Alcohol outlets and problem drinking among adults in California.

Objective: The purpose of the study was to examine the relationship between alcohol environments and problem drinking, including excessive alcohol consumption, heavy episodic drinking, driving after drinking, and riding with a drinking driver.

Method: We merged geo-coded individual-level data from the California Health Interview Survey and Los Angeles County Health Survey with alcohol license data from the California Department of Alcoholic Beverage Control, distinguishing off-sale retails from on-sale establishments and, among on-sales, eating places from bars and taverns as well as minor-unrestricted establishments from minor-restricted establishments (i.e., youth below age 21 not allowed on business premises). The primary explanatory variable was alcohol outlets within various distances from an individual's residence or census tract. Multivariate logistic regression and simulation were run for men and women separately.

Results: On-sale establishments, particularly minor-restricted establishments, were significantly associated with excessive alcohol consumption and heavy episodic drinking, after controlling for individual and neighborhood sociodemographics. The effect was limited to outlets located within proximity, roughly 1 mile from residential homes. Off-sale retails were not found to be related to problem drinking. If the number of minor-restricted establishments increases from median to 90th percentile of their distribution, heavy episodic drinking would increase from 11.1% to 14.3% among women and from 19.6% to 22.0% among men.

Conclusions: Certain types of alcohol retailers in neighborhoods were associated with problem drinking. Moratorium of new licenses based on number of licenses per capita at county level is not effective because only a subgroup of licenses matters, and alcohol is more available in terms of distance, travel time, or search costs in densely populated cities.