title: Patterns of change in implementation of state alcohol control policies in the United States, 1999-2011.
abstract: OBJECTIVE
  To examine state alcohol control policy implementation by policy efficacy and intent.
  
  
  METHODS
  A descriptive longitudinal analysis of policy implementation.
  
  
  METHODS
  The United States, 1999-2011.
  
  
  METHODS
  Fifty states and the District of Columbia.
  
  
  METHODS
  Twenty-nine state-level policies were rated based on an implementation rating (IR; range = 0.0-1.0) gathered from the Alcohol Policy Information System, government and industry reports and other sources; and expert judgment about policy efficacy for addressing binge drinking and alcohol-impaired driving among the general population and youth, respectively.
  
  
  RESULTS
  On average, implementation of the most effective general population policies did not change [mean IR = 0.366 in 1999; 0.375 in 2011; slope for annual change = 0.001; 95% confidence interval (CI) for the slope -0.001, 0.002]. In contrast, implementation increased over time for less effective policies (mean IR = 0.287 in 1999; 0.427 in 2011; slope for annual change compared with most effective policies = 0.009; slope 95% CI = 0.002-0.007), for youth-oriented policies (mean IR = 0.424 in 1999; 0.511 in 2011; slope for annual change compared with most effective policies = 0.007; slope 95% CI = 0.005-0.009), and for impaired driving policies (mean IR = 0.493 in 1999; 0.608 in 2011; slope for annual change compared with most effective policies = 0.0105; slope 95% CI = 0.007-0.014).
  
  
  CONCLUSIONS
  Implementation of politically palatable state alcohol policies, such as those targeting youth and alcohol-impaired driving, and less effective policies increased during 1999-2011 in the United States, while the most effective policies that may maximally protect public health remained underused.
authors.affiliation: Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Toben F
authors.initials: TF
authors.lastname: Nelson
authors.forename: Ziming
authors.initials: Z
authors.lastname: Xuan
authors.forename: Jason G
authors.initials: JG
authors.lastname: Blanchette
authors.forename: Timothy C
authors.initials: TC
authors.lastname: Heeren
authors.forename: Timothy S
authors.initials: TS
authors.lastname: Naimi
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000331:legislation & jurisprudence / Q000517:prevention & control*; D000434:Alcoholic Beverages / Q000600:supply & distribution; D001334:Automobile Driving / Q000331:legislation & jurisprudence; D063425:Binge Drinking / Q000331:legislation & jurisprudence / Q000517:prevention & control; D006291:Health Policy / Q000331:legislation & jurisprudence*; D006801:Humans; D008137:Longitudinal Studies; D013219:State Government; D000066608:Underage Drinking / Q000331:legislation & jurisprudence / Q000517:prevention & control; D014481:United States
keywords: Alcohol; legislation; policy; public health