Relationships Between Alcohol and Cannabis Policies in U.S. States, 1999-2019.

Objective: A crucial question regarding the public health impacts of cannabis legalization is its impact on alcohol consumption and alcohol-related harm. However, little is known about whether these changing cannabis policies are occurring in liberal or in restrictive alcohol policy environments, either of which likely affect public health outcomes. We constructed comprehensive state-level alcohol and cannabis policy indices and explored relationships between them.

The Cannabis Policy Scale: A New Research and Surveillance Tool for U.S. States.

Objective: Rapid shifts toward cannabis liberalization in the United States have created immense policy variability that is challenging to measure. We developed composite measures to characterize the restrictiveness of U.S.

Rating the comparative efficacy of state-level cannabis policies on recreational cannabis markets in the United States.

Background: Cannabis policy is developing faster than empirical evidence about policy effects. With a panel of experts in substance use policy development and research, we identified key cannabis policies and their provisions enacted by U.S.

Trends in Cannabis Involvement and Risk of Alcohol Involvement in Motor Vehicle Crash Fatalities in the United States, 2000‒2018.

To assess cannabis and alcohol involvement among motor vehicle crash (MVC) fatalities in the United States. In this repeated cross-sectional analysis, we used data from the Fatality Analysis Reporting System from 2000 to 2018. Fatalities were cannabis-involved if an involved driver tested positive for a cannabinoid and alcohol-involved based on the highest blood alcohol concentration (BAC) of an involved driver.

Current U.S. State Cannabis Sales Limits Allow Large Doses for Use or Diversion.

Introduction: Legal limits on the amount of cannabis sold per transaction in states with recreational cannabis may promote moderate use and limit diversion. However, state sales limits are heterogeneous and difficult to interpret in terms of tetrahydrocannabinol dose equivalents.

Methods: This cross-sectional study examined how transaction sales limits on recreational cannabis translate to tetrahydrocannabinol doses among U.

The Rise and Fall of Alcohol Excise Taxes in U.S. States, 1933-2018.

Objective: Higher alcohol taxation is protective against alcohol-related morbidity and mortality. All states have specific (volume-based) excise taxes for alcohol that decrease if not adjusted for inflation. These taxes have diminished substantially in real terms since their inception after National Prohibition in the United States.

Alcohol Policies in U.S. States, 1999-2018.

Objective: U.S. policymakers and public health practitioners lack composite indicators (indices) to assess and compare the restrictiveness of state-level alcohol policy environments, conceptualized as the presence of multiple policies in effect in a particular place and time.

The Composition and Magnitude of Alcohol Taxes in States: Do They Cover Alcohol-Related Costs?

Objective: At least one type of tax is applied to the sale of alcoholic beverages in all U.S. states.

Erosion of State Alcohol Excise Taxes in the United States.

Objective: In the United States, excessive alcohol consumption is responsible for 88,000 deaths annually and cost $249 billion, or $2.05 per drink, in 2010. Specific excise taxes, the predominant form of alcohol taxation in the United States, are based on the volume of alcohol sold rather than a percentage of price and can thus degrade over time because of inflation.

Alcohol Policies and Alcohol-Related Motor Vehicle Crash Fatalities Among Young People in the US.

Background: Motor vehicle crashes (MVCs) are a leading cause of death among young people in the United States. We examined the relationship between states' alcohol policy environments and alcohol-related MVC fatalities among children, adolescents, and young adults under the minimum legal drinking age of 21 years.

Methods: We used the Alcohol Policy Scale (APS), an assessment of 29 alcohol policies across 50 states and Washington, DC, developed with the assistance of an interdisciplinary Delphi panel.

Who Would Pay for State Alcohol Tax Increases in the United States?

Introduction: Despite strong evidence that increasing alcohol taxes reduces alcohol-related harm, state alcohol taxes have declined in real terms during the past 3 decades. Opponents of tax increases argue that they are unfair to "responsible" drinkers and those who are financially disadvantaged. The objectives of this study were to assess the impact of hypothetical state alcohol tax increases on the cost of alcohol for adults in the United States on the basis of alcohol consumption and sociodemographic characteristics.

Alcohol policies and impaired driving in the United States: Effects of driving- vs. drinking-oriented policies.

Aims: To test the hypotheses that stronger policy environments are associated with less impaired driving and that driving-oriented and drinking-oriented policy subgroups are independently associated with impaired driving.

Design: State-level data on 29 policies in 50 states from 2001-2009 were used as lagged exposures in generalized linear regression models to predict self-reported impaired driving.

Setting: Fifty United States and Washington, D.

Alcohol Policies and Alcoholic Cirrhosis Mortality in the United States.

Introduction: Stronger alcohol policies predict decreased alcohol consumption and binge drinking in the United States. We examined the relationship between the strength of states' alcohol policies and alcoholic cirrhosis mortality rates.

Methods: We used the Alcohol Policy Scale (APS), a validated assessment of policies of the 50 US states and Washington DC, to quantify the efficacy and implementation of 29 policies.

Youth Drinking in the United States: Relationships With Alcohol Policies and Adult Drinking.

Background: The relationship between the alcohol policy environment (ie, the combined effectiveness and implementation of multiple existing alcohol policies) and youth drinking in the United States has not been assessed. We hypothesized that stronger alcohol policy environments are inversely associated with youth drinking, and this relationship is partly explained by adult drinking.

Methods: Alcohol Policy Scale (APS) scores that characterized the strength of the state-level alcohol policy environments were assessed with repeated cross-sectional Youth Risk Behavior Survey data of representative samples of high school students in grades 9 to 12, from biennial years between 1999 and 2011.

The relationship between alcohol taxes and binge drinking: evaluating new tax measures incorporating multiple tax and beverage types.

Aims: U.S. studies contribute heavily to the literature about the tax elasticity of demand for alcohol, and most U.

Patterns of change in implementation of state alcohol control policies in the United States, 1999-2011.

Aims: To examine state alcohol control policy implementation by policy efficacy and intent.

Design: A descriptive longitudinal analysis of policy implementation.

Setting: The United States, 1999-2011.

The alcohol policy environment and policy subgroups as predictors of binge drinking measures among US adults.

Objectives: We examined the relationships of the state-level alcohol policy environment and policy subgroups with individual-level binge drinking measures.

Methods: We used generalized estimating equations regression models to relate the alcohol policy environment based on data from 29 policies in US states from 2004 to 2009 to 3 binge drinking measures in adults from the 2005 to 2010 Behavioral Risk Factor Surveillance System surveys.

Results: A 10 percentage point higher alcohol policy environment score, which reflected increased policy effectiveness and implementation, was associated with an 8% lower adjusted odds of binge drinking and binge drinking 5 or more times, and a 10% lower adjusted odds of consuming 10 or more drinks.