State Alcohol Policies Most Strongly Associated With College Students' Drinking, Driving Risks, and Alcohol-Related Harm.

INTRODUCTION

State-level alcohol policies reduce excessive drinking and related harms in the general population, but their effectiveness may vary by policy type and age group. This study examined the associations that mutually exclusive policy subgroups of the Alcohol Policy Scale had with alcohol use and alcohol-related negative consequences among U.S. college students.

METHODS

Data were from repeated cross-sectional surveys of 902,486 college students aged 18-24 years from 591 four-year institutions in 47 states during 2008-2019. Outcomes were past 2-week binge drinking, 30-day frequent alcohol use, 30-day driving after drinking, 12-month use of designated drivers, and a series of 12-month negative consequences after drinking. Three sets of mutually exclusive Alcohol Policy Scale policy subgroups were used to evaluate their independent effects: consumption-oriented versus impaired driving-oriented policies, general population versus youth-specific policies, and tax versus nontax policies. Multilevel logistic and negative binomial models were adjusted for individual- and institution-level covariates and time trends. Data analyses were conducted in 2025.

RESULTS

Stronger general population-oriented, consumption-oriented, and tax and nontax policies were associated with lower odds of negative alcohol-related consequences, binge drinking, and frequent alcohol use. More restrictive youth-specific policies were associated with lower odds of binge drinking among students aged 21-24 years but not among those aged 18-20 years (i.e., underage students). The effects of impaired driving policies were specific to lower odds of driving after drinking, whereas the effects of consumption-oriented policies were specific to lower alcohol use and alcohol-related negative consequences.

CONCLUSIONS

Population-based alcohol policies, including taxation, appear to protect against risky drinking patterns and alcohol-related harms among college students.