Policy is defined as a course or principle of action adopted or proposed by a government, party, business, or individual.

Policy is an important tool society uses to govern most aspects of public and private life, including issues related to substance abuse prevention, public health and public safety.   As an example, it is a policy in every state in the US that it is illegal to drink alcohol if you are under the age of 21.  This policy was put into place in part to protect against drunk driving deaths and injuries, which are more prevalent among younger drivers who drink.

There are myriad policy suggestions and ideas advanced by a variety of organizations that are designed to reduce harms associated with substance use and abuse.  They cover tobacco, alcohol, prescription misuse, illegal drug distribution and use and more.  States and local governments and other organizations are particularly interested in learning how they can save lives and improve health through policy implementation.  The web links below will provide more information and resources on policies designed to make communities safer by reducing problems associated with alcohol, tobacco and other drugs.  Within the prevention community, these broad-ranging policies that affect the entire community are called environmental interventions because they target the environment in which we live, work and go to school.

The Guide to Community Preventive Services is a free resource compiled by the US Community Preventive Services Task Force to help you choose policies proven to improve health and prevent disease in your community. Systematic reviews are used to answer these questions:

• Which program and policy interventions have been proven effective?
• Are there effective interventions that are right for my community?
• What might effective interventions cost; what is the likely return on investment?

The community guide includes a broad range of resources on topics from obesity to excessive alcohol consumption and provides a wealth of information on policies and programs that work, as supported by research findings.  The database is searchable by keyword.

Alcohol policy recommendations in the Community Guide cover several proven interventions including the following:

Alcohol outlet density is defined as applying regulatory authority to reduce alcoholic beverage outlet density or to limit the increase of alcoholic beverage outlet density. Regulation is often implemented through licensing or zoning processes. An alcohol outlet is a place where alcohol may be legally sold for the buyer to drink there (on-premises outlets, such as bars or restaurants) or elsewhere (off-premises outlets, such as liquor stores). Density refers to the number of alcohol outlets in a given area

Dram shop liability allows the owner or server of a retail alcohol establishment where a customer recently consumed alcoholic beverages to be held legally responsible for the harms inflicted by that customer.  Examples of such harms may include death, injury or other damages as a result of an alcohol-related car crash.  Historically, the term dram shop referred to any establishment where alcohol was sold; a dram was a measure of alcohol.

Electronic Screening and Brief Intervention  (e-SBI) Traditional screening and brief intervention (SBI) to reduce excessive alcohol consumption consists of assessing patients’ drinking patterns, followed by providing those who screen positive for excessive drinking with face-to-face feedback about its risks, and a short conversation about changing their drinking patterns, including referral to treatment if appropriate.

Electronic screening and brief intervention (e-SBI) to reduce excessive alcohol consumption uses electronic devices (e.g., computers, telephones, or mobile devices) to facilitate the delivery of key elements of traditional SBI. At a minimum, e-SBI involves screening individuals for excessive drinking, and delivering a brief intervention, which provides personalized feedback about the risks and consequences of excessive drinking.

Increases in alcohol excise taxes affect the price of alcohol, and are intended to reduce alcohol-related harms, raise revenue, or both. Alcohol taxes are implemented at the state and federal level, and are beverage-specific (i.e., they differ for beer, wine and spirits). These taxes are usually based on the amount of beverage purchased (not on the sales price), so their effects can erode over time due to inflation if they are not adjusted regularly.

Maintaining Limits on Days of Sale– Limiting the days when alcohol can be sold is intended to prevent excessive alcohol consumption and related harms by regulating access to alcohol. Most policies limiting days of sale target weekend days (usually Sundays). They may apply to alcohol outlets in which alcohol may be legally sold for the buyer to drink at the place of purchase (on-premises outlets, such as bars or restaurants) or elsewhere (off-premises outlets, such as liquor stores). In the United States, policies may be made at the state level and, where not prohibited by state pre-emption laws, at local levels.

Maintaining Limits on Hours of Sale– One strategy to prevent excessive alcohol consumption and related harms is to limit access by regulating the hours during which alcohol can legally be sold. Approaches may include:

• Maintaining existing limits in response to efforts to expand hours of sale
• Expanding current limits on hours of sale
• Policies limiting hours of sale may apply to outlets that sell alcohol for consumption at the place of purchase (on-premises outlets, such as bars or restaurants) or elsewhere (off-premises outlets, such as liquor stores). In the United States, policies may be made at the state level and, where not prohibited, by state pre-emption laws at local levels.

Overservice Law Enforcement Initiatives– Overservice law enforcement initiatives are proactive community efforts to increase the enforcement of laws that prohibit the service of alcoholic beverages to intoxicated customers. Alcohol Beverage Control personnel or plainclothes or uniformed police carry out enforcement, which may include fines or licensing actions.

Overservice law enforcement initiatives often involve two more components. The first is to notify alcohol beverage outlets of enforcement plans in order to foster the awareness essential for effective deterrence. The second is to provide information or training to help outlet managers and staff comply with overservice laws by learning how to better recognize intoxicated customers and by providing strategies to prevent overservice. Because overservice laws are not actively enforced in many communities, overservice law enforcement initiatives often involve increases in enforcement from low baseline levels.

Privatization of Retail Alcohol Sales– The privatization of retail alcohol sales is the repeal of government (i.e., nation, state, county, city, or other geo-political unit) control over the retail sales of one or more types of alcoholic beverages, thus allowing commercial retailing of those beverages. States with government control of alcohol sales are referred to as control states, and states with privatized sale are referred to as license states. The privatization of retail alcohol sales generally applies only to off-premises alcohol outlets–retail locations, such as liquor stores, where alcoholic beverages are sold for consumption elsewhere. Privatization does not generally affect the retail sales of alcoholic beverages at on-premises alcohol outlets–locations such as bars and restaurants, where alcoholic beverages are sold for consumption on-site. Re-monopolization of retail alcohol sales is the re-establishment of government control over the retail sale of one or more types of alcoholic beverage.

Responsible Beverage Service (RBS) training programs give owners, managers, and staff of establishments that serve alcohol knowledge and skills to help them serve alcohol responsibly and fulfill the legal requirements of alcohol service.

Training programs for managers and owners most often provide guidance on implementation of service policies and practices. Training programs for servers focus on knowledge and skills that enhance their ability to prevent excessive alcohol consumption among patrons and minimize harms from excessive drinking that has already occurred.

Server training may address:

• Checking IDs
• Service practices that reduce the likelihood of excessive consumption
• Identifying and responding to early signs of excessive consumption (e.g., rapid consumption)
• Identifying intoxicated patrons and refusing service to them
• Intervening to prevent intoxicated patrons from driving

Enhanced Enforcement of Laws Prohibiting Sales to Minors Enhanced enforcement programs initiate or increase the frequency of retailer compliance checks for laws against the sale of alcohol to minors in a community. Retailer compliance checks, or “sting operations,” are conducted by, or coordinated with local law enforcement or alcohol beverage control (ABC) agencies, and violators receive legal or administrative sanctions.

Enhanced enforcement programs are often conducted as part of multicomponent, community-based efforts to reduce underage drinking. Many also include strategies to increase perceived risk of detection by publicizing the increased enforcement activities and cautioning proprietors against selling alcohol to minors. These messages can be delivered using either mass media or by sending letters to all local alcohol retailers.

The Guide To Community Preventive Services also includes information on policies and practices shown to reduce tobacco use and second-hand smoke exposure.

Tobacco use is responsible for more than 430,000 deaths each year and is the largest cause of preventable morbidity and mortality in the United States.  In Best Practices for Comprehensive Tobacco Control Programs, the Centers for Disease Control and Prevention (CDC) recommends statewide programs that combine and coordinate community-based interventions that focus on the following areas.

• Preventing initiation of tobacco use among youth and young adults
• Promoting quitting among adults and youth
• Eliminating exposure to secondhand smoke, and
• Identifying and eliminating tobacco-related disparities among population groups

Among the research-proven interventions are:

Comprehensive tobacco control programs are coordinated efforts to implement population-level interventions to reduce appeal and acceptability of tobacco use, increase tobacco use cessation, reduce secondhand smoke exposure, and prevent initiation of tobacco use among young people.  Such programs combine and integrate evidence-based educational, clinical, regulatory, economic, and social strategies at local, state, or national levels.

Interventions that increase the unit price of tobacco products are based on strong evidence of effectiveness in reducing tobacco use. Public health effects are proportional to the size of the price increase and the scale of implementation. Evidence is considered strong based on findings from studies demonstrating that increasing the price of tobacco products:

• Reduces the total amount of tobacco consumed
• Reduces the prevalence of tobacco use
• Increases the number of tobacco users who quit
• Reduces initiation of tobacco use among young people
• Reduces tobacco-related morbidity and mortality

The Community Preventive Services Task Force recommends mass-reach health communication interventions based on strong evidence of effectiveness in:

• Decreasing the prevalence of tobacco use
• Increasing cessation and use of available services such as quit-lines
• Decreasing initiation of tobacco use among young people

Mass-reach health communication interventions target large audiences through television and radio broadcasts, print media (e.g., newspaper), out-of-home placements (e.g., billboards, movie theaters, point-of-sale), and digital media to change knowledge, beliefs, attitudes, and behaviors affecting tobacco use.