D
authors.lastname: Hendrie
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality*; D000293:Adolescent; D000428:Alcohol Drinking / Q000191:economics / Q000331:legislation & jurisprudence*; D000434:Alcoholic Beverages / Q000191:economics; D003132:Commerce / Q000191:economics* / Q000331:legislation & jurisprudence; D004465:Economic Competition; D006801:Humans; D012044:Regression Analysis; D014481:United States / Q000453:epidemiology