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. 2014 Jun 10;8(2):e73–e80.

Table 2.

Purchase, consumption, use: evidence-based regulatory strategies for alcohol and tobacco

Policy category Alcohol * Tobacco
Legal purchase age High degree of effectiveness in reducing traffic fatalities and other harms with minimal enforcement, but enforcement substantially increases effectiveness and cost. Prohibit the sales of tobacco products to persons under a set age. These measures may include signage about the prohibition of tobacco sales to minors, requiring identification, banning direct access such as to store shelves, and ensuring that vending machines are not accessible to minors. (Article 16, s. 1)
Rationing Moderate effectiveness, especially for heavy drinkers. Not mentioned.
Size of purchase limitations Not mentioned. Prohibit sale of individual cigarettes or small packets that increase affordability for minors. (Article 16, s. 3)
Bans on public consumption No controlled studies / insufficient evidence. Bans affect young or marginalized high-risk drinkers and may displace harm without necessarily reducing it. Implement measures providing for protection from exposure to tobacco smoke in indoor workplaces, public transport, indoor public places and other public places. (Article 8, s. 1, 2)
Driving-related measures
  • Sobriety checkpoints: moderate effectiveness. Police campaigns are typically effective only in the short term. Deterrence is proportional to frequency of implementation and high visibility.

  • Random breath tests: high degree of effectiveness. Effectiveness depends on the number of drivers directly affected and on the extent of consistent and high-profile enforcement.

  • Lowered BAC limits: high degree of effectiveness. The lower the BAC limit, the more effective the policy. Very low BAC limits ("zero tolerance") are effective for youth and can be effective for adult drivers, but BAC limits below 0.02 are difficult to enforce.

  • Administrative licence suspension: moderate effectiveness. When punishment is swift, effectiveness is increased. Effective in countries where it is applied consistently.

  • Low BAC for young drivers: high degree of effectiveness. Clear evidence of effectiveness for those below the legal drinking or alcohol purchase age.

  • Graduated licensing for novice drivers: moderate effectiveness. Can be used to incorporate lower BAC limits and licensing restrictions within one strategy. Some studies note that "zero tolerance" provisions are responsible for this effect.

  • Severity of punishment: lack of effectiveness / limited effectiveness. Mixed evidence concerning mandatory or tougher sanctions for drunkdriving convictions. Effects decay over time in the absence of renewed enforcement or media publicity.

  • Mandatory treatment of drunk-driving repeat offenders: limited effectiveness—punitive and coercive approaches have time-limited effects, and sometimes distract attention from more effective interventions.

Not mentioned.

BAC = blood alcohol concentration

*

Effectiveness statements are based on Babor and colleagues, table 16.1, p. 240.4

Paraphrased from the WHO Framework Convention on Tobacco Control.5