Binge drinking is a common and risky pattern of alcohol consumption that is responsible for more than half of the 80,000 alcohol-attributable deaths that occur each year in the United States. "If alcohol policies were a newly discovered gene, pill or vaccine, we'd be investing billions of dollars to bring them to market," said Tim Naimi, MD, MPH, senior author of the study, and associate professor of medicine at BUSM and attending physician at BMC.

While previous research demonstrates that individual alcohol policies can reduce risky drinking and alcohol-related harms, this is the first study to characterize the effect of the overall alcohol policy environment. States with stronger policy scores had lower rates of binge drinking, and states with larger increases in policies had larger decreases in binge drinking over time. Specifically, compared with states with weaker policy environments, states with stronger policy environments had only one-fourth of the likelihood of having binge drinking rates in the top 25% of states, even after accounting for a variety of factors associated with alcohol consumption such as age, sex, race, religious composition, income, geographic region, urban-rural differences, and levels of police and alcohol enforcement personnel.

Alcohol policy environments differed considerably between states, with policy scores varying up to threefold between them. Among all states and Washington D.C., almost half had a rating of less than 50 percent of the maximum possible score in any particular year from 2000-2010, and states in the bottom quartile of policy strength had binge drinking rates that were 33% higher than those in the top quartile. "Unfortunately, most states have not taken advantage of these policies to help drinkers consume responsibly, and to protect innocent citizens from the devastating second-hand effects and economic costs from excessive drinking," added Naimi.

Overall, analyses showed that the policy environment was largely responsible for state-level differences in binge drinking. "The bottom line is that this study adds an important dimension to a large body of research demonstrating that alcohol policies matter -- and matter a great deal -- for reducing and preventing the fundamental building block of alcohol-related problems," said Naimi.