Alcohol policies : Ratings of strategies and interventions

Table: Ratings of strategies and interventions (adapted from Anderson & Baumberg, 2006).

Strategy or Intervention	Effectiveness	Breadth of Research Support	Cost Efficiency
drink-driving countermeasures
lowered BAC levels	+++	+++	+++
random breath testing (RBT)	+++	++	+
license suspension	+++	++	++
alcohol locks	+	+	+
low BAC for youth	+++	++	+++
graduated licensing	++	++	+++
server training and civil liability	+	++	+
designated drivers and ride services	O	+	++
school based education courses	?/O	+	+
community programmes	++	++	+
education and public awareness
public service messages	O	+++	++
warning labels	O	+	+++
alcohol education in schools	O/+	+++	+
pricing and taxation
taxes	+++	+++	+++
restrictions on the availability of alcohol
minimum drinking age	+++	+++	++
government retail outlets	+++	+++	+++
number of outlets	++	+	+++
density of outlets	++	++	+++
hours and days of sale	++	+++	+++
advertising controls
reducing the volume of advertising	+/++	++	+++
advertising content controls	?	O	++
drinking environments
responsible beverage service	+	+++	++
active enforcement	++	+	+
server liabillity	+++	+	+++
enforcement of on-premise regulations	++	+	+
public transport	?	+	+
safer bar environment/containers	?	O	++
community mobilization
community mobilization	++	++	+
interventions
social welfare based programmes	+	+	+
pregnancy based programmes	+	+	+
work based programmes	++	+	+
brief advice in primary care	+++	+++	++
brief advice in accident and	++	++	++
emergency departments

Remarks

The above table should be interpreted using the following criteria.

Effectiveness

This criterion refers to the scientific evidence demonstrating whether a particular strategy is effective in reducing alcohol consumption, alcohol-related problems or their costs to society. The following rating scale was used:

0 Evidence indicates a lack of effectiveness
+ Evidence for limited effectiveness.
++ Evidence for moderate effectiveness.
+++ Evidence of a high degree of effectiveness

? No studies have been undertaken or there is insufficient evidence upon which to make a judgment.

Breadth of research support

The highest rating was influenced by the availability of integrative reviews and meta analyses. Breadth of research support was evaluated independent of the rating of effectiveness (i.e., it is possible for a strategy to be rated low in effectiveness but to also have a high rating on the breadth of research supporting this evaluation). The following scale was used:

0 No studies of effectiveness have been undertaken
+ Only one well designed study of effectiveness completed.
++ From 2 to 4 studies of effectiveness have been completed.
+++ 5 or more studies of effectiveness have been completed.
? There is insufficient evidence on which to make a judgment.

Cost Efficiency

This criterion seeks to estimate the relative monetary cost to the state to implement, operate and sustain this strategy, regardless of effectiveness. For instance, increasing alcohol excise duties does not cost much to the state but may be costly to alcohol consumers. In this criterion, the lowest possible cost is the highest standard. Therefore, the higher the rating, the lower the relative cost to implement and sustain this strategy. The following scale was used:

0 Very high cost to implement and sustain
+ Relatively high cost to implement and sustain.
++ Moderate cost to implement and sustain.
+++ Low cost to implement and sustain.
? There is no information about cost or cost is impossible to estimate.